Abstract
Purpose: :
To describe the natural course of adult-onset foveomacular vitelliform dystrophy (AOFVD) using spectral-domain optical coherence tomography (SD-OCT).
Methods: :
Retrospective analysis of patients with AOFVD that underwent SD-OCT at baseline and at least 12 months later (last visit).
Results: :
Forty-six eyes (31 patients, 15 males and 16 females; mean age 74.6±8.2 years) were included. Follow-up was 16.2±6 (range, 12-30) months. Visual acuity (VA) reduced from 0.32±0.22 LogMAR at baseline to 0.39±0.28 LogMAR at last visit (p=0.03). The stage of the disease was vitelliform in 28 eyes (60.8%), pseudohypopyon in 7 eyes (15.2%), vitelliruptive in 11 eyes (23.9%) at baseline; vitelliform in 23 eyes (50%), pseudohypopyon in 5 eyes (10.9%), vitelliruptive in 13 eyes (28.2%), atrophic in 5 eyes (10.9%) at last visit. Stabilization of the disease stage, and central photoreceptor internal segment/outer segment (IS/OS) interface status and lesion reflectivity on SD-OCT determined no VA changes (p>0.05), while their worsening determined a reduction of VA (p=0.03). In eyes that presented a progression of the disease stage, mean central macular thickness, maximal thickness of the lesion and maximal width of the lesion showed a significant change (from 404.1±107.6 µm to 246.1±74.0 µm, p=0.004; from 277.0±80.8 µm to 105.3±92.3 µm, p=0.001; from 2324.2±1250.3 µm to 1751.0±858.3 µm, p=0.04, respectively).
Conclusions: :
In AOFVD a progression of the lesion stage (partial/complete resorption of the material) is generally accompanied by central photoreceptor IS/OS interface disruption/loss and visual impairment.
Keywords: imaging/image analysis: clinical • retina • macula/fovea