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Corcóstegui I, Subirás J, Corcóstegui B. Outcomes of rhegmatogenous retinal detachment surgery in patients with Stickler syndrome. Graefes Arch Clin Exp Ophthalmol 2024; 262:2093-2099. [PMID: 38358525 DOI: 10.1007/s00417-024-06406-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 02/16/2024] Open
Abstract
PURPOSE Despite recent developments in vitrectomy technology and instrumentation, rhegmatogenous retinal detachment in Stickler syndrome (RDS) remains a challenge for surgeons. RDSs are associated with a higher rate of complications and surgical failures than those not associated with Stickler syndrome. This study is a report about anatomic and visual outcomes of RDS surgery and describes the surgical techniques associated with the treatment of this specific condition. METHODS This is a retrospective, interventional, consecutive case series of patients with RDS undergoing retinal reattachment surgery from 1990 to 2020 at the Institute of Ocular Microsurgery (IMO) in Barcelona, Spain. RESULTS Twenty-four eyes of 18 patients with genetically confirmed Stickler syndrome were included in the study. Ten eyes (41.6%) presented a giant retinal tear. Retinal reattachment was achieved in all cases after an average of 1.21 (range 1-6) surgical interventions. Nineteen eyes (79%) required only one operation to achieve complete retinal reattachment. The most common first surgical procedure was a 4-mm scleral buckle with posterior pars plana vitrectomy and silicone oil endotamponade, performed on 16 (66.6%) of the eyes. The mean follow-up period was 10.2 years. Mean preoperative visual acuity LogMar was 1.10 (Snellen equivalent 20/252), which improved to 0.50 (Snellen equivalent 20/63) at final follow-up (p < 0.05). CONCLUSION In most RDS cases, anatomic success and visual acuity improvement can be achieved with the first surgical procedure, using a combination of silicone oil tamponade and a 4-mm scleral encircling band. In some early cases of RDS, other less invasive surgical techniques can be used.
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Affiliation(s)
| | - Javier Subirás
- Vitreo-Retinal Department, Institute of Ocular Microsurgery, Barcelona, Spain
| | - Borja Corcóstegui
- Vitreo-Retinal Department, Institute of Ocular Microsurgery, Barcelona, Spain
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Nagashima T, Akiyama H, Nakamura K, Tokui S, Nitta K. Posterior Precortical Vitreous Pocket in Stickler Syndrome: A Report of Two Cases. Cureus 2024; 16:e59633. [PMID: 38832188 PMCID: PMC11146095 DOI: 10.7759/cureus.59633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2024] [Indexed: 06/05/2024] Open
Abstract
Stickler syndrome is a genetic disorder characterized by collagen abnormalities leading to various ocular manifestations, such as retinal detachment. We present two cases of siblings clinically diagnosed with Stickler syndrome who exhibited retinal detachment. Case 1, a seven-year-old girl, and case 2, her 14-year-old brother, both displayed severe myopia and other clinical signs consistent with Stickler syndrome. Despite their ages, neither case showed evidence of posterior precortical vitreous pocket (PPVP) on imaging or during surgical intervention. These findings suggest a potential relationship between collagen abnormalities and PPVP dysplasia in Stickler syndrome.
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Affiliation(s)
- Tetsuhiro Nagashima
- Department of Ophthalmology, Gunma University Graduate School of Medicine, Maebashi, JPN
| | - Hideo Akiyama
- Department of Ophthalmology, Gunma University Graduate School of Medicine, Maebashi, JPN
| | - Kosuke Nakamura
- Department of Ophthalmology, Gunma University Graduate School of Medicine, Maebashi, JPN
| | - Shunsuke Tokui
- Department of Ophthalmology, Gunma University Graduate School of Medicine, Maebashi, JPN
| | - Keisuke Nitta
- Department of Ophthalmology, Gunma University Graduate School of Medicine, Maebashi, JPN
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Chen T, Fooladi M, Alabek M, Scanga H, Tripi K, Nischal K, Martel J. Recurrent Retinal Detachment in Stickler Syndrome. RESEARCH SQUARE 2024:rs.3.rs-3941698. [PMID: 38645110 PMCID: PMC11030509 DOI: 10.21203/rs.3.rs-3941698/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Objective To assess clinical factors leading to recurrent retinal detachment (RD) and characteristics of recurrence in patients with Stickler Syndrome. Methods Retrospective case series study of patients with clinical diagnosis of Stickler Syndrome who underwent rhegmatogenous RD repair. Recurrent RD after initial surgery was categorized as "early" if the recurrence was within 1 year or "late" if greater than 1 year. Results Thirty eyes from 22 patients underwent rhegmatogenous RD repair. For initial repair, 13 eyes underwent pars plana vitrectomy combined with scleral buckling (PPV/SB), 16 eyes underwent primary scleral buckling (SB), and 1 eye underwent pneumatic retinopexy (PnR). Recurrent RD occurred in 6 (46%) PPV/SB eyes (5 early and 1 late), 10 (63%) SB eyes (3 early and 7 late), and 0 (0%) PnR eyes (p = 0.61). PPV/SB was preferred for eyes presenting with total detachment (82%), giant retinal tears (100%), and proliferative vitreoretinopathy (PVR) (80%). For eyes with early recurrent RD, 6 (75%) developed PVR leading to recurrence. For eyes with late recurrent RD, 7 (87.5%) developed a new retinal break leading to recurrence, including 4 with a break posterior to the buckle indentation apex. At last follow-up, median LogMAR visual acuity was 0.68 for eyes with recurrent RD compared to 0.29 for eyes without recurrence (p = 0.27). Conclusions Early recurrent RD was mostly caused by PVR, while late recurrent RD was mostly due to new retinal breaks. Eyes with seemingly uncomplicated rhegmatogenous RD repair with primary SB remained at high risk for late re-detachment.
