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Hecht I, Weiner C, Kotlyar A, Shoshany N, Pras E. Micro chromosomal deletions at the NYS7 locus and autosomal dominant nystagmus. Exp Eye Res 2023; 230:109459. [PMID: 37001852 DOI: 10.1016/j.exer.2023.109459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/13/2023] [Accepted: 03/25/2023] [Indexed: 03/31/2023]
Abstract
Nystagmus is an ocular condition characterized by bilateral involuntary ocular oscillation which can severely affect vision. When not associated with other ocular or systemic diseases, it is referred to as idiopathic or congenital motor nystagmus (CMN). Genome-wide linkage studies have previously identified several loci associated with CMN, however the genes responsible for some of these loci have yet to be identified. We have examined a large, five-generation family with autosomal dominant CMN. Our purpose was to characterize the clinical manifestations and reveal the molecular basis of the disease in this family. In addition to full ophthalmic examination and imaging, molecular analysis included copy number variation analysis, linkage studies, and Sanger sequencing. Expression analyses of candidate genes was done by real-time PCR. Of the 68 family members, 27 subjects in five-generations had CMN, in line with an autosomal dominant inheritance pattern. Molecular analysis was performed on 27 members, 15 of them affected by CMN. Copy number variation analysis using array comparative genomic hybridization (aCGH) revealed a novel deletion located on 1q32 (NYS7) among affected individuals. Linkage analysis using polymorphic markers demonstrated full segregation with a heterozygous haplotype in all affected patients, with a LOD score of >5. Sanger sequencing of affected subjects revealed a novel deletion of 732,526 bp in the linkage interval. No protein-coding genes exist within the deleted region; however, the deletion disrupts topologically associated domains encompassing the gene NR5A2 and the non-protein coding MIR181A. Both are strongly associated with other genes expressed in the retina such as PROX1, which in turn is also associated with genes related to nystagmus such as PAX6. We therefore hypothesized that the deletion might affect NR5A2 and MIR181A expression, causing CMN. Expression analysis by real-time PCR showed significantly lower expression of NR5A2, and significantly higher expression of PROX1 among patients compared with controls. To conclude, among a large five-generation family with autosomal dominant CMN, a large deletion in the interval of NYS7 was linked with the disease. No protein-coding genes exist inside the deleted region, and so the exact mechanism in which CMN is caused is uncertain. Based on topological association and expression analyses we suggest a possible mechanism for the pathogenesis.
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Affiliation(s)
- Idan Hecht
- Department of Ophthalmology, Shamir Medical Center (formerly Assaf-Harofeh), Tzrifin, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; The Matlow's Ophthalmo-Genetics Laboratory, Department of Ophthalmology, Shamir Medical Center (formerly Assaf-Harofeh), Tzrifin, Israel.
| | - Chen Weiner
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; The Matlow's Ophthalmo-Genetics Laboratory, Department of Ophthalmology, Shamir Medical Center (formerly Assaf-Harofeh), Tzrifin, Israel
| | - Alina Kotlyar
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; The Matlow's Ophthalmo-Genetics Laboratory, Department of Ophthalmology, Shamir Medical Center (formerly Assaf-Harofeh), Tzrifin, Israel
| | - Nadav Shoshany
- Department of Ophthalmology, Shamir Medical Center (formerly Assaf-Harofeh), Tzrifin, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; The Matlow's Ophthalmo-Genetics Laboratory, Department of Ophthalmology, Shamir Medical Center (formerly Assaf-Harofeh), Tzrifin, Israel
| | - Eran Pras
- Department of Ophthalmology, Shamir Medical Center (formerly Assaf-Harofeh), Tzrifin, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; The Matlow's Ophthalmo-Genetics Laboratory, Department of Ophthalmology, Shamir Medical Center (formerly Assaf-Harofeh), Tzrifin, Israel
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Law JJ, Zheng Y, Donahue SP. Recession-Resection of the Vertical Rectus Muscles for Chin-up Vertical Abnormal Head Position Associated With Infantile Nystagmus Syndrome. J Pediatr Ophthalmol Strabismus 2022; 59:410-415. [PMID: 35446190 DOI: 10.3928/01913913-20220216-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To review the correction of chin-up abnormal head position (AHP) due to infantile nystagmus syndrome via surgery on the vertical rectus muscles, typically a combined recession-resection of these muscles. METHODS This was a review of 6 patients who underwent surgical correction of chin-up vertical AHP in the context of infantile nystagmus syndrome at an academic institution. The correction of AHP, visual acuity, ductions, and ocular alignment were noted both preoperatively and postoperatively. The need for repeat surgery, induced strabismus, or correction of AHP were also noted. RESULTS Six patients underwent surgery for chin-up AHP. A combined recession-resection of the vertical rectus muscles (bilateral inferior rectus muscle recession of 5 to 8 mm; bilateral superior rectus muscle resection of 7 to 8 mm) was performed in 4 of 6 patients, and isolated bilateral recession of the inferior rectus muscles was performed in the remaining 2 patients. Four of 6 patients (67%) achieved complete correction of their AHP at the last follow-up visit, with a mild residual chin-up AHP persisting in the other 2 patients. One patient developed large angle exotropia, one had restrictive hypertropia and horizontal plane null position, and another developed an incomitant horizontal strabismus with exotropia in right gaze. Reoperation was performed in the former 2 patients, with successful correction of the strabismus in each. CONCLUSIONS Surgery on the vertical rectus muscles can reduce or eliminate a chin-up head position in patients with infantile nystagmus syndrome. Care should be taken to avoid producing a restriction of depression in abduction if the amount of resection is too large. [J Pediatr Ophthalmol Strabismus. 2022;59(6):410-415.].
