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R. Dell'Omo, M. Liverani, E. Interlandi, G. D'Alonzo, C. E. Pavésio; Resolved Uveitic Macular Edema Mimicking Vitelliform Distrophy: An OCT, Autofluorescence and Electrophysiology Study. Invest. Ophthalmol. Vis. Sci. 2009;50(13):6023. doi: https://doi.org/.
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to examine optical coherence tomography (OCT), fundus autofluorescence (FAF) and electrophysiology (EPH) findings in uveitic patients presenting with yellowish lesion at the fovea resembling vitelliform dystrophy.
retrospective review of 92 patients with history of previous, resolved uveitic-related macular edema.Patients with round, elevated yellowish subfoveal lesions on ophthalmoscopy were selected and their records including Stratus OCT( Carl Zeiss Meditec, Inc., Dublin, CA), confocal scanning laser ophthalmoscope FAF (Heidelberg Retinal Angiograph, Heidelberg Engineering, Germany) and EPH assessment, reviewed .
five patients (eight eyes affected) were identified. None of them had family history positive for inherited macular distrophies. In addition to systemic immunosuppressive therapy all the patients had received at least one posterior sub-Tenon’s steroid injection to treat macular edema complicating the course of the disease. FAF showed an increased signal that corresponded to the foveal deposits. OCT showed that the material at the fovea consisted of a hyper reflective structure located between the photoreceptors and a linear, not elevated retinal pigment epithelium layer. The retina overlying the hyper reflective structure was raised by the material and moderately thinned. No foveal serous detachment or intraretinal cysts were observed on OCT at the time of EPH assessment (Table).
subfoveal yellowish deposits represent a rare finding after resolution of uveitic macular edema. Ophthalmoscopic, OCT and FAF appearances may mimic inherited vitelliform dystrophies but history of uveitis along with only mildly altered electrophysiologic tests help in the differential diagnosis. Usually good VA is maintained.
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