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Sela TC, Hadayer A. Continuous Curvilinear Capsulorhexis - A Practical Review. Semin Ophthalmol 2022; 37:583-592. [PMID: 35389763 DOI: 10.1080/08820538.2022.2054663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Continuous curvilinear capsulorhexis (CCC) has become the gold standard technique for anterior capsulotomy, a cardinal development in modern cataract surgery. CCC enables safer and relatively convenient access to the crystalline lens, however it is more challenging to master than older methods. Understanding the physics underlying this procedure is key to achieving the desired results and avoiding complications. PURPOSE To review and present the established information about CCC, and to create a practical guide to this important step in cataract surgery. METHODS A literature review was conducted using PubMed, Embase, Cochrane and Scopus databases, with emphasis on up-to-date information. The first part of this review describes the evolution of CCC and discusses the different approaches, the various instruments available, tips and pearls and the general setup for best results. The second half covers more recent innovations and common complications, and strategies to prevent or manage them. This paper provides a practical review of all aspects of CCC.
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Affiliation(s)
- Tal Corina Sela
- Clalit Health Services, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Amir Hadayer
- Sackler Faculty of Medicine, Tel Aviv University, Israel.,Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel
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2
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Abstract
Anterior lenticonus is a characteristic ocular feature of Alport syndrome, leading to progressive vision deterioration. Surgical lens removal may be an option in such cases, and the role of femtosecond laser-assisted cataract surgery (FLACS) has been recently described. Herein, we report the third described case, to our knowledge, of bilateral anterior lenticonus surgically approached through FLACS. A 25-year-old man with X-linked Alport syndrome complained of bilateral progressive vision loss. Ophthalmological evaluation revealed a corrected distance visual acuity of 20/63 in both eyes and bilateral anterior lenticonus associated with anterior polar cataract. FLACS was performed, followed by IOL placement on the capsular bag, without any intraoperative complications. One month postoperatively, uncorrected distance visual acuity was 20/20 in both eyes. Considering these results and the information published so far, this technology might be a good option for these patients.
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3
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Mimura T, Iida M, Noma H, Kamei Y, Kondo A, Yoshida M, Oguri M, Tanaka Y, Mizota A. Does Clear Corneal Cataract Surgery Influence Conjunctivochalasis? J Ophthalmic Vis Res 2020; 15:270-272. [PMID: 32308966 PMCID: PMC7151499 DOI: 10.18502/jovr.v15i2.6749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 09/04/2019] [Indexed: 11/24/2022] Open
Affiliation(s)
- Tatsuya Mimura
- Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan.,Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.,Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Michiko Iida
- Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Hidetaka Noma
- Department of Ophthalmology, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan
| | - Yuko Kamei
- Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Aki Kondo
- Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.,Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Maiko Yoshida
- Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.,Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Manami Oguri
- Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Yuka Tanaka
- Department of Ophthalmology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
| | - Atsushi Mizota
- Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan
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4
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Orts-Vila P, Amparo F, Rodríguez-Prats JL, Tañá-Rivero P. Alport Syndrome and Femtosecond Laser-assisted Cataract Surgery. J Ophthalmic Vis Res 2020; 15:264-269. [PMID: 32308965 PMCID: PMC7151501 DOI: 10.18502/jovr.v15i2.6748] [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: 04/23/2019] [Accepted: 01/07/2020] [Indexed: 11/24/2022] Open
Abstract
We report the surgical management of a patient with bilateral anterior lenticonus due to Alport syndrome using femtosecond laser-assisted cataract surgery (FLACS) and the Optiwave Refractive Analysis (ORA) system. A 38-year-old man with Alport syndrome presented to our department with visual loss due to anterior lenticonus in both eyes. Adjustments during bilateral FLACS were performed with the software's calipers to manually delineate the anterior capsulotomy. Multifocal toric intraocular lenses (IOLs) were selected and placed in the posterior chamber with the aid of intraoperative aberrometry. The intended postoperative positioning parameters for the IOL as well as the planned visual acuity and refraction were achieved. The implementation of FLACS and intraoperative wavefront aberrometry is a safe and useful surgical approach for the management of cataract in challenging cases such as patients with anterior lenticonus due to Alport syndrome.
