Abstract
Purpose: To report an unusual appearance on Spectralis optical coherence tomography (OCT) finding: bilateral adult-onset foveomacular vitelliform dystrophy (AFVD) concomitant with diabetic cystoid macular edema. Case Description: Fundus examination of a 55 year-old patient demonstrated a round, elevated yellowish lesion centered by a pigmented spot, widespread intraretinal microaneurysms and dot-blot hemorrhages with a small number of hard exudates in the both eyes. OCT scans of both eyes disclosed that the foveal retina was raised by a hyperreflective material which was located between the retina pigment epithelium and the photoreceptor layer with a persistent posterior hyaloid attachment, exerting adhesion on the fovea in the both eyes. Moreover, multiple hyperreflective retinal dots which had shadowing effects and cystoid macular edema without subretinal fluid were revealed in OCT images. Additionally, fundus autofluorescence (FAF) imaging demonstrated that the vitelliform lesions were hyper-autofluorescence in the fovea which were compatible with accumulation of lipofuscin while the hemorrhages were seen as hypo-autofluorescence dots in both eyes. Conclusion: Diabetic cystoid macular edema may rarely accompany AFVD; OCT and FAF are helpful diagnostic imaging techniques to identify this condition.
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