Early Detection of Stargardt Disease with OCT and AF – Page 22 of 30

The abnormal ELM (for the reasons explained on the previous page) is probably the earliest clinical indication of Stargardts Disease. We have not seen a similar finding in RP or other retinal degenerations to date. This apparent thickened, irregular and hyper-reflective ELM may be a bio-marker for very early SD. Another possibility is that the thickening is due to toxic vitamin A “dimers” accumulating in the photoreceptors.⁶