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Affiliation(s)
| | - Francisco Amparo
- Cornea Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.,Department of Clinical Sciences, Division of Health Sciences, University of Monterrey, Monterrey, Mexico
| | - José Luís Rodríguez-Prats
- Department of Cataract and Refractive Surgery, Clínica Vistahermosa, Oftalvist Alicante, Alicante, Spain
| | - Pedro Tañá-Rivero
- Department of Cataract and Refractive Surgery, Clínica Vistahermosa, Oftalvist Alicante, Alicante, Spain
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5
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Sedaghat MR, Momeni-Moghaddam H, Haghighi B, Moshirfar M. Phacoemulsification in bilateral anterior lenticonus in Alport syndrome: A case report. Medicine (Baltimore) 2019; 98:e17054. [PMID: 31574802 PMCID: PMC6775371 DOI: 10.1097/md.0000000000017054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
RATIONALE To report the visual status and results of phacoemulsification cataract surgery in a young patient with Alport syndrome associated with bilateral anterior lenticonus. The milestone of this report is the use of anterior segment optical coherence tomography (AS-OCT) to confirm the central protrusion of the anterior surface of the crystalline lens. PATIENT CONCERNS A 23-year-old young woman presented with severe progressive visual loss in both eyes, which started several years ago. DIAGNOSES Refractive status was indicative of high myopia with astigmatism and vision was not improved with optimal correction to better than 0.1 in the right eye and 0.2 in the left eye (visual acuities given in decimal notation). Slit-lamp examination showed transparent cornea, anterior lenticonus and posterior sub-capsular cataract in both eyes. The classical appearance of oil droplet was evident using retro-illumination on the slit lamp. INTERVENTIONS The natural lenses were replaced with intraocular lens (IOL). OUTCOMES An excellent refractive status achieved associated with an uncorrected distance visual acuity 0.9 and 0.8 in the right and left eye, respectively. LESSONS AS-OCT is a valuable device for confirming the budging of the anterior crystalline lens surface.
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MESH Headings
- Female
- Humans
- Lens Capsule, Crystalline/diagnostic imaging
- Lens Capsule, Crystalline/pathology
- Lens Capsule, Crystalline/surgery
- Lens Cortex, Crystalline/diagnostic imaging
- Lens Cortex, Crystalline/pathology
- Lens Cortex, Crystalline/surgery
- Nephritis, Hereditary/diagnostic imaging
- Nephritis, Hereditary/pathology
- Nephritis, Hereditary/surgery
- Phacoemulsification
- Tomography, Optical Coherence
- Vision, Low/diagnostic imaging
- Vision, Low/etiology
- Vision, Low/surgery
- Young Adult
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Affiliation(s)
| | - Hamed Momeni-Moghaddam
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Batool Haghighi
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan
| | - Majid Moshirfar
- John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, School of Medicine, University of Utah
- Utah Lions Eye Bank, Murray
- HDR Research Center, Hoopes Vision, Draper, UT
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6
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Raimundo M, Fonseca C, Silva R, Figueira J. Bilateral giant macular holes: A rare manifestation of Alport syndrome. Eur J Ophthalmol 2018; 29:NP13-NP16. [PMID: 29873249 DOI: 10.1177/1120672118781232] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE: Alport syndrome is a rare condition characterized by the clinical triad of nephritic syndrome, sensorineural deafness, and ophthalmological alterations. Herein, we present a rare case of a patient diagnosed with Alport syndrome and bilateral giant macular holes. CASE DESCRIPTION: A 40-year-old woman with a previously unreported mutation in the COL4A4 gene suggestive of autosomal-recessive Alport syndrome presented at our department. The patient exhibited bilateral full-thickness macular holes measuring >1500 µm at their smallest diameters. The very large dimensions of both macular holes were indicative of a bad prognosis regarding hole closure, and a conservative approach was adopted. The patient was maintained on renal substitution therapy, and genetic counseling was offered to other family members. CONCLUSION: Ophthalmological findings associated to Alport syndrome commonly include anterior lenticonus and dot-and-fleck retinopathy, although giant macular holes can also be associated with this condition. A multidisciplinary approach is crucial in the management of these patients, as Alport syndrome is an inherited systemic basement membrane disease.
