Multimodal Image Analysis in Acquired Vitelliform Lesions and Adult-Onset Foveomacular Vitelliform Dystrophy

Abstract

Purpose. To characterize vitelliform lesions (VLs) in adult-onset foveomacular vitelliform dystrophy (AOFVD) and acquired vitelliform (AVL) patients using multimodal image analysis. Methods. Retrospective study of twenty-eight eyes from nineteen patients diagnosed with AVL or AOFVD. They were evaluated by color fundus photographs, fundus autofluorescence (FAF), fluorescein angiography (FA), and spectral-domain optical coherence tomography (SD-OCT). Results. Bilateral VLs were associated with AOFVD (p = 0.013). Regular and centered VLs were associated with AOFVD (p = 0.004 and p = 0.016), whereas irregular and noncentered lesions were more frequent in AVL patients. Visual acuity, greatest linear dimension (GLD), lesion height (LH), and pseudohypopyon were similar between groups. Whereas median LH and GLD in AVL group diminished significantly during follow-up (p = 0.009 and p = 0.001), AOFVD lesions tended to become larger and thicker. Conclusions. When consulting a patient presenting a VL with unknown age of onset, familial history, or previous retinal diseases, some aspects of multimodal imaging assessment may lead the ophthalmologist to a correct diagnosis.

Natural course of acquired vitelliform lesions associated with pigment epithelial detachments in dry age related macular degeneration

“…In contrast to adult-onset foveomacular vitelliform dystrophy, AVL had been reported in one study to diminish in size significantly during follow-ups; however, in that study, the AVL was accompanied by many different clinical entities. 9 The current report presents a single-center study analyzing a pure cohort of dry AMD with AVL with a mean of 33-month follow-up; which is a valuable addition to the limited data in the literature on this subject. 10,11…”

“…In contrast to adult-onset foveomacular vitelliform dystrophy, AVL had been reported in one study to diminish in size significantly during follow-ups; however, in that study, the AVL was accompanied by many different clinical entities. 9 The current report presents a single-center study analyzing a pure cohort of dry AMD with AVL with a mean of 33-month follow-up; which is a valuable addition to the limited data in the literature on this subject. 10,11 The Age-Related Eye Disease Study (AREDS) group evaluated the natural course of drusenoid PED(s) for 5 years and estimated the rates of progression to geographic atrophy, central geographic atrophy, and neovascular AMD as 54%, 50%, and 34%, respectively.…”

Spontaneous Closure of the Macular Hole in a Patient with Acquired Vitelliform Lesion

“…The disease concept of AVL was established relatively recently, and the number of reported cases remains small [1][2][3][4][5][6][7][8][9]. AVL is usually unilateral, and the most common symptoms are scotoma and metamorphopsia.…”

Acquired Vitelliform Lesions in the Setting of Nonexudative Age-Related Macular Degeneration

“…The OCT reveals a hyper-fluorescent material within the subretinal space primarily between the RPE and Ellipsoid zone. 2 The macular layers will show the hyper reflective material within the subretinal space, thickening of the intact IS/OS junction, preservation of the external limiting membrane, and mild thinning of the outer nuclear layer. 1 A split between the retinal pigment epithelium-basal laminar-Bruch's membrane band on OCT may indicate CNV.…”

“…Vitelliform lesions in younger individuals usually occur in Best's Macular Dystrophy, which is associated with a mutation of the bestrophin gene. 1,2 Adult onset foveo-macular dystrophy is most common in individuals between 30 to 50 years of age and is associated with a mutation in peripherin 2 gene. 2 Acquired vitelliform lesions (AVLs) are most commonly seen in patients older than 60 years of age and do not have any genetic associations.…”