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Fan J, da Cruz NFS, Fan KC, Negron CI, Amescua G, Grajewski AL, Chang TC, Berrocal AM. A patient with concurrent Axenfeld-Rieger and Stickler syndromes verified by molecular genetics. Am J Ophthalmol Case Rep 2023; 32:101931. [PMID: 37822332 PMCID: PMC10562680 DOI: 10.1016/j.ajoc.2023.101931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 07/25/2023] [Accepted: 09/09/2023] [Indexed: 10/13/2023] Open
Abstract
Purpose To report a case of Axenfeld-Rieger and Stickler Syndrome in a pediatric patient. Observations A 3-month-old male was referred to the glaucoma clinic after he was noted to have elevated intraocular pressures in both eyes. His family history was notable for infantile glaucoma on his maternal side and retinal detachment on his paternal side. He was found to have anterior segment dysgenesis with iris strands, iridocorneal adhesions, and corectopia, as well as veil-like vitreous in both eyes. He required trabeculotomy, goniotomy, and multiple Baerveldt glaucoma implants in both eyes to achieve intraocular pressure control. Furthermore, the patient later developed macula-involving retinal detachments in both eyes, requiring pars plana vitrectomy with silicone oil tamponade. Genetic analysis confirmed heterozygous pathogenic variants in both the FOXC1 and COL2A1 genes, leading to the concurrent diagnoses of Axenfeld-Rieger and Stickler syndromes. Conclusions and importance This is a rare case of a patient with concurrent Axenfeld-Rieger and Stickler syndromes. The severity of pathology in both the anterior and posterior segments required a collaborative multidisciplinary approach. In the diagnostic evaluation of congenital eye diseases, if there is strong family history of atypical findings for a given diagnosis, concurrent syndromes should be considered and ruled out. A comprehensive eye genetics panel may be a useful tool in these cases.
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Affiliation(s)
- Jason Fan
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA
| | | | - Kenneth C. Fan
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA
| | - Catherin I. Negron
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA
| | - Guillermo Amescua
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA
| | - Alana L. Grajewski
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA
| | - Ta C. Chang
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA
| | - Audina M. Berrocal
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA
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Govers BM, van Huet RAC, Roosing S, Keijser S, Los LI, den Hollander AI, Klevering BJ. The genetics and disease mechanisms of rhegmatogenous retinal detachment. Prog Retin Eye Res 2023; 97:101158. [PMID: 36621380 DOI: 10.1016/j.preteyeres.2022.101158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 01/07/2023]
Abstract
Rhegmatogenous retinal detachment (RRD) is a sight threatening condition that warrants immediate surgical intervention. To date, 29 genes have been associated with monogenic disorders involving RRD. In addition, RRD can occur as a multifactorial disease through a combined effect of multiple genetic variants and non-genetic risk factors. In this review, we provide a comprehensive overview of the spectrum of hereditary disorders involving RRD. We discuss genotype-phenotype correlations of these monogenic disorders, and describe genetic variants associated with RRD through multifactorial inheritance. Furthermore, we evaluate our current understanding of the molecular disease mechanisms of RRD-associated genetic variants on collagen proteins, proteoglycan versican, and the TGF-β pathway. Finally, we review the role of genetics in patient management and prevention of RRD. We provide recommendations for genetic testing and prophylaxis of at-risk patients, and hypothesize on novel therapeutic approaches beyond surgical intervention.
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Affiliation(s)
- Birgit M Govers
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ramon A C van Huet
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Susanne Roosing
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Sander Keijser
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Leonoor I Los
- Department of Ophthalmology, University Medical Center Groningen, Groningen, the Netherlands
| | - Anneke I den Hollander
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands; AbbVie, Genomics Research Center, Cambridge, MA, USA
| | - B Jeroen Klevering
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands.
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Burdová MČ, Štěpánková J, Pourová RK, Mahelková G, Hložánek M, Kožner P, Dotřelová D. Long-term anatomical and functional outcomes of surgical treatment of retinal complications in children and adolescents with Stickler syndrome between 2004 and 2021. Graefes Arch Clin Exp Ophthalmol 2023; 261:1723-1729. [PMID: 36595051 DOI: 10.1007/s00417-022-05960-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/30/2022] [Accepted: 12/21/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Stickler syndrome (STL) is an inherited progressive connective tissue collagen disorder. STL is the most common hereditary cause of retinal complications, retinal tears, and the development of retinal detachment (RD) in childhood. The aim of the study was to evaluate the long-term anatomical and functional results of surgical treatment of retinal complications in children and adolescents affected by STL. METHODS A retrospective, single-center study was performed a cohort of children with STL who underwent retinal surgery between 2004 and 2021. RESULTS The study group consisted of nine children; the mean age at the time of the retinal tear with/without retinal detachment was 7.2 (2-10) years, and the mean follow-up period was 9.6 (5-16) years. Pathogenic variants COL2A1 (5 children) and COL11A1 (3 children) were confirmed in our cohort. In total, we operated on 13 eyes, 11 eyes with complicated RD and two eyes with multiple retinal defects, but without RD. At the end of the follow-up period, an attached retina was achieved 77% (10 eyes) with or without silicone oil tamponade: cryopexy alone was successful in one eye (10%), scleral buckling (EB) in five eyes (50%), and vitrectomy with silicone oil tamponade combined with EB in four eyes (40%). The mean number of surgeries was 2.3 per eye. The resulting best corrected visual acuity ranged from 0.03 to 0.1 in one eye, from 0.16 to 0.4 in two eyes, and from 0.5 to 1.0 in 7 eyes. CONCLUSION Repair of retinal tears with/without retinal detachment in patients with Stickler syndrome often requires multiple surgeries with combinations of cryopexy, scleral buckling, and/or vitrectomy with silicone oil tamponade. Treatment of the ocular complications arising from STL requires long-term comprehensive care.
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Affiliation(s)
- Marie Česká Burdová
- Department of Ophthalmology, Charles University, 2nd Faculty of Medicine and University Hospital in Motol, V Úvalu 84/1, 150 06, Prague, Czech Republic.