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Affiliation(s)
- Miguel Raimundo
- 1 Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra, Portugal.,2 Faculty of Medicine, Universidade de Coimbra, Coimbra, Portugal
| | - Cristina Fonseca
- 1 Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra, Portugal.,2 Faculty of Medicine, Universidade de Coimbra, Coimbra, Portugal
| | - Rufino Silva
- 1 Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra, Portugal.,2 Faculty of Medicine, Universidade de Coimbra, Coimbra, Portugal.,3 AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - João Figueira
- 1 Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra, Portugal.,2 Faculty of Medicine, Universidade de Coimbra, Coimbra, Portugal.,3 AIBILI-Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
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7
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Ladi JS, Shah NA. Toric multifocal intraocular lens implantation in a case of bilateral anterior and posterior lenticonus in Alport syndrome. Indian J Ophthalmol 2017; 64:847-849. [PMID: 27958211 PMCID: PMC5200990 DOI: 10.4103/0301-4738.195606] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We report the first case of toric multifocal intraocular lens (IOL) implantation in both the eyes of a young patient of Alport syndrome with anterior and posterior lenticonus with a successful outcome. An 18-year-old female patient presented with progressively blurred vision in both eyes since 4–5 years not improving with glasses. Refraction showed high myopia with astigmatism; however, the vision did not improve beyond 6/60 with glasses correction. Clinical examination on slit lamp showed anterior and posterior lenticonus bilaterally with a classical oil droplet appearance. We performed clear lens extraction by phacoemulsification with toric multifocal IOL implantation in both eyes. Postoperatively, the patient achieved an excellent refractive outcome with the unaided vision of 6/9, N6 in both eyes.
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Affiliation(s)
- Jeevan S Ladi
- Department of Cataract and Refractive Surgery, Dada Laser Eye Institute, Pune, Maharashtra, India
| | - Nitant A Shah
- Department of Cataract and Refractive Surgery, Dada Laser Eye Institute, Pune, Maharashtra, India
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8
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Barnes AC, Roth AS. Femtosecond laser-assisted cataract surgery in anterior lenticonus due to Alport syndrome. Am J Ophthalmol Case Rep 2017; 6:64-66. [PMID: 29260061 PMCID: PMC5722156 DOI: 10.1016/j.ajoc.2017.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 01/13/2017] [Indexed: 10/25/2022] Open
Abstract
Purpose We describe a case of bilateral anterior lenticonus in a patient with Alport syndrome treated with femtosecond laser-assisted cataract surgery (FLACS). Observations FLACS was performed without complication, and a desirable postoperative visual acuity was achieved. Conclusions and importance Femtosecond laser-assisted cataract surgery is an effective approach for managing patients with anterior lenticonus secondary to Alport syndrome.
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Affiliation(s)
- Alexander C Barnes
- Cleveland Clinic Cole Eye Institute, 9500 Euclid Avenue/i-13, Cleveland, OH 44195, United States
| | - Allen S Roth
- Cleveland Clinic Cole Eye Institute Beachwood, 2000 Auburn Drive, Suite 100, Beachwood, OH 44122, United States
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9
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Femtosecond Laser-Assisted Cataract Surgery in Alport Syndrome with Anterior Lenticonus. Eur J Ophthalmol 2015; 25:507-11. [DOI: 10.5301/ejo.5000603] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2015] [Indexed: 11/20/2022]
Abstract
Purpose To report the surgical treatment of 3 eyes of 2 patients with bilateral anterior lenticonus due to Alport syndrome using femtosecond laser-assisted cataract surgery (FLACS). Methods Two patients with Alport syndrome presented to our department due to anterior lenticonus in both eyes. We performed FLACS with posterior chamber lens implantation in both eyes of one patient and in one eye of the other patient. Anterior segment morphologic changes were visualized with a Scheimpflug camera, and anterior segment optical coherence tomography preoperatively and 3 months after surgery. Ultrastructure of the cut capsule edges was observed with scanning electron microscopy and compared to the edge of femtosecond laser capsulotomy performed on an otherwise healthy patient with cataract (control). Results The intraocular lens (IOL) postoperative positioning parameters met the international requirements of aspherical and wavefront customized IOLs (tilt <10 degree, decentration <800 μm). Scanning electron microscopy revealed the same characteristics of the cut capsule edges in the Alport and in the control eyes. Conclusions Femtosecond laser cataract surgery can be a safe and successful method for optical rehabilitation of anterior lenticonus in patients with Alport syndrome.
