White Dot Fovea Syndrome (WDF)

Title White Dot Fovea Syndrome (WDF)
Author, Co-Author Sherry Bass, Daniella Rutner, Linda Sohn
Program Number
Great Hall Foyer
State University of New York
Abstract Introduction: White dot fovea is a rare macular disorder characterized by small, white spots on or near the surface of the fovea with normal VA. First reported in 1997 in a series of elderly Japanese patients, WDF is considered a benign condition. Reports of SD-OCT in WDF reveal that these white dots lie in the inner retina and fundus autofluorescence (FAF) reveal these spots to hyperAF despite their location in the inner retina.

Case Report: We report a 7 year old female who presented for a routine eye examination. Entering BCVAs were 20/20 OD and 20/20 OS. There was no family history of any ocular disease. External examination of the eyes did not reveal any abnormalities. Pupillary responses were normal. Internal examination revealed normal optic nerve heads in both eyes, normal vasculature and fundus grounds with the exception of several discrete, small white spots near the foveas in both eyes. SD-OCT revealed these deposits to be localized to the inner retinal layers. FAF revealed hyper-AF despite the fact that the spots were in the inner retinas and the outer retinas were intact. Follow-up visit 6 m months later revealed no change.

Discussion: Differential diagnosis of white spots in a child includes Best viteliform macular dystrophy, Stargardt disease, crystalline maculopathy secondary to Bietti’s disease, Sjogren-Larsson syndrome, talc retinopathy, canthaxanthine use and White Dot Fovea. The reason for the fundus hyperAF is puzzling since the spots appear to be confined to the inner retina on OCT. Similar hyperAF findings have been reported in the syndrome without explanation. The composition of these white spots is also unknown.

Conclusion: WDF is another rare etiology of small white spots near the fovea and should be considered in young patients when there is no other etiology. SD-OCT and FAF are important imaging technologies in this condition. WDF appears to be a benign non-progressive condition of unknown cause.
Affiliation of Co-Authors SUNY College of Optometry, SUNY College of Optometry