title: Atypical vitelliform macular dystrophy misdiagnosed as chronic central serous chorioretinopathy: case reports.
abstract: BACKGROUND
  To report two cases of atypical vitelliform macular dystrophy misdiagnosed as chronic central serous chorioretinopathy.
  
  
  METHODS
  Two patients with incidentally discovered abnormalities of the retina without specific symptoms were referred to our hospital for consultation. Bilateral macula atrophic lesions were observed and optical coherence tomography revealed serous retinal detachment in the macula. Fluorescein angiography showed multiple leakages around the central hypofluorescent area and indocyanine green angiography showed partially dilated choroidal vessels. Fundus autofluorescence (FAF) showed a decreasing pattern of autofluorescence in the subretinal fluid area, and increasing autofluorescence at the border of the serous retinal detachment. Both patients were diagnosed with chronic central serous chorioretinopathy. Photodynamic therapy and intravitreal bevacizumab injection were administered for engorged choroidal vessels during follow-up, but neither patient showed improvement in symptoms or ophthalmologic findings. Based on re-evaluation by fundus photography, optical coherence tomography, fluorescein angiography, and comparison of the results of FAF with the first visit, vitelliform macular dystrophy was suspected and a definite diagnosis was made by electrooculography and genetic testing.
  
  
  CONCLUSIONS
  In patients with continuous serous retinal detachment without response to photodynamic therapy or intravitreal bevacizumab injection, careful fundus exam and FAF can be used to diagnose atypical vitelliform macular dystrophy.
authors: Department of Ophthalmology, School of Medicine, Kyung Hee University, Seoul, South Korea.
authors: Young Seob
authors: YS
authors: Lee
authors: Eung-Suk
authors: ES
authors: Kim
authors: Moosang
authors: M
authors: Kim
authors: Young-Gyun
authors: YG
authors: Kim
authors: Hyung-Woo
authors: HW
authors: Kwak
authors: Seung-Young
authors: SY
authors: Yu
mesh_terms: D000328:Adult; D056833:Central Serous Chorioretinopathy / Q000175:diagnosis*; D002908:Chronic Disease; D003951:Diagnostic Errors; D005451:Fluorescein Angiography; D005453:Fluorescence; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D041623:Tomography, Optical Coherence; D057826:Vitelliform Macular Dystrophy / Q000175:diagnosis*
chemical_list: D007208:Indocyanine Green