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Yuzbasıoglu S, Icoz M, Yaman D, Yulek F. Relationship between retraction and refraction values in patients with Duane's retraction syndrome. J Fr Ophtalmol 2024; 47:104214. [PMID: 38788253 DOI: 10.1016/j.jfo.2024.104214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/24/2023] [Accepted: 12/31/2023] [Indexed: 05/26/2024]
Abstract
PURPOSE To evaluate refractive findings in patients with unilateral Duane's retraction syndrome (DRS). METHODS This retrospective study included 40 patients followed for unilateral DRS. Detailed ophthalmological examinations of the patients were performed. The spherical and cylindrical refractive error, spherical equivalent, and type of refractive error in the eyes with DRS and the fellow eyes were determined. The patients were divided into three subgroups according to their type of DRS. The refractive properties of the eyes with DRS were examined in subgroup analyses. Eye movement limitation was graded between +1 and +4 and compared according to the refractive error type. RESULTS The mean age of the patients was 16.8±12.6 (range, 1-60) years. Of the eyes with DRS, 11 (27.5%) were emmetropic, four (10%) were hyperopic, two (5%) were myopic, 11 (27.5%) were myopic astigmatic, and 12 (30.0%) were hyperopic astigmatic. There was no statistically significant difference between the eyes with DRS and fellow eyes in relation to the spherical or cylindrical refractive errors or spherical equivalent (P>0.05 for all). The refraction values for the patients with type 1, type 2 and type 3 DRS were similar between groups (P>0.05). No statistically significant difference was detected in the degree of eye movement limitation according to refractive status (P>0.05). CONCLUSION In patients with unilateral DRS, there was no significant difference between the affected eyes and the fellow eyes in terms of refractive error values or types. Refractive status did not significantly differ according to the degree of eye movement limitation. Therefore, although extraocular muscles are affected by DRS, there may not be any significant refractive changes.
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Affiliation(s)
- S Yuzbasıoglu
- Department of Ophthalmology, Ophthalmology Clinic, Yıldırım Beyazıt University Faculty of Medicine, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - M Icoz
- Department of Ophthalmology, Yozgat City Hospital, Yozgat, Turkey.
| | - D Yaman
- Department of Ophthalmology, Yüksek İhtisas Hospital, Kırıkkale, Turkey
| | - F Yulek
- Private Physician, Ankara, Turkey
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López Gutierrez D, Luna López I, Medina Mata BA, Moreno Castro S, García Rangel FY. Physiopathologic Bases of Moebius Syndrome: Combining Genetic, Vascular, and Teratogenic Theories. Pediatr Neurol 2024; 153:1-10. [PMID: 38306744 DOI: 10.1016/j.pediatrneurol.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/16/2023] [Accepted: 01/05/2024] [Indexed: 02/04/2024]
Abstract
Moebius syndrome (MBS) is a congenital cranial dysinnervation disorder (CCDD) characterized by a bilateral palsy of abducens and facial cranial nerves, which may coexist with other cranial nerves palsies, mostly those found in the dorsal pons and medulla oblongata. MBS is considered a "rare" disease, occurring in only 1:50,000 to 1:500,000 live births, with no gender predominance. Three independent theories have been described to define its etiology: the vascular theory, which talks about a transient blood flow disruption; the genetic theory, which takes place due to mutations related to the facial motor nucleus neurodevelopment; and last, the teratogenic theory, associated with the consumption of agents such as misoprostol during the first trimester of pregnancy. Since the literature has suggested the existence of these theories independently, this review proposes establishing a theory by matching the MBS molecular bases. This review aims to associate the three etiopathogenic theories at a molecular level, thus submitting a combined postulation. MBS is most likely an underdiagnosed disease due to its low prevalence and challenging diagnosis. Researching other elements that may play a key role in the pathogenesis is essential. It is common to assume the difficulty that patients with MBS have in leading an everyday social life. Research by means of PubMed and Google Scholar databases was carried out, same in which 94 articles were collected by using keywords with the likes of "Moebius syndrome," "PLXND1 mutations," "REV3L mutations," "vascular disruption AND teratogens," and "congenital facial nerve palsy." No exclusion criteria were applied.
