Adult-onset foveomacular vitelliform dystrophy. A, Yellowish, egg yolk–like lesion with focal pigment clumping and mottling in the central macula. B, FAF image of the same patient as shown in A reveals increased FAF corresponding to the vitelliform lesion (arrow). Note the reticular pseudodrusen, which are inconspicuous in the clinical photograph, in the superior and inferior macula (asterisks). C, SD-OCT of the same patient as shown in parts A and B reveals subfoveal hyperreflective material (asterisk). Note the irregular RPE elevation (between arrowheads). D, Histologic findings include pigment-containing cells in the subretinal space (arrowheads) and outer neurosensory retina (arrow) (H&E stain). E, Electron microscopy shows pigment-containing cells filled with lipofuscin (arrowheads).