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10
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Sonarkhan S, Ramappa M, Chaurasia S, Mulay K. Bilateral anterior lenticonus in a case of Alport syndrome: a clinical and histopathological correlation after successful clear lens extraction. BMJ Case Rep 2014; 2014:bcr-2013-202036. [PMID: 24969069 DOI: 10.1136/bcr-2013-202036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 29-year-old woman presented with symptoms of gradual, progressive, painless diminution of vision in both eyes for past 8-10 years. On examination, uncorrected visual acuity was 20/60 in the right eye and 20/126 in the left eye. Anterior segment examination was essentially normal except for a conical protrusion in the pupillary axis of the anterior lens capsule with a clear underlying lens. During surgery, central protruded fragile lens capsule was meticulously handled to create well-centered continuous curvilinear capsulorhexis by using paediatric rhexis forceps. Histopathology of excised capsule showed markedly thinned lens capsule with normal epithelium. Electron microscopy of the anterior lens capsule showed multiple linear and irregular zones of dehiscence. Few of these had fibrillar, irregular electron-dense material and vacuoles; and adjacent cells were irregular suggestive of Alport syndrome. Postoperative course was uneventful and visual acuity improved to 20/20 unaided. Clear lens extraction is an effective means of rehabilitating visually symptomatic anterior lenticonus of Alport syndrome.
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Affiliation(s)
- Shilpa Sonarkhan
- Department of Pediatric Ophthalmology, L V Prasad Eye Institute, Hyderabad, Andhra Pradesh, India
| | - Muralidhar Ramappa
- Department of Cornea and Anterior Segment Services, L V Prasad Eye Institute, Hyderabad, Andhra Pradesh, India
| | - Sunita Chaurasia
- Department of Cornea and Anterior Segment Services, L V Prasad Eye Institute, Hyderabad, Andhra Pradesh, India
| | - Kaustubh Mulay
- Department of Ocular Pathology Services, L V Prasad Eye Institute, Hyderabad, Andhra Pradesh, India
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11
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Clear lens phacoemulsification in Alport syndrome: refractive results and electron microscopic analysis of the anterior lens capsule. Eur J Ophthalmol 2013; 24:345-51. [PMID: 24170525 DOI: 10.5301/ejo.5000365] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2013] [Indexed: 11/20/2022]
Abstract
PURPOSE To report the ocular findings of patients with Alport syndrome and the results of clear lens extraction in this patient group. METHODS Twenty-three eyes of 15 patients with a diagnosis of Alport syndrome were included in this study. Clear corneal phacoemulsification and intraocular foldable lens implantation was performed in eyes with indeterminate refractive errors and/or poor visual acuity and anterior capsule samples were analyzed with electron microscopy. RESULTS All patients had a history of hereditary nephritis and/or deafness as systemic involvement. Ophthalmologic examination revealed anterior lenticonus with high myopia and/or irregular astigmatism in all patients. The mean best-corrected visual acuity (BCVA) was 0.67 ± 0.17 logMAR (range 1.0-0.4) preoperatively and 0.17 ± 0.08 logMAR (range 0.3-0.0) postoperatively. Postoperative refractive lenticular astigmatism dramatically decreased and no ocular complications arose during the follow-up period. Transmission electron microscopic analysis of the lens capsules supported the diagnosis of Alport syndrome. CONCLUSIONS Clear lens phacoemulsification and foldable intraocular lens implantation is a safe and effective therapeutic choice for the management of uncorrectable refractive errors and low visual acuity due to anterior lenticonus in patients with Alport syndrome.
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Gyoneva L, Segal Y, Dorfman KD, Barocas VH. Mechanical response of wild-type and Alport murine lens capsules during osmotic swelling. Exp Eye Res 2013; 113:87-91. [PMID: 23707242 DOI: 10.1016/j.exer.2013.05.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 05/06/2013] [Accepted: 05/13/2013] [Indexed: 01/05/2023]
Abstract
The mechanical support of basement membranes, such as the lens capsule, is believed to arise from one of their main constituents - collagen IV. The basement membranes of the lens, kidney, and ear normally contain two different types of collagen IV networks, referred to as the major and minor chain networks. In Alport syndrome, a mutation in one of the minor chain COL4 genes leads to the absence of the minor chain network, causing life-threatening disturbances. We hypothesized that the absence of the minor chain network increases basement membrane distensibility, as measured in wild-type (n = 25) and Alport syndrome (n = 21) mice using the lens capsule as a model. Osmotic swelling experiments revealed direction-dependent changes. As a reflection of lens capsule properties, Alport lenses strained significantly more than wild-type lenses in the anterior-posterior direction, i.e. along their thickness, but not in the equatorial direction (p = 0.03 and p = 0.08, respectively). This is consistent with clinical data: Alport patients develop conical protrusions on the anterior and posterior lenticular poles. There was no evidence of significant change in total amount of collagen between Alport and wild-type lenses (p = 0.6). The observed differences in distensibility could indicate that the major chain network alone cannot fully compensate for the absence of the more highly cross-linked minor chain network, which is believed to be stronger, more stable, and resistant to deformation. The addition of mechanical information on Alport syndrome to the currently available biological data provides a fuller picture into the progression of the disease.
