A Study by Optical Coherence Tomography of Retinal Flecks in Fundus Flavimaculatus

Abstract Purpose: Retinal flecks are common features in both Stargardt disease (STGD) and fundus flavimaculatus (FFM). Our purpose was to localize prospectively the retinal flecks within the retinal layers using Stratus Optical Coherence Tomography (OCT) in FFM patients. Methods: A complete ophthalmologic examination, including best corrected visual acuity (BCVA), autofluorescence, FA and OCT was performed in 49 eyes of 26 consecutive patients with FFM (23 to 71 years old). OCT examination consisted in 6 to 12 OCT linear scans focused on the retinal flecks. Results:BCVA ranged from 20/20 to 20/400. On Stratus OCT, we observed two types of hyperreflective deposits: type 1 (94% of eyes, all patients), that presented as dome–shaped deposits located in the inner part of the RPE layer; and type 2 (86% of eyes, all patients), that presented as small linear deposits located at the level of the outer nuclear layer, clearly separated from the RPE. Conclusions: Stratus OCT is a non–invasive tool that provides new information on the location of retinal flecks in FFM. The location of type 2 lesions is unusual among macular dystrophies. OCT may be useful in the diagnosis and in the understanding of the pathogenesis of the retinal flecks in FFM.

Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • retina: distal (photoreceptors, horizontal cells, bipolar cells) • retinal pigment epithelium