PMC3655500_01
(a) Retinography of the left eye showing a circular yellowish macular lesion with an apparent horizontal level. (b) Fundus auto-fluorescence of the left eye with hyperautofluorescence of the bottom half of the lesion and hypoautofluorescence of the top half. (c) Vertical SD-OCT section of the left eye showing hyperdense subretinal material accumulated in the bottom half. (d) Fluorescein angiography of the left eye with the "stars-in-the-sky" pattern and late hyperfluorescence of the macular lesion.
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There were also multiple round small whitish lesions, suggestive of cuticular drusen (Figure 1(a)). The macular lesion showed an early hypofluorescence and a late hyperfluorescence in its bottom half (Figure 1(d)).
(a) After 3 years of followup, the fundoscopic aspect showed a resolution of the previous lesion. (b) The FAF shows two well-circumscribed areas of hypoautofluorescence. (c) Fluorescein angiography with the "stars-in-the-sky" pattern. (d) Vertical SD-OCT section shows integrity of the IS/OS junction, with an area of RPE atrophy adjacent to the fovea.
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Fundus examination showed disappearance of the previous lesion, with evolution to a state similar to vitelli disruptive phase of Best disease (Figure 2(a)). FAF revealed two well-circumscribed round areas of EPR atrophy (Figure 2(b)) with disappearance of the hyperautofluorescent material. The FA showed the same "stars-in-the-sky" pattern, with hyperfluorescence of the areas of RPE atrophy (Figure 2(c)). SD-OCT revealed that, in the fovea, the EPR was integer as long as the photoreceptor inner/outer segment (IS/OS) junction (Figure 2(d)).