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Affiliation(s)
| | - Ingrid Luna López
- Facultad Mexicana de Medicina, Universidad La Salle, Mexico City, Mexico
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Pompilio S, Scuttari M, Zerbetto K, Andreis ME, Tirrito F. First case of presumed trigemino-oculomotor synkinesis in a dog. Vet Ophthalmol 2024. [PMID: 38329273 DOI: 10.1111/vop.13191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/29/2023] [Accepted: 01/22/2024] [Indexed: 02/09/2024]
Abstract
An 11-year old, intact male Border Collie was referred with a history of subacute and progressive left eye exophthalmos and mydriasis associated with reduced pupillary light reflex, ventrolateral strabismus, and absence of physiologic nystagmus in the left eye. Neuroanatomical localization was consistent with a left oculomotor neuropathy, involving the general somatic and visceral parasympathetic efferent components. Computed tomography and magnetic resonance imaging of the head were performed. Imaging findings were consistent with an infectious-inflammatory process involving the left retrobulbar space and regional muscles, extending intracranially through the left orbital fissure. Cerebrospinal fluid (CSF) was collected from the cerebellomedullary cistern, and the analysis revealed albuminocytologic dissociation. The dog was treated with amoxicillin and clavulanic acid and prednisolone at anti-inflammatory dose; a significant improvement of neurologic status was observed afterward. However, 4 weeks after the initial presentation, the dog showed an abnormal, bilateral adduction of both eyes and third eyelid protrusion of the left eye while chewing the leash; the dog's mental status was normal, and the patient did not appear to be in discomfort during these episodes. A presumptive diagnosis of acquired trigemino-oculomotor synkinesis, induced by the intracranial inflammation was made. To the authors' best knowledge, this is the first case of presumed trigemino-oculomotor synkinesis reported in veterinary medicine.
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Affiliation(s)
- Silvia Pompilio
- AniCura Istituto Veterinario di Novara, Granozzo con Monticello, Novara, Italy
| | - Michela Scuttari
- AniCura Istituto Veterinario di Novara, Granozzo con Monticello, Novara, Italy
- Neurologica, Professional Association, Torino, Italy
| | - Katia Zerbetto
- AniCura Istituto Veterinario di Novara, Granozzo con Monticello, Novara, Italy
| | - Maria Elena Andreis
- AniCura Istituto Veterinario di Novara, Granozzo con Monticello, Novara, Italy
| | - Federica Tirrito
- AniCura Istituto Veterinario di Novara, Granozzo con Monticello, Novara, Italy
- Studio Veterinario Associato Vet2Vet di Ferri e Porporato, Orbassano, Torino, Italy
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Gates RW, Webb BD, Stevenson DA, Jabs EW, DeFilippo C, Ruzhnikov MRZ, Tise CG. Monozygotic twins discordant for a congenital cranial dysinnervation disorder with features of Moebius syndrome. Am J Med Genet A 2023; 191:2743-2748. [PMID: 37675855 DOI: 10.1002/ajmg.a.63389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/08/2023]
Abstract
Moebius syndrome is a congenital cranial dysinnervation disorder (CCDD) that presents with nonprogressive cranial nerve (CN) VI and VII palsies resulting in facial weakness and inability to abduct the eye(s). While many CCDDs have an underlying genetic cause, the etiology of Moebius syndrome remains unclear as most cases are sporadic. Here, we describe a pair of monochorionic, diamniotic twin girls; one with normal growth and development, and one with micrognathia, reduced facial expression, and poor feeding. Magnetic resonance imaging of the brain performed on the affected twin at 19 months of age showed severely hypoplastic or absent CN IV bilaterally, left CN VI smaller than right, and bilateral hypoplastic CN VII and IX, consistent with a diagnosis of a CCDD, most similar to that of Moebius syndrome. Genomic sequencing was performed on each twin and data was assessed for discordant variants, as well as variants in novel and CCDD-associated genes. No pathogenic, likely pathogenic, or variants of uncertain significance were identified in genes known to be associated with CCDDs or other congenital facial weakness conditions. This family provides further evidence in favor of a stochastic event as the etiology in Moebius syndrome, rather than a monogenic condition.
