Figure 1. Color retinography of the right eye showing central atrophy of the pigmented epithelium and the presence of flecks in the posterior pole and extending outside the upper temporal arch.
Figure 2. Compositional retinography of the right eye
Figure 3. Retinography of the left eye showing central atrophy of the pigmented epithelium and the presence of flecks in the posterior pole and extending outside the upper temporal arch.
Figure 4. Compositional retinography of the left eye
Autofluorescence of the right and left eyes respectively, with foveal hypoautofluorescence and hyperautofluorescence of the flecks located in the posterior pole.
Currently, fundus flavimaculatus (FF) and Stargardt Disease (SD) are terms that can be used to name a heterogeneous group of hereditary retinal disorders caused by mutations in the same gene, ABCA4, which has an autosomal recessive inheritance pattern. Up to 6% of the population has different mutations in this gene in at least one of their two chromosomes 1, which confers the different clinical phenotypes. Most patients experience central vision loss during the first two decades of life.
Comments
Indication
A 55-year-old male comes to the office for a check-up of his SD, diagnosed at age 20 following the onset of progressive central vision loss, which progressed significantly between ages 20 and 25. Family history includes a brother affected by SD and two other siblings without pathology. The corrected visual acuity is 0 “1 in the right eye and 0” 2 in the left eye (decimal scale, Snellen), and the fundus examination reveals the presence of macular retinal pigment epithelium atrophy in both eyes, as well as the presence of flecks in the posterior pole (figures 1 to 5). In the autofluorescence images (figures 5 and 6), the extent of the lesions can be seen in greater detail, and this is a useful tool for monitoring their evolution.
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