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Wang W, Yan S, Zhang S, Han R, Li D, Liu Y, Zhang T, Liu S, Wu Y, Li Y, Yang X, Gu P. Clinical Application of Different Vertical Position Tests for Posterior Canal-Benign Paroxysmal Positional Vertigo-Cupulolithiasis. Front Neurol 2022; 13:930542. [PMID: 35903115 PMCID: PMC9315446 DOI: 10.3389/fneur.2022.930542] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPosterior canal-benign paroxysmal positional vertigo-cupulolithiasis (PC-BPPV-cu) is a new and controversial type of benign paroxysmal positional vertigo (BPPV). At present, there are few relevant clinical studies as to whether the Half Dix-Hallpike test (Half D-HT) induces more obvious nystagmus than the Dix Hallpike test (D-HT) and straight head hanging test (SHH) in patients with PC-BPPV-cu.ObjectivesTo investigate the clinical characteristics of PC-BPPV-cu, and analyze the diagnostic significance of the Dix-Hallpike test (D-HT), Half D-HT, and straight head hanging (SHH) test in these patients.MethodsA total of 46 patients with PC-BPPV-cu were enrolled, and divided into two groups (N = 23): a group A (induction order: D-HT, Half D-HT, SHH) and a group B (induction order: Half D-HT, D-HT, SHH).ResultsAmong 46 patients with PC-BPPV-cu, the bilateral and unilateral abnormality rates of the disease side were 5 cases and 41 cases, respectively. There were significant differences in the proportion of torsional-upbeating nystagmus and upbeating nystagmus among the three headhanging positions in 46 patients with PC-BPPV-cu (P < 0.001). The slow phase velocity (SPV) of induced nystagmus at half D-HT supine position was slower than D-HT supine position (P < 0.05) and SHH supine position (P < 0.05). The nystagmus latency of D-HT supine position was significantly shorter than half D-HT (P < 0.05) and SHH (P < 0.05). PC-BPPV-cu patients were accompanied by 53.5% semicircular canal paresis, 69.6% audiological abnormalities, 76% cervical vestibular evoked myogenic potential (cVEMP), and 75% video head impulse test (vHIT) abnormalities, the concordance rates of the four detection methods were similar (χ2 = 0.243, P = 0.970).ConclusionsThe Half D-HT is simple and feasible, but might have a risk of false-negative diagnoses of the torsional-upbeating nystagmus and upbeating nystagmus. The D-HT is still a classic induction method for PC-BPPV-cu. The two complement each other and may aid in the diagnosis of PC-BPPV-cu patients. Future clinical applications of Half D-HT require extensive research to determine its diagnostic efficacy.
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Affiliation(s)
- Wenting Wang
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Shuangmei Yan
- Department of Vertigo Center, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Sai Zhang
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Rui Han
- Department of Vertigo Center, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Dong Li
- Department of Vertigo Center, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yihan Liu
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ting Zhang
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Shaona Liu
- Department of Vertigo Center, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yuexia Wu
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ya Li
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xu Yang
- Department of Neurology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China
- *Correspondence: Xu Yang
| | - Ping Gu
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, China
- Department of Vertigo Center, The First Hospital of Hebei Medical University, Shijiazhuang, China
- Brain Aging and Cognitive Neuroscience Laboratory of Hebei Province, Shijiazhuang, China
- Ping Gu
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Papageorgiou E, Lazari K, Gottlob I. The challenges faced by clinicians diagnosing and treating infantile nystagmus Part II: treatment. EXPERT REVIEW OF OPHTHALMOLOGY 2021. [DOI: 10.1080/17469899.2021.1970533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Eleni Papageorgiou
- Ulverscroft Eye Unit, Neuroscience, Psychology and Behaviour, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, University of Leicester, Leicester, UK
- Department of Ophthalmology, University Hospital of Larissa, Mezourlo Area, Larissa, Greece
| | - Katerina Lazari
- Department of Ophthalmology, University Hospital of Larissa, Mezourlo Area, Larissa, Greece
| | - Irene Gottlob
- Ulverscroft Eye Unit, Neuroscience, Psychology and Behaviour, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, University of Leicester, Leicester, UK
- Department of Neurology, Cooper University Hospital, Neurological Institute, Camden, New Jersey, USA
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A Family with a High Incidence of Migraine and Vestibular Migraine and a Case of Menière's Disease. Case Rep Med 2021; 2021:9984047. [PMID: 34512765 PMCID: PMC8433000 DOI: 10.1155/2021/9984047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 08/19/2021] [Indexed: 11/22/2022] Open
Abstract
Vestibular migraine (VM) and Menière's disease (MD) are common neurotological disorders causing episodic vertigo. Sometimes, VM is accompanied by cochlear symptoms suggestive for MD. Therefore, in those cases, the differential diagnosis between the two disorders can be difficult. Moreover, a comorbidity with migraine in MD patients is widely reported, up to the hypothesis of a possible MD-VM overlapping syndrome. In this brief case report, we consider the clinical history of a family presenting high incidence of subjects fulfilling the diagnostic criteria of VM and single case fulfilling criteria for definite MD. The relationship between VM and MD is still under debate; anyway, it can be speculated that commonly shared genetic mutations could play a role as predisposing factors in both disorders. A congenital nystagmus in the family was present too, but its correlation with the other conditions is still not clear. Future goal of our work will be to assess genetics in this family.
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Choi JH, Kim SJ, Thomas MG, Jung JH, Oh EH, Shin JH, Cho JW, Kim HS, Park JY, Choi SY, Choi HY, Choi KD. Diagnostic yield of targeted next-generation sequencing in infantile nystagmus syndrome. Ophthalmic Genet 2021; 42:561-569. [PMID: 34132631 DOI: 10.1080/13816810.2021.1938138] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Infantile nystagmus syndrome (INS) is a genetically heterogeneous disorder. Identifying genetic causes of INS would help clinicians to facilitate clinical diagnosis and provide appropriate treatment. The aim of this study was to determine the diagnostic utility of targeted next-generation sequencing (NGS) for INS.Materials and methods: We recruited 37 patients who were referred to the Neuro-ophthalmology clinics for evaluations of INS. NGS was performed using a targeted panel that included 98 candidate genes associated with INS. We identified pathogenic variants according to guidelines of the American College of Medical Genetics and Genomics. We also calculated the sensitivity and specificity of each clinical sign to assess the diagnostic yield of our gene panel.Results: After variant filtering, annotation, and interpretation, the potential pathogenic variants were detected in 13 of the 37 patients, achieving a molecular diagnostic rate of 35%. The identified genes were PAX6 (n = 4), FRMD7 (n = 4), GPR143 (n = 2), CACNA1F (n = 1), CNGA3 (n = 1) and GUCY2D (n = 1). In approximately 30% (n = 4) of the patients, the initial clinical diagnosis was revised after a molecular diagnosis was performed. The presence of a family history had the highest predictive power for a molecular diagnosis (sensitivity = 61.5%, specificity = 91.7%), and the sensitivity increased when the family history was considered together with one of two clinical signs such as pendular nystagmus waveforms or anterior segment dysgenesis.Conclusions: Our study shows that targeted NGS can be useful to determine a molecular diagnosis for patients with INS. Targeted NGS also helps to confirm a clinical diagnosis in atypical phenotypes or unresolved cases.
