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61-year-old woman has concentric annular macular dystrophy. She began to have vision loss back in 2004. I saw her in 2005, at which point she had relatively small areas of retinal atrophy. Since then the areas of retinal atrophy have spread. She has magnifiers and vision aids and she is no longer able to function even with the magnifiers and vision aids that she has. Her brother who is ten years younger than her, is recently diagnosed with the same macular dystrophy and her father and grandfather may have had similar problems in the past. VISUAL ACUITY: OD 4/200, OS 2/200. IOP: OD 12, OS 14. SLIT EXAMINATION: There is 1+ nuclear sclerosis in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation and no vitreous cells. There is macular atrophy. The retinal vessels though are reasonably intact and there is only trace optic atrophy. OS: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. Again, there is geographic atrophy at the macula. The optic nerve looks pink and the retinal vessels overlying the optic nerve look nearly normal. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows atrophy of the pigment epithelium in the macula. The choriocapillaris looks to be reasonably intact throughout the area of macular atrophy and stains in geographic atrophy pattern in the macula in the late frames. Each area has a central region of greater than 6 disc areas of pigment epithelial loss centered on the fovea, also nasal to the optic nerve there is some atrophy and there are scattered drusen throughout the macula. OCT SCAN: The OCT scan shows dense retinal atrophy in both eyes. The average foveal thickness in the right eye is 164 microns with a volume of 5.37 mm3. The left eye is 121 microns with a volume of 3.88 mm3. IMPRESSION: 1. FAMILIAL CONCENTRIC ANNULAR MACULAR DYSTROPHY – BOTH EYES 2. MILD CATARACTS DISCUSSION: I explained to the patient unfortunately the macular atrophy has worsened. At this point there is no treatment for her, maybe down the road we would be able to do cell transplantation. At this moment she would be an excellent candidate for that if the technology is ever useful in humans. I asked her to return for a check in two to three years.

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Concentric Annular Macular Dystrophy 4/200 2/200 vision 61 Year Old Macular Crystals197 views61-year-old woman has concentric annular macular dystrophy. She has had vision loss for 10 years who is no longer able to function even with the magnifiers and vision aids that she has. Her brother who is ten years younger than her, is recently diagnosed with the same macular dystrophy and her father and grandfather may have had similar problems in the past.

VISUAL ACUITY: OD 4/200, OS 2/200.
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Concentric Annular Macular Dystrophy 4/200 2/200 vision 61 Year Old Macular Crystals147 views61-year-old woman has concentric annular macular dystrophy. She has had vision loss for 10 years who is no longer able to function even with the magnifiers and vision aids that she has. Her brother who is ten years younger than her, is recently diagnosed with the same macular dystrophy and her father and grandfather may have had similar problems in the past.

VISUAL ACUITY: OD 4/200, OS 2/200.
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Concentric Annular Macular Dystrophy 4/200 2/200 vision 61 Year Old Macular Crystals100 views61-year-old woman has concentric annular macular dystrophy. She has had vision loss for 10 years who is no longer able to function even with the magnifiers and vision aids that she has. Her brother who is ten years younger than her, is recently diagnosed with the same macular dystrophy and her father and grandfather may have had similar problems in the past.

VISUAL ACUITY: OD 4/200, OS 2/200.
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Concentric Annular Macular Dystrophy 4/200 2/200 vision 61 Year Old Macular Crystals134 views61-year-old woman has concentric annular macular dystrophy. She has had vision loss for 10 years who is no longer able to function even with the magnifiers and vision aids that she has. Her brother who is ten years younger than her, is recently diagnosed with the same macular dystrophy and her father and grandfather may have had similar problems in the past.

VISUAL ACUITY: OD 4/200, OS 2/200.
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Concentric Annular Macular Dystrophy 4/200 2/200 vision 61 Year Old Macular Crystals137 views61-year-old woman has concentric annular macular dystrophy. She has had vision loss for 10 years who is no longer able to function even with the magnifiers and vision aids that she has. Her brother who is ten years younger than her, is recently diagnosed with the same macular dystrophy and her father and grandfather may have had similar problems in the past.

