Article
Spectral domain OCT findings due to bilateral congenital albinotic spots of the retinal pigment epithelium
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Published: | June 29, 2009 |
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Purpose: Congenital albinotic spots of the retina are a very rare anomaly of the retina. Functional as well as morphological changes of these lesions have been previously discussed controversially.
Methods: Case report of a 54-year old man with bilateral, asymptomatic fundus findings, which were evaluated using autofluorescence imaging, perimetry, and high resolution spectral domain OCT.
Results: The patient had 20/20 vision and regular findings at slit lamp-examination. Fundus examination revealed multiple, sharply outlined, non-confluent, asymmetrical, hypopigmented spots involving the macular area of both eyes. The lesions did not include the fovea. The autofluorescence imaging showed in two of these lesions a typical „bear track“ configuration. Perimetry demonstrated absolute scotomas in the central visual field consistent with the lesions. These visual field defects were not registered by the patient at all which points to a congenital genesis. For the first time we performed high resolution spectral domain OCT in this pathology and detected an aplasia of the retinal pigment epithelium and a hypoplasia of the outer photoreceptor segments.
Conclusion: Congenital albinotic spots of the retinal pigment epithelium or „polar bear tracks“ can be associated with visual dysfunction like in our case with absolute scotomas. Consistent with these functional alterations are our morphological findings by spectral-domain OCT indicating an aplasia of the retinal pigment epithelium and a hypoplasia of the outer receptor segments in this patient.