Case #14 – Stargardt Plus Glaucoma

Stargardt Plus Glaucoma – Page 30 of 30

Suggested Readings E. Ergun, B. Hermann, M. Wirtitsch, A. Unterhuber, TH Ko, H. Sattmann, C. Scholda, JG Fujimoto, M. Stur, W. Drexler 2005 Assessment of Central Visual Function in Stargardt's Disease/ Fundus Flavimaculatus with Ultra-high Resolution Optical Coherence Tomography. Investigative Ophthalmology & Visual Science. 46(1): 310-316 GA Fishman, EM Stone, S. Grover, DJ Derlacki,

Stargardt Plus Glaucoma – Page 30 of 302020-06-15T07:30:25+00:00

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References K. Stargardt (1909) Uber familiare, progressive Degeneration in der Makulagegend des Auges. Graefe's Arch Clin Exp Ophthalmol. 71: 534-550 N. Lois, A. Halfyard, AC Bird, G. Holder, FW Fitzke 2004 Fundus Autofluorescence in Stargardt Macular Dystrophy- Fundus Flavimaculatus. American Journal of Ophthalmology.138(1): 55-63 S. Ozdek, Z. Onaran, G. Gürelik, K. Bilgihan, C. Acar,

Stargardt Plus Glaucoma – Page 29 of 302020-07-17T18:16:52+00:00

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Jerome Sherman, OD, FAAO Jerome Sherman, O.D., is perhaps optometry's most prolific writer, publishing over 650 clinical articles, research manuscripts, book chapters and two CDs. He is senior author of three books that were published in 2007, and has delivered over three thousand lectures both nationally and internationally. He has served as a

Stargardt Plus Glaucoma – Page 27 of 302020-07-17T18:22:02+00:00

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Comments and Follow-up The Photoreceptor Integrity Line (PIL) as revealed by SD OCT easily documents Stargardt photoreceptor involvement in various retinal locations.6 SD OCT, such as in this case, can help detect a retinal nerve fiber layer/optic nerve disorder such as glaucoma, in a patient with an outer retinal degeneration such as Stargardt. Our compliant

Stargardt Plus Glaucoma – Page 25 of 302020-09-09T17:16:16+00:00

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Comments and Follow-up One hundred years ago, Karl Stargardt described for the first time the features of what is now known to be the most common juvenile macula dystrophy.1 Stargardt's Disease or Dystrophy with or without the white-yellow deep retinal lesions or the so-called flecks of Fundus Flavimaculatus2, is inherited as an autosomal recessive

Stargardt Plus Glaucoma – Page 24 of 302020-07-17T18:26:10+00:00

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ERG Cone Response OD and OS The flicker ERG which reflects cone activity is also normal in each eye. The normal ERGs rule out widespread functional disease and suggest only a localized abnormality in function. However, the widespread flecks as documented in the optos® images may indicate early structural changes prior to functional

Stargardt Plus Glaucoma – Page 23 of 302020-09-09T17:13:22+00:00

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ERG Rod Response OD and OS The ERG is the best objective test of retinal function. Scotopic or rod dominated ERGS are traditionally measured after 20 minutes of complete dark adaptation. In our patient, the scotopic ERG is essentially normal in amplitude and implicit time in each eye. Also note that these

Stargardt Plus Glaucoma – Page 22 of 302020-07-17T18:26:39+00:00

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The large "central" field loss OU is due to the macula lesions. It is not unusual for patients with Stargardt to fixate with a retinal point above the lesion and with such eccentric viewing, the field defect will be projected in the superior field. In this case, the PIL was more normal superior to

Stargardt Plus Glaucoma – Page 21 of 302020-07-17T18:26:49+00:00