Medical Retina & the Posterior Segment:
                           Case sixteen

This 55 year-old man was referred by his optician because of the above macular appearance which was found in both eyes. His visual acuity was otherwise normal at 6/6 and there was no metamorphosia.

a. What is the diagnosis?

Adult vitelliform macular dystrophy.

It is also called adult Best's disease because of the round yellowish subfoveal lesion occurring adult. Unlike Best's disease, the disease first appears in the fourth and fifth decade of life and the lesion tends to be smaller about 1/3 the size of the optic disc. In addition, the EOG may be normal which is always abnormal in Best's disease.

b. Is this condition inherited?

The condition may be sporadic or inherited in a dominant fashion

c. What is the visual prognosis?

The visual acuity is usually good initially but progresses slowly over the years to 6/18 to 6/36. In some cases, the visual acuity may deteriorate further due to formation of choroidal neovascular membranes.

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