title: Morphological and functional analyses of adult onset vitelliform macular dystrophy.
abstract: OBJECTIVE
  To evaluate the morphology and visual function of the macula in eyes with adult onset vitelliform macular dystrophy (AVMD).
  
  
  METHODS
  12 eyes of six patients with AVMD were examined by ophthalmoscopy, scanning laser ophthalmoscopy (SLO), optical coherence tomography (OCT), and multifocal electroretinography (mfERGs). The macular lesions were bilateral in all patients and varied from the typical vitelliform (five eyes), faded vitelliform changes with retinal pigment epithelium (RPE) atrophy (five eyes), and a normal fovea associated with small flecks around the macula (two eyes).
  
  
  RESULTS
  SLO demonstrated small abnormal bright spots in the deep retina throughout the posterior retina in all cases. OCT showed a highly reflective fusiform thickened layer at the level of the RPE and choriocapillaris in patients with a submacular yellow vitelliform lesion. A well circumscribed, optically clear space was observed beneath the retinal layer in the macular lesions with RPE atrophy. The mfERGs were significantly reduced not only in the macular area but also in the outermost ring (20-30 degrees ) of the mfERGs.
  
  
  CONCLUSIONS
  The submacular materials that accumulate within the RPE or subepithelial layers reported in previous histopathological studies of vitelliform lesions can be detected by OCT. In the macular lesions with RPE atrophy, the material may have disappeared leaving a subretinal or subepithelial optical clear space. These SLO and mfERG observations suggest that the morphological and functional abnormalities may not be localised just in the macular area but may be present throughout the posterior pole in eyes with AVMD.
authors.affiliation: Department of Ophthalmology, Toho University Sakura Hospital, Sakura, Japan.
authors.forename: W
authors.initials: W
authors.lastname: Saito
authors.forename: S
authors.initials: S
authors.lastname: Yamamoto
authors.forename: M
authors.initials: M
authors.lastname: Hayashi
authors.forename: K
authors.initials: K
authors.lastname: Ogata
mesh_terms: D000328:Adult; D004596:Electroretinography / Q000379:methods; D005260:Female; D006801:Humans; D008266:Macula Lutea; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy / Q000379:methods; D012164:Retinal Diseases / Q000473:pathology* / Q000503:physiopathology; D014054:Tomography / Q000379:methods; D014792:Visual Acuity