Purpose:To correlate the functional results of maculartranslocation(MT )in a patient suffering from an adult-onset foveomacular vitellif orm dystrophy(AFVD)with the microscopic findings of the surgically removed subfoveal retinal pigment epithelium(RPE).Methods:A78-year-old woman with AFVD underwe nt MT with 360°retinotomy 3-4months after loss of r eading ability.Most of the vitelliform material was lost during surgery;the subfoveal tissue was excised,fixed in aldehydes,postfixed in reduced OSO4and embedded in epoxy resin.Semithin sections were stained with toluidin e blue for light mi-croscopy(LM)and thin sections with uranyl acetate and lead citrate for transmission electron microscopy(TEM).Results:Postoperatively,the pati ent developed a retinal detachment complicated by proliferative vitreoretinopathy(PVR)requiring two additional vitreoretinal procedures before finally the silicone oil coul d be removed.Twen-ty-two months after MT the distance v isual acuity was un-changed at 0.2;the near visual acuit y had improved from less than 0.1before MT to 0.4.The retina was completely attached.LM and TEM revealed seriou s alterations in-dicative of a breakdown of the outer l ayer of the retina.Conclusion:Through the present sin gle case it is not possible to determine whether MT cou ld be a therapeutic approach in patients with AFVD.The m ost important cause for the limited postoperative visual improvement seems to be a primary injury of the foveal function due to the AFVD.This is supported by the extensive subfoveal degeneration and necrosis affectin g not only the RPE cells but also their basement membrane and the interposed basal laminar deposits. Purpose: To correlate the functional results of maculartranslocation (MT) in a patient suffering from an adult-onset foveomacular vitellif orm dystrophy (AFVD) with the microscopic findings of the surgically removed subfoveal retinal pigment epithelium (RPE). Methods: A78- old woman with AFVD underwe nt MT with 360 ° retinotomy 3-4months after loss of r eading ability. Most of the vitelliform material was lost during surgery; the subfoveal tissue was excised, fixed in aldehydes, postfixed in reduced OSO4 and embedded in epoxy resin. Semithin sections were stained with toluidin e blue for light mi-croscopy (LM) and thin sections with uranyl acetate and lead citrate for transmission electron microscopy (TEM). Results: Postoperatively, the pati ent developed a retinal detachment complicated by proliferative vitreoretinopathy (PVR ) require two additional vitreoretinal procedures before finally the silicone oil coul d be removed. Tewen-ty-two months after MT the distance v isual acuity was un-changed at 0.2; the near visual acuit y had improved from less than 0.1before MT to 0.4.The retina was completely attached.LM and TEM revealed seriou alterations in-dicative of a breakdown of the outer l ayer of the retina.Conclusion: Through the present sin gle case it is not possible to determine whether MT cou ld be a therapeutic approach in patients with AFVD. The m ost important cause for the limited postoperative visual improvement seems to be a primary injury of the foveal function due to the AFVD. This is supported by the extensive subfoveal degeneration and necrosis affect in not only the RPE cells but also their basement membrane and the interposed basal laminar deposits.