| | - Jana Štěpánková
- Department of Ophthalmology, Charles University, 2nd Faculty of Medicine and University Hospital in Motol, V Úvalu 84/1, 150 06, Prague, Czech Republic
| | - Radka Kremlíková Pourová
- Department of Biology and Medical Genetics, Charles University, 2nd Faculty of Medicine, Prague, Czech Republic
| | - Gabriela Mahelková
- Department of Ophthalmology, Charles University, 2nd Faculty of Medicine and University Hospital in Motol, V Úvalu 84/1, 150 06, Prague, Czech Republic.,Department of Physiology, Charles University, 2nd Faculty of Medicine, Prague, Czech Republic
| | - Martin Hložánek
- Department of Ophthalmology, Charles University, 2nd Faculty of Medicine and University Hospital in Motol, V Úvalu 84/1, 150 06, Prague, Czech Republic
| | - Pavel Kožner
- Department of Ophthalmology, Charles University, 2nd Faculty of Medicine and University Hospital in Motol, V Úvalu 84/1, 150 06, Prague, Czech Republic
| | - Dagmar Dotřelová
- Department of Ophthalmology, Charles University, 2nd Faculty of Medicine and University Hospital in Motol, V Úvalu 84/1, 150 06, Prague, Czech Republic
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Alexander P, Snead MP. Prevention of Blindness in Stickler Syndrome. Genes (Basel) 2022; 13:genes13071150. [PMID: 35885933 PMCID: PMC9318672 DOI: 10.3390/genes13071150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 12/04/2022] Open
Abstract
Stickler syndromes are inherited conditions caused by abnormalities of structural proteins in the eye, inner ear and cartilage. The risk of retinal detachment, particularly due to the development of giant retinal tears, is high. Stickler syndrome is the most common cause of childhood retinal detachment. Although retinal detachment surgery in the general population has a high success rate, outcomes from surgical repair in Stickler syndrome patients are notoriously poor, providing a strong argument for prophylactic intervention. Variable case selection, absence of molecular genetic sub-typing and inconsistent treatment strategies have all contributed to the historic uncertainty regarding the safety and efficacy of prophylactic treatment. This paper reviews the major published clinical studies that have evaluated different methods and strategies for prophylaxis. Based on the current body of literature, there is extremely strong evidence from cohort comparison studies demonstrating the efficacy and safety of prophylactic retinopexy to reduce, but not eliminate, the risk of retinal detachment in Stickler syndrome patients. It is vital that this body of evidence is provided to Stickler syndrome patients, to enable them to make their own fully informed choice about whether to receive prophylaxis for themselves and particularly on behalf of their affected children, to reduce the risk of retinal detachment.
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Affiliation(s)
- Philip Alexander
- NHS England Stickler Syndrome Highly Specialised Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK;
- Vitreoretinal Service, Addenbrooke’s Hospital, Hills Road, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
- Correspondence: ; Tel.: +44-(0)-1223-216106
| | - Martin P. Snead
- NHS England Stickler Syndrome Highly Specialised Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK;
- Vitreoretinal Service, Addenbrooke’s Hospital, Hills Road, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
- Vitreoretinal Research Group, John van Geest Centre for Brain Repair, University of Cambridge, Forvie Site, Cambridge CB2 0PY, UK
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Traboulsi EI. Preventing Retinal Detachment in Patients with Stickler Syndrome: The Effects of Preemptive Laser Photocoagulation. Ophthalmol Retina 2022; 6:261-262. [PMID: 35393073 DOI: 10.1016/j.oret.2021.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
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9
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Khanna S, Rodriguez SH, Blair MA, Wroblewski K, Shapiro MJ, Blair MP. Laser Prophylaxis in Patients with Stickler Syndrome. Ophthalmol Retina 2021; 6:263-267. [PMID: 34774838 DOI: 10.1016/j.oret.2021.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To evaluate the association between laser prophylaxis, retinal detachment, and visual acuity among patients with Stickler syndrome DESIGN: Retrospective comparative case series PARTICIPANTS: Patients with Stickler syndrome INTERVENTION: Patients received extended vitreous base laser (EVBL), non-protocol laser (NPL), or no laser prophylaxis of any kind MAIN OUTCOME MEASURES: The two main outcome measures that were examined were rates of retinal detachment and visual acuity in these patients. RESULTS 230 eyes of 115 patients were included in this study. 59 patients were female (51%). The median age at laser prophylaxis was 9.5 years old (6-13), and the median age of patients with RD was 11 years old (7-18). 92 of those eyes did not undergo any laser, 9 received NPL, and 129 received EVBL. Of the 129 eyes who underwent EVBL, 4 (3%) had an RD, compared to the 74 eyes (73%) which had an RD that did not receive laser treatment or had NPL (P<0.001). Eyes with EVBL had about 8 lines better vision, on average, compared to those without laser or NPL (-0.86 logMAR, 95% CI -1.1- -0.64, P< 0.001). CONCLUSIONS EVBL appears to reduce the rate of subsequent RD and is associated with better visual acuity in patients with Stickler syndrome.
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Affiliation(s)
- Saira Khanna
- Department of Ophthalmology and Visual Sciences, University of Chicago Medical Center, Chicago, IL
| | - Sarah H Rodriguez
- Department of Ophthalmology and Visual Sciences, University of Chicago Medical Center, Chicago, IL
| | | | - Kristen Wroblewski
- Department of Public Health Sciences, University of Chicago, Chicago, IL
| | | | - Michael P Blair
- Department of Ophthalmology and Visual Sciences, University of Chicago Medical Center, Chicago, IL; Retina Consultants, Ltd, Des Plaines, IL.
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Balikov DA, Jacobson A, Prasov L. Glaucoma Syndromes: Insights into Glaucoma Genetics and Pathogenesis from Monogenic Syndromic Disorders. Genes (Basel) 2021; 12:genes12091403. [PMID: 34573386 PMCID: PMC8471311 DOI: 10.3390/genes12091403] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/02/2021] [Accepted: 09/08/2021] [Indexed: 11/21/2022] Open
Abstract
Monogenic syndromic disorders frequently feature ocular manifestations, one of which is glaucoma. In many cases, glaucoma in children may go undetected, especially in those that have other severe systemic conditions that affect other parts of the eye and the body. Similarly, glaucoma may be the first presenting sign of a systemic syndrome. Awareness of syndromes associated with glaucoma is thus critical both for medical geneticists and ophthalmologists. In this review, we highlight six categories of disorders that feature glaucoma and other ocular or systemic manifestations: anterior segment dysgenesis syndromes, aniridia, metabolic disorders, collagen/vascular disorders, immunogenetic disorders, and nanophthalmos. The genetics, ocular and systemic features, and current and future treatment strategies are discussed. Findings from rare diseases also uncover important genes and pathways that may be involved in more common forms of glaucoma, and potential novel therapeutic strategies to target these pathways.
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Affiliation(s)
- Daniel A. Balikov
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI 48105, USA; (D.A.B.); (A.J.)
| | - Adam Jacobson
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI 48105, USA; (D.A.B.); (A.J.)
| | - Lev Prasov
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI 48105, USA; (D.A.B.); (A.J.)
