"Comet-tail" lesions of pseudoxanthoma elasticum.

Comet-tail lesions are small, round, white bodies seen commonly in the inferior midperiphery of the retina [Fig. 1a]. These are frequently associated with a tail, which always points toward the optic disc. On red-free imaging, comet-tail lesion appears as a bright dot with a less bright tail [Fig. 1b]. Optical coherence tomography reveals them as hyporeflective spaces covered by hyperreflective margin, which overlie retinal pigment epithelium [Fig. 1c]. Comet-tail lesions are considered to be pathognomonic of pseudoxanthoma elasticum (PE) and may appear earlier than other changes of PE such as angioid streaks and Peau d'orange.[12]

Figure 1

Color (a), red-free (b) and optical coherence tomography imaging (c) of comet-tail lesions

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