Idiopathic acute exudative polymorphous vitelliform maculopathy in an Indian male: A case report

A 42-year-old had best-corrected visual acuity (BCVA) of 20/30 in either eye. Multiple orange subretinal vitelliform lesions were noted. These were hyperautofluorescent. Optical coherence tomography of the macula revealed vitelliform material, hyperreflective material at the outer surface of neurosensory retina, and serous macular detachment. The Arden ratio was reduced in both eyes. Genetic analysis did not detect a mutation in the BEST1 gene. Whole-body positron emission tomography-computed tomography (PET-CT) scan did not detect any active metabolic lesion in the patient. At 20 months after the initial presentation, the BCVA was 20/20p in either eye, and spontaneous improvement of the lesions was noted. Considering the absence of a genetic mutation of the bestrophin gene, offending medications, and an evident neoplastic/paraneoplastic process, a diagnosis of idiopathic acute exudative polymorphous vitelliform maculopathy was made. A detailed workup of patients presenting with similar features is necessary to rule out underlying systemic condition/s, if any.