- Department of Human Genetics, University of Michigan, Ann Arbor, MI 48109, USA
- Correspondence:
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Wu H, Che S, Li S, Cheng Y, Xiao J, Liu Z. Case report of the first molecular diagnosis of Stickler syndrome with a pathogenic COL2A1 variant in a Mongolia family. Mol Genet Genomic Med 2021; 9:e1781. [PMID: 34405586 PMCID: PMC8580100 DOI: 10.1002/mgg3.1781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/20/2021] [Accepted: 07/08/2021] [Indexed: 12/20/2022] Open
Abstract
Background Stickler syndrome is a group of connective tissue disorders that can affect eye (myopia, cataract, and retinal detachment), skeleton (spondyloepiphyseal dysplasia and precocious arthritis), craniofacies (midfacial under development and cleft palate), and inner ear (conductive and sensorineural); with the degree of symptoms varying among patients. Mutations in the COL2A1, COL11A1, COL11A2, COL9A1, COL9A2, and COL9A3 procollagen genes cause Stickler syndrome. Case presentation A 16‐year‐old Mongolian girl approached our clinics with retinal detachment. The proband had vitreous degeneration in both eyes, rhegmatogenous retinal detachment in her right eye, a large area of retina degeneration in her left eye, and coupled with severe myopia. No obvious hearing disorder was found, no abnormalities in bones and joints, and her communication and learning capability were also normal. Further clinical examination showed that the patient's other five family members across three generations had vitreous and retina degenerations. Exome sequencing showed a heterozygous splicing variant in COL2A1 in all patients. Conclusions In this case report, a pathogenic splicing variant in the COL2A1 gene was identified in a Mongolian family affected with Stickler syndrome type I by exome sequencing. This heterozygous splicing variant in COL2A1 (NM_001844.4:C.2518‐1G>A) that may impair splicing, which was suggested by in silico prediction. Next‐generation sequencing is helpful for the differential diagnosis of this clinically variable and genetically heterogeneous disorder.
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Affiliation(s)
- Hong Wu
- Eye Center of the Second Hospital, Jilin University, Changchun, China
| | - Songtian Che
- Eye Center of the Second Hospital, Jilin University, Changchun, China
| | - Shuchun Li
- Department of Pain, the Second Hospital of Jilin University, Changchun, China
| | - Yan Cheng
- Eye Center of the Second Hospital, Jilin University, Changchun, China
| | - Jun Xiao
- Eye Center of the Second Hospital, Jilin University, Changchun, China
| | - Zaoxia Liu
- Eye Center of the Second Hospital, Jilin University, Changchun, China
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12
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A Practical Approach to Pediatric Retinal Surgery. Int Ophthalmol Clin 2021; 60:115-134. [PMID: 32576728 DOI: 10.1097/iio.0000000000000321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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13
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Morris RE, Parma ES, Robin NH, Sapp MR, Oltmanns MH, West MR, Fletcher DC, Schuchard RA, Kuhn F. Stickler Syndrome (SS): Laser Prophylaxis for Retinal Detachment (Modified Ora Secunda Cerclage, OSC/SS). Clin Ophthalmol 2021; 15:19-29. [PMID: 33447008 PMCID: PMC7802593 DOI: 10.2147/opth.s284441] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/11/2020] [Indexed: 12/03/2022] Open
Abstract
Purpose To introduce a novel technique of encircling laser prophylaxis (ora secunda cerclage Stickler syndrome, OSC/SS) to prevent rhegmatogenous retinal detachment (RRD) in Stickler syndrome eyes. Patients and Methods After first eye RRD at age 50 and at age 18, respectively, a 53-year-old father and his 22-year-old son with type 2 SS (STL2) gave informed consent and underwent OSC/SS prophylaxis, performed in each fellow eye. A 26-year-old STL2 daughter then suffered first eye retinal detachment and similarly chose fellow eye OSC/SS prophylaxis. A second son, 28 years of age with STL2, chose OSC/SS prophylaxis in both eyes. Results The three OSC/SS treated fellow eyes have gone 12 years, 11 years, and 8 years without RRD. STL1 and less common STL2 eyes are known to have a similar rate of RRD, and 80% of STL1 fellow eyes develop RRD at a median of 4 years in the absence of prophylaxis. Moreover, five of six (83%) known STL2 family members suffered RRD, only the STL2 son with bilateral OSC/SS remaining bilaterally attached. All five OSC/SS treated eyes (average 8.7 years post-prophylaxis) retained preoperative visual acuity of 20/20 to 20/30, with an average, asymptomatic reduction of meridional field in each eye to 50 degrees. In contrast, in the three eyes having suffered RRD prior to presentation, visual acuity ranged from 20/125 to 8/200 and average meridional field was 29 degrees. Conclusion Encircling grid laser (OSC) modified in Stickler eyes to encompass the ora serrata and extend posteriorly to and between the vortex vein ampullae (OSC/SS) is a reasonable RRD prophylaxis option to offer STL1 and STL2 patients as an alternative to no treatment or less effective prophylaxis. Because of rarity and severity, the ultimate proof of safety and efficacy will likely come not from randomized trials, but from a non-randomized, prospective, cohort comparison study of such individual efforts. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/AzHz4xYUV_w
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Affiliation(s)
- Robert E Morris
- Retina Specialists of Alabama, Birmingham, AL, USA.,Helen Keller Foundation for Research and Education, Birmingham, AL, USA.,University of Alabama at Birmingham (UAB), Department of Ophthalmology, Birmingham, AL, USA.,UAB Callahan Eye Hospital, Birmingham, AL, USA
| | | | | | - Mathew R Sapp
- Retina Specialists of Alabama, Birmingham, AL, USA.,Helen Keller Foundation for Research and Education, Birmingham, AL, USA.,University of Alabama at Birmingham (UAB), Department of Ophthalmology, Birmingham, AL, USA.,UAB Callahan Eye Hospital, Birmingham, AL, USA
| | - Matthew H Oltmanns
- Retina Specialists of Alabama, Birmingham, AL, USA.,Helen Keller Foundation for Research and Education, Birmingham, AL, USA.,University of Alabama at Birmingham (UAB), Department of Ophthalmology, Birmingham, AL, USA.,UAB Callahan Eye Hospital, Birmingham, AL, USA
| | - Matthew R West
- Retina Specialists of Alabama, Birmingham, AL, USA.,Helen Keller Foundation for Research and Education, Birmingham, AL, USA.,University of Alabama at Birmingham (UAB), Department of Ophthalmology, Birmingham, AL, USA.,UAB Callahan Eye Hospital, Birmingham, AL, USA
| | - Donald C Fletcher
- University of Kansas Medical Center, Department of Ophthalmology and KU Eye Center, Kansas City, KS, USA.,Retina Consultants of Southwest Florida, Ft. Myers, FL, USA
| | | | - Ferenc Kuhn
- Helen Keller Foundation for Research and Education, Birmingham, AL, USA.,Milos Eye Hospital, Belgrade, Serbia.,University of Pécs, Department of Ophthalmology, Pécs, Hungary
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14
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Lee AC, Greaves GH, Rosenblatt BJ, Deramo VA, Shakin EP, Fastenberg DM, Ferrone PJ. Long-Term Follow-Up of Retinal Detachment Repair in Patients With Stickler Syndrome. Ophthalmic Surg Lasers Imaging Retina 2020; 51:612-616. [PMID: 33231693 DOI: 10.3928/23258160-20201104-02] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/09/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To report the long-term anatomic and visual outcomes of patients with Stickler syndrome undergoing retinal detachment (RD) surgery. PATIENTS AND METHODS Retrospective, interventional, consecutive case series of patients with Stickler syndrome undergoing RD repair from 1999 to 2017 at the Long Island Vitreoretinal Consultants, New York. Retinal attachment status and visual acuity (VA) at 1-year and last follow-up were assessed. RESULTS Successful reattachment was achieved in 28 of 29 eyes (97%) with an average of 2.3 surgeries (including silicone oil removal surgeries). Redetachment after the first surgery occurred in 13 eyes (45%). Mean Snellen VA at initial presentation, 1-year follow-up, and last follow-up were 20/289, 20/118 (P = .012), and 20/103 (P = .022), respectively. CONCLUSIONS Anatomic success can be achieved in most eyes. However, redetachments are common, and multiple surgeries are often required. Reasonable visual recovery is possible in many eyes. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:612-616.].
