Adult vitelliform macular degeneration.

Adult vitelliform macular degeneration SIR, We believe there is confusion concerning the definition of 'adult vitelliform macular degeneration."Gass described important features of this condition in his original report2: 'symptoms usually begin during the fourth or fifth decade of life, are mild, and progress of visual loss is slow.'There is a characteristic ophthalmoscopic appearance which bears a resemblance to typical vitelliform degener- ation, is autosomal dominant, and the EOG may be reduced in the presence of good visual function.Gass originally described this lesion as 'peculiar foveomacular dystrophy' and, because of its resemblance to Best's disease, subse- quently labelled the condition 'foveomacular vitelliform dystrophy: adult type.'3However, the visual loss occurs later in life and the lesions are smaller than seen in typical Best's disease.'Pseudovitelliform macular degeneration,'4 'adult-onset foveomacular pigment epithelial dystrophy,'5 and 'adult vitelliform macular degeneration" have been applied to disorders simulating that originally described by Gass.The subsequent lack of agreement as to terminology is illustrated well by a recent article by Epstein and Rabb6 in which cases labelled 'adult vitelliform macular degeneration' were published and yet autosomal dominant inherit- ance was proved in none.Only one published case had an