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Affiliation(s)
- Jae-Hwan Choi
- Department of Neurology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Su-Jin Kim
- Department of Ophthalmology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Mervyn G Thomas
- Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Jae-Ho Jung
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
| | - Eun Hye Oh
- Department of Neurology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jin-Hong Shin
- Department of Neurology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jae Wook Cho
- Department of Neurology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hyang-Sook Kim
- Department of Neurology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ji-Yun Park
- Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Seo Young Choi
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, Korea
| | - Hee Young Choi
- Department of Ophthalmology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, Korea
| | - Kwang-Dong Choi
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, Korea
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Hertle RW, Kelleher C, Bruckman D, McNinch N, Ricker I, Bouhenni R, Wiseman K. Analysis of anomalous head posturing in patients with infantile nystagmus syndrome. J AAPOS 2021; 25:145.e1-145.e5. [PMID: 34087474 DOI: 10.1016/j.jaapos.2021.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/15/2021] [Accepted: 02/15/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To investigate anomalous head posturing in patients with INS. METHODS This was a prospective, cohort analysis of clinical and anomalous head posture (AHP) data in 34 patients with INS and an AHP. Particular outcome measures included measurement of AHP in three dimensions of pitch (anterior posterior flexion/extension), yaw (lateral rotation), and roll (lateral flexion) during best-corrected binocular acuity testing and during their subjective sense of straight. Patients were also queried as to their subjective sense of head posture in forced straight position and in their preferred AHP. The paired t test was used to determine significance in differences between measures. RESULTS A total of 34 patients (19 males [56%]) 9-56 years of age (mean, 16.5 ± 6) were included. Associated systemic or ocular system deficits were present in 30 patients (88%). AHP during best-corrected visual acuity testing averaged 16.5° ± 8.20° (range, 10°-51°), which was significantly different from the mean voluntary "comfortable" position only in the pitch and roll directions (P < 0.001). There was a significant noncongruous response during subjective response to head posturing with most sensing their head as "crooked" (76.5%) when manually straightened (P = 0.001). CONCLUSIONS The clinical AHP of patients with INS exists in all three spatial dimensions of pitch, yaw, and roll. Although the visual system may be causally related to the onset, amount, and direction of a compensatory AHP in patients with INS, its persistence over time or after surgical intervention is likely due to a combination of visual system (eg, nystagmus, strabismus) and nonvisual system (egocentric and musculo-skeletal) factors.
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Affiliation(s)
- Richard W Hertle
- Akron Children's Hospital Vision Center, Akron, Ohio; The Considine Research Institute, Akron Children's Hospital, Akron, Ohio; Northeast Ohio Medical College, Rootstown, Ohio.
| | - Cecily Kelleher
- Akron Children's Hospital Vision Center, Akron, Ohio; The Considine Research Institute, Akron Children's Hospital, Akron, Ohio
| | - David Bruckman
- Center for Populations Health Research, Cleveland Clinic, Cleveland, Ohio
| | - Neil McNinch
- The Considine Research Institute, Akron Children's Hospital, Akron, Ohio
| | - Isabel Ricker
- Akron Children's Hospital Vision Center, Akron, Ohio; The Considine Research Institute, Akron Children's Hospital, Akron, Ohio
| | - Rachida Bouhenni
- Akron Children's Hospital Vision Center, Akron, Ohio; The Considine Research Institute, Akron Children's Hospital, Akron, Ohio; Northeast Ohio Medical College, Rootstown, Ohio
| | - Kelly Wiseman
- Akron Children's Hospital Vision Center, Akron, Ohio; The Considine Research Institute, Akron Children's Hospital, Akron, Ohio
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Volk AE, Hedergott A, Preising M, Rading S, Fricke J, Herkenrath P, Nürnberg P, Altmüller J, von Ameln S, Lorenz B, Neugebauer A, Karsak M, Kubisch C. Biallelic mutations in L-dopachrome tautomerase (DCT) cause infantile nystagmus and oculocutaneous albinism. Hum Genet 2021; 140:1157-1168. [PMID: 33959807 DOI: 10.1007/s00439-021-02285-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/19/2021] [Indexed: 11/26/2022]
Abstract
Infantile nystagmus syndrome (INS) denominates early-onset, involuntary oscillatory eye movements with different etiologies. Nystagmus is also one of the symptoms in oculocutaneus albinism (OCA), a heterogeneous disease mainly caused by defects in melanin synthesis or melanosome biogenesis. Dopachrome tautomerase (DCT, also called TYRP2) together with tyrosinase (TYR) and tyrosin-related protein 1 (TYRP1) is one of the key enzymes in melanin synthesis. Although DCT´s role in pigmentation has been proven in different species, until now only mutations in TYR and TYRP1 have been found in patients with OCA. Detailed ophthalmological and orthoptic investigations identified a consanguineous family with two individuals with isolated infantile nystagmus and one family member with subtle signs of albinism. By whole-exome sequencing and segregation analysis, we identified the missense mutation c.176G > T (p.Gly59Val) in DCT in a homozygous state in all three affected family members. We show that this mutation results in incomplete protein maturation and targeting in vitro compatible with a partial or total loss of function. Subsequent screening of a cohort of patients with OCA (n = 85) and INS (n = 25) revealed two heterozygous truncating mutations, namely c.876C > A (p.Tyr292*) and c.1407G > A (p.Trp469*), in an independent patient with OCA. Taken together, our data suggest that mutations in DCT can cause a phenotypic spectrum ranging from isolated infantile nystagmus to oculocutaneous albinism.
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Affiliation(s)
- Alexander E Volk
- Institute of Human Genetics, University Medical Center Hamburg Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany.
| | - Andrea Hedergott
- Department of Ophthalmology, Faculty of Medicine, University Hospital Cologne, 50931, Cologne, Germany
| | - Markus Preising
- Department of Ophthalmology, Justus-Liebig-University Giessen, 35392, Giessen, Germany
| | - Sebastian Rading
- Neuronal and Cellular Signal Transduction, Center for Molecular Neurobiology Hamburg (ZMNH), University Medical Center Hamburg-Eppendorf (UKE), 20246, Hamburg, Germany
| | - Julia Fricke
- Department of Ophthalmology, Faculty of Medicine, University Hospital Cologne, 50931, Cologne, Germany
| | - Peter Herkenrath
- Department of Paediatrics, University of Cologne, 50931, Cologne, Germany
| | - Peter Nürnberg
- Cologne Center for Genomics, University of Cologne, 50931, Cologne, Germany
| | - Janine Altmüller
- Cologne Center for Genomics, University of Cologne, 50931, Cologne, Germany
| | - Simon von Ameln
- Institute of Human Genetics, University of Ulm, 89081, Ulm, Germany
| | - Birgit Lorenz
- Department of Ophthalmology, Justus-Liebig-University Giessen, 35392, Giessen, Germany
- Department of Ophthalmology, University Hospital of Bonn, 53127, Bonn, Germany
| | - Antje Neugebauer
- Department of Ophthalmology, Faculty of Medicine, University Hospital Cologne, 50931, Cologne, Germany
| | - Meliha Karsak
- Neuronal and Cellular Signal Transduction, Center for Molecular Neurobiology Hamburg (ZMNH), University Medical Center Hamburg-Eppendorf (UKE), 20246, Hamburg, Germany
| | - Christian Kubisch
- Institute of Human Genetics, University Medical Center Hamburg Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany
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Jin S, Park SE, Won D, Lee ST, Han SH, Han J. TUBB3 M323V Syndrome Presents with Infantile Nystagmus. Genes (Basel) 2021; 12:genes12040575. [PMID: 33921132 PMCID: PMC8071555 DOI: 10.3390/genes12040575] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 01/28/2023] Open
Abstract
Variants in the TUBB3 gene, one of the tubulin-encoding genes, are known to cause congenital fibrosis of the extraocular muscles type 3 and/or malformations of cortical development. Herein, we report a case of a 6-month-old infant with c.967A>G:p.(M323V) variant in the TUBB3 gene, who had only infantile nystagmus without other ophthalmological abnormalities. Subsequent brain magnetic resonance imaging (MRI) revealed cortical dysplasia. Neurological examinations did not reveal gross or fine motor delay, which are inconsistent with the clinical characteristics of patients with the M323V syndrome reported so far. A protein modeling showed that the M323V mutation in the TUBB3 gene interferes with αβ heterodimer formation with the TUBA1A gene. This report emphasizes the importance of considering TUBB3 and TUBA1A tubulinopathy in infantile nystagmus. A brain MRI should also be considered for these patients, although in the absence of other neurologic signs or symptoms.
