Butterfly-shaped Pattern Dystrophy : Findings of Retinal Imaging

Butterfly shaped pattern dystophy (BPD) is a inherited macular disease which is characterized by the accumulation of pigment/lipofuscin in the retinal pigment epithelium, it might be misdiagnosed as age-related macular degeneration (AMD). Retinal imaging is a useful tool for the differential diagnosis of pattern dystrophy. In this report, we describe a 64 year old man presented metamorphopsia and reduced visual acuity in both eyes. Fundus examination showed an area of depigmentation delimited resembling a butterfly. The OCT revealed a subfoveal hyperreflective deposit above the retinal pigment epithelium (RPE) while fundus autofluorescence (FAF) shows hypoautofluorescent areas outlined by a lipofuscin deposits as hyperautofluorescent Finally, fluoroscein angiography (FFA) revealed early macular hyperfluorescence.