This patient has Stargardt’s disease with beaten-bronze macular atrophy and scattered pisciform flecks, which are more obvious on fundus autofluorescence. OCT scanning shows central outer retinal atrophy.
Learning Points:
Stargardt’s disease is caused by a mutation in the ABCA4 gene, which codes for a protein in the outer segments responsible for facilitating movement of retinoids across the disc membrane.
Lipofuscin accumulates in the RPE, eventually causing degeneration of the photoreceptors and RPE.
