visual acuities were 6/60 OD and 6/7.5 OS. Fundoscopy revealed bilateral central atrophy, seen clearly on autofluorescence imaging (AF) (Fig. 1a and b). Eight years later AF imaging showed a preserved small central spot of AF, surrounded by a reduced AF signal corresponding to the area of atrophy, which increased in size over time, with a ring of AF. (Fig. 1c-f). Optical coherence tomography (OCT) imaging, 10 years after initial presentation, showed loss of the ellipsoid zone
imaging showing atrophic maculae, Autofluorescence (AF) shows loss of signal centrally corresponding to atrophy with a surrounding band of increased AF within the arcades, optical coherence tomography (OCT) imaging showing the temporal extent of the loss of the ellipsoid zone demarcated, increased atrophy after a 4-year interval. Optos imaging shows increased bilateral macular atrophy, AF imaging shows extension of patchy AF surrounding the central atrophy with a small preserved foveal remnant, OCT showing further extension of the loss of the ellipsoid zone