To the Editor.
—I read with great interest the article by Daily and Mets1 in the June issue of the Archives. The authors described several family members with the presence of a central macular sheen associated with tiny red fenestrations.In their final comments, the authors suggested that this fenestrated sheen and macular dystrophy may, in fact, be related to a defect or alteration of the macular yellow pigment. However, on studying the fluorescein angiographic frame in Fig 4, one should note that the areas of hyperfluorescence are located in a region surrounding the absolute macular dark spot. Centrally, the macular dark spot consists not only of blocked fluorescence from the increased concentration of melanin in the retinal pigment epithelium but an additional contribution from the macular yellow pigment.2 It would appear that any disturbance in the concentration or distribution of macular yellow pigment would give rise to
Nussbaum JJ. Fenestrated Sheen Macular Dystrophy. Arch Ophthalmol. 1984;102(12):1749. doi:10.1001/archopht.1984.01040031415009