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Affiliation(s)
- Lazarina Gyoneva
- Department of Biomedical Engineering, University of Minnesota, 7-105 Nils Hasselmo Hall, 312 Church St. SE, Minneapolis, MN 55455, United States.
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13
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Yao XD, Chen X, Huang GY, Yu YT, Xu ST, Hu YL, Wang QW, Chen HP, Zeng CH, Ji DX, Hu WX, Tang Z, Liu ZH. Challenge in pathologic diagnosis of Alport syndrome: evidence from correction of previous misdiagnosis. Orphanet J Rare Dis 2012; 7:100. [PMID: 23259488 PMCID: PMC3552947 DOI: 10.1186/1750-1172-7-100] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 11/30/2012] [Indexed: 12/03/2022] Open
Abstract
Background Pathologic studies play an important role in evaluating patients with Alport syndrome besides genotyping. Difficulties still exist in diagnosing Alport syndrome (AS), and misdiagnosis is a not-so-rare event, even in adult patient evaluated with renal biopsy. Methods We used nested case–control study to investigate 52 patients previously misdiagnosed and 52 patients initially diagnosed in the China Alport Syndrome Treatments and Outcomes Registry e-system. Results We found mesangial proliferative glomerulonephritis (MsPGN, 26.9%) and focal and segmental glomerulosclerosis (FSGS, 19.2%) were the most common misdiagnosis. FSGS was the most frequent misdiagnosis in female X-linked AS (fXLAS) patients (34.8%), and MsPGN in male X-linked AS (mXLAS) patients (41.2%). Previous misdiagnosed mXLAS patients (13/17, 76.5%) and autosomal recessive AS (ARAS) patients (8/12, 66.7%) were corrected after a second renal biopsy. While misdiagnosed fXLAS patients (18/23, 78.3%) were corrected after a family member diagnosed (34.8%) or after rechecking electronic microscopy and/or collagen-IV alpha-chains immunofluresence study (COL-IF) (43.5%) during follow-up. With COL-IF as an additional criterion for AS diagnosis, we found that patients with less than 3 criteria reached have increased risk of misdiagnosis (3.29-fold for all misdiagnosed AS patients and 3.90-fold for fXLAS patients). Conclusion We emphasize timely and careful study of electronic microscopy and COL-IF in pathologic evaluation of AS patients. With renal and/or skin COL-IF as additional criterion, 3 diagnosis criteria reached are the cutoff for diagnosing AS pathologically.
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Affiliation(s)
- Xiao-Dan Yao
- Research Institute of Nephrology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
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Gupta A, Ramesh Babu K, Srinivasan R, Mohanty D. Clear lens extraction in Alport syndrome with combined anterior and posterior lenticonus or ruptured anterior lens capsule. J Cataract Refract Surg 2012; 37:2075-8. [PMID: 22018369 DOI: 10.1016/j.jcrs.2011.09.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2011] [Revised: 06/24/2011] [Accepted: 06/24/2011] [Indexed: 10/16/2022]
Abstract
UNLABELLED We describe the results of clear lens extraction in 7 eyes of 4 Alport-syndrome patients. Three patients (6 eyes) had both anterior and posterior lenticonus; the fourth patient had spontaneous rupture of the anterior lens capsule, resulting in an acute drop in vision. Clear lens extraction was an effective method for visual rehabilitation in Alport syndrome patients. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Arvind Gupta
- Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
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15
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Retinal Manifestations of Renal and Connective Tissue Diseases. Clin Ophthalmol 2012; 52:93-105. [DOI: 10.1097/iio.0b013e31823bbb32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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16
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Kittisupamongkol W. Ocular abnormalities in Alport syndrome. J Cataract Refract Surg 2010; 36:189. [PMID: 20117741 DOI: 10.1016/j.jcrs.2009.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2009] [Accepted: 07/31/2009] [Indexed: 11/17/2022]
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