Degenerative choroidal sclerosis with a peculiar bilateral pattern

A 60 year-old black man when seen in consultation for foreign body sensation and presbyopic complaints was noted on ophthalmoscopy to have bilateral pigment epithelial defects. These defects were curiously symmetrical and there were visual field defects corresponding to the areas showing loss of pigment epithelium. The electrooculogram was abnormal and fluorescein angiography showed normal large choroidal vessels but totally absent choriocapillaris in the involved areas and abnormal pigment epithelium at the edge of the defect.