Case 4: Zeiss Cirrus RNFL Analysis OU

The RNFL is reduced inferiorly in both eyes. However, the temporal quadrant, which grossly corresponds to the papillo-macula bundle (PMB) is normal in thickness. Hence, there is no evidence that the reduction in VA is due to an optic nerve disorder.

Based upon the central visual field reduction but a normal RNFL in the PMB, the diagnosis is likely a maculopathy. Stargardt Disease is the most common juvenile macular degeneration. Genetic testing for a Stargardt Disease gene (ABCA4) is presently underway. This case demonstrates only mild structural deficits but a profound loss of field on the M program. The RNFL defects warrants careful follow-up.