Figure 1 (A, B) Color fundus photos (Optos) showing retinal pigment epithelium (RPE) mottling in addition to hyperemic and swollen optic discs in both eyes, with a watermark nasal to the disc and obscuration of some vessels. (C, D) Autofluorescence photographs showing symmetrical abnormal patterns of autofluorescence due to retinal atrophy and RPE mottling involving the peripheral and macular areas. Hyperautofluorescence is not observed within the optic nerve head, indicating the absence of drusen. (E, F) Fundus fluorescein angiography images showing early filling of the optic nerve heads, which increases significantly in the late phase with diffuse hyperfluorescence extending beyond the disc margins. Leakage at the left optic nerve is more pronounced than that at the right optic disc. (G, H) Ultrasound scans (B-scans) showing an elevated optic nerve head in both eyes, with no detectable drusen.