Author: Rita Serras-Pereira (Portugal)
Co-authors: Diogo Maleita, Catarina Xavier, Afonso Murta, Rita Anjos, Eduardo Silva, Rita Flores
Purpose
The purpose of this work is to describe a case of a patient with Best vitelliform macular dystrophy (BVMD) and imagiologic features compatible with a macular neovascularization, with good visual acuity.
Setting/Venue
Ophthalmology Department, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
Methods
Patient case report with history and clinical findings, biomicroscopy, fundoscopic examinations, electrophysiology, Optical Coherence Tomography (OCT), OCT-Angiography (OCTA), Fluorescein Angiography (FA) and Indocyanine Green Angiography (ICGA) imaging.
Results
An 18-year-old male with no prior medical history presented to the Ophthalmology Department with complaints of reduced visual acuity (VA) in his right eye (OD). Best corrected visual acuity (BCVA) was 0.3 OD and 1.0 left eye (OS). Biomicroscopy was unremarkable and fundoscopy revealed accumulation of yellowish material in the macular area on both eyes (OU), with associated with areas of hyper/hypopigmentation. OCT revealed an accumulation of hyperreflective material in the subretinal space of the subfoveal area OD and inferior parafovea OS, with neurosensorial retinal detachment in the macular area OU. In OCTA, a vascular network suggestive of macular neovascularization (MNV) was detected in the corresponding OCT area OU. These lesions showed staining without leakage in the FA. Because the patient has been stable and without clinical signs of activity, he is maintained under observation.
Conlusions
MNVs have been described as possible complications of BVMD, especially in the early stages. Previous studies have described two subtypes of MNV in these patients: an exudative MNV, typical of the early stages, and a non-exudative MNV, which can be detected in patients with more advanced stages. Because it is difficult do detect non-exudative lesions on FA due to staining of the vitelliform deposits, many MNV are undetected but easily identifiable by OCTA.
Financial Disclosure
None.
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