Quiz: Yellowish Macular Lesions

A 16‑year‑old girl was referred for evaluation of reduced vision in her right eye of 6 months duration. There was no history of ocular trauma and she reported that her left eye was normal. She had no complaints of nyctalopia, photophobia, or other symptoms. The girl was otherwise healthy and denied taking medications of any kind. Her family history was also unremarkable. Best‑corrected visual acuity was 20/50 right and 20/20 left. Anterior segment examination was unremarkable in both eyes. Fundus examination showed yellowish macular lesions in both eyes. The right eye lesion was dispersed and associated with pigment clumping while the left eye lesion was homogenous and consolidated. Retinal macular OCT imaging showed subretinal, hyper-reflective deposits in both eyes. The right eye additionally showed subretinal fluid, disruption of the ellipsoid zone, and photoreceptor thinning, while the left eye showed a dome-shaped elevation (Fig. 2). Fundus autofluorescence of the left eye demonstrated hyper-autofluorescence corresponding to the deposits (Fig. 3).

Fig 1

Fig 2

Fig 3 

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Dr. Anuradha Ganesh, Oman

Alex V. Levin, MD, MHSc, FRCSC
Chief, Pediatric Ophthalmology and Ocular Genetics
Wills Eye Hospital
Philadelphia, USA