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Galli J, Loi E, Dusi L, Pasini N, Rossi A, Scaglioni V, Mauri L, Fazzi E. Oculocutaneous albinism: the neurological, behavioral, and neuro-ophthalmological perspective. Eur J Pediatr 2023:10.1007/s00431-023-04938-w. [PMID: 37009951 PMCID: PMC10257606 DOI: 10.1007/s00431-023-04938-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/11/2023] [Accepted: 03/15/2023] [Indexed: 04/04/2023]
Abstract
Oculocutaneous albinism (OCA) is a group of rare, genetic disorders caused by absent/reduced melanin biosynthesis. The aim of this study was to explore the neurovisual, cognitive, adaptive, and behavioral profile of children affected by OCA, also evaluating any possible effect of the visual acuity deficit on the clinical profile and genotype-phenotype correlations. Eighteen children (9 males, mean age 84 months ± 41; range 18-181 months) with a molecular confirmed diagnosis of OCA were enrolled in the study. We collected data on clinical history, neurodevelopmental profile, neurological and neurovisual examination, and cognitive, adaptive, and emotional/behavioral functioning. A global neurodevelopmental impairment was detected in 56% of the children, without evolving into an intellectual disability. All the patients showed signs and symptoms of visual impairment. Low adaptive functioning was observed in 3 cases (17%). A risk for internalizing behavioral problems was documented in 6 cases (33%), for externalizing problems in 2 (11%), and for both in 5 (28%). Twelve children (67%) showed one or more autistic-like features. Correlation analyses revealed significant associations between the visual acuity level and performance intelligence quotient (p = 0.001), processing speed index (p = 0.021), Vineland total score (p = 0.020), Vineland communication (p = 0.020), and socialization (p = 0.037) domains. No significant correlations were found between genotype and phenotype. CONCLUSION Children with OCA may present a global neurodevelopmental delay that seems to improve with age and emotional/behavioral difficulties, along with the well-known visual impairment. An early neuropsychiatric evaluation and habilitative training are recommended to improve vision-related performance, neurodevelopment, and any psychological difficulties. WHAT IS KNOWN • Children with oculocutaneous albinism show dermatological and ophthalmological problems. • An early visual impairment may have negative implications on motor, emotional, and cognitive processes that would allow the child to organize his or her experiences. WHAT IS NEW • In addition to a variable combination of ocular signs and symptoms, children with oculocutaneous albinism may present an early neurodevelopmental delay and emotional/behavioral difficulties. • An early visual treatment is recommended to improve vision-related performance, neurodevelopment, and any psychological difficulties.
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Affiliation(s)
- Jessica Galli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy.
| | - Erika Loi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Laura Dusi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Nadia Pasini
- Department of Neurological and Vision Sciences, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Andrea Rossi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Vera Scaglioni
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Lucia Mauri
- Medical Genetics Unit, Department of Laboratory Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Elisa Fazzi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
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Martins TGDS, Andreghetto LDAF, Brito RM, Provenzano LB, Fowler S. Evaluation of the prematurity retinopathy and other eye changes in the newborn. EINSTEIN-SAO PAULO 2022; 20:eAO6692. [PMID: 35544894 PMCID: PMC9071256 DOI: 10.31744/einstein_journal/2022ao6692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 08/27/2021] [Indexed: 11/30/2022] Open