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15
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Wang D, Gao F, Hu F, Li J, Zhang S, Xu P, Chang Q, Jiang R, Wu J. Next-generation sequencing-aided precise diagnosis of Stickler syndrome type I. Acta Ophthalmol 2020; 98:e440-e446. [PMID: 31736238 DOI: 10.1111/aos.14302] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 10/15/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE To explore an early, rapid and precise diagnosis of Stickler syndrome type I (STL1) and to enrich the spectrum of COL2A1 mutations in the Chinese population, which is poorly studied at present. METHODS In the current study, we analysed 115 patients with high myopia by next-generation sequencing and identified five STL1 patients from four unrelated Chinese families. The clinical features of all patients were reviewed in detail. RESULTS Four variants of COL2A1 were identified, including two novel variants (c.1435delG and c.184delG) and two previously reported variants (c.1221+1G>A and c.1030C>T). Three variants caused premature termination codons which were common in STL1. In addition, we proposed a new diagnostic tactic to improve early diagnostics of STL1 in patients. CONCLUSION In this study, our findings expanded the spectrum of COL2A1 mutations with two novel variants and provided a new diagnostic tactic for reference, which was of great significance. Precise diagnosis on the basis of clinical manifestations and genetic testing will become the gold standard to diagnose inherited ocular disorders or syndromes in the future.
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Affiliation(s)
- Dan‐Dan Wang
- Eye Institute Eye and ENT Hospital Shanghai Medical College Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
| | - Feng‐Juan Gao
- Eye Institute Eye and ENT Hospital Shanghai Medical College Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
| | - Fang‐Yuan Hu
- Eye Institute Eye and ENT Hospital Shanghai Medical College Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
| | | | - Sheng‐Hai Zhang
- Eye Institute Eye and ENT Hospital Shanghai Medical College Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
| | - Ping Xu
- Eye Institute Eye and ENT Hospital Shanghai Medical College Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
| | - Qing Chang
- Eye Institute Eye and ENT Hospital Shanghai Medical College Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
| | - Rui Jiang
- Eye Institute Eye and ENT Hospital Shanghai Medical College Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
| | - Ji‐Hong Wu
- Eye Institute Eye and ENT Hospital Shanghai Medical College Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
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16
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Boysen KB, La Cour M, Kessel L. Ocular complications and prophylactic strategies in Stickler syndrome: a systematic literature review. Ophthalmic Genet 2020; 41:223-234. [PMID: 32316871 DOI: 10.1080/13816810.2020.1747092] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Stickler syndrome is a collagenopathy caused by mutations in the genes COL2A1 (STL1) or COL11A1 (STL2). Affected patients manifest ocular, auditory, articular, and craniofacial manifestations in varying degrees. Ocular symptoms include myopia, retinal detachment, cataract, and glaucoma. The aim of this systematic review was to evaluate the prevalence of ocular manifestations and the outcome of prophylactic treatment on reducing the risk of retinal detachment. METHOD A systematic literature search was performed in the PubMed database. Information on the cross-study prevalence of myopia, retinal detachment, cataract, glaucoma, visual impairment, severity and age of onset of myopia and retinal detachments. Studies that reported on the outcome of prophylactic treatment against a control group were explored. RESULTS 37 articles with 2324 individual patients were included. Myopia was found in 83% of patients, mostly of a moderate to severe degree. Retinal detachments occurred in 45% of patients. Generally, the first detachment occurred in the second decade of life in STL1 patients and later in STL2. Cataracts were more common in STL2 patients, 59% versus 36% in STL1. Glaucoma (10%) and visual impairment (blind: 6%; vision loss in one eye: 10%) were rare. Three studies reported on the effect of prophylactic treatment being protective. CONCLUSION Ocular manifestations are common in Stickler patients, but the comparison between studies was difficult because of inconsistencies in diagnostic and inclusion criteria by different studies. Sight-threatening complications such as retinal detachments are common but although prophylactic therapy is reported to be effective in retrospective studies, evidence from randomized trials is missing.
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Affiliation(s)
| | - Morten La Cour
- Department of Ophtalmology, Rigshospitalet , Glostrup, Denmark.,Department of Clinical Medicine, University of Copenhagen , Copenhagen, Denmark
| | - Line Kessel
- Department of Ophtalmology, Rigshospitalet , Glostrup, Denmark.,Department of Clinical Medicine, University of Copenhagen , Copenhagen, Denmark
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17
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Rhegmatogenous Retinal Detachment in Nonsyndromic High Myopia Associated with Recessive Mutations in LRPAP1. ACTA ACUST UNITED AC 2020; 4:77-83. [DOI: 10.1016/j.oret.2019.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 08/13/2019] [Accepted: 08/13/2019] [Indexed: 01/19/2023]
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18
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Abstract
PURPOSE OF REVIEW The literature regarding prophylactic treatment of rhegmatogenous retinal detachment in Stickler syndrome remains controversial. We review major published clinical studies and offer a critical analysis of this subject. SUMMARY Stickler syndrome is a systemic collagenopathy affecting multiple organ systems including the eye, ear, and skeleton. Stickler syndrome is probably the most common cause of genetically determined pediatric rhegmatogenous retinal detachment. Congenital developmental anomalies constitute over half rhegmatogenous detachments (RRD) in patients less than 10 years. The majority are caused by hereditary vitreoretinopathies associated with Stickler syndrome. Sixty percent of patients with Stickler syndrome develop RRD's over their lifetime with possible severe visual loss and subsequent lifelong morbidity. In view of these complications, some have emphasized the importance of prophylactic laser treatment to the retina of patients with Stickler syndrome to reduce the occurrence of and/or prevent future rhegmatogenous retinal detachment, but there appears to be insufficient data to support the absolute benefit of such prophylactic treatment. Guidelines regarding the age at prophylactic treatment as well as type and frequency of intervention are scarce and would benefit from additional clinical investigations.
