BACKGROUND: Oguchi disease is a form of congenital stationary night-blindness characterized by a golden tapetal fundus reflex. This reflex is known to disappear in the dark-adapted state ("Mizuo-Nakamura phenomenon"). The origin of the reflex is not clear. We report a case of Oguchi disease with the disappearance of the golden tapetal reflex after vitreous resection. CASE: An 80-year-old man was referred for rhegmatogenous retinal detachment of the left eye. Golden tapetal reflex was observed in both eyes. Negative b-wave in the electroretinogram and mutation in the SAG gene indicated Oguchi disease. Pars plana vitrectomy and posterior hyaloid membrane peeling were performed. The tapetal reflex in the all regions of the fundus in the operated eye disappeared after the retina was reattached. The reflex partially recovered 2 years after the operation. CONCLUSION: It is suggested that the change in vitreo-retinal interface after a vitreous operation leads to the disappearance of the reflex. This report presents a hypothesis on the origin of the golden tapetal reflex in Oguchi disease.
BACKGROUND:Oguchi disease is a form of congenital stationary night-blindness characterized by a golden tapetal fundus reflex. This reflex is known to disappear in the dark-adapted state ("Mizuo-Nakamura phenomenon"). The origin of the reflex is not clear. We report a case of Oguchi disease with the disappearance of the golden tapetal reflex after vitreous resection. CASE: An 80-year-old man was referred for rhegmatogenous retinal detachment of the left eye. Golden tapetal reflex was observed in both eyes. Negative b-wave in the electroretinogram and mutation in the SAG gene indicated Oguchi disease. Pars plana vitrectomy and posterior hyaloid membrane peeling were performed. The tapetal reflex in the all regions of the fundus in the operated eye disappeared after the retina was reattached. The reflex partially recovered 2 years after the operation. CONCLUSION: It is suggested that the change in vitreo-retinal interface after a vitreous operation leads to the disappearance of the reflex. This report presents a hypothesis on the origin of the golden tapetal reflex in Oguchi disease.