Abstract Purpose To investigate the long-term longitudinal changes of the retinal morphology and visual function in patients with fundus albipunctatus (FA). Study design Retrospective observational study. Methods Seventeen Japanese patients with FA who had pathogenic variants of the RDH5 gene were studied in a multicenter retrospective study. Results The baseline ages ranged from 3 to 61 years, and the patients were followed longitudinally for 3 to 21 years. The relative size of the flecks/dots decreased throughout the course of the disease; rapidly in the first and second decades of life and slowly thereafter. The flecks/dots in the OCT images were seen as hyperreflective flat deposits on the retinal pigment epithelium in the first decade of life, and as hyperreflective pile-like formations that extended to the ellipsoid zone (EZ) of the photoreceptors after the second decade of life. At later ages, the EZ in the mid-peripheral retina was not present due to photoreceptor atrophy. The Goldmann visual fields had a peripheral constriction in 7 of 11 cases that developed during the course of the disease process. Conclusion The long-term longitudinal observations of the morphological changes of the retina and visual fields revealed that FA is a slowly progressive retinal dystrophy with atrophy of the peripheral photoreceptors in older patients. These findings will be very important information for the patients when providing genetic counseling.
HAYAKAWA et al. (2026) studied this question.