Geographic Atrophy - Concentric - Bulls Eye - Charles Bonnet Syndrome
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88-year-old woman has age-related macular degeneration in both eyes with geographic atrophy. Her vision unfortunately, has gradually declined over the last year. This summer, for the first time, her husband needed to read the menus for her. She is having a lot of difficulty seeing at night. She sees spots in her vision, like red spots and dark spots and she even notices during the daytime, for example when she was looking at her minister, it looked like there were little flowering pots coming out of his head.
VISUAL ACUITY: OD 20/200, OS 20/400. IOP: OD 17, OS 16.
SLIT EXAMINATION: The posterior chamber intraocular lens is in good position in both eyes. The right eye has an open capsule.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There is posterior vitreous separation with concentric geographic atrophy. There is a dot hemorrhage nasal to the fovea, which looks to probably be diabetic. There is 2+ equatorial drusen.
OS: Vertical C/D ratio is 0.1. There is posterior vitreous separation with concentric geographic atrophy.
OCT SCAN: The OCT scan shows retinal atrophy in both eyes, but no intraretinal or subretinal fluid. There is unfortunately, foveal thinning as well as loss of the retinal architecture and retinal pigment epithelial architecture.
Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows hyperfluorescence in the macula of each eye consistent with her geographic atrophy. There is no evidence of any choroidal neovascularization in either eye. The hemorrhage in the right eye blocks the fluorescein a little bit in the early frames.
IMPRESSION:
1. MILD BACKGROUND DIABETIC RETINOPATHY – BOTH EYES
2. ADVANCED DRY AGE-RELATED MACULAR DEGENERATION – BOTH EYES
WITH CONCENTRIC FOVEAL INVOLVING GEOGRAPHIC ATROPHY
3. CHARLES BONNET SYNDROME
DISCUSSION: I explained to the patient she does unfortunately have retinal thinning in both eyes, which has compromised her central vision. At this moment we have no treatment for retinal atrophy. Hopefully, her visual decline won’t progress to much more. I told her though it is probable she will lose a little more vision. It may be possible in her situation with better magnification and lighting, she might be able to see a little bit more, and I asked her to discuss that with you. I told her that sometimes when she sees things, especially in low lighting that aren’t there, that, that’s normal for eyes like hers.
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Concentric Geograophic Atrophy - Age-related Macular Degeneration - Charles Bonnet Syndrome - Bulls Eye672 views88-year-old woman has age-related with vision gradually declining over the last year. She sees spots in her vision, like red spots and dark spots and she even notices during the daytime, for example when she was looking at her minister, it looked like there were little flowering pots coming out of his head.
VISUAL ACUITY: OD 20/200, OS 20/400.
(0 votes)
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Concentric Geograophic Atrophy - Age-related Macular Degeneration - Charles Bonnet Syndrome - Bulls Eye482 views88-year-old woman has age-related with vision gradually declining over the last year. She sees spots in her vision, like red spots and dark spots and she even notices during the daytime, for example when she was looking at her minister, it looked like there were little flowering pots coming out of his head.
VISUAL ACUITY: OD 20/200, OS 20/400.
(0 votes)
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Concentric Geograophic Atrophy - Age-related Macular Degeneration - Charles Bonnet Syndrome - Bulls Eye542 views88-year-old woman has age-related with vision gradually declining over the last year. She sees spots in her vision, like red spots and dark spots and she even notices during the daytime, for example when she was looking at her minister, it looked like there were little flowering pots coming out of his head.
VISUAL ACUITY: OD 20/200, OS 20/400.
(0 votes)
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Concentric Geograophic Atrophy - Age-related Macular Degeneration - Charles Bonnet Syndrome - Bulls Eye555 views88-year-old woman has age-related with vision gradually declining over the last year. She sees spots in her vision, like red spots and dark spots and she even notices during the daytime, for example when she was looking at her minister, it looked like there were little flowering pots coming out of his head.
VISUAL ACUITY: OD 20/200, OS 20/400.
(0 votes)
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Concentric Geograophic Atrophy - Age-related Macular Degeneration - Charles Bonnet Syndrome - Bulls Eye618 views88-year-old woman has age-related with vision gradually declining over the last year. She sees spots in her vision, like red spots and dark spots and she even notices during the daytime, for example when she was looking at her minister, it looked like there were little flowering pots coming out of his head.
VISUAL ACUITY: OD 20/200, OS 20/400.
(0 votes)
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Concentric Geograophic Atrophy - Age-related Macular Degeneration - Charles Bonnet Syndrome - Bulls Eye442 views88-year-old woman has age-related with vision gradually declining over the last year. She sees spots in her vision, like red spots and dark spots and she even notices during the daytime, for example when she was looking at her minister, it looked like there were little flowering pots coming out of his head.
VISUAL ACUITY: OD 20/200, OS 20/400.
