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Bilateral Tapetal Reflex in a 12-Year-Old Girl

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Bilateral fundus examination of a 12-year-old girl with visual acuity 6/9, N6 OU, and myopia of −10 diopters in the right eye and −7 diopters in left eye revealed a golden metallic tapetal sheen sparing the central macula and peripheral retina in both eyes (Figure). She had no visual symptoms and no similar family history. Electroretinography (ERG) revealed nonrecordable scotopic responses with normal photopic responses and a negative b wave in dark-adapted 3.0 ERG and 10.0 ERG. A provisional diagnosis of Oguchi disease was made; however, prolonged dark adaptation to evaluate for Mizuo-Nakamura phenomenon could not be done. Oguchi disease is an autosomal recessive form of congenital stationary night blindness.1 It is characterized by a golden-brown fundus with a metallic sheen in the light-adapted state, which disappears after prolonged dark adaptation; this is called the Mizuo-Nakamura phenomenon.2 Tapetal-like reflex is also seen in carriers of X-linked retinitis pigmentosa and in juvenile-linked retinoschisis.3

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Article Information

Corresponding Author: Sashwanthi Mohan, MBBS, DNB, Sankara Nethralaya, No. 41 Old No. 18, College Road, Chennai 600006, India (sashu23@gmail.com).

Conflict of Interest Disclosures: None reported.

Additional Contributions: We thank the patient’s mother for granting permission to publish this information.

References
1.
Rishi  P , Rishi  E , Abraham  S .  Oguchi disease with Mizuo-Nakamura phenomenon in a 7-year-old boy.   GMS Ophthalmol Cases. 2018;8:Doc07.PubMedGoogle Scholar
2.
Mittal  K , Chawla  R .  Mizuo-Nakamura phenomena.   Ophthalmic Surg Lasers Imaging Retina. 2016;47(11):1068. doi:10.3928/23258160-20161031-14PubMedGoogle ScholarCrossref
3.
Schatz  P , Bregnhøj  J , Arvidsson  H ,  et al.  A tapetal-like fundus reflex in a healthy male: evidence against a role in the pathophysiology of retinal degeneration?   Mol Vis. 2012;18:1147-1155.PubMedGoogle Scholar
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