Macular Disease Resembling Adult Foveomacular Vitelliform Dystrophy in Older Adults

Fifty-three eyes of 31 patients over age 50 with macular disease were reviewed. Clinical appearance of the macula was of two types: (1) a yellow slightly elevated lesion (29 eyes) and (2) a pigmented flat lesion with surrounding atrophy (24 eyes). Drusen were found in 60% of affected eyes. No familial tendencies were documented. A reduced electro-oculogram (EOG) was present in approximately 50% of all eyes tested. Fluorescein angiographic findings and differential diagnosis are described. Visual prognosis was markedly different for the two groups: 69% of eyes with yellow elevated lesions lost two or more lines of visual acuity and 48% went on to visual acuity equal to or less than 20/200, whereas 33% of eyes with pigmented flat lesions lost two or more lines of visual acuity and 8% went on to visual acuity equal to or less than 20/200.