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S. Shah, L. Chang, J. Chen, D. Sarraf; Natural History and OCT Imaging of Vitelliform Maculopathy Associated With Age–Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2137.
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To describe the natural history and OCT 3 imaging features of vitelliform maculopathy associated with age related macular degeneration (ARMD).
Retrospective chart review of 23 eyes from 17 patients over the age of 65 with ARMD and vitelliform maculopathy as confirmed by clinical exam, stereo fundus photography, and fluorescein angiography. Vitelliform macular lesions were identified as being greater than 750 um in shortest diameter with a raised appearance by stereo fundus photography and late ooze by fluorescein angiography. OCT 3 imaging features of these lesions were analyzed when available.
The average follow up period was 28 months (range 3 – 61). The mean lesion size was measured to be 1395.65 microns (range 750 to 2800 microns). Mean Log Mar visual acuity at initial exam was 0.54 (range 0.18 to 1.00) and was 0.65 at final follow up (range 0.10 to 2.00). Lesions remained clinically stable except for 4 cases that became atrophic. None of the lesions developed subretinal heme or disciform scars or other features of choroidal neovascularization. OCT imaging of vitelliform maculopathy demonstrated dome–shaped, hyper–reflective submacular thickening in the absence of a frank pigment epithelial detachment.
The natural history of Vitelliform Maculopathy in the setting of ARMD is very favorable. Diagnosis may be confirmed with stereo fundus photography and FA. OCT 3 imaging of the macula is an important additional resource in identifying these characteristic lesions. Treatment with laser therapies or intravitreal pharmacotherapy may be safely deferred.
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