Abstract
Objective To assess the prevalence of ophthalmologic manifestations in newborns in a maternity hospital in the city of São Paulo, SP, and the main risk factors related with the development of retinopathy of prematurity. Methods A retrospective, longitudinal study with patients born from 2015 to 2017 who required ophthalmological evaluation. The research variables were obtained by analysis of the newborn medical charts. Results A total of 773 patients were studied. The sample consisted of 288 examinations performed by indication of gestational age ≤32 weeks: 118 (42.4%) in 2015, 105 (42.2%) in 2016, 65 (26.4%) cases in 2017. There were 329 evaluations indicated due to birth weight: 113 (40.6%) in 2015, 108 (43.4%) in 2016, and 108 (43.9%) in 2017. The prevalence of associated risk factors was 97 (34.9%) cases in 2015, 96 (38.6%) in 2016, and 54 (22%) in 2017, followed by mechanical ventilation with 82 (29.5%) cases in 2015, 64 (25.7%) in 2016 and 41 (16.7%) in 2017, and continuous positive airway pressure with 59 (21.2%) cases in 2015, 72 (28.9%) in 2016, and 46 (18.7%) in 2017. For the other indications, the evaluations performed due to congenital syphilis were the majority in the 3-year period of the study, with 55 (19.8%) newborns in 2015, 54 (21.7%) in 2016, and 59 (24.0%) in 2017. The most prevalent ophthalmologic diagnosis was retinopathy of prematurity, with 79 (35.3%) cases in 2015, 64 (32.2%) in 2016, and 41 (24.1%) in 2017. Conclusion Most neonates born in the organization do not present risk factors for ophthalmological manifestations. Retinopathy of prematurity was the disease with greater strength of association found in our study. For the other indications, the evaluations performed due to congenital syphilis prevail in the 3- year period of the study.
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Galli J, Loi E, Morandi A, Scaglioni V, Rossi A, Molinaro A, Pasini N, Semeraro F, Ruberto G, Fazzi E. Neurodevelopmental Profile in Children Affected by Ocular Albinism. Neuropediatrics 2022; 53:7-14. [PMID: 34327695 DOI: 10.1055/s-0041-1732430] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM The aim of this study was to detail the neurodevelopmental profile of subjects affected by ocular albinism (OA) and to collect data on GPR143 gene analysis. DESIGN The design of the study involves a retrospective longitudinal observational case series. METHODS We collected data on the neurodevelopmental profile of 13 children affected by OA from clinical annual assessments conducted for a period of 6 years after the first evaluation. We described visual profile, neuromotor development and neurological examination, cognitive profile, communication and language skills and behavioral characteristics. The GPR143 gene analysis was performed as well. RESULTS Children presented a variable combination of ocular and oculomotor disorders unchanged during the follow-up, a deficit in visual acuity and in contrast sensitivity that progressively improved. Abnormalities in pattern visual evoked potential were found. No deficits were detected at neurological examination and neuromotor development except for a mild impairment in hand-eye coordination observed in five cases. A language delay was observed in five cases, two of whom had also a developmental quotient delay at 2 years evolving to a borderline/deficit cognitive level at preschool age, difficulties in adaptive behavior and autistic-like features were found. Mutations in the GPR143 gene were identified in the two patients who presented the most severe clinical phenotype. CONCLUSION Children with OA may share, in addition to a variable combination of ocular signs and symptoms, a neurodevelopment impairment regarding mostly the cognitive, communicative, and social area, especially those with GPR143 mutation.
