SHWACHMAN-DIAMOND SYNDROME ASSOCIATED WITH ROD-CONE DYSTROPHY.

Abstract

Purpose: The aim of this study was to report a patient with Shwachman-Diamond syndrome and concomitant rod-cone dystrophy who underwent bone marrow transplantation.

Methods: This was a retrospective single case report.

Results: A female patient with Shwachman-Diamond syndrome was referred to a tertiary hospital to investigate possible pigmentary retinopathy at the age of 16 years. She described poor night vision and was found to have reduced VA (6/20 right eye, 6/38 left eye). Over the 10-year follow-up, her VA remained relatively stable with no new visual symptoms. Optical coherence tomography revealed progressive, diffuse outer retinal thinning with disruption of the ellipsoid zone, which initially was relatively preserved subfoveally. Fundus autofluorescence images revealed generalized areas of hypoautofluorescence beyond the vascular arcades and a perimacular ring of increased autofluorescence. The flash electroretinogram was in keeping with a severe rod-cone dystrophy. The pattern visual evoked potential was abnormal but detectable, indicating macular pathway dysfunction, suggesting encroachment into central macular regions but with some functional preservation.

Conclusion: The authors report a patient with Shwachman-Diamond syndrome with severe early-onset rod-cone dystrophy noted at the age of 16 years. Slow anatomical progression has been observed over the subsequent 10 years, with relative functional macular preservation to support a VA of 6/36 in both eyes.