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Affiliation(s)
- Soohwa Jin
- Department of Opthalmology, Yonsei University College of Medicine, Seoul 03722, Korea;
| | - Sung-Eun Park
- Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (S.-E.P.); (S.-H.H.)
| | - Dongju Won
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (D.W.); (S.-T.L.)
| | - Seung-Tae Lee
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (D.W.); (S.-T.L.)
| | - Sueng-Han Han
- Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (S.-E.P.); (S.-H.H.)
| | - Jinu Han
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
- Correspondence: ; Tel.: +82-2-2019-3445
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Wang XF, Chen H, Huang PJ, Feng ZK, Hua ZQ, Feng X, Han F, Xu XT, Shen RJ, Li Y, Jin ZB, Yu HY. Genotype-Phenotype Analysis and Mutation Spectrum in a Cohort of Chinese Patients With Congenital Nystagmus. Front Cell Dev Biol 2021; 9:627295. [PMID: 33732697 PMCID: PMC7958879 DOI: 10.3389/fcell.2021.627295] [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: 11/09/2020] [Accepted: 01/06/2021] [Indexed: 11/28/2022] Open
Abstract
Purpose: Congenital nystagmus (CN) is a genetically and clinically heterogeneous ocular disorder that manifests as involuntary, periodic oscillations of the eyes. To date, only FRMD7 and GPR143 have been reported to be responsible for causing CN. Here, we aimed to identify the disease-causing mutations and describe the clinical features in the affected members in our study. Methods: All the subjects underwent a detailed ophthalmic examination. Direct sequencing of all coding exons and splice site regions in FRMD7 and GPR143 and a mutation assessment were performed in each patient. Results: We found 14 mutations in 14/37 (37.8%) probands, including nine mutations in the FRMD7 gene and five mutations in the GPR143 gene, seven of which are novel, including c.284G>A(R95K), c.964C>T(P322S), c.284+10T>G, c.901T>C (Y301H), and c.2014_2023delTCACCCATGG(S672Pfs*12) in FRMD7, and c.250+1G>C, and c.485G>A (W162*) in GPR143. The mutation detection rate was 87.5% (7/8) of familial vs. 24.1% (7/29) of sporadic cases. Ten mutations in 24 (41.7%) non-syndromic subjects and 4 mutations in 13(30.8%) syndromic subjects were detected. A total of 77.8% (7/9) of mutations in FRMD7 were concentrated within the FERM and FA domains, while all mutations in GPR143 were located in exons 1, 2, 4 and 6. We observed that visual acuity tended to be worse in the GPR143 group than in the FRMD7 group, and no obvious difference in other clinical manifestations was found through comparisons in different groups of patients. Conclusions: This study identified 14 mutations (seven novel and seven known) in eight familial and 29 sporadic patients with congenital nystagmus, expanding the mutational spectrum and validating FRMD7 and GPR143 as mutation hotspots. These findings also revealed a significant difference in the screening rate between different groups of participants, providing new insights for the strategy of genetic screening and early clinical diagnosis of CN.
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Affiliation(s)
- Xiao-Fang Wang
- School of Ophthalmology and Optometry, The Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Hui Chen
- School of Ophthalmology and Optometry, The Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Peng-Juan Huang
- School of Ophthalmology and Optometry, The Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Zhuo-Kun Feng
- School of Ophthalmology and Optometry, The Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Zi-Qi Hua
- School of Ophthalmology and Optometry, The Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xiang Feng
- School of Ophthalmology and Optometry, The Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Fang Han
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xiao-Tao Xu
- School of Ophthalmology and Optometry, The Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Ren-Juan Shen
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yang Li
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zi-Bing Jin
- School of Ophthalmology and Optometry, The Eye Hospital, Wenzhou Medical University, Wenzhou, China.,Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Huan-Yun Yu
- School of Ophthalmology and Optometry, The Eye Hospital, Wenzhou Medical University, Wenzhou, China
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Comparison of Techniques for Correction of Chin-down Vertical Abnormal Head Position Associated with Infantile Nystagmus Syndrome. Am J Ophthalmol 2020; 213:57-61. [PMID: 31953059 DOI: 10.1016/j.ajo.2020.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 01/04/2020] [Accepted: 01/06/2020] [Indexed: 11/23/2022]
Abstract
PURPOSE We evaluated the relative effectiveness of combined recession-resection of vertical rectus muscles versus superior rectus recession with inferior oblique weakening for patients who underwent surgical correction of chin-down abnormal head position (AHP) associated with infantile nystagmus syndrome (INS). DESIGN Retrospective interventional case series. METHODS This is a review of 22 patients who underwent surgical correction of chin-down vertical AHP associated with INS at an academic institution. The primary outcome was collapse of AHP. Unfavorable outcomes included repeat surgery and induced strabismus, in addition to failure of collapse of AHP. RESULTS Twenty-two patients had chin-down AHP. Recession-resection (bilateral superior rectus recession 6-9 mm; bilateral inferior rectus resection 5-9 mm) was performed in 11 cases; weakening of both elevators (bilateral superior rectus recession 5-8 mm, bilateral inferior oblique recession or myectomy) occurred in 11 cases. Unfavorable outcome rates were 64% (7/11) compared with 18% (2/11), respectively (P = .03). Reoperation was performed for 6 of 22 patients. Five patients were from the recession-resection group, namely 3 for induced V-pattern esotropia, 1 for alternating esotropia, and 1 to correct recurrent AHP. The last of the 6 who required reoperation was in the elevator weakening group, and required correction of a recurrent AHP (P = .06). CONCLUSIONS While recession-resection of the vertical recti and weakening of both elevators each produce acceptable collapse of chin-down AHP, the former frequently induces a V-pattern esotropia requiring reoperation.