(0 votes)
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Concentric Geograophic Atrophy - Age-related Macular Degeneration - Charles Bonnet Syndrome - Bulls Eye440 views88-year-old woman has age-related with vision gradually declining over the last year. She sees spots in her vision, like red spots and dark spots and she even notices during the daytime, for example when she was looking at her minister, it looked like there were little flowering pots coming out of his head.
VISUAL ACUITY: OD 20/200, OS 20/400.
(0 votes)
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Concentric Geograophic Atrophy - Age-related Macular Degeneration - Charles Bonnet Syndrome - Bulls Eye408 views88-year-old woman has age-related with vision gradually declining over the last year. She sees spots in her vision, like red spots and dark spots and she even notices during the daytime, for example when she was looking at her minister, it looked like there were little flowering pots coming out of his head.
VISUAL ACUITY: OD 20/200, OS 20/400.
(0 votes)
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Concentric Geograophic Atrophy - Age-related Macular Degeneration - Charles Bonnet Syndrome - Bulls Eye508 views88-year-old woman has age-related with vision gradually declining over the last year. She sees spots in her vision, like red spots and dark spots and she even notices during the daytime, for example when she was looking at her minister, it looked like there were little flowering pots coming out of his head.
VISUAL ACUITY: OD 20/200, OS 20/400.
(0 votes)
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Concentric Geograophic Atrophy - Age-related Macular Degeneration - Charles Bonnet Syndrome - Bulls Eye446 views88-year-old woman has age-related with vision gradually declining over the last year. She sees spots in her vision, like red spots and dark spots and she even notices during the daytime, for example when she was looking at her minister, it looked like there were little flowering pots coming out of his head.
VISUAL ACUITY: OD 20/200, OS 20/400.
(0 votes)
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Concentric Geograophic Atrophy - Age-related Macular Degeneration - Charles Bonnet Syndrome - Bulls Eye473 views88-year-old woman has age-related with vision gradually declining over the last year. She sees spots in her vision, like red spots and dark spots and she even notices during the daytime, for example when she was looking at her minister, it looked like there were little flowering pots coming out of his head.
VISUAL ACUITY: OD 20/200, OS 20/400.
(0 votes)
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Concentric Geograophic Atrophy - Age-related Macular Degeneration - Charles Bonnet Syndrome - Bulls Eye573 views88-year-old woman has age-related with vision gradually declining over the last year. She sees spots in her vision, like red spots and dark spots and she even notices during the daytime, for example when she was looking at her minister, it looked like there were little flowering pots coming out of his head.
VISUAL ACUITY: OD 20/200, OS 20/400.
(0 votes)
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88-year-old woman has age-related macular degeneration in both eyes with geographic atrophy. Her vision unfortunately, has gradually declined over the last year. This summer, for the first time, her husband needed to read the menus for her. She is having a lot of difficulty seeing at night. She sees spots in her vision, like red spots and dark spots and she even notices during the daytime, for example when she was looking at her minister, it looked like there were little flowering pots coming out of his head.
VISUAL ACUITY: OD 20/200, OS 20/400. IOP: OD 17, OS 16.
SLIT EXAMINATION: The posterior chamber intraocular lens is in good position in both eyes. The right eye has an open capsule.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There is posterior vitreous separation with concentric geographic atrophy. There is a dot hemorrhage nasal to the fovea, which looks to probably be diabetic. There is 2+ equatorial drusen.
OS: Vertical C/D ratio is 0.1. There is posterior vitreous separation with concentric geographic atrophy.
OCT SCAN: The OCT scan shows retinal atrophy in both eyes, but no intraretinal or subretinal fluid. There is unfortunately, foveal thinning as well as loss of the retinal architecture and retinal pigment epithelial architecture.
Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows hyperfluorescence in the macula of each eye consistent with her geographic atrophy. There is no evidence of any choroidal neovascularization in either eye. The hemorrhage in the right eye blocks the fluorescein a little bit in the early frames.
IMPRESSION:
1. MILD BACKGROUND DIABETIC RETINOPATHY – BOTH EYES
2. ADVANCED DRY AGE-RELATED MACULAR DEGENERATION – BOTH EYES
WITH CONCENTRIC FOVEAL INVOLVING GEOGRAPHIC ATROPHY
3. CHARLES BONNET SYNDROME
DISCUSSION: I explained to the patient she does unfortunately have retinal thinning in both eyes, which has compromised her central vision. At this moment we have no treatment for retinal atrophy. Hopefully, her visual decline won’t progress to much more. I told her though it is probable she will lose a little more vision. It may be possible in her situation with better magnification and lighting, she might be able to see a little bit more, and I asked her to discuss that with you. I told her that sometimes when she sees things, especially in low lighting that aren’t there, that, that’s normal for eyes like hers.
