Multifocal pattern dystrophy simulating Stargardt disease

Similar to Stargardt disease, multifocal pattern dystrophy presents with irregular yellow flecks within the posterior pole. These flecks are initially hyper-autofluorescent but can change over time. OCT shows disturbance and abnormalities in the photoreceptor outer segment-RPE level.

The two conditions may be difficult to differentiate. Multifocal pattern dystrophy can be differentiated from Stargardt disease based on its autosomal dominant inheritance pattern (whereas Stargardt disease is typically autosomal recessive), later age of onset, a comparatively better visual prognosis, and the absence of dark choroid on fluorescein angiography.