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Zheng Y, Law JJ, Holt DG, Morrison DG, Donahue SP. Long-term Outcomes Following Surgery for Infantile Nystagmus Syndrome With Abnormal Head Positioning. Am J Ophthalmol 2020; 210:3-7. [PMID: 31730837 DOI: 10.1016/j.ajo.2019.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 11/01/2019] [Accepted: 11/04/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate long-term outcomes of surgical treatment for abnormal head positioning (AHP) associated with infantile nystagmus syndrome (INS). DESIGN Retrospective observational case series. METHODS Review of 150 patients who underwent surgery for AHP associated with nystagmus. Outcomes included head positioning, duction limitations, and strabismus, and were evaluated several times postoperatively. Successful collapse of AHP was defined as being ≤10°. RESULTS Thirty-one patients had surgery for AHP in the pitch (chin up/down) position, whereas 119 had surgery for a horizontal AHP. In addition, 54 underwent 50%-60% augmentation, 19 underwent 40% augmentation, 5 underwent less than 40% augmentation. Thirty-eight had surgical dose modified to correct strabismus, and 3 underwent surgery different from standard Kestenbaum procedures. Collapse of AHP: At the 1-3-week follow-up (n = 131), 125 patients (95%) had collapse of AHP. The percentage trended down at the 2-5-month (91%, n = 106) and 2-year follow-ups (83%, n = 57). However, at 5 and 10 years, it was 93% (n = 42) and 93% (n = 14), respectively, due to reoperation in a small minority. Over- and undercorrection: At 1-3 weeks, 5% of patients were overcorrected whereas 0% were undercorrected. Over- and undercorrection rates peaked at 2 years postoperatively. Ten years out, there were no overcorrections and 7% undercorrections. Four percent of patients required reoperation for overcorrection (mean 2.7 years) and 5% did for undercorrection (mean 3.9 years). CONCLUSION Surgery for the head positioning associated with INS produces excellent outcomes throughout 10 years postoperatively. Overcorrection presents early and resolves either over time or with additional surgery. Undercorrection develops later and can persist despite reoperation.
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Zheng Y, Holt DG, Law JJ, Morrison DG, Donahue SP. Management of Strabismus Associated With Infantile Nystagmus Syndrome: A Novel Classification to Assist in Surgical Planning. Am J Ophthalmol 2019; 208:342-346. [PMID: 31472158 DOI: 10.1016/j.ajo.2019.08.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/20/2019] [Accepted: 08/21/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE There is no consensus on the surgical management of head position associated with infantile nystagmus syndrome (INS) when strabismus coexists, and few outcome data have been published. We propose classifying strabismus into concordant or discordant based on the relationship between head positioning and strabismus and then modifying surgery accordingly. Our objective is to describe this system and to review surgical outcomes. DESIGN Retrospective observational case series. METHODS Twenty-eight patients with INS and coexisting horizontal strabismus underwent surgery for horizontal head positioning and had ≥2 months of follow-up from 1995-2018 at the Vanderbilt Eye Institute. Outcome variables included head positioning (minimal, ≤10°; mild, 11-30°; moderate 31-44°; and severe ≥45°), strabismus (range 0-70 prism diopters [PDs]; minimal ≤10 PD), and reoperation rates. Nonparametric Wilcoxon signed rank, Fisher exact, and Mann-Whitney U tests were used for statistical analysis. RESULTS Twenty-one cases were concordant and 7 were discordant; the mean follow-up was 4.1 years. Ninety-six percent of patients had moderate to severe head positioning at baseline. Correction rates (to minimal) were 100% at 2-5 months postoperatively and 86% at last follow-up (P < .0001 at both time points compared with preoperatively). The magnitude of strabismus decreased compared with preoperative strabismus (30.8 ± 10.8 PDs; n = 28), strabismus at 2-5 months (9.1 ± 11.9 PDs; P = .0001; n = 26), and last follow-up (12.0 ± 14.1 PDs; P = .0003; n = 28). The overall reoperation rate was 32%. CONCLUSIONS Our classification system in patients with INS allows a systematic way to surgically improve head positioning and strabismus in cases of moderate to severe baseline head positioning.
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Choi JH, Jung JH, Oh EH, Shin JH, Kim HS, Seo JH, Choi SY, Kim MJ, Choi HY, Lee C, Choi KD. Genotype and Phenotype Spectrum of FRMD7-Associated Infantile Nystagmus Syndrome. Invest Ophthalmol Vis Sci 2019; 59:3181-3188. [PMID: 30025138 DOI: 10.1167/iovs.18-24207] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose We investigate the genotype and phenotype spectrum of FRMD7-associated infantile nystagmus syndrome in Korean probands. Methods A total of 37 patients with infantile nystagmus syndrome were recruited prospectively for genetic analysis. We performed polymerase chain reaction (PCR)-based direct sequencing and haplotype analysis for FRMD7. Detailed ophthalmic examinations and eye movement recordings were compared between FRMD7 and non-FRMD7 groups. Results In 13 (35%) of 37 patients, five different mutations of FRMD7 were detected: start codon mutation c.1A>G, splice site mutation c.162+6T>C, and three missense mutations (c.575A>C, c.722A>G, and c.875T>C). The latter mutation was identified in seven unrelated patients, and always was accompanied with two single nucleotide polymorphisms of exon 12 (rs6637934, rs5977623). Compared to non-FRMD7 groups, a cup-to-disc ratio was significantly decreased in FRMD7 groups (P < 0.001), and a disc-macula distance to disc diameter ratio markedly increased in the FRMD7 group (P = 0.015). Most patients in the FRMD7 group had at least two types of the nystagmus waveforms, and the most common type was unidirectional jerk nystagmus (75%), such as pure jerk and jerk with extended foveation, followed by pendular (25%), bidirectional jerk (19%), and dual jerk (6%) nystagmus. No significant differences were observed between FRMD7 and non-FRMD7 groups in terms of the nystagmus waveform, presence of periodic alternating nystagmus, and mean foveation time. Conclusions We identified five FRMD7 mutations in 35% of our infantile nystagmus syndrome cohort, expanding its mutational spectrum. The missense mutation c.875T>C may be a common mutation arisen from the founder effect in Korea. Optic nerve dysplasia associated with FRMD7 mutations suggests that the abnormal development of afferent visual systems may affect neural circuitry within the oculomotor system.
