Night Blindness, Ring Scotoma, and a Nonrecordable Electroretinogram in an Elderly Woman

A woman in her 70s and of Korean descent reported difficulty seeing in dimly lit settings for the past 6 years and was referred for evaluation. Her medical history was remarkable for long-standing hypertension, diabetes, and mixed connective tissue disease. Ophthalmoscopic examination revealed bilateral pigment mottling with extensive peripheral depigmentation of the retinal pigment epithelium, sparing the central fovea bilaterally.