Bietti crystalline retinal dystrophy with subfoveal neurosensory detachment and congenital tortuosity of retinal vessels: case report

Doc Ophthalmol. 2011 Jun;122(3):199-206. doi: 10.1007/s10633-011-9274-1. Epub 2011 May 25.

Abstract

A 34-year-old man presented with reduction and distortion of vision in both the eyes. The best-corrected vision was 20/20 parts, N6 in either eye. The external and slit lamp examination of both the eyes was unremarkable. The fundus examination showed multiple intraretinal crystalline deposits at the posterior pole, extending up to midperiphery, tortuous retinal blood vessels with S-shaped deflections, and absent foveal reflex in both the eyes. There were no corneal crystals, and the color vision was defective in both the eyes. Fundus autofluorescence and fundus fluorescein angiogram (FFA) were suggestive of geographic areas of retinal pigment epithelium (RPE) and choriocapillary (CC) loss. OCT revealed subfoveal neurosensory detachment. Flash ERG and EOG were normal except for a slight decrease in amplitude and delay in latency of pattern ERG waveforms. The Humphrey's visual field showed paracentral scotoma with reduction in the amplitude of waveforms from the corresponding area in the multifocal ERG in both the eyes. Systemic evaluation for crystalline retinopathy was unremarkable. He was diagnosed to be a case of Bietti crystalline retinopathy (local/regional variant). The subfoveal neurosensory detachment could represent early RPE dysfunction caused by these crystals and could account for the mild visual disturbance in both the eyes. Retinal vascular tortuosity and neurosensory detachment seen in this case is the first time to be reported in literature.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Corneal Dystrophies, Hereditary / complications*
  • Corneal Dystrophies, Hereditary / diagnosis
  • Corneal Dystrophies, Hereditary / physiopathology
  • Electrooculography
  • Electroretinography
  • Fluorescein Angiography
  • Fluorescence
  • Fovea Centralis*
  • Fundus Oculi
  • Humans
  • Male
  • Retinal Detachment / diagnosis
  • Retinal Detachment / etiology*
  • Retinal Detachment / physiopathology
  • Retinal Diseases / complications*
  • Retinal Diseases / diagnosis
  • Retinal Diseases / physiopathology
  • Retinal Vessels / abnormalities*
  • Retinal Vessels / pathology
  • Tomography, Optical Coherence
  • Visual Fields

Supplementary concepts

  • Bietti Crystalline Dystrophy