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Affiliation(s)
- Jae-Hwan Choi
- Department of Neurology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Jae-Ho Jung
- Department of Ophthalmology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Eun Hye Oh
- Department of Neurology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Jin-Hong Shin
- Department of Neurology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Hyang-Sook Kim
- Department of Neurology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Je Hyun Seo
- Department of Ophthalmology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Seo Young Choi
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, South Korea
| | - Min-Ji Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, South Korea
| | - Hee Young Choi
- Department of Ophthalmology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, South Korea
| | - Changwook Lee
- Department of Biological Sciences, School of Life Sciences, Ulsan National Institute of Sciences and Technology, Ulsan, South Korea
| | - Kwang-Dong Choi
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, South Korea
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15
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Nichols D. Case of congenital nystagmus. J Paediatr Child Health 2019; 55:229-231. [PMID: 30242942 DOI: 10.1111/jpc.14161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 06/29/2018] [Indexed: 11/30/2022]
Affiliation(s)
- David Nichols
- Department of Paediatrics, Sunshine Coast University Hospital, Sunshine Coast Region, Queensland, Australia
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16
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Chen J, Wei Y, Tian L, Kang X. A novel frameshift mutation in FRMD7 causes X-linked infantile nystagmus in a Chinese family. BMC MEDICAL GENETICS 2019; 20:5. [PMID: 30616528 PMCID: PMC6323710 DOI: 10.1186/s12881-018-0720-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 11/14/2018] [Indexed: 12/03/2022]
Abstract
Background Infantile nystagmus (IN) is an oculomotor disorder that is characterized by conjugate involuntary, rapid and repetitive movement of the eyes. To date, the pathogenesis of IN remains unclear. Many patients show an X-linked inheritance pattern. In this study, we explored the mutation in the FERM domain-containing 7 (FRMD7) gene in a Chinese family with X-linked infantile nystagmus. Methods We conducted comprehensive ocular examinations and collected 5 ml of blood samples from members of a family with X-linked IN and 100 normal controls. Mutations in FRMD7 were identified by sequencing PCR products. Results We found a 7-bp deletion(c.823-829delACCCTAC) in the 9th exon of FRMD7 in a Chinese family with IN, which predicted a truncation of the protein. Conclusions This study reported a novel mutation of the FRMD7 gene occurred in a Chinese family with IN, thus expanding the spectrum of FRMD7 mutations causing IN, and further confirming that the mutations of FRMD7 are the underlying molecular cause of IN.
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Affiliation(s)
- Junjue Chen
- Department of Ophthalmology in XinHua hospital, Shanghai Jiao Tong University, Kongjiang road 1665, Yangpu District, Shanghai, China
| | - Yan Wei
- Department of Ophthalmology in XinHua hospital, Shanghai Jiao Tong University, Kongjiang road 1665, Yangpu District, Shanghai, China
| | - Linlu Tian
- Department of Ophthalmology in XinHua hospital, Shanghai Jiao Tong University, Kongjiang road 1665, Yangpu District, Shanghai, China
| | - Xiaoli Kang
- Department of Ophthalmology in XinHua hospital, Shanghai Jiao Tong University, Kongjiang road 1665, Yangpu District, Shanghai, China.
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Gravier N. [Etiological assessment of a nystagmus in childhood]. J Fr Ophtalmol 2018; 41:868-878. [PMID: 30361175 DOI: 10.1016/j.jfo.2018.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 04/04/2018] [Indexed: 11/19/2022]
Abstract
Apart from the latent nystagmus, which arises as a consequence of failure to develop binocular vision, every case of childhood nystagmus needs an etiological assessment. Knowledge of the pathogenesis of the various types of nystagmus guides this assessment, particularly considering the morphological characteristics of the nystagmus. The clinical ophthalmologic examination is complemented by OCT and electrophysiologic testing (ERG, VEP). If this testing is normal, an MRI and genetic assessment are required.
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Affiliation(s)
- N Gravier
- Unité de strabologie-polyclinique de l'Atlantique, avenue Claude-Bernard, BP 40419, 44819 Nantes-Saint-Herblain cedex, France.
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Silveira SL, Cantle Moore R. Exploring the Functional Impact of Childhood Vision Impairment: An e-Delphi Study. J Binocul Vis Ocul Motil 2018; 68:110-121. [PMID: 30332340 DOI: 10.1080/2576117x.2018.1522233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The principles of the World Health Organization's International Classification of Function, Disability and Health have been embraced globally as a framework to support people with disability. This framework recognizes the functional needs of a person, as well as their medical diagnosis. However, the challenge of assessing the functional impact of disability to determine a person's needs and eligibility for support remains an issue. One example is that of childhood vision impairment, where a child's eligibility is often gauged from their visual performance in a clinical environment, a setting that is far removed from the child's real-world environment. Such clinical environments fail to reveal those factors that have a functional impact and affect the child's continuous visual function in their everyday situation. To examine this issue a three round modified e-Delphi technique was applied to explore the functional impact of childhood vision impairment. A panel of experienced Australian orthoptists and specialist teachers in vision impairment was convened, and the recently revised vision classifications in the World Health Organization International Statistical Classification of Diseases and Health Related Problems Version 11 were reviewed and modified for their application to children. This paper describes the e-Delphi technique and the major study outcomes including the modifications proposed by the study's participants, and the emerging paradigm that progresses an understanding of the functional impact of childhood vision impairment.
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Affiliation(s)
- Susan L Silveira
- a Royal Institute for Deaf and Blind Children , RIDBC Renwick Centre , Sydney , Australia.,b Department of Educational Studies , Faculty of Human Sciences, Macquarie University , Sydney, Australia.,c School of Education , Faculty of Education and Arts, University of Newcastle , Newcastle , Australia
| | - Robyn Cantle Moore
- a Royal Institute for Deaf and Blind Children , RIDBC Renwick Centre , Sydney , Australia.,b Department of Educational Studies , Faculty of Human Sciences, Macquarie University , Sydney, Australia.,c School of Education , Faculty of Education and Arts, University of Newcastle , Newcastle , Australia
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Imai T, Takimoto Y, Okumura T, Higashi-Shingai K, Takeda N, Kitamura K, Kalubi B, Fujikado T, Hirota M, Midoh Y, Nakamae K, Inohara H. Visual Target Strategies in Infantile Nystagmus Patients With Horizontal Jerk Waveform. Front Neurol 2018; 9:622. [PMID: 30104998 PMCID: PMC6077220 DOI: 10.3389/fneur.2018.00622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 07/10/2018] [Indexed: 11/24/2022] Open
Abstract
The aim of this study was to propose a new pathophysiological hypothesis for involuntary eye oscillation in infantile nystagmus (IN): patients with IN exhibit impaired gaze fixation, horizontal smooth pursuit and optokinetic nystagmus (OKN) and use saccadic eye movements for these underlying impairments. In order to induce saccades, they make enough angle between gaze and target by precedent exponential slow eye movements. IN consists of the alternate appearance of the saccade and the slow eye movements. Unlike most previous theories, IN is therefore considered a necessary strategy allowing for better vision and not an obstacle to clear vision. In five patients with IN, eye movements were analyzed during the smooth pursuit test, saccadic eye movement test, OKN test and vestibulo-ocular reflex (VOR) test. Their gaze fixation, horizontal smooth pursuit, OKN and the last half of the slow phase of VOR were impaired. The lines obtained by connection of the end eye positions of fast phase of nystagmus coincided with the trajectories of targets. The findings indicate that patients followed the target by the fast but not the slow phase of nystagmus, which supports our hypothesis. By setting the direction of slow phase of nystagmus opposite to the direction of the OKN stimulation, enough angle can be effectively made between the gaze and target for the induction of saccade. This is the mechanism of reversed OKN response. In darkness and when eyes are closed, IN weakens because there is no visual target and neither the saccade for catching up the target or slow phase for induction of the saccade is needed.
