Long-term follow-up in Bietti crystalline dystrophy

Eur J Ophthalmol. Jul-Aug 2007;17(4):680-2. doi: 10.1177/112067210701700434.


Purpose: To present a long-term follow-up of Bietti crystalline dystrophy.

Methods: Two brothers are presented including the clinical findings, fluorescein angiography, electrophysiology (electroretinography [ERG], electrooculography [EOG], adaptometry), optical coherence tomography (OCT), and transmission electron microscopy of bulbar conjunctiva and peripheral blood lymphocytes. The clinical findings were documented over a period of 25 years in one brother and 5 years in the other.

Results: The most striking features were deposits in the retina that were formed de novo with old ones replaced by choroidal atrophy in advanced stage of the disease. The light rise (EOG), rod- and cone-driven responses (ERG), and visual fields were affected progressively during the course. These changes of the retinal pigment epithelium and choriocapillaris were observed in the second decade and worsened gradually. OCT demonstrated preferential crystal accumulation in the inner retina. Cytoplasmic lipid crystalline inclusions were found in lymphocytes and conjunctival fibroblasts by transmission electron microscopy.

Conclusions: Bietti crystalline retinopathy is a progressive retinal disease characterized by retinal crystals gradually replaced by atrophy of the retinal pigment epithelium and gradual constriction of visual fields.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Corneal Diseases / genetics
  • Corneal Diseases / pathology*
  • Cytochrome P-450 Enzyme System / genetics
  • Cytochrome P450 Family 4
  • Electrooculography
  • Electroretinography
  • Fibroblasts / pathology
  • Fluorescein Angiography
  • Follow-Up Studies
  • Humans
  • Inclusion Bodies / pathology
  • Lipids
  • Lymphocytes / pathology
  • Male
  • Mutation
  • Retina / pathology
  • Retinal Degeneration / genetics
  • Retinal Degeneration / pathology*


  • Lipids
  • Cytochrome P-450 Enzyme System
  • CYP4V2 protein, human
  • Cytochrome P450 Family 4