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19
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Savarirayan R, Bompadre V, Bober MB, Cho TJ, Goldberg MJ, Hoover-Fong J, Irving M, Kamps SE, Mackenzie WG, Raggio C, Spencer SS, White KK. Best practice guidelines regarding diagnosis and management of patients with type II collagen disorders. Genet Med 2019; 21:2070-2080. [PMID: 30696995 DOI: 10.1038/s41436-019-0446-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 01/16/2019] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Skeletal dysplasias comprise a heterogeneous group of inherited disorders of development, growth, and maintenance of the human skeleton. Because of their relative rarity and wide phenotypic variability, patients should be accurately identified, uniformly assessed, and managed by clinicians who are aware of their potential complications and possess the knowledge and resources to treat them effectively. This study presents expert guidelines developed to improve the diagnosis and management of patients with type II collagen skeletal disorders to optimize clinical outcomes. METHODS A panel of 11 multidisciplinary international experts in the field of skeletal dysplasia participated in a Delphi process, which comprised analysis of a thorough literature review with subsequent generation of 26 diagnosis and care recommendations, followed by two rounds of anonymous voting with an intervening face-to-face meeting. Those recommendations with more than 80% agreement were considered as consensual. RESULTS After the first voting round, consensus was reached to support 12 of 26 (46%) statements. After the panel discussion, the group reached consensus on 22 of 24 revised statements (92%). CONCLUSIONS Consensus-based, expert best practice guidelines developed as a standard of care to assist accurate diagnosis, minimize associated health risks, and improve clinical outcomes for patients with type II collagen skeletal dysplasias.
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Affiliation(s)
- Ravi Savarirayan
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, University of Melbourne, VIC, Parkville, Australia.
| | - Viviana Bompadre
- Department of Orthopedics and Sports Medicine, Seattle Children's Hospital, Seattle, WA, USA
| | - Michael B Bober
- Division of Genetics, Nemours A.I. duPont Hospital for Children, Wilmington, DE, USA
| | - Tae-Joon Cho
- Division of Pediatric Orthopaedics, Seoul National University Children's Hospital, Seoul, South Korea
| | - Michael J Goldberg
- Department of Orthopedics and Sports Medicine, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | - Julie Hoover-Fong
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Melita Irving
- Department of Clinical Genetics, Guy's and St Thomas NHS, London, UK
| | - Shawn E Kamps
- Department of Radiology, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | - William G Mackenzie
- Department of Orthopedic Surgery, Nemours A.I. duPont Hospital for Children, Wilmington, DE, USA
| | - Cathleen Raggio
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Samantha S Spencer
- Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Klane K White
- Department of Orthopedics and Sports Medicine, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
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20
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Gan NY, Lam WC. Retinal detachments in the pediatric population. Taiwan J Ophthalmol 2018; 8:222-236. [PMID: 30637194 PMCID: PMC6302562 DOI: 10.4103/tjo.tjo_104_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 10/17/2018] [Indexed: 11/10/2022] Open
Abstract
In this review, we present a concise summary of the more commonly seen types of retinal detachments (RDs) that one can encounter in pediatric patients. A spectrum of diseases from rhegmatogenous RD in Stickler syndrome, Marfan syndrome, and choroidal coloboma to exudative RD in Coats disease, to tractional RD in persistent fetal vasculature, and combined RDs in familial exudative vitreoretinopathy are described with the management pearls for each.
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Affiliation(s)
- Nicola Yi'an Gan
- Department of Ophthalmology, Tan Tock Seng Hospital, National Healthcare Group, Singapore
| | - Wai-Ching Lam
- Department of Ophthalmology, The University of Hong Kong, Hong Kong
- Department of Ophthalmology and Vision Science, University of Toronto, Toronto, Ontario, Canada
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21
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Wubben TJ, Branham KH, Besirli CG, Bohnsack BL. Retinal detachment and infantile-onset glaucoma in Stickler syndrome associated with known and novel COL2A1 mutations. Ophthalmic Genet 2018; 39:615-618. [DOI: 10.1080/13816810.2018.1509355] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Thomas J. Wubben
- Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Kari H. Branham
- Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Cagri G. Besirli
- Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Brenda L. Bohnsack
- Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
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22
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Öztürk C, Sarıgül Sezenöz A, Yılmaz G, Akkoyun İ. Bilateral Asymmetric Rhegmatogenous Retinal Detachment in a Patient with Stickler Syndrome. Turk J Ophthalmol 2018; 48:95-98. [PMID: 29755825 PMCID: PMC5938485 DOI: 10.4274/tjo.60430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 11/29/2017] [Indexed: 12/01/2022] Open
Abstract
Here we present the long-term anatomical and visual outcomes of bilateral asymmetric rhegmatogenous retinal detachment repair in a patient with Stickler syndrome. A 17-year-old girl presented with decreased visual acuity in both eyes for more than one year. Her best-corrected visual acuity (BCVA) was 0.1 in the right eye and 0.05 in the left eye. Slit-lamp anterior segment examination revealed subcapsular cataract in both eyes. Fundus examination showed bilateral rhegmatogenous retinal detachment, chronic retinal detachment accompanied by multiple retinal holes, tears and membranous fibrillary vitreous in the peripheral retina. Grade C2 proliferative vitreoretinopathy was observed in the left eye. Scleral buckling surgery was performed initially for both eyes. After the primary surgical procedure, retinal reattachment was achieved in the right eye and the left eye underwent phacoemulsification, intraocular lens implantation, pars plana vitrectomy (PPV), and silicone oil injection. After these surgical procedures retinal reattachment was achieved in the left eye. Silicone oil removal was performed six months after PPV surgery. After surgical treatment, BCVA was 0.6 in the right eye at the end of the 3.5-year follow-up period. After silicone oil removal, BCVA reached 0.2 in the left eye after 36 months of follow-up and retinal reattachment was achieved in both eyes. Scleral buckling surgery and PPV are effective and confidential methods for the treatment of chronic retinal detachment cases in Stickler syndrome.
