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Kelly Rue, Lisa C Olmos; Collapse of Pseudovitelliform Lesions: A New Clinical Presentation. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5132.
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© ARVO (1962-2015); The Authors (2016-present)
Pseudovitelliform lesions appear in the macula as round yellowish deposits that are hyperautoflourescent on fundus autofluorescence (FAF). On optical coherence tomography (OCT), they appear as hyperreflective lesions in the subretinal space. Over the course of greater than six months, some of these lesions have been described as gradually decreasing in size and resorbing, leaving areas of atrophy and hypoautoflourescence on FAF. This imaging study reviews a series of two pseudovitelliform lesions that underwent sudden and rapid collapse over the course of one month. This represents a new clinical presentation of a known clinical entity.
This is a retrospective case review of a series of two patients with pseudovitelliform lesions that underwent sudden collapse over the course of one month.
These two cases both had single large pseudovitelliform subfoveal lesions with typical FAF and OCT characteristics. Visual acuities were stable at that stage at 20/30 and 20/60. There were no signs of subretinal or intraretinal fluid. Both patients were taking prophylactic AREDS formula antioxidant vitamin suppelmentation. Each underwent sudden collapse, with urgent presentation to the clinic, as noted by significant decline in visual acuity, both to 20/100. Visual acuity stabilized after the initial drop, the final level of acuity seemingly corresponding with the degree of subretinal tissue loss. One eye returned to the visual actuity baseline of 20/30 over the course of one month. The other eye further declined and remained at 20/200, also over the course of one month. Both cases developed pigmentary changes on fundus exam and corresponding foveal atrophy on OCT. The eye with persistent low vision appeared to have greater atrophic changes on OCT than the eye that returned to baseline visual acuity.
This imaging study describes a new clinical presentation of pseudovitelliform lesions that has not been described in the literature previously. These reported cases underwent sudden collapse of their lesions with rapid subjective decline in visual acuity. Vision then stabilized over the course of one month with the final outcome appearing to correspond with the degree of subretinal atrophy noted on OCT.
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