This 38 year old woman has a chief complaint of a sudden drop in visual acuity in the right eye two weeks earlier, which was accompanied by new metamorphopsia in that eye. Her visual acuity had been previously normal.

The clinical features favoring the diagnosis of ABCA4-associated autosomal recessive Stargardt disease in this patient include pisciform flecks in the macula and normally sighted parents. The sudden change in vision in the right eye was caused by a choroidal neovascular membrane, which is an infrequent complication of ABCA4-associated Stargardt disease.