"Vitelliform" lesions in adults

Symmetric yellow ("vitelliform") foveal lesions are occasionally seen in adults. These patients should not be diagnosed as having Best's vitelliform dystrophy unless the EOG light/dark ratio is severely depressed and the family history reveals a dominantly-inherited maculopathy. Adult vitelliform lesions may vary in size from one third to several disc diameters, and may be present with or without drusen. More than one etiology may be involved, but many of these lesions seem to be degenerative changes related to drusen or pigment epithelial detachment.