%0 Case Reports
%T Late-onset Stargardt disease.
%A Alsberge JB
%A Agarwal A
%J Am J Ophthalmol Case Rep
%V 26
%N 0
%D Jun 2022
%M 35243166
暂无%R 10.1016/j.ajoc.2022.101429
%X <B>OBJECTIVE: </B>To report a case of late-onset Stargardt disease, discuss the differential diagnosis, and review the role of vitamin A supplementation in Stargardt disease.<BR><B>METHODS: </B>A 60-year-old man presented with blurry vision in the right eye for the past two years. Current medications included a daily multivitamin containing vitamin A and age-related eye disease study vitamins. Examination revealed bilateral macular atrophy and scattered yellow flecks which were intensely hyperautofluorescent. Fluorescein angiography revealed a dark choroid. Full-field electroretinogram showed normal rod and cone responses, and genetic testing revealed two pathogenic ABCA4 gene variations confirming the diagnosis of late-onset Stargardt disease.<BR><B>CONCLUSIONS: </B>Stargardt disease is typically described in young patients but may develop later in adulthood and masquerade as age-related macular degeneration and a number of other conditions. Though the evidence is limited, there is concern that high-dose vitamin A supplementation could lead to progression of Stargardt disease. Avoidance of high-dose vitamin A supplementation should be discussed with Stargardt disease patients.