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Affiliation(s)
- Jessica Galli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Erika Loi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Alessandra Morandi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Vera Scaglioni
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Andrea Rossi
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Anna Molinaro
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Nadia Pasini
- Department of Neurological and Vision Sciences, ASST Spedali Civili of Brescia, Eye Clinic, Brescia, Italy
| | - Francesco Semeraro
- Department of Neurological and Vision Sciences, ASST Spedali Civili of Brescia and University of Brescia, Eye Clinic, Brescia, Italy
| | - Giulio Ruberto
- Department of Surgical and Clinical, Diagnostic and Pediatric Sciences, Section of Ophthalmology, Univeristy of Pavia, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Elisa Fazzi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
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Moreno-Artero E, Morice-Picard F, Bremond-Gignac D, Drumare-Bouvet I, Duncombe-Poulet C, Leclerc-Mercier S, Dufresne H, Kaplan J, Jouanne B, Arveiler B, Taieb A, Hadj-Rabia S. Management of albinism: French guidelines for diagnosis and care. J Eur Acad Dermatol Venereol 2021; 35:1449-1459. [PMID: 34042219 DOI: 10.1111/jdv.17275] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 03/22/2021] [Indexed: 12/12/2022]
Abstract
Albinism is a worldwide genetic disorder caused by mutations in at least 20 genes, identified to date, that affect melanin production or transport in the skin, hair and eyes. Patients present with variable degrees of diffuse muco-cutaneous and adnexal hypopigmentation, as well as ocular features including nystagmus, misrouting of optic nerves and foveal hypoplasia. Less often, albinism is associated with blood, immunological, pulmonary, digestive and/or neurological anomalies. Clinical and molecular characterizations are essential in preventing potential complications. Disease-causing mutations remain unknown for about 25% of patients with albinism. These guidelines have been developed for the diagnosis and management of syndromic and non-syndromic forms of albinism, based on a systematic review of the scientific literature. These guidelines comprise clinical and molecular characterization, diagnosis, therapeutic approach and management.
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Affiliation(s)
- E Moreno-Artero
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Hôpital Universitaire Necker- Enfants Malades, Assistance Publique - Hôpitaux de Paris-Centre (AP-HP5), Paris, France
| | - F Morice-Picard
- Pediatric Dermatology Unit, National Centre for Rare Skin Disorders, Hôpital Pellegrin-Enfants, CHU de Bordeaux, Bordeaux, France
| | - D Bremond-Gignac
- Department of Ophthalmology, Reference Centre for Rare Ocular Diseases (OPHTARA), Hôpital Necker-Enfants Malades, APHP5, Paris, France.,Université de Paris-Centre, Paris, France
| | - I Drumare-Bouvet
- Service d'exploration de la vision et neuro-ophtalmologie, CHRU de Lille, Lille, France
| | | | - S Leclerc-Mercier
- Department of Pathology, Hôpital Necker-Enfants Malades, APHP5, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Université de Paris-Centre, Paris, France
| | - H Dufresne
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Hôpital Universitaire Necker- Enfants Malades, Assistance Publique - Hôpitaux de Paris-Centre (AP-HP5), Paris, France.,Service Social Pédiatrique, Hôpital Necker-Enfants Malades, APHP5, Université de Paris-Centre, Paris, France
| | - J Kaplan
- Laboratory of Genetics in Ophthalmology, Imagine Institute, Paris, France
| | - B Jouanne
- French Association for Albinism (Genespoir), Rennes, France
| | - B Arveiler
- Molecular Genetics Laboratory, CHU de Bordeaux, Bordeaux, France.,INSERM U1211, Maladies Rares, Génétique et Métabolisme, Bordeaux, France
| | - A Taieb
- Pediatric Dermatology Unit, National Centre for Rare Skin Disorders, Hôpital Pellegrin-Enfants, CHU de Bordeaux, Bordeaux, France
| | - S Hadj-Rabia
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Hôpital Universitaire Necker- Enfants Malades, Assistance Publique - Hôpitaux de Paris-Centre (AP-HP5), Paris, France.,Université de Paris-Centre, Paris, France
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Shah M, Khan MT, Saeed N. Visual rehabilitation of people with oculocutaneous albinism in a tertiary clinical setting in Pakistan. Saudi J Ophthalmol 2021; 34:111-115. [PMID: 33575532 PMCID: PMC7866724 DOI: 10.4103/1319-4534.305036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 06/25/2020] [Accepted: 09/05/2020] [Indexed: 12/03/2022] Open
Abstract
PURPOSE: All people with oculocutaneous albinism (OCA) have reduced vision. This study aimed to assess the benefits of low vision aids for people with OCA. METHODS: Seventy-seven consecutive people with OCA age 4 years and above examined in a low vision clinic were included in the study. Uncorrected and best-corrected visual acuity (VA), VA with low vision devices, types of low vision aids, and refractive errors data were analyzed. RESULTS: Of the 77 people with OCA, 57% were in the age group between 4 and 15 years and 43% in the age group of 16 years and above. At the time of presentation, the percentages of visually impaired, severe visually impaired, and blind (using WHO low vision criteria) were 52%, 22%, and 25%. Among them, 39% has near VA of 1 M or better. Difference in the means of the spherical equivalent refractive error in the right eyes and left eyes was −0.494 diopters (−01.686, 0.699; 95% confidence interval). VA improved significantly after adequate refractive correction by more than one log MAR lines in 38.6% (P < 0.01). With low vision devices, in 85.7% (n = 66) participants, VA was enhanced to normal level (6/18 or better) in the better eye while 7.8% still remained in the blind category. Telescopes were prescribed to 61% people for the enhancement of distance VA and hand hold magnifiers were prescribed to 22% people to meet their needs. CONCLUSION: Low vision aids can be successfully used in visual rehabilitation of people with OCA to meet their needs.
