Purpose To report the morphologic data of adult-onset foveomacular vitelliform dystrophy (AFVD) provided by third-generation optical coherence tomography (OCT 3). Design Observational case report. Methods An 85-year-old woman presenting with AFVD underwent fundus biomicroscopy, fluorescein angiography, and OCT examination. Results Fundus examination disclosed a round, elevated yellowish lesion, centered by a pigmented spot, in the macula of the left eye. Examination with OCT disclosed an area of hyperreflectivity located between the retinal pigment epithelium layer and the photoreceptor layer, compatible in size with the yellowish elevated lesion. The hyperreflective line corresponding to the photoreceptor layer was elevated by the material and separated from the retinal pigment epithelium layer. Conclusions In AFVD, examination with OCT 3 demonstrates elevation of the photoreceptor layer by the material and supports the previous hypothesis that the material is located between the photoreceptor and the retinal pigment epithelium layer.