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Affiliation(s)
- Caner Öztürk
- Başkent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
| | | | - Gürsel Yılmaz
- Başkent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
| | - İmren Akkoyun
- Başkent University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
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23
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Kimura D, Sato T, Oosuka S, Kohmoto R, Fukumoto M, Mimura M, Tajiri K, Kobayashi T, Kida T, Ikeda T. Case Report of a Family Affected by Stickler Syndrome in Which Rhegmatogenous Retinal Detachment Occurred in Five Eyes of Three Siblings. Case Rep Ophthalmol 2018; 9:1-8. [PMID: 29643775 PMCID: PMC5892342 DOI: 10.1159/000485551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 11/22/2017] [Indexed: 11/19/2022] Open
Abstract
Purpose Stickler syndrome is an autosomal dominant inherited disorder that is well known to be highly associated with the development of rhegmatogenous retinal detachment. In this study, we report the case of a family affected by Stickler syndrome in which rhegmatogenous retinal detachment developed in 5 eyes of 3 siblings. Case Series For treatment, we performed vitreous surgery on 1 eye of the eldest son, and bilateral scleral buckling surgery on the 2 younger children. A good postoperative outcome was obtained on the 4 eyes that underwent scleral buckling surgery, yet the prognosis was poor on the 1 eye that underwent vitrectomy due to redetachment of the retina and corneal complication. Since vitreous surgery was quite difficult due to strong vitreoretinal adhesion, we created an artificial posterior vitreous detachment via the bimanual technique combined with encircling. For the scleral buckling surgery, broad scleral extrusion was needed to seal multiple retinal breaks. Conclusions The findings of this study showed a high prevalence of rhegmatogenous retinal detachment in a single family with Stickler syndrome. In these cases, scleral buckling surgery was effective for treating the detached retina, and some prophylactic treatment, such as laser photocoagulation to prevent the occurrence of rhegmatogenous retinal detachment, should be considered for such cases in the future.
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Affiliation(s)
- Daisaku Kimura
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan.,Department of Ophthalmology, Takatsuki Red Cross Hospital, Takatsuki-City, Japan
| | - Takaki Sato
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Shou Oosuka
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Ryohsuke Kohmoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Masanori Fukumoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Masashi Mimura
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Kensuke Tajiri
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | | | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
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24
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Shapiro MJ, Blair MP, Solinski MA, Zhang DL, Jabbehdari S. The importance of early diagnosis of Stickler syndrome: Finding opportunities for preventing blindness. Taiwan J Ophthalmol 2018; 8:189-195. [PMID: 30637190 PMCID: PMC6302565 DOI: 10.4103/tjo.tjo_97_18] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Stickler Syndrome (SS) is a significant cause of retinal blindness in children. The immediate cause of blindness is retina detachment from giant retinal tear (GRT). It is frequently diagnosed late and the giant retinal tear (GRT) may be complicated by high-grade proliferative vitreoretinopathy (PVR). The surgery for the combined GRT with PVR has limited structural results and the vision mainly remains impaired. In order to improve the visual outcomes, we propose an organized program oriented toward early diagnosis and surveillance. Adding an effective prophylaxis may maintain normal vision in a high percent of patients. The critical diagnostic moments for this program are prenatal and at birth. The tools include a directed history, general physical exam and advanced ophthalmologic exam looking for the particular features of SS. Some features may need advanced skills transfer, because they are not reliably taught in retina fellowships. Much of this program requires a partnership with obstetricians, pediatricians, neonatologists and geneticists. Finally, we review the evidence regarding prophylaxis and discuss our approach in the absence of guidance from a randomized clinical trial.
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Affiliation(s)
- Michael J Shapiro
- Retina Consultants Ltd., Des Plaines, Illinois, USA.,Department of Ophthalmology and Visual Science, University of Illinois, Chicago, Illinois, USA
| | - Michael P Blair
- Retina Consultants Ltd., Des Plaines, Illinois, USA.,Department of Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois, USA
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25
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Reddy DN, Yonekawa Y, Thomas BJ, Nudleman ED, Williams GA. Long-term surgical outcomes of retinal detachment in patients with Stickler syndrome. Clin Ophthalmol 2016; 10:1531-4. [PMID: 27574392 PMCID: PMC4993392 DOI: 10.2147/opth.s111526] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose The aim of the study was to present the long-term anatomical and visual outcomes of retinal detachment repair in patients with Stickler syndrome. Patients and methods This study is a retrospective, interventional, consecutive case series of patients with Stickler syndrome undergoing retinal reattachment surgery from 2009 to 2014 at the Associated Retinal Consultants, William Beaumont Hospital. Results Sixteen eyes from 13 patients were identified. Patients underwent a mean of 3.1 surgical interventions (range: 1–13) with a mean postoperative follow-up of 94 months (range: 5–313 months). Twelve eyes (75%) developed proliferative vitreoretinopathy. Retinal reattachment was achieved in 100% of eyes, with ten eyes (63%) requiring silicone oil tamponade at final follow-up. Mean preoperative visual acuity (VA) was 20/914, which improved to 20/796 at final follow-up (P=0.81). There was a significant correlation between presenting and final VA (P<0.001), and patients with poorer presenting VA were more likely to require silicone oil tamponade at final follow-up (P=0.04). Conclusion Repair of retinal detachment in patients with Stickler syndrome often requires multiple surgeries, and visual outcomes are variable. Presenting VA is significantly predictive of long-term VA outcomes.
