Multimodal imaging in a case of butterfly pattern dystrophy of retinal pigment epithelium

To report multi-modal imaging findings in a case of butterfly pattern dystrophy of retinal pigment epithelium.

A middle-aged female with butterfly pattern dystrophy, who presented with progressive loss of vision, was examined using coloured fundus photographs, short wave autofluorescence, swept source optical coherence tomography (SS-OCT), fundus fluorescein angiography and enface optical coherence tomography.

Multi-modal imaging was useful in the characterization of the various disease features. Autofluorescence pattern was opposite to that of fluorescein angiogram and SS-OCT showed disruption in the outer retinal layers. Enface OCT images depicted the pigment deposition prominently.

The features of butterfly pattern dystrophy on these modalities correlated well with the histopathological findings described in the literature. Enface imaging highlights the deposition of pigment/lipofuscin and has never been described in BPD.