AMD Differential

A vitelliform-like lesion and the pattern that gives it away

A 77-year-old woman is referred with a vitelliform-like left macular lesion on OCT. Near-infrared fundus imaging of both eyes reveals a characteristic cruciform pigment pattern - diagnostic of butterfly-shaped pattern dystrophy, and a reminder that the image beside the OCT is sometimes the most important one.

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When the age doesn't fit the diagnosis

A 57-year-old man is referred having carried a diagnosis of early-onset dry AMD since his late thirties. The age of onset alone is enough to question the label - and the imaging raises a broad differential including dominant drusen, pachychoroid drusen, and inherited macular dystrophy.

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