[Progressive dystrophy of the cones]

The 31-year-old female patient preserved photophobia, learning tiredness, pigmentary remaniations in the macular region to both eyes. With emphasis on the right eye. The photopic visual field shows a paracentral scotoma, 4 degrees inferior at the right eye, without the modification of the peripheric isopters. The darkness adaptation curve is monophasic, with reduction and delay of the alpha angulation. The chromatic sensation exam shows protanomaly. Angiographically, isolated macular lesions with the pigmentary epithelium atrophy and the persistency of the fluorescein in late venous time are confirmed. A genetic deficit of the membrane receptors, at the level of the pigmentary epithelium cells, might explain the selective dystrophia of the cone cells. The different renewal process of cones, compared to the stick cells, stays at the origin of selectively separated pathological processes.