Two sisters, 54 and 60 years o
ld, with a history of diabetes and deafness, consu
lted for decreased visua
l acuity (VA). Funduscopic examination revea
led patchy areas of chorioretina
l atrophy with annu
lar arrangement around the fovea. Genetic study identified the heterop
lasmic mutation 3
243A>G in mitochondria
l DNA, which supports the syndrome materna
lly inherited diabetes and deafness (MIDD) or Ba
llinger-Wa
llace disease.
Discussion
The finding of such macular disorders, especially in the presence of diabetes mellitus and deafness, should suggest the performing of a mitochondrial genome screening to identify this unusual syndrome.