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11-year-old who I saw in the office on July 23, 2009. He has Best’s disease that runs in his family on his mothers side. His left eye was seeing pretty well. He had some changes in the retina. He had photodynamic laser in April of 2009 and Avastin subsequently in June of 2009. Unfortunately with that his vision is substantially declining. His vision in the right eye remains good. VISUAL ACUITY: OD 20/30, OS 20/100. IOP: 16 OU. SLIT EXAMINATION: Normal with clear lenses. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is a classic yellow egg yolk-shaped lesion under the fovea a 1000 microns across. OS: Vertical C/D ratio is 0.1 There is pigment epithelial atrophy in the fovea. There is no intraretinal or subretinal fluid in either eye. Photos confirm clinical findings. IMPRESSION: 1. BEST’S DISEASE – BOTH EYES 2. MACULAR SCARRING – LEFT EYE DISCUSSION: I explained to the patient the macula in the right eye looks good. The left eye unfortunately has some thinning and scarring. At this point I do not think any further treatment in that eye would be helpful to him. I suggest he return here for a check unless the clinical picture changes. I asked him to return in three months or sooner if he should notice a problem.

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Best Disease - Left Eye Treated Previously, Elsewhere, with PDT and Avastin341 views11-year-old has Best’s disease that runs in his family on his mothers side. At another retina specialists office, he had photodynamic laser in April of 2009 and Avastin subsequently in June of 2009. Unfortunately with that his vision is substantially declining. OD 20/30, OS 20/10000000
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Best Disease - Left Eye Treated Previously, Elsewhere, with PDT and Avastin652 views11-year-old has Best’s disease that runs in his family on his mothers side. At another retina specialists office, he had photodynamic laser in April of 2009 and Avastin subsequently in June of 2009. Unfortunately with that his vision is substantially declining. OD 20/30, OS 20/10000000
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Best Disease - Left Eye Treated Previously, Elsewhere, with PDT and Avastin465 views11-year-old has Best’s disease that runs in his family on his mothers side. At another retina specialists office, he had photodynamic laser in April of 2009 and Avastin subsequently in June of 2009. Unfortunately with that his vision is substantially declining. OD 20/30, OS 20/10000000
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Best Disease - Left Eye Treated Previously, Elsewhere, with PDT and Avastin537 views11-year-old has Best’s disease that runs in his family on his mothers side. At another retina specialists office, he had photodynamic laser in April of 2009 and Avastin subsequently in June of 2009. Unfortunately with that his vision is substantially declining. OD 20/30, OS 20/10000000
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bestmimc_28329.png
Best Disease - Left Eye Treated Previously, Elsewhere, with PDT and Avastin473 views11-year-old has Best’s disease that runs in his family on his mothers side. At another retina specialists office, he had photodynamic laser in April of 2009 and Avastin subsequently in June of 2009. Unfortunately with that his vision is substantially declining. OD 20/30, OS 20/10000000
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bestmimc_28429.png
Best Disease - Left Eye Treated Previously, Elsewhere, with PDT and Avastin464 views11-year-old has Best’s disease that runs in his family on his mothers side. At another retina specialists office, he had photodynamic laser in April of 2009 and Avastin subsequently in June of 2009. Unfortunately with that his vision is substantially declining. OD 20/30, OS 20/10044444
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11-year-old who I saw in the office on July 23, 2009. He has Best’s disease that runs in his family on his mothers side. His left eye was seeing pretty well. He had some changes in the retina. He had photodynamic laser in April of 2009 and Avastin subsequently in June of 2009. Unfortunately with that his vision is substantially declining. His vision in the right eye remains good. VISUAL ACUITY: OD 20/30, OS 20/100. IOP: 16 OU. SLIT EXAMINATION: Normal with clear lenses. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is a classic yellow egg yolk-shaped lesion under the fovea a 1000 microns across. OS: Vertical C/D ratio is 0.1 There is pigment epithelial atrophy in the fovea. There is no intraretinal or subretinal fluid in either eye. Photos confirm clinical findings. IMPRESSION: 1. BEST’S DISEASE – BOTH EYES 2. MACULAR SCARRING – LEFT EYE DISCUSSION: I explained to the patient the macula in the right eye looks good. The left eye unfortunately has some thinning and scarring. At this point I do not think any further treatment in that eye would be helpful to him. I suggest he return here for a check unless the clinical picture changes. I asked him to return in three months or sooner if he should notice a problem.