Oman Journal of Ophthalmology

CLINICAL IMAGE
Year
: 2022  |  Volume : 15  |  Issue : 3  |  Page : 423--424

Benign fleck retina


Sashwanthi Mohan, Sujatha Mohan, Mohan Rajan 
 Department of Vitreoretina, Rajan Eye Care Hospital, Chennai, Tamil Nadu, India

Correspondence Address:
Sashwanthi Mohan
Rajan Eye Care Hospital, No. 5, Vidyodaya, East 2nd Street, T. Nagar, Chennai - 600 017, Tamil Nadu
India

Abstract




How to cite this article:
Mohan S, Mohan S, Rajan M. Benign fleck retina.Oman J Ophthalmol 2022;15:423-424


How to cite this URL:
Mohan S, Mohan S, Rajan M. Benign fleck retina. Oman J Ophthalmol [serial online] 2022 [cited 2023 Feb 6 ];15:423-424
Available from: https://www.ojoonline.org/text.asp?2022/15/3/423/360408


Full Text



A 26-year-old female patient came for a regular ophthalmic examination. Her visual acuity was 6/6 in both eyes and anterior segment examination was within normal limits.

Fundus examination revealed multiple discrete yellow-white flecked lesions involving the entire fundus of both eyes and sparing the macula in both eyes [Figure 1]a and [Figure 1]b. She had no complaints of night blindness. There was no history of consanguineous marriage between the parents. Examination of her parents and her younger sister did not reveal any abnormalities.{Figure 1}

Optical coherence tomography in both eyes revealed a normal macula and discrete deposit accumulation posterior to the photoreceptors' inner segment/outer segment junction (arrows) without disrupting it and also sparing the fovea [Figure 1]c and [Figure 1]d.

Full-field and pattern electroretinogram as well as electrooculogram in both eyes did not reveal any abnormalities.

A diagnosis of benign fleck retina was made.

Benign familial fleck retina (BFFR) belongs to a heterogeneous group of so-called flecked retina syndromes and should be considered in patients with yellowish-white retinal lesions without the involvement of the macula. It is a rare autosomal recessive condition. Sporadic cases are even more uncommon.

It was first described by Sabel Aish and Dajani in 1980 in a family where 7 out of 10 siblings showed the presence of flecks involving the whole fundus except the disc and macula with no visual disturbances.[1]

Recessive mutations in the gene encoding group V phospholipase A2 (PLA2G5) are said to be associated with this condition.[2]

Some individuals can also have mildly elevated low-density lipoprotein and total cholesterol levels which were not found in our patient.[3]

Other flecked retinal disorders include conditions such as fundus albipunctatus, fundus flavimaculatus, familial drusen, retinitis punctata albescens, and fleck retina of Kandori. These disorders can be associated with night blindness, central visual problems, abnormal ERG, and abnormal perimetry. In contrast, the ERG is normal in BFFR, and the patient has no symptoms.[4]

It is important to differentiate BFFR from these disorders to educate the patient about their visual prognosis.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the legal guardian has given her consent for images and other clinical information to be reported in the journal. The guardian understands that her names and initials will not be published and due efforts will be made to conceal the patient's identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Sabel Aish SF, Dajani B. Benign familial fleck retina. Br J Ophthalmol 1980;64:652-9.
2Sergouniotis PI, Davidson AE, Mackay DS, Lenassi E, Li Z, Robson AG, et al. Biallelic mutations in PLA2G5, encoding group V phospholipase A2, cause benign fleck retina. Am J Hum Genet 2011;89:782-91.
3Krill AE. Hereditary Retinal and Choroidal Diseases: Flecked Retina Diseases. Vol. 2. Hagerstown: Harper and Row; 1877. p. 739-819.
4Sangoram R, Karambelkar VH, Paranjpe G. Benign familial fleck retina. J Curr Med Res Opin 2020;3:702-6.