Adult vitelliform macular degeneration: diagnosis and natural history

True vitelliform dystrophy rarely appears in the adult population. We describe 10 cases in adults of bilateral vitelliform lesions clinically mistaken for Best's disease. Fluorescein angiography is a useful tool in distinguishing this dystrophy from Best's disease or other diseases. The angiographic findings suggest pigment epithelial disease. Adult vitelliform degeneration may lead to dry atrophic macular degeneration in a similar fashion as macular drusen. Symptoms and visual findings in these patients are fairly stable, and may be only slowly progressive in spite of ophthalmoscopic and fluorescein angiographic changes over a period of years. The electro-oculogram is useful in separating adult vitelliform macular degeneration from true vitelliform dystrophy.