First Author: I.Martins de Almeida PORTUGAL
Co Author(s): R. Soares C. Costa Ferreira M. Monteiro T. Painhas J. Chibante Pedro 0 0 0 0 0 0 0 0 0
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Age-Related Macular Degeneration (AMD) and late onset of inherited macular dystrophy conditioning macular atrophy, can both be responsible for loss of central visual acuity, resulting of a progressive loss of retinal pigment epithelium (RPE) and photoreceptors cells. The authors describe a case of Fundus Flavimaculatus (FFVM) disease with an uncommon presentation.
FFVM, a retinal dystrophy, is characterized by the presence of an atrophic macular lesion associated with white deep retinal flecks, varying in size, shape and density, limited to the posterior pole and equatorial region. Like AMD, FFVM leads to macular atrophy with central visual acuity loss in 90% of cases.
Clinical case report
A 59-year-old female was refered to Ophthalmology observation by Neurology Department because of a horizontal diplopia complaint of unknown etiology. Her visual acuity was 10/10 right eye and 9/10 left eye with -0,25x15°. She presented an alternating small angle exotropia with normal ocular movements and there was no relative afferent papillary defect. Asmler grid was normal in the right eye but distorted in the left eye. Slit lamp anterior segment was normal in both eyes and fundoscopy showed multiple with lesions in the posterior pole with central macular atrophy. Complementary study documented an important macular atrophy with optical coherence tomography showing retinal layers disorganization, fluorescein angiography demonstrating a macular window defect and multifocal electroretinogram was abnormal without P1 wave bilaterally.
FFVM is a progressive macular dystrophy that appears in the middle age and causes decrease central visual acuity. Besides other and more common diagnostic possibilities, the age of the patient and the presence of retinal flecks were the main points to the correct diagnosis. The authors describe a clinical case whose main complaint was diplopia; at her last visit the patient maintains a good visual acuity despiste her maculopathy.