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Purpose To evaluate the retinal features of elderly patients affected by pseudoxanthoma elasticum (PXE). Materials and methods This is a retrospective case series of 62 eyes of 31 elderly PXE patients (age 50 years). Clinical data, ultra-widefield fundus imaging (color, red-free (RF), infra-red imaging (IR), fundus autofluorescence (FAF)), and OCT examinations were collected. Diagnosis was confirmed by genetic testing or skin biopsy. Results Thirty-one patients (10 males and 21 females (mean age 61.3 years, range 50-74 years)) were