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Affiliation(s)
- Ryan W Gates
- Department of Genetics, Cook Children's Hospital, Fort Worth, Texas, USA
| | - Bryn D Webb
- Division of Genetics and Metabolism, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - David A Stevenson
- Division of Medical Genetics, Department of Pediatrics, Lucile Packard Children's Hospital and Stanford University, Stanford, California, USA
| | - Ethylin Wang Jabs
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Colette DeFilippo
- Division of Genomic Medicine, Department of Pediatrics, UC Davis MIND Institute, Sacramento, California, USA
| | - Maura R Z Ruzhnikov
- Division of Child Neurology, Department of Pediatrics, Lucile Packard Children's Hospital and Stanford University, Stanford, California, USA
| | - Christina G Tise
- Division of Medical Genetics, Department of Pediatrics, Lucile Packard Children's Hospital and Stanford University, Stanford, California, USA
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Arrigoni F, Rombetto L, Redaelli D, Mancarella G, Polenghi F, Salati R, Romaniello R, Peruzzo D, Bianchi PE, Piozzi E, Mazza M, Magli A. Congenital isolated unilateral third nerve palsy in children: the diagnostic contribution of high-resolution MR imaging. Neuroradiology 2023; 65:865-870. [PMID: 36580093 DOI: 10.1007/s00234-022-03106-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/15/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE To describe the neuroanatomical correlates of unilateral congenital isolated oculomotor palsy by means of high-resolution MRI. METHODS Children with a clinical diagnosis of congenital isolated oculomotr palsy and with a high-resolution MRI acquisition targeted on the orbits and cranial nerves were selected and included in the study. An experienced pediatric neuroradiologist evaluated all the exams, assessing the integrity and morphology of extraocular muscles, oculomotor, trochlear and abducens nerves as well as optic nerves and globes. Clinical data and ophthalmologic evaluations were also collected. RESULTS Six children (age range: 1-16 years; males: 3) were selected. All patients showed, on the affected side (left:right = 5:1), anomalies of the III nerve and extraocular muscles innervated by the pathological nerve. One patient had complete nerve agenesis, two patients showed a diffuse thinning of the nerve, from the brainstem to the orbit and 3 patients showed a distal thinning of the oculomotor nerve, starting at the level of the cavernous sinus. In all cases atrophy of corresponding muscles was noticed, but the involvement of the affected muscles varied with the nervous pattern of injury. CONCLUSIONS High-resolution MRI represents a valuable tool for the diagnosis of III nerve anomalies in unilateral congenital IOP, showing different patterns of nerve involvement and muscular atrophy.
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Affiliation(s)
- Filippo Arrigoni
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Italy.
- Paediatric Radiology and Neuroradiology Department, V. Buzzi Children's Hospital, Via Castelvetro 32, 20154, Milan, Italy.
| | - Luca Rombetto
- Pediatric Ophthalmology Unit, Niguarda Ca'Granda Metropolitan Hospital, Milan, Italy
| | | | | | | | - Roberto Salati
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Italy
| | | | - Denis Peruzzo
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Italy
| | | | - Elena Piozzi
- Pediatric Ophthalmology Unit, Niguarda Ca'Granda Metropolitan Hospital, Milan, Italy
| | - Marco Mazza
- Pediatric Ophthalmology Unit, Niguarda Ca'Granda Metropolitan Hospital, Milan, Italy
| | - Adriano Magli
- Department of Pediatric Ophthalmology, University Hospital of Salerno, University of Salerno, Salerno, Italy
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Frontalis Suspension Using Autologous Fascia Lata in Children Under 3 Years Old. Ophthalmic Plast Reconstr Surg 2021; 37:377-380. [PMID: 33237671 DOI: 10.1097/iop.0000000000001882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To analyze functional results and complications of the use of autologous fascia lata in frontalis suspension in children under 3 years old and to confirm its technical viability. METHODS A retrospective review of 8 patients (12 eyes) who underwent frontalis suspension using autologous fascia lata sling. RESULTS Twelve eyes of 8 patients were analyzed, with an average age of 1.8 ± 0.6 years. Preoperatively, the mean margin-to-reflex distance 1 was -0.17 ± 0.577 mm. Postoperatively the mean margin-to-reflex distance 1 was 2.66 ± 0.492 mm without any graft donor site or corneal complications. No recurrence was recorded in the follow-up period (mean follow-up period 28.5 ± 32.33 months). CONCLUSIONS Autologous fascia lata is an eligible material in frontalis suspension in children under 3 years old, despite the traditional oculoplastic dogma that advises against.
