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Karolinska Institutet, Institutionen för klinisk neurovetenskap,.
Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping. Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
2013 (English)In: RETINAL Cases & Brief Reports, ISSN 1935-1089, Vol. 7, no 2, 123-127 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: To describe ocular findings before and after the diagnosis of acute exudative polymorphous vitelliform maculopathy, in an otherwise healthy 28-year-old woman.

Methods: Case report with 21-months of follow-up. Fundus photography, optical coherence tomography, fluorescein angiography, indocyanine green angiography, and autofluorescence were used for imaging the retina. To examine retinal function, full-field electroretinogram, multifocal electroretinogram, electrooculography, and dark adaptometry were performed. Genetic analysis for mutations associated with Best disease was done.

Results: In the asymptomatic patient before diagnosis, white-yellow, drusen-like, subretinal depositions were found in both eyes. A few months later, the patient developed bilateral visual disturbances. Retinal examination at the acute phase revealed a characteristic pattern of multifocal white-yellow subretinal lesions in both posterior poles, imaged by ophthalmoscopy, fluorescein angiography, indocyanine green angiography, and optical coherence tomography. Additionally, electrooculography and dark adaptometry were abnormal. Full-field electroretinogram was normal, but multifocal electroretinogram revealed central depression of peak amplitudes. During the 21-month follow-up without any treatment, visual acuity recovered, electrooculography and dark adaptometry normalized, and the patient experienced one episode of relapse. Genetic studies excluded mutations in the bestrophin gene (BEST1).

Conclusion: Acute exudative polymorphous vitelliform maculopathy is still a condition of unknown origin, primarily affecting the pigment epithelium. Earlier reports have discussed whether the condition is inherited or acquired. In this report, the presymptomatic retinal findings in acute exudative polymorphous vitelliform maculopathy are described for the first time, indicating that a condition may be associated with primarily affected retinal pigment epithelium.

Place, publisher, year, edition, pages
2013. Vol. 7, no 2, 123-127 p.
Keyword [en]
acute exudative polymorphous vitelliform maculopathy, macular edema, presymptomatic findings, subretinal lesions
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-107177DOI: 10.1097/ICB.0b013e31825956dcOAI: diva2:722725
Available from: 2014-06-09 Created: 2014-06-09 Last updated: 2014-06-09

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Bourghardt Peebo, Beatrice
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Department of Ophthalmology in LinköpingDepartment of Clinical and Experimental MedicineFaculty of Health Sciences
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