Natural History of Fuchs’ Spot: A Long-Term Follow-Up Study

Abstract

Basic data on 206 eyes of 145 patients with Fuchs’ spot and follow-up results on 55 eyes of 36 patients were reported to elucidate the nature and natural course of this condition.

Fuchs’ spot is not a rare occurence, affecting 5–10% of myopes over — 5.D. Sex bears an influence on incidence, women being twice as often affected as men. Fuchs’ spot tends to develope in both maculas in a considerable percentage (20-50%) during a short interval. There is a marked effect of age, refraction and axial length on incidence with peaks of manifestion between 40–50 years, around — 12,0 D and between 26,5 to 31,4 mm of axial length.

In unilateral cases affected eyes are usually more myopic than nonaffected eyes. Anisomyopia is no protection for the less myopic eye against Fuchs’ spot. In unilateral cases usually the higher myopic eye will be affected. There is a tendency to earlier manifestation with rising degree of myopia. Patients with Fuchs’ spot are almost exclusively juvenile myopes with a high percentage of myopia in their families.

The follow-up study revealed in general a relatively benign visual prognosis, especially for near vision. Fuchs’ spot seems to be largely a nonprogressive, relatively stationary condition for about 2/3 of patients. The high percentage of spontaneous scarring of subretinal neovascularisation (SRN) is of favourable prognostic significance. SRN in high myopes seem to posses a less active potential than SRN in emmetropes, probably due to the atrophic changes that take over. The course of this condition is mostly self-limited. Spontaneous cicatrization of SRN and stabilization or slight improvement of vision in 2/3 of cases characterize the natural course of Fuchs’ spot.