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Affiliation(s)
- Devasis N Reddy
- Oakland University William Beaumont School of Medicine, Rochester, MI
| | - Yoshihiro Yonekawa
- Oakland University William Beaumont School of Medicine, Rochester, MI; Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, MI; Massachusetts Eye and Ear Infirmary, Boston, MA; Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Benjamin J Thomas
- Oakland University William Beaumont School of Medicine, Rochester, MI; Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, MI; Florida Retina Institute, Jacksonville, FL
| | - Eric D Nudleman
- Shiley Eye Institute, University of California San Diego School of Medicine, San Diego, CA, USA
| | - George A Williams
- Oakland University William Beaumont School of Medicine, Rochester, MI; Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, MI
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26
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Alshahrani ST, Ghazi NG, Al-Rashaed S. Rhegmatogenous retinal detachments associated to Stickler syndrome in a tertiary eye care center in Saudi Arabia. Clin Ophthalmol 2015; 10:1-6. [PMID: 26730175 PMCID: PMC4697790 DOI: 10.2147/opth.s91444] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate the clinical findings and outcomes of rhegmatogenous retinal detachment (RRD) in Stickler syndrome on affected and fellow eyes that underwent prophylactic retinopexy. Patients and methods Chart review of 70 eyes (62 patients). Incidence of RRD, postoperative visual acuity, and risk factors were evaluated. Results Twenty-two patients (35%) had RRD in the fellow eye, 37% of the eyes had cataract, 93% had macular detachment, 50% had proliferative vitreoretinopathy, and 41% had posterior vitreous detachment. Success rates were: 60% of patients after scleral buckling; 57.1% after pars plana vitrectomy; and 75% after combined scleral buckling and pars plana vitrectomy. Sixty-one (93.8%) of patients had successful surgery (including second surgery). Silicone oil tamponade was significantly associated with final anatomic outcome, with a protective odds ratio of 0.11 (P=0.027). Visual acuity improved in 54% of eyes and decreased in 5%. Statistically significant associations were present for eyes with final visual acuity ≥20/200, and total retinal detachment (P<0.001); preoperative cataract (P=0.023); and proliferative vitreoretinopathy (P<0.001). RRD developed in 16/44 eyes despite laser prophylaxis. Conclusion Prophylactic retinopexy was not beneficial for Stickler syndrome patients. Success of primary surgery for RRD remains low. The primary surgery should be vitrectomy combined with scleral buckling and silicone oil tamponade.
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Affiliation(s)
- Saeed T Alshahrani
- Ophthalmology Department, King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia
| | - Nicola G Ghazi
- Vitreoretinal Department, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia
| | - Saba Al-Rashaed
- Vitreoretinal Department, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia
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27
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Suemori S, Sawada A, Shiraki I, Mochizuki K. Stickler syndrome type 1 accompanied by membranous vitreous anomaly in two Japanese sisters. Semin Ophthalmol 2013; 29:45-7. [PMID: 24164106 DOI: 10.3109/13506129.2013.839805] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We report two cases of Stickler syndrome type 1 accompanied by a membranous vitreous anomaly in two Japanese sisters. A nine-year-old girl was referred to us for a rhegmatogeneous retinal detachment in her right eye. She had moderate myopia and a membranous vitreous anomaly in both eyes. She also had micrognathia and a saddle nose, leading to a diagnosis of Stickler syndrome type 1. The retinal detachment persisted even after scleral buckling surgery; however, the retina was reattached after 25-gauge microincision vitreous surgery 11 days later. Her seven-year-old sister had been diagnosed with Pierre Robin sequence due to micrognathia, cleft palate, and saddle nose. She was myopic by about -9.0 diopters with a membranous vitreous anomaly in both eyes and circumferential perivascular retinal degeneration in the right eye. Genetic analyses showed that both sisters and their mother carried the same mutation in the COL2A1 gene. The findings in these sisters indicate that retinal detachment is associated with Stickler syndrome type 1. Micro-incison vitreous surgery might be effective for rhegmatogeneous retinal detachment with high vitreous liquefaction.
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Affiliation(s)
- Shinsuke Suemori
- Department of Ophthalmology, Gifu University Graduate School of Medicine , Gifu-shi , Japan
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28
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Al-Zaaidi S, Al-Rashaed S, Al-Harthi E, Al-Kahtani E, Abu El-Asrar AM. Rhegmatogenous retinal detachment in children 16 years of age or younger. Clin Ophthalmol 2013; 7:1001-14. [PMID: 23818752 PMCID: PMC3693844 DOI: 10.2147/opth.s40056] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To study the anatomical and visual outcomes and prognostic factors that may predict the outcomes of rhegmatogenous retinal detachment (RRD) in children. METHODS A retrospective chart review was performed for patients 16 years of age or younger who underwent retinal reattachment surgery for RRD at the King Abdulaziz University Hospital from 1996 to 2005 and the King Khalid Eye Specialist Hospital from 2002 to 2006, Riyadh, Saudi Arabia. Good visual outcome was defined as ≥20/200. The association between two categorical variables was evaluated with the Chi-squared test or the exact test, as appropriate. Predictors for RRD and good final visual acuity were identified by conducting stepwise logistic regression analysis. P < 0.05 was statistically significant. RESULTS The study population comprised 148 patients (166 eyes). There were 104 (70%) males and 44 (30%) females. Mean age at presentation was 8.33 ± 3.26 years (range 1.5-16 years). The retina was reattached after one surgical procedure in 106 (63.8%) eyes and reattached in 130 (78.3%) eyes after multiple surgeries. Factors predicting recurrence after the first surgery were myopia (P = 0.028), proliferative vitreoretinopathy (PVR) at presentation (P = 0.024), and total retinal detachment (P = 0.032). Good final visual outcome was achieved in 60 (44.4%) eyes. Predictors of good visual acuity were: good visual acuity at presentation (P < 0.001); absence of PVR at presentation (P < 0.001); one quadrant of retinal detachment (P = 0.0024); macula on (P = 0.0107); absence of primary repair of a ruptured globe (P = 0.0059); no pars plana vitrectomy (PPV) (P = 0.0123); clear phakic lens at follow-up (P < 0.001); absence of postoperative complications (P < 0.001); absence of recurrence of RRD (P < 0.001); and absence of epiretinal membrane (P = 0.0088). Logistic regression analysis indicated that recurrence of RRD was associated with myopia and previous congenital cataract surgery; good final visual outcome was associated with macula on detachment and poor visual outcome was associated with recurrence of RRD and occurrence of postoperative complications and previous repair of a ruptured globe. CONCLUSION RRD in children is usually associated with a predisposing factor, a high rate of PVR, and total retinal detachment. Despite late diagnosis and the presence of PVR, favorable anatomical and visual outcomes can be achieved.
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Meier P, Wiedemann P. Surgery for Pediatric Vitreoretinal Disorders. Retina 2013. [DOI: 10.1016/b978-1-4557-0737-9.00115-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Couchouron T, Masson C. Early-onset progressive osteoarthritis with hereditary progressive ophtalmopathy or Stickler syndrome. Joint Bone Spine 2011; 78:45-9. [DOI: 10.1016/j.jbspin.2010.03.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2010] [Indexed: 11/27/2022]
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