Imran Akram, Amjad Akram.
Benign concentric Annular Maculopathy: A Case Report.
Pak J Ophthalmol Jan ;12(4):136.

We report a case of a very rare condition which is characterized by a bull`s eye macula picture in an asymptomatic patient.

A 28-year-old serving soldier presented in our outpatient for routine ophthalmic examination prior to UN deployment. He had no complaints. Uncorrected visual acuity was 6/6 in both eyes. A quick glance at his fundus caught our attention and a complete examination was carried out. The soldier had never been taking any drug of significance in the past. The macular region in his left eye presented a classical bull`s eye picture, i.e. a central pigmented area ircumferentially surrounded by an area of hypopigmentation which was again surrounded by an area of pigmentation. The appearance of the right eye was similar, although somewhat less marked. Colour vision was tested using the Ishihara plates and revealed no abnormality. Examination of the visual fields also showed no abnormality. Fluorescein angiography showed central perfluorescence. Electrodiagnostic tests could not be done due to non-availability of the equipment in our unit. The soldier was declared fit for UN deployment. A number of conditions can lead to a bull`s eye macula picture. Notable among these are drug toxicities (especially chloroquin) and the cone dystrophies However, these conditions are usually accompanied by subtle disturbances of visual acuity or of colour perception. A rare, autosomal dominantly inherited condition has been described in ophthalmic literature. by the name of Benign Concentric Annular Maculopathy This is characterized by a bull`s eye pattern of geographic atrophy of the RPE around the fovea, with no functional abnormality. Although the individual may have normal or near-normal vision initially, long term follow-up of such cases has shown abnormalities of both cone and rod systems with the appearance of bone spicule pigmentation in some patients On the basis of our findings, we label this young soldier as a case of Benign Concentric Annular Maculopathy.

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