PMC3806677_01
Color photographs (a, b) show bilateral asymmetric irregular diffuse hypopigmented macular changes associated with focal hyperpigmented areas. A radial pattern of hyperautofluorescence was seen in the short-wavelength fundus autofluorescent images (c, d), consistent with butterfly-shaped macular pattern dystrophy. These lesions were associated with hypoautofluorescent patches corresponding to the areas of RPE hypertrophy.
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F1
Dilated fundus examination was remarkable for macular pigmentary changes with multifocal yellowish depigmented patches within the macular area in both eyes (fig. 1). Fundus autofluorescence highlighted a branching linear pattern of mixed hyper- and hypoautofluorescence limited to the macular area in both eyes (fig. 1).
The near-infrared fundus autofluorescence images (a, b) show a radial hyperautofluorescent pattern overlying a hypoautofluorescent background (butterfly-shaped macular pattern). Spectral-domain optical coherence tomography scans (c-f) reveal the presence of a diffuse subretinal hyperreflective material replacing the normal interdigitation zone with adjacent areas of mottled disruption of the outer retinal layers and focal hyperreflective subretinal deposits consistent with acquired vitelliform deposits.
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F2
No subretinal or intraretinal fluid was found in association with the deposits (fig. 2).