Spectral-Domain Optical Coherence Tomography of White Dot Fovea

Figure 1. Color fundus photographs of the maculae of case 1 and case 2. A, Close-up color fundus photograph of the right (OD) macula of case 1. A posterior subcapsular cataract is causing the media to be hazy. A ring of white perifoveal granular material is visible. B, Close-up color fundus photograph of the left (OS) macula of case 1. A ring of white perifoveal granular material is evident. C and D, Close-up color fundus photographs of the right and left macula of case 2. In both eyes, fine whitish granules are evident throughout the fovea, with a higher-density “ring” formed by the granules at the peripheral edge of the fovea.

Figure 2. Optical coherence tomography (OCT) images of case 1. A, Spectral-domain OCT image of the right (OD) macula of case 1 reveals a macular hole. Hyperreflective granular material is present in the inner retinal layers (arrows). Cystic intraretinal changes are also evident along with an epiretinal membrane. B, Spectral-domain OCT image of the left (OS) macula of case 1 reveals reflective granular material in the inner retina of the juxtafoveal region (arrows). The highly reflective material blocks OCT signal penetration into deeper layers of the retina. There is a posterior vitreous detachment and the posterior hyaloid is visible anterior to the macula.

Figure 3. Spectral-domain optical coherence tomography images of the right (OD) (A) and left (OS) (B) macula of case 2 reveal fine, highly reflective granular material within the innermost layer of the fovea. Original magnification ×2 images of the fovea are shown in the insets, and an arrow points to the white, hyperreflective material. Although the granules seem to be concentrated in the perifoveal region clinically, the hyperreflective material seems to be more uniformly distributed across the entire inner fovea on spectral-domain optical coherence tomography. A partial vitreous detachment with vitreofoveal attachment is evident in the left eye.

Figure 4. Spectral-domain optical coherence tomography images of the right (OD) (A) and left (OS) (B) macula of case 3 reveal fine, highly reflective granular material within the innermost layer of the fovea. Original magnification ×2 images of the fovea are shown, and an arrow points to the white, hyperreflective material. Again, although the granules seem to be concentrated in the perifoveal region clinically, the hyperreflective material seems to be more uniformly distributed across the entire inner fovea on spectral-domain optical coherence tomography. A partial vitreous detachment with vitreofoveal attachment is evident in both eyes.