Correlation of Visual Function Impairment and Oct Findings in Patients With Adult-Onset Foveomacular Vitelliform Macular Dystrophy

Purpose:To investigate the relationship between morphological and functional abnormalities, in patients affected with adult-onset foveomacular vitelliform macular dystrophy (AFVD).

Methods:A complete ophthalmologic examination, including best-corrected visual acuity (BCVA), fundus examination, fundus-related perimetry and optical coherence tomography (OCT) was performed in 20 consecutive AFVD patients. The stage of the disease and the thickness of the neuroepithelium at the foveola (neurosensory retina) were compared to the BCVA as well as to the type of scotoma, the average retinal sensitivity, and the location and stability of fixation.

Results:Thirty-five eyes of 20 consecutive patients (10 men and 10 women; mean age 58.2 years) were graded as follows: 10 had vitelliform stage (stage 1), 9 had pseudohypopion stage (stage 2), 10 had vitelliruptive (stage 3), and 6 had atrophic stage (stage 4). Reduced thickness of the neuroepithelium at the foveola and BCVA were statistically correlated to advanced stage of the disease (respectively P = .001 and P = .0062). Moreover, worse BCVA was statistically correlated to reduced thickness of the neuroepithelium at the foveola (r = .14, P = .02). Reduced thickness of the neuroepithelium at the foveola was statistically correlated to the development of absolute scotoma (P = .03), eccentric fixation (P = .01) and instable fixation (P = .03).

Conclusions:OCT and fundus-related perimetry allow to define a correlation between foveal thickness and visual function, and are useful tools to better define the degree of anatomical and functional impairment in AFVD patients.