Abstract
-
Stargardt disease (STGD) is one of the most common macular dystrophies in young adults. It progresses slowly. Its prevalence is about 1:8000–10,000.
-
Age of onset is a surrogate marker: The earlier the onset, the more severe the disease course. Onset usually occurs in childhood or early adolescence, at about 10–15 years of age.
-
Vision is between about 20/70 and 20/200.
-
The fundus shows a bull’s eye pattern or beaten-bronze appearance, with or without yellowish flecks (fundus flavimaculatus).
-
Fluorescein angiography may show dark choroid in about 80% of cases.
-
On fundus autofluorescence (FAF), newer flecks appear hyperautofluorescent (hyperAF); older ones become progressively more hypoAF with time. Some flecks are surrounded by a ring of decreased AF.
-
Peripapillary sparing is one the characteristics of Stargardt disease, but this area can be involved in about 2–7% of cases. The reason for this sparing is unclear; this area may be more resilient to the deleterious effect of ABCA4 gene mutation, and there might be a more favorable RPE photoreceptor ratio, resulting in less lipofuscin build-up, in the presence of a thicker overlying peripapillary retinal nerve fiber layer.
-
Patients with Stargardt disease should avoid bright light and excessive vitamin A.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Suggested Reading
Burke TR, Tsang SH. Allelic and phenotypic heterogeneity in ABCA4 mutations. Ophthalmic Genet. 2011;32:165–74.
Gelman R, Smith RT, Tsang SH. Diagnostic accuracy evaluation of visual acuity and fundus autofluorescence macular geographic atrophy area for the discrimination of Stargardt groups. Retina. 2016;36:159–601.
Greenstein VC, Nunez J, Lee W, Schuerch K, Fortune B, Tsang SH, et al. A comparison of en face optical coherence tomography and fundus autofluorescence in Stargardt disease. Invest Ophthalmol Vis Sci. 2017;58:5227–36.
Nõupuu K, Lee W, Zernant J, Tsang SH, Allikmets R. Structural and genetic assessment of the ABCA4-associated optical gap phenotype. Invest Ophthalmol Vis Sci. 2014;55:7217–26.
Tanna P, Strauss RW, Fujinami K, Michaelides M. Stargardt disease: clinical features, molecular genetics, animal models and therapeutic options. Br J Ophthalmol. 2017;101:25–30.
Zernant J, Lee W, Collison FT, Fishman GA, Sergeev YV, Schuerch K, et al. Frequent hypomorphic alleles account for a significant fraction of ABCA4 disease and distinguish it from age-related macular degeneration. J Med Genet. 2017;54:404–12.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Tsang, S.H., Sharma, T. (2018). Stargardt Disease. In: Tsang, S., Sharma, T. (eds) Atlas of Inherited Retinal Diseases. Advances in Experimental Medicine and Biology, vol 1085. Springer, Cham. https://doi.org/10.1007/978-3-319-95046-4_27
Download citation
DOI: https://doi.org/10.1007/978-3-319-95046-4_27
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-95045-7
Online ISBN: 978-3-319-95046-4
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)