Case ReportMAINTENANCE OF GOOD VISUAL ACUITY IN BEST DISEASE ASSOCIATED WITH CHRONIC BILATERAL SEROUS MACULAR DETACHMENTGattoussi, Sarra MD*,†,‡; Boon, Camiel J. F. MD, PhD§,¶; Freund, K. Bailey MD*,†,**Author Information *LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York; †Vitreous Retina Macula Consultants of New York, New York, New York; ‡Department of Ophthalmology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France; §Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands; ¶Department of Ophthalmology, Academic Medical Center, Amsterdam, the Netherlands; and **Department of Ophthalmology, New York University School of Medicine, New York, New York. Reprint requests: K. Bailey Freund, MD, Vitreous Retina Macula Consultants of New York, 460 Park Avenue, New York, NY 10022; e-mail: email@example.com Supported by The Macula Foundation Inc, New York, NY. Atlantic Coast Retina Conference, Baltimore, MD, January 5, 2017. K. B. Freund: consultant to Genentech, Optos, Optovue, Heidelberg Engineering, Graybug Vision. Research Support: Genentech/Roche. The remaining authors have no financial/conflicting interests to disclose. Retinal Cases & Brief Reports: Winter 2020 - Volume 14 - Issue 1 - p 1-5 doi: 10.1097/ICB.0000000000000618 Buy Metrics AbstractIn Brief Purpose: We describe the long-term follow-up of a patient with multifocal Best disease with chronic bilateral serous macular detachment and unusual peripheral findings associated with a novel mutation in the BEST1 gene. Methods: Case report. Results: A 59-year-old white woman was referred for an evaluation of her macular findings in 1992. There was a family history of Best disease in the patient's mother and a male sibling. Her medical history was unremarkable. Best-corrected visual acuity was 20/20 in her right eye and 20/25 in her left eye. The anterior segment examination was normal in both eyes. Funduscopic examination showed multifocal hyperautofluorescent vitelliform deposits with areas of subretinal fibrosis in both eyes. An electrooculogram showed Arden ratios of 1.32 in the right eye and 1.97 in the left eye. Ultra-widefield color and fundus autofluorescence imaging showed degenerative retinal changes in areas throughout the entire fundus in both eyes. Optical coherence tomography, including annual eye-tracked scans from 2005 to 2016, showed persistent bilateral serous macular detachments. Despite chronic foveal detachment, visual acuity was 20/25 in her right eye and 20/40 in her left eye, 24 years after initial presentation. Genetic testing showed a novel c.238T>A (p.Phe80Ile) missense mutation in the BEST1 gene. Conclusion: Some patients with Best disease associated with chronic serous macular detachment can maintain good visual acuity over an extended follow-up. To our knowledge, this is the first report of Best disease associated with this mutation in the BEST1 gene. The multimodal imaging for a patient with Best disease is shown. Eye-tracked optical coherence tomographies show bilateral serous macular detachment over 11 years of follow-up during which there was maintenance of a good visual acuity. Genetic testing shows a novel missense mutation in the BEST1 gene.