Butterfly-shaped pattern dystrophy in myotonic dystrophy.

A 50-year-old woman with myotonic dystrophy (MD) presented with bilateral blurred vision. Visual acuity was 16/ 20 in both eyes. Slit lamp examination showed cortical and posterior subcapsular opacities in both lenses. Funduscopy showed depigmented changes at the macula, however, details were unclear due to the presence of cataract (Picture 1). Fundus autofluorescence (FAF) imaging clearly defined butterfly-shaped pattern dystrophy (BPD) in the hypofluorescent area corresponding to the depigmented changes (Picture 2). Kimizuka et al. evaluated 49 patients with MD for macular changes as examined by fluorescein angiography (1);