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Affiliation(s)
- Takao Imai
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | | | - Tomoko Okumura
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | | | - Noriaki Takeda
- Department of Otorhinolaryngology - Head and Neck Surgery, Tokushima University Graduate School of Medicine, Tokushima, Japan
| | - Koji Kitamura
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Bukasa Kalubi
- Medical Education Center, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takashi Fujikado
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masakazu Hirota
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoshihiro Midoh
- Department of Information Systems Engineering, Osaka University Graduate School of Information Science and Technology, Osaka, Japan
| | - Koji Nakamae
- Department of Information Systems Engineering, Osaka University Graduate School of Information Science and Technology, Osaka, Japan
| | - Hidenori Inohara
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
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Jivraj I, Beres SJ, Liu GT. Characteristics and Long-term Follow-up of Isolated Vertical Nystagmus in Infancy. J Pediatr Ophthalmol Strabismus 2018; 55:159-163. [PMID: 29384562 DOI: 10.3928/01913913-20171120-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Accepted: 08/24/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine the clinical characteristics and long-term outcomes of infants who presented with isolated vertical nystagmus. METHODS The medical records of 114 infants who were diagnosed as having nystagmus from 1996 to 2016 were screened. Patients with vertical nystagmus within the first year of life who had unremarkable magnetic resonance imaging of the brain and demonstrated age-appropriate visual behavior were included. The parents of patients in the final study cohort were contacted by telephone to obtain long-term follow-up information. RESULTS Eight patients comprised the final cohort. Vertical nystagmus was first observed at a mean age of 1.4 months (range: 1 to 2.5 months) and resolved in 87.5% of patients at a mean age of 3.8 months (range: 2 to 10 months). Vertical nystagmus was intermittent in 62.5%, upbeat in 62.5%, and pendular in 37.5% of patients. One patient's nystagmus did not resolve. Seventy-five percent of patient guardians participated in the telephone questionnaire. The mean age of patients at follow-up was 3.5 years (range: 0.5 to 8.1 years). Isolated iris transillumination was discovered in one patient without other features of albinism. Fifty percent of patients had speech delay requiring intervention. No other developmental delays or general medical conditions were identified. CONCLUSIONS Nystagmus resolved in 87.5% of patients, all before the first year of life, and speech delay was later identified in half of the patients. [J Pediatr Ophthalmol Strabismus. 2018;55(3):159-163.].
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Rim JH, Lee ST, Gee HY, Lee BJ, Choi JR, Park HW, Han SH, Han J. Accuracy of Next-Generation Sequencing for Molecular Diagnosis in Patients With Infantile Nystagmus Syndrome. JAMA Ophthalmol 2017; 135:1376-1385. [PMID: 29145603 PMCID: PMC6583550 DOI: 10.1001/jamaophthalmol.2017.4859] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 09/23/2017] [Indexed: 01/10/2023]
Abstract
Importance Infantile nystagmus syndrome (INS) is a group of disorders presenting with genetic and clinical heterogeneities that have challenged the genetic and clinical diagnoses of INS. Precise molecular diagnosis in early infancy may result in more accurate genetic counseling and improved patient management. Objective To assess the accuracy of genomic data from next-generation sequencing (NGS) and phenotypic data to enhance the definitive diagnosis of INS. Design, Setting, and Participants A single-center retrospective case series was conducted in 48 unrelated, consecutive patients with INS, with or without associated ocular or systemic conditions, who underwent genetic testing between June 1, 2015, and January 31, 2017. Next-generation sequencing analysis was performed using a target panel that included 113 genes associated with INS (n = 47) or a TruSight One sequencing panel that included 4813 genes associated with known human phenotypes (n = 1). Variants were filtered and prioritized by in-depth clinical review, and finally classified according to the American College of Medical Genetics and Genomics guidelines. Patients underwent a detailed ophthalmic examination, including electroretinography and optical coherence tomography, if feasible. Main Outcomes and Measures Diagnostic yield of targeted NGS testing. Results Among the 48 patients (21 female and 27 male; mean [SD] age at genetic testing, 9.2 [10.3] years), 8 had a family history of nystagmus and 40 were simplex. All patients were of a single ethnicity (Korean). Genetic variants that were highly likely to be causative were identified in 28 of the 48 patients, corresponding to a molecular diagnostic yield of 58.3% (95% CI, 44.4%-72.2%). FRMD7, GPR143, and PAX6 mutations appeared to be the major genetic causes of familial INS. A total of 10 patients (21%) were reclassified to a different diagnosis based on results of NGS testing, enabling accurate clinical management. Conclusions and Relevance These findings suggest that NGS is an accurate diagnostic tool to differentiate causes of INS because diagnostic tests, such as electroretinography and optical coherence tomography, are not easily applicable in young infants. Accurate application of NGS using a standardized, stepwise, team-based approach in early childhood not only facilitated early molecular diagnosis but also led to improved personalized management in patients with INS.
