Occult maculopathy.
OBJECTIVE
To report a case of bilateral decrease in central vision with almost normal fundus examination.


METHODS
A 50-year-old white man with central visual loss followed since 2006 with detailed ophthalmologic examinations and ancillary tests, including autoimmune and antiretinal antibody analyses.


RESULTS
Virtually normal ophthalmoscopic examination, fluorescein and indocyanine green angiography, autofluorescence, red-free fundus pattern, and peripheral visual field testing. Abnormalities include reduced central macula thickness values (right and left eyes were 150 μm and 146 μm, respectively) on the spectral-domain optical coherent tomography (normal value, 200-250 μm) and decreased sensitivity of foveal eccentricities on multifocal electroretinogram. Antiretinal antibody tested positive for 27-kDa protein; and anti-optic nerve antibodies tested positive against 33-kDa, 35-kDa, and 46-kDa proteins.


CONCLUSIONS
A central visual deficit with a nearly normal clinical picture and no family history are indicative of poorly defined entity called occult maculopathy. The role of antiretinal antibodies is unclear.
From the *Lewyckyj Taglia Felton Eye Clinic, Valparaiso, Indiana; and †Department of Ophthalmology, Feinberg School Of Medicine, Northwestern University, Chicago, Illinois.
Nandini
N
Menon
Lee M
LM
Jampol