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Case Nine: Bull's Eye Maculopathy/Cone-Rod Dystrophy |
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Color Photo of right eye. Note the beaten-bronze appearance to the central (macular) region. No deep yellow lesions are seen. | Color photo of left eye. Note the beaten-bronze appearance of the central region. Irregular coloration and pigmentation is seen in this area. |
Red Free photo of right eye. Note de-pigmentation and the generally oval shape of the disturbed area |
Red Free photo of left eye. Note irregular pigmentation |
Early phase FA right eye. Note central blocking by intra-retinal pigment surrounded by transmission defects. | Mid Phase FA right eye. Note focal area of macular disturbance. No 'silent choroid' is seen. |
Late phase FA right eye. Note fading of hyperfluorescence. No leakage of dye or staining is seen. | Late phase FA left eye. Note the absence of leakage of dye. No choroidal lesions are seen |
Comment |
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This 21 year old Caucasian female presented because of blurred vision which caused her to fail her drivers license exam. Her vision with glasses was 20/30 right eye and 20/40 left eye. She missed half of the color vision plates in each eye. There was no pupillary abnormality. Her visual fields were normal. She had a bulls-eye and beaten-bronze appearance to each macula. She refused electrophysiologic testing and therefore we were not able to pinpoint her diagnosis. Since she took no systemic medications, a toxic maculopathy is not likely. Since there is no 'silent choroid' and there are no yellow lesions, the diagnosis of Stargardt's disease is unlikely. These bulls-eye maculae most likely represent a cone dystrophy, either the rod-cone variant or the cone-rod variant.
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Photo credit: , Director of Photography/Webmaster- Southeastern Eye Center |
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