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M. E. J. Van Velthoven, R. O. Schlingemann, F. D. Verbraak; Acute Visual Deterioration in Patients With Adult Onset Vitelliform Macular Dystrophy Without Distinct Choroidal Neovascularisation. Invest. Ophthalmol. Vis. Sci. 2010;51(13):917.
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© ARVO (1962-2015); The Authors (2016-present)
To describe patients with Adult Onset Vitelliform Macular Dystrophy (AOVMD), who present with acute visual symptoms, due to presumed leakage, without evident signs of neovascularisation (CNV) on fluorescein angiography (FA).
14 consecutive patients diagnosed with AOVMD were seen at the outpatient clinic of the Academic Medical Center and examined with OCT and FA. Two patients advanced their follow up visit because of acute deterioration of vision and / or metamorphopsia and were re-examined with FA and OCT. With patient consent, treatment with anti-VEGF was provided, despite evidence of active CNV of FA.
Prior to treatment, OCT showed an increase in the volume of the central lesion typically seen in AOVMD, while FA showed a typical central hyperfluorescent lesion with staining and no evident leakage suggestive of CNV. Both patients received 3 monthly injections with ranibizumab, with disappearance of metamorphopsia, improvement of visual acuity, and reduction of volume of the central lesion on OCT.
In patients diagnosed with AOVMD acute deterioration of vision can be caused by an increased volume of the central lesion, in the absence of a distinct CNV on FA, which responds favourably to treatment with anti-VEGF injections.
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