VISUAL ACUITY: OD 4/200, OS 2/200.
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Concentric Annular Macular Dystrophy 4/200 2/200 vision 61 Year Old Macular Crystals119 views61-year-old woman has concentric annular macular dystrophy. She has had vision loss for 10 years who is no longer able to function even with the magnifiers and vision aids that she has. Her brother who is ten years younger than her, is recently diagnosed with the same macular dystrophy and her father and grandfather may have had similar problems in the past.

VISUAL ACUITY: OD 4/200, OS 2/200.
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Concentric Annular Macular Dystrophy 4/200 2/200 vision 61 Year Old Macular Crystals105 views61-year-old woman has concentric annular macular dystrophy. She has had vision loss for 10 years who is no longer able to function even with the magnifiers and vision aids that she has. Her brother who is ten years younger than her, is recently diagnosed with the same macular dystrophy and her father and grandfather may have had similar problems in the past.

VISUAL ACUITY: OD 4/200, OS 2/200.
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Concentric Annular Macular Dystrophy 4/200 2/200 vision 61 Year Old Macular Crystals120 views61-year-old woman has concentric annular macular dystrophy. She has had vision loss for 10 years who is no longer able to function even with the magnifiers and vision aids that she has. Her brother who is ten years younger than her, is recently diagnosed with the same macular dystrophy and her father and grandfather may have had similar problems in the past.

VISUAL ACUITY: OD 4/200, OS 2/200.
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Concentric Annular Macular Dystrophy 4/200 2/200 vision 61 Year Old Macular Crystals129 views61-year-old woman has concentric annular macular dystrophy. She has had vision loss for 10 years who is no longer able to function even with the magnifiers and vision aids that she has. Her brother who is ten years younger than her, is recently diagnosed with the same macular dystrophy and her father and grandfather may have had similar problems in the past.

VISUAL ACUITY: OD 4/200, OS 2/200.
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Concentric Annular Macular Dystrophy 4/200 2/200 vision 61 Year Old Macular Crystals106 views61-year-old woman has concentric annular macular dystrophy. She has had vision loss for 10 years who is no longer able to function even with the magnifiers and vision aids that she has. Her brother who is ten years younger than her, is recently diagnosed with the same macular dystrophy and her father and grandfather may have had similar problems in the past.

VISUAL ACUITY: OD 4/200, OS 2/200.
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61-year-old woman has concentric annular macular dystrophy. She began to have vision loss back in 2004. I saw her in 2005, at which point she had relatively small areas of retinal atrophy. Since then the areas of retinal atrophy have spread. She has magnifiers and vision aids and she is no longer able to function even with the magnifiers and vision aids that she has. Her brother who is ten years younger than her, is recently diagnosed with the same macular dystrophy and her father and grandfather may have had similar problems in the past. VISUAL ACUITY: OD 4/200, OS 2/200. IOP: OD 12, OS 14. SLIT EXAMINATION: There is 1+ nuclear sclerosis in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation and no vitreous cells. There is macular atrophy. The retinal vessels though are reasonably intact and there is only trace optic atrophy. OS: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. Again, there is geographic atrophy at the macula. The optic nerve looks pink and the retinal vessels overlying the optic nerve look nearly normal. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows atrophy of the pigment epithelium in the macula. The choriocapillaris looks to be reasonably intact throughout the area of macular atrophy and stains in geographic atrophy pattern in the macula in the late frames. Each area has a central region of greater than 6 disc areas of pigment epithelial loss centered on the fovea, also nasal to the optic nerve there is some atrophy and there are scattered drusen throughout the macula. OCT SCAN: The OCT scan shows dense retinal atrophy in both eyes. The average foveal thickness in the right eye is 164 microns with a volume of 5.37 mm3. The left eye is 121 microns with a volume of 3.88 mm3. IMPRESSION: 1. FAMILIAL CONCENTRIC ANNULAR MACULAR DYSTROPHY – BOTH EYES 2. MILD CATARACTS DISCUSSION: I explained to the patient unfortunately the macular atrophy has worsened. At this point there is no treatment for her, maybe down the road we would be able to do cell transplantation. At this moment she would be an excellent candidate for that if the technology is ever useful in humans. I asked her to return for a check in two to three years.