Clinical features of choroidal neovascularization as complication of Late–Onset Stargardt disease

Abstract

Abstract: : Purpose:Analysis of clinical features of choroidal newvessels in late–onset Stargardt macular dystrophy, mimicing AMD. Methods:A retrospective review of 10 eyes (9 patients) followed for late–onset Stargardt disease with choroidal newvessels. An ophthalmologic examination included a visual acuity measurement, a fundus biomicroscopic examination, an autofluorescent frame, fluorescein and ICG angiography. Results:Diagnosis of neovascularization was done at a mean age of 64, 5 years–old Five patients were women and 3 were men. The mean follow–up was 20 months. In 10 eyes, 9 had fundus flavimaculatus flecks. A macular atrophy was present in only 1 eye. In 7 eyes, the newvessels were classic and in 3 eyes occult., The classic newvessels were subfoveal in 60% of cases and extrafoveal in 40% of cases. Occult were extrafoveal in 1 of the 2 cases. In this study, the leakage of the dye appeared moderate. According to their localization, the classic newvessels were treated by PDT (6 cases), or by surgical exsision (1 case) . The extrafoveal classic newvessels were treated by Laser Photocoagulation CNV were followed. Stargardt macular dystrophy appears clinically heterogeneous. Choroidal neovascular complication is unfrequent. Classic and occult newvessels can be observed. These choroidal newvessels do not appear on the border of an atrophy but on an area with pigmentary epithelium alterations and fundus flavimaculatus flecks. Conclusions:This study of neovascular complication in late–discovery Stargardt disease can help in the understanding of this dystrophy. An ICG angiography could be discrinimant to distinguish the hypofluorescent flecks from the hyperfluorescent newvessels.

Keywords: retinal degenerations: hereditary • neovascularization • degenerations/dystrophies