IDIOPATHIC ACUTE EXUDATIVE POLYMORPHOUS VITELLIFORM MACULOPATHY-CASE SERIES AND EXTENDED FEATURES.
Efrat Naaman, Assaf Rosenberg, Wasim Nasser et al.
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Case in brief
Three subjects with idiopathic acute exudative polymorphous vitelliform maculopathy had bilateral localized serous macular detachments that coalesced into yellow-white vitelliform deposits with a hyperautofluorescent meniscus. SD-OCT showed selective elongation of the outer retina across the macula, sparing the midperiphery. Full-field electroretinography was near normal in two subjects, whereas multifocal ERG responses were reduced. Testing found no pathogenic PRPH2 or BEST1 mutations, and systemic evaluation ruled out malignancy.
What made this case unusual
The outer retinal elongation was confined to the macula, with the retinal midperiphery spared—an imaging feature not previously described in the report.
Diagnostic / clinical pearl
In this condition, macula-limited outer retinal elongation on SD-OCT may coexist with near-normal full-field ERG and reduced multifocal ERG responses.
Why it matters
The imaging and electrophysiology findings suggest dysfunction involving macular photoreceptors, the retinal pigment epithelium, or their interactions.