Angioid streaks in identical twins

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Abstract
A 66 year old man with no significant medical history presented to the eye clinic with reduced central vision in the left eye for 6 months. On examination, best corrected visual acuities were RE 6/12 and LE 6/36. Amsler grid testing of the central field showed a central scotoma in both eyes, more pronounced in the right. Funduscopy revealed bilateral, red/brown bands radiating from the optic disc suggestive of angioid streaks, and a lesion at the left macula suggestive of a subretinal neovascular membrane. Fluorescein angiography confirmed angioid streaks showing increased transmission of fluorescence overlying the streaks and peripapillary region. The macula also showed leakage of fluorescein suggestive of a subfoveal neovascular membrane (fig 1). Visual acuity deteriorated to counting fingers in the left eye over 9 months and, to date, he maintains acuity of 6/12 in the right.