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Miller DB, Piccolo SR. A Survey of Compound Heterozygous Variants in Pediatric Cancers and Structural Birth Defects. Front Genet 2021; 12:640242. [PMID: 33828584 PMCID: PMC8019969 DOI: 10.3389/fgene.2021.640242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/24/2021] [Indexed: 11/13/2022] Open
Abstract
Compound heterozygous (CH) variants occur when two recessive alleles are inherited and the variants are located at different loci within the same gene in a given individual. CH variants are important contributors to many different types of recessively inherited diseases. However, many studies overlook CH variants because identification of this type of variant requires knowing the parent of origin for each nucleotide. Using computational methods, haplotypes can be inferred using a process called "phasing," which estimates the chromosomal origin of most nucleotides. In this paper, we used germline, phased, whole-genome sequencing (WGS) data to identify CH variants across seven pediatric diseases (adolescent idiopathic scoliosis: n = 16, congenital heart defects: n = 709, disorders of sex development: n = 79, ewing sarcoma: n = 287, neuroblastoma: n = 259, orofacial cleft: n = 107, and syndromic cranial dysinnervation: n = 172), available as parent-child trios in the Gabriella Miller Kids First Data Resource Center. Relatively little is understood about the genetic underpinnings of these diseases. We classified CH variants as "potentially damaging" based on minor allele frequencies (MAF), Combined Annotation Dependent Depletion scores, variant impact on transcription or translation, and gene-level frequencies in the disease group compared to a healthy population. For comparison, we also identified homozygous alternate (HA) variants, which affect both gene copies at a single locus; HA variants represent an alternative mechanism of recessive disease development and do not require phasing. Across all diseases, 2.6% of the samples had a potentially damaging CH variant and 16.2% had a potentially damaging HA variant. Of these samples with potentially damaging variants, the average number of genes per sample was 1 with a CH variant and 1.25 with a HA variant. Across all samples, 5.1 genes per disease had a CH variant, while 35.6 genes per disease had a HA variant; on average, only 4.3% of these variants affected common genes. Therefore, when seeking to identify potentially damaging variants of a putatively recessive disease, CH variants should be considered as potential contributors to disease development. If CH variants are excluded from analysis, important candidate genes may be overlooked.
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Affiliation(s)
| | - Stephen R. Piccolo
- Department of Biology, Brigham Young University, Provo, UT, United States
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Imaging of congenital cranial dysinnervation disorders: What radiologist wants to know? Clin Imaging 2020; 71:106-116. [PMID: 33189029 DOI: 10.1016/j.clinimag.2020.10.055] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/03/2020] [Accepted: 10/17/2020] [Indexed: 11/22/2022]
Abstract
We aim to review the imaging features of congenital cranial dysinnervation disorders. Characteristic imaging findings can define subtypes of these disorders through assessment of cranial nerves, extraocular muscles, orbital, and brain abnormalities. Duane retraction syndrome shows absent or hypoplasic 6th cranial nerve and preserved extraocular muscles (EOM). Mobius syndrome shows absent 7th and 6th cranial nerves, absence of facial colliculus, flattening of the dorsal aspect of the pons, hypoplasia of the pons and medulla, and flattening of the 4th ventricular floor. Congenital fibrosis of the extraocular muscles reveals unilateral or bilateral hypoplasia or aplasia of the 3rd cranial nerve, atrophy of superior rectus and levator palpebrae superioris muscles, and atrophy of the brainstem and cerebellar hemispheres. Horizontal gaze palsy and progressive scoliosis show characteristic split pons sign, butterfly medulla, absent facial colliculi, and spinal scoliosis. HOXA1 Mutations show a bilateral absence of 6th cranial nerves with the underdeveloped inner ear. Pontine Cap Tegmental Dysplasia shows ventral pontine hypoplasia, dorsal tegmental projection into the 4th ventricle, and variable cranial nerve deficits.
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Lee YJ, Lee HJ, Kim SJ. Clinical Features of Duane Retraction Syndrome: A New Classification. KOREAN JOURNAL OF OPHTHALMOLOGY 2020; 34:158-165. [PMID: 32233150 PMCID: PMC7105791 DOI: 10.3341/kjo.2019.0100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 11/20/2019] [Accepted: 12/09/2019] [Indexed: 11/23/2022] Open
Affiliation(s)
- Yun Jeong Lee
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
| | - Haeng Jin Lee
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
| | - Seong Joon Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.,Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea.
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