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Affiliation(s)
- Mufarriq Shah
- Department of Optometry, Pakistan Institute of Community Ophthalmology, Hayatabad Medical Complex, Peshawar, Pakistan
| | - Muhammad T Khan
- Department of Ophthalmology, Hayatabad Medical Complex, Peshawar, Pakistan
| | - Nasir Saeed
- Department of Optometry, Pakistan Institute of Community Ophthalmology, Hayatabad Medical Complex, Peshawar, Pakistan.,Department of Ophthalmology, Hayatabad Medical Complex, Peshawar, Pakistan
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Pediatric ophthalmology and childhood reading difficulties: Overview of reading development and assessments for the pediatric ophthalmologist. J AAPOS 2017; 21:433-436.e1. [PMID: 28882501 DOI: 10.1016/j.jaapos.2017.06.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 06/16/2017] [Indexed: 11/20/2022]
Abstract
Reading difficulties are common in the pediatric population, and large socioeconomic disparities exist. In the United States 46% of white children achieved expected reading proficiency by the end of fourth grade, while only 21% of Hispanic and 18% of African American children were reading at the expected level. Reading is an involved cognitive process with many subskills; likewise, development of reading proficiency is a complex and continuous process. Failure to achieve reading proficiency or even early difficulty with reading can affect a child's academic performance for years to come. Some studies suggest reading proficiency may be related to later success in life. Although many problems with reading are not related to vision, a vision assessment is recommended for children with reading difficulties and a suspected vision problem. The process of reading development as well as the varied educational assessments of reading are presented here for pediatric ophthalmologists.
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Kronick B, John RM. Unseen Impairment: Pediatric Primary Care Management of Oculocutaneous Albinism 2. J Nurse Pract 2016. [DOI: 10.1016/j.nurpra.2016.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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MacDonald JT, Kutzbach BR, Holleschau AM, Wyckoff S, Summers CG. Reading skills in children and adults with albinism: the role of visual impairment. J Pediatr Ophthalmol Strabismus 2012; 49:184-8. [PMID: 22074358 DOI: 10.3928/01913913-20111101-03] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 09/14/2011] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate whether visual impairment in albinism contributes significantly to the acquisition of normal reading skills. METHODS The authors administered standardized reading tests to 41 children and 18 adults with albinism. The Young Children's Achievement Test was used for children between 4 and 6 years old and the Woodcock-Johnson III was used for children 7 years and older and adults. Parents of children and adult subjects also completed a questionnaire to document developmental, academic, and/or work experiences. The Spearman test was used to evaluate the relationship between binocular best-corrected visual acuity (BCVA) and reading test results. RESULTS Standardized reading tests in both children and adults with albinism showed a normal distribution of scores. BCVA did not appear to play a significant role in the development of normal reading ability in these individuals who were visually impaired except for a mild correlation of decreased reading fluency on the Woodcock-Johnson III with decreased