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Affiliation(s)
- John Hoon Rim
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Department of Medicine, Yonsei University Graduate School of Medicine, Seoul, Korea
- Department of Pharmacology, Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Seung-Tae Lee
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Heon Yung Gee
- Department of Medicine, Yonsei University Graduate School of Medicine, Seoul, Korea
- Department of Pharmacology, Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Byung Joo Lee
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - Jong Rak Choi
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Won Park
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Sueng-Han Han
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Jinu Han
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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23
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Bertsch M, Floyd M, Kehoe T, Pfeifer W, Drack AV. The clinical evaluation of infantile nystagmus: What to do first and why. Ophthalmic Genet 2017; 38:22-33. [PMID: 28177849 DOI: 10.1080/13816810.2016.1266667] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Infantile nystagmus has many causes, some life threatening. We determined the most common diagnoses in order to develop a testing algorithm. METHODS Retrospective chart review. Exclusion criteria were no nystagmus, acquired after 6 months, or lack of examination. DATA COLLECTED pediatric eye examination findings, ancillary testing, order of testing, referral, and final diagnoses. Final diagnosis was defined as meeting published clinical criteria and/or confirmed by diagnostic testing. Patients with a diagnosis not meeting the definition were "unknown." Patients with incomplete testing were "incomplete." Patients with multiple plausible etiologies were "multifactorial." Patients with negative complete workup were "motor." RESULTS A total of 284 charts were identified; 202 met inclusion criteria. The three most common causes were Albinism (19%), Leber Congenital Amaurosis (LCA; 14%), and Non-LCA retinal dystrophy (13%). Anatomic retinal disorders comprised 10%, motor another 10%. The most common first test was MRI (74/202) with a diagnostic yield of 16%. For 28 MRI-first patients, nystagmus alone was the indication; for 46 MRI-first patients other neurologic signs were present. 0/28 nystagmus-only patients had a diagnostic MRI while 14/46 (30%) with neurologic signs did. The yield of ERG as first test was 56%, OCT 55%, and molecular genetic testing 47%. Overall, 90% of patients had an etiology identified. CONCLUSION The most common causes of infantile nystagmus were retinal disorders (56%), however the most common first test was brain MRI. For patients without other neurologic stigmata complete pediatric eye examination, ERG, OCT, and molecular genetic testing had a higher yield than MRI scan. If MRI is not diagnostic, a complete ophthalmologic workup should be pursued.
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Affiliation(s)
- Morgan Bertsch
- a Department of Ophthalmology and Visual Sciences, Wynn Institute for Vision Research , Roy J. and Lucille A. Carver College of Medicine, University of Iowa , Iowa City , Iowa , USA
| | - Michael Floyd
- a Department of Ophthalmology and Visual Sciences, Wynn Institute for Vision Research , Roy J. and Lucille A. Carver College of Medicine, University of Iowa , Iowa City , Iowa , USA.,b HealthPartners , Minneapolis , Minnesota , USA
| | - Taylor Kehoe
- a Department of Ophthalmology and Visual Sciences, Wynn Institute for Vision Research , Roy J. and Lucille A. Carver College of Medicine, University of Iowa , Iowa City , Iowa , USA.,c Physician Assistant Program , University of Iowa , Iowa City , Iowa , USA
| | - Wanda Pfeifer
- a Department of Ophthalmology and Visual Sciences, Wynn Institute for Vision Research , Roy J. and Lucille A. Carver College of Medicine, University of Iowa , Iowa City , Iowa , USA
| | - Arlene V Drack
- a Department of Ophthalmology and Visual Sciences, Wynn Institute for Vision Research , Roy J. and Lucille A. Carver College of Medicine, University of Iowa , Iowa City , Iowa , USA
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24
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Juricek L, Carcaud J, Pelhaitre A, Riday TT, Chevallier A, Lanzini J, Auzeil N, Laprévote O, Dumont F, Jacques S, Letourneur F, Massaad C, Agulhon C, Barouki R, Beraneck M, Coumoul X. AhR-deficiency as a cause of demyelinating disease and inflammation. Sci Rep 2017; 7:9794. [PMID: 28851966 PMCID: PMC5575046 DOI: 10.1038/s41598-017-09621-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 07/24/2017] [Indexed: 12/29/2022] Open
Abstract
The Aryl hydrocarbon Receptor(AhR) is among the most important receptors which bind pollutants; however it also regulates signaling pathways independently of such exposure. We previously demonstrated that AhR is expressed during development of the central nervous system(CNS) and that its deletion leads to the occurrence of a congenital nystagmus. Objectives of the present study are to decipher the origin of these deficits, and to identify the role of the AhR in the development of the CNS. We show that the AhR-knockout phenotype develops during early infancy together with deficits in visual-information-processing which are associated with an altered optic nerve myelin sheath, which exhibits modifications in its lipid composition and in the expression of myelin-associated-glycoprotein(MAG), a cell adhesion molecule involved in myelin-maintenance and glia-axon interaction. In addition, we show that the expression of pro-inflammatory cytokines is increased in the impaired optic nerve and confirm that inflammation is causally related with an AhR-dependent decreased expression of MAG. Overall, our findings demonstrate the role of the AhR as a physiological regulator of myelination and inflammatory processes in the developing CNS. It identifies a mechanism by which environmental pollutants might influence CNS myelination and suggest AhR as a relevant drug target for demyelinating diseases.
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Affiliation(s)
- Ludmila Juricek
- INSERM UMR-S1124, Toxicologie Pharmacologie et Signalisation cellulaire, Paris, France.,Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France
| | - Julie Carcaud
- CNRS UMR8119, Centre de Neurophysique, Physiologie, Pathologie, Paris, France.,Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France
| | - Alice Pelhaitre
- INSERM UMR-S1124, Toxicologie Pharmacologie et Signalisation cellulaire, Paris, France.,Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France
| | - Thorfinn T Riday
- CNRS FR 3636, Glia-Glia and Glia-Neuron Interactions Group, Paris, France.,Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France
| | - Aline Chevallier
- INSERM UMR-S1124, Toxicologie Pharmacologie et Signalisation cellulaire, Paris, France.,Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France
| | - Justine Lanzini
- CNRS UMR8638 Chimie Organique, Médicinale et Extractive et Toxicologie Expérimentale, Paris, France.,Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France
| | - Nicolas Auzeil
- CNRS UMR8638 Chimie Organique, Médicinale et Extractive et Toxicologie Expérimentale, Paris, France.,Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France
| | - Olivier Laprévote
- CNRS UMR8638 Chimie Organique, Médicinale et Extractive et Toxicologie Expérimentale, Paris, France.,Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France
| | - Florent Dumont
- Plate-Forme Séquençage et Génomique, Institut Cochin, Paris, France.,Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France
| | - Sebastien Jacques
- Plate-Forme Séquençage et Génomique, Institut Cochin, Paris, France.,Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France
| | - Frank Letourneur
- Plate-Forme Séquençage et Génomique, Institut Cochin, Paris, France.,Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France
| | - Charbel Massaad
- INSERM UMR-S1124, Toxicologie Pharmacologie et Signalisation cellulaire, Paris, France.,Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France
| | - Cendra Agulhon
- CNRS FR 3636, Glia-Glia and Glia-Neuron Interactions Group, Paris, France.,Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France
| | - Robert Barouki
- INSERM UMR-S1124, Toxicologie Pharmacologie et Signalisation cellulaire, Paris, France.,Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France
| | - Mathieu Beraneck
- CNRS UMR8119, Centre de Neurophysique, Physiologie, Pathologie, Paris, France.,Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France
| | - Xavier Coumoul
- INSERM UMR-S1124, Toxicologie Pharmacologie et Signalisation cellulaire, Paris, France. .,Université Paris Descartes, 45 rue des Saints-Pères, 75006, Paris, France.
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