PMC3526907_01
Clinical picture of the patient's face showing the gray-bluish hue of the skin of the face, scalp, and neck (A), including the periocular region, conjunctiva, and sclera (B).
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During the initial consultation, the patient's appearance was remarkable for a generalized gray-bluish hue of the skin and fingernails, more pronounced on the face, periorbital area, and forearms (Figure 1).
Fundus color photographs and early and late phases of fluorescein angiography.. Notes: In the color photographs, there is evidence of pigmentary changes at the level of the retinal pigmented epithelium and drusen formation in both macula. Fluorescein angiography shows early and late hyperfluorescence probably due to the aforementioned changes.
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Fundus examination was remarkable for retinal pigment epithelium (RPE) changes and drusen formation on macula OU, consistent with age-related macular degeneration (Figure 2).
Fundus autofluorescence images (A and B) and optical coherent tomography images (C and D).. Notes: The images show no evidence of metabolic dysfunction in the retinal pigmented epithelium. Optical coherence tomography shows small pigment epithelial detachments secondary to drusen.
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Spectralis domain optical coherence tomography showed multiple excrescences of RPE in both eyes, most likely representing drusen from age-related macular degeneration (Figure 3).