title: Adult-onset foveomacular pigment epithelial dystrophy: clinicopathologic correlation of three cases.
abstract: OBJECTIVE
  The authors describe the clinicopathologic features of three patients with adult onset foveomacular pigment epithelial dystrophy (AOFPED).
  
  
  METHODS
  The eyes of three patients were studied ophthalmoscopically and by fluorescein angiography, and obtained postmortem and studied by light and electron microscopy.
  
  
  RESULTS
  Histopathologic study of the three patient's eyes disclosed central loss of the retinal pigment epithelium and photoreceptor cell layer with a moderate number of pigment-containing macrophages present in the subretinal space and outer retina. To either side, the retinal pigment epithelium was distended with much lipofuscin. Basal laminar and basal linear deposits were present throughout the central area. No discontinuities of Bruch membrane were present.
  
  
  CONCLUSIONS
  The findings in the eyes of three patients with AOFPED included marked aging changes that are similar to those seen in age-related macular degeneration. Pigmented cells with lipofuscin in the subretinal space account for the vitelliform appearance.
authors.affiliation: Wilmer Ophthalmological Institute, and Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Dubovy
authors.forename: R J
authors.initials: RJ
authors.lastname: Hairston
authors.forename: H
authors.initials: H
authors.lastname: Schatz
authors.forename: A P
authors.initials: AP
authors.lastname: Schachat
authors.forename: N M
authors.initials: NM
authors.lastname: Bressler
authors.forename: D
authors.initials: D
authors.lastname: Finkelstein
authors.forename: W R
authors.initials: WR
authors.lastname: Green
mesh_terms: D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005451:Fluorescein Angiography; D005584:Fovea Centralis / Q000378:metabolism / Q000648:ultrastructure*; D006801:Humans; D008062:Lipofuscin / Q000378:metabolism; D008268:Macular Degeneration / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D008297:Male; D009887:Ophthalmoscopy; D020419:Photoreceptor Cells, Vertebrate / Q000378:metabolism / Q000648:ultrastructure; D010857:Pigment Epithelium of Eye / Q000378:metabolism / Q000648:ultrastructure*; D014792:Visual Acuity
chemical_list: D008062:Lipofuscin