title: Reappearance of the tapetal-like reflex after prolonged dark adaptation in a female carrier of RPGR ORF15 X-linked retinitis pigmentosa.
abstract: OBJECTIVE
  To report changes in the tapetal-like reflex in a female carrier of RPGR ORF15 c.3395delA X-linked retinitis pigmentosa (XLRP) between examinations at 16 and 22 years of age, and to report the observation that the tapetal-like reflex faded due to exposure to daylight and reappeared with prolonged dark adaptation at 22 years of age.
  
  
  METHODS
  Clinical examination, kinetic Goldmann perimetry, dark adaptometry, fundus autofluorescence photography, spectral domain optical coherence tomography (SD-OCT), full-field electroretinography (ffERG), and multifocal electroretinography (mfERG) were performed.
  
  
  RESULTS
  A female carrier of RPGR XLRP presented with a tapetal-like reflex at age 16. At age 22, the tapetal-like reflex was absent upon examination in daylight; however, the reflex reappeared after 12 h of dark adaptation. Fundus autofluorescence was unremarkable and did not change after prolonged dark adaptation. Full-field electroretinography and dark adaptometry at age 22 demonstrated reduced rod and cone function compared to at age 16.
  
  
  CONCLUSIONS
  Dark adaptation before fundus photography may enable the detection of a tapetal-like reflex where it is otherwise invisible. The light-dependent fluctuation of a disease-related substance in the photoreceptors should prompt further study of the potential role of light as a modulator of the progression of RPGR XLRP.
authors: Department of Ophthalmology, Glostrup Hospital, University of Copenhagen, Denmark ; National Eye Clinic for the Visually Impaired and Kennedy Center, Glostrup, Denmark.
authors: Jesper
authors: J
authors: Bregnhøj
authors: Department of Ophthalmology, Glostrup Hospital, University of Copenhagen, Denmark ; National Eye Clinic for the Visually Impaired and Kennedy Center, Glostrup, Denmark.
authors: Sermed
authors: S
authors: Al-Hamdani
authors: Department of Ophthalmology, Glostrup Hospital, University of Copenhagen, Denmark ; Faculty of Health Sciences, University of Copenhagen, Denmark.
authors: Birgit
authors: B
authors: Sander
authors: Department of Ophthalmology, Glostrup Hospital, University of Copenhagen, Denmark ; National Eye Clinic for the Visually Impaired and Kennedy Center, Glostrup, Denmark ; Faculty of Health Sciences, University of Copenhagen, Denmark.
authors: Michael
authors: M
authors: Larsen
authors: Department of Ophthalmology, Glostrup Hospital, University of Copenhagen, Denmark ; National Eye Clinic for the Visually Impaired and Kennedy Center, Glostrup, Denmark ; Department of Ophthalmology, Clinical Sciences, Scane County University Hospital, Lund, Sweden.
authors: Patrik
authors: P
authors: Schatz
mesh_terms: D002648:Child; D003623:Dark Adaptation / Q000502:physiology*; D004596:Electroretinography; D005136:Eye Proteins / Q000235:genetics*; D005190:Family; D005260:Female; D005654:Fundus Oculi; D040181:Genetic Diseases, X-Linked / Q000235:genetics* / Q000503:physiopathology; D006579:Heterozygote; D006801:Humans; D008297:Male; D016366:Open Reading Frames / Q000235:genetics*; D010375:Pedigree; D012018:Reflex / Q000502:physiology*; D012174:Retinitis Pigmentosa / Q000235:genetics* / Q000503:physiopathology*; D041623:Tomography, Optical Coherence; D055815:Young Adult
chemical_list: D005136:Eye Proteins; C099929:RPGR protein, human