Clinicopathologic findings in Best vitelliform macular dystrophy.
OBJECTIVE
To correlate the clinical and histopathologic features of Best vitelliform macular dystrophy (BVMD).


METHODS
Two eyes were obtained postmortem from a patient with BVMD. The patient's clinical information was reviewed. Series sections of the globes were performed and sequentially stained with hematoxylin-eosin, periodic acid-Schiff or Masson trichrome. A section of the left macula was submitted for electron microscopic processing. Histopathologic findings were reconstructed in a scaled two-dimensional map and compared with fundus photography, fundus autofluorescence (FAF), fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) images.


RESULTS
The macular lesion of the right eye was identified as a well-demarcated region with pigment, elevated submacular yellow material and subretinal fluid. This corresponded histopathologically to a well-circumscribed area of RPE hyperplasia, accumulation of lipofuscin in the RPE, deposition of granular material in the photoreceptors, macrophages and drusen. The left eye displayed a 1 disc diameter chorioretinal scar with surrounding shallow fluid and submacular pigment. This corresponded to RPE changes and a fibrocellular proliferation in the choriocapillaris.


CONCLUSIONS
Histopathologic mapping revealed retinal edema, RPE abnormalities, drusen and a chorioretinal scar in BVMD that correlated with the fundus, FFA, FAF and OCT findings.
Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.
Qing
Q
Zhang
Kent W
KW
Small
Hans E
HE
Grossniklaus
D000369:Aged, 80 and over; D017809:Fatal Outcome; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D006965:Hyperplasia; D007091:Image Processing, Computer-Assisted; D008266:Macula Lutea / Q000648:ultrastructure; D008297:Male; D010211:Papilledema / Q000175:diagnosis; D010375:Pedigree; D015593:Retinal Drusen / Q000175:diagnosis; D055213:Retinal Pigment Epithelium / Q000473:pathology; D058471:Subretinal Fluid; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D057826:Vitelliform Macular Dystrophy / Q000473:pathology*