NYCTALOPIA AS THE INITIAL MANIFESTATION OF LATE-ONSET RETINAL DEGENERATION: CLINICAL-OPHTHALMOLOGICAL CORRELATION AND MULTIMODAL FINDINGS IN A CASE REPORT

Abstract

Late-Onset Retinal Degeneration (L-ORD) is a rare, progressive, late-onset inherited retinal dystrophy whose resemblance to age-related ophthalmic changes may hinder clinical recognition. This article aimed to describe and analyze a case with clinical suspicion of L-ORD by correlating visual manifestations, ophthalmic examination, and multimodal findings. This is a case report of a 73-year-old man with diabetes mellitus and systemic arterial hypertension who developed progressive nyctalopia and difficulty adapting to dim environments. The evaluation showed reduced visual acuity, bilateral nuclear cataract, peripheral degenerative retinal changes, and optical coherence tomography findings of reduced central macular thickness and increased retinal reflectivity. The Potential Acuity Meter indicated better potential vision than conventional visual acuity, suggesting that the impairment was not explained solely by cataract. Integration of history taking, fundus examination, functional assessment, and imaging supported the suspicion of late-onset retinal degeneration. It is concluded that recognizing nyctalopia and performing complementary investigations are relevant to differential diagnosis and specialized follow-up, although the absence of molecular genetic confirmation is a limitation of this case.