This 38 year old woman has a chief complaint of mildly reduced visual acuity. She first noticed some distortion of her vision in both eyes a few months ago. She also reports some reduction in her acuity when she moves from bright environments to dim ones although her acuity eventually returns to normal after a several minute delay. Her visual acuity was completely normal as a child and young adult.

The clinical features favoring the diagnosis of autosomal dominant pattern dystrophy in this patient include the numerous yellow flecks in the macula and mid-periphery, the dark green color of the most central flecks, the relatively good visual acuity and the extensive autosomal dominant family history. Autosomal dominant macular dystrophies often have good acuity despite a fairly dramatic fundus appearance.