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Purpose: This study investigated the correlation between the relative afferent pupillary defect (RAPD) and retinal nerve fiber layer thickness (RNFLT) in optic neuropathy. Methods: RAPD assessment was performed using a log unit neutral density filter bar. Spectral domain optical coherence tomography RTVue-100 (Optovue) was used to examine the subjects. The optic nerve head pattern (ONH) was subdivided and identified for the purpose of the study into circumpapillary RNFLT (cpRNFLT) and peripheral circumpapillary RNFLT (pcpRNFLT). The cpRNFLT, pcpRNFLT and ganglion cell complex (GCC) parameters were analyzed. Results: Eighteen females and twenty three males with asymmetric optic neuropathy and a RAPD participated. Thirty-three subjects had glaucoma and eight had optic neuropathy other than glaucoma. Significant correlations (p

Introduction: Central areolar choroidal dystrophy (CACD) is a rare, inherited disease that can lead to profound visual disturbance. It is characterized by atrophic changes, particularly in the macula. Specific genotypic mutations are responsible for the autosomal dominant form of this disease. However, there is a distinct retinal dystrophy that combines central areolar choroidal dystrophy with autosomal dominantly inherited drusen. It has been proposed that patients with a specific mutation in the peripherin/RDS gene may manifest a combined presentation. Case report: Here we describe a case of a patient who reported with significantly decreased best-corrected visual acuity of fifteen years of duration in the right eye more than the left. Dilated fundus examination found macular changes that were consistent with central areolar choroidal dystrophy. In addition, there was evidence of surrounding congenital drusen throughout the arcades of both eyes. Electrodiagnostics, optical coherence tomography, and fundus fluorescein angiography were used to confirm the diagnosis of CACD. Conclusion: Central areolar choroidal dystrophy normally presents without drusen. However, in patients manifesting a specific mutation, central areolar choridal dystrophy may present in conjunction with drusen. It appears that the Arg142Trp mutation is one of the factors predisposing to drusen formation.

Background Adult-onset vitelliform dystrophy (AOVD) is as a bilateral macular dystrophy that presents as a subretinal, oval, or round yellowish deposition in the macula. The lesions may be elevated and measure approximately 1/3 to 1 disc diameter (DD) in size. The dystrophy usually manifests between 30 and 50 years of age and has been genetically linked. Features of AOVD have been evaluated by optical coherence tomography (OCT). OCT examination shows subfoveal hyperreflective lesions lying on the retinal pigment epithelium (RPE) with slight separation between the RPE and photoreceptor layers. OCT is a diagnostic tool that provides insight into the morphologic characteristics of AOVD. Case report A 67-year-old black woman presented with complaints of decreased vision and metamorphopsia in her right eye of 1 year’s duration. The patient’s ocular history was positive for “macular degeneration” for which she was given eye vitamins. The patient’s best-corrected visual acuities were 20/30 in the right eye and 20/20 in the left eye. Fundus examination found bilateral, subfoveal lesions. Optical coherence tomography demonstrated an elevated, well-circumscribed area of hyperreflectivity within the RPE in each eye. This description is that of a pattern-dystrophy of the RPE, namely, adult-onset vitelliform dystrophy. Conclusion OCT is a noninvasive instrument that provides information on the morphology of AOVD. It not only isolates the location of the lesion but can be utilized to monitor the stability of the condition. OCT interpretation of macular lesions can aid in diagnosis and management.