ADULT-ONSET FOVEOMACULAR PIGMENT EPITHELIAL DYSTROPHY - A 4-YEAR FOLLOW-UP WITH FLUORESCEIN ANGIOGRAPHY

A four-year follow-up with fluorescein angiography of a case of adult-onset foveomacular pigment epithelial dystrophy (AOFPED) is presented. A 45-year-old man visited our clinic in November 1987, complaining of visual disturbance. At the first examination, a drusen-like subretinal lesion was seen at the right macula. The left eye had a doughnut-shaped yellow subretinal lesion at the macula. Fluorescein angiography showed granular hyperfluorescence at the right macula, and petal-like window defects around a doughnut-shaped pseudofluorescence at the left macula. Hypofluorescent areas existed adjacent to the petal-like window defects. Corrected visual acuity was 1.0 in the right eye and 0.2 in the left eye. Ten months later, new window defects appeared at the edge of the hypofluorescent areas in the left eye. Four years after the first examination, the window defects in the left macula fused to form a ring-shaped hyperfluorescence. The doughnut-shaped pseudofluorescence disappeared, followed by atrophic change. The visual acuity did not change during the four years. Our findings suggest that some material which blocks choroidal fluorescence in fluorescein angiography may precede retinal pigment epithelial change in AOFPED.