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1. History
2. Exam
3. Photos
4. Diagnosis
5. Teaching Points
6. Comments

Case 92 Diagnosis

Pattern dystrophy, adult-onset foveomacular vitelliform dystrophy subtype

Differential Diagnosis

• Best disease: typically younger age of onset (< 30 years old). Lesions usually larger with layering of vitelliform material in the dependent portions of the lesion. Electro-oculogram severely abnormal.
• Age-related macular degeneration: typically occurs in older patients (> 65 years old) with associated drusen.
• Central serous chorioretinopathy: same age distribution. Typically unilateral. Self-limited or episodic rather than chronic course. “Hot-spot” of leakage on fluorescein angiogram.
• Pigment epithelial detachment: typically unilateral. Pooling seen on fluorescein angiogram. Optical coherence tomography demonstrates elevation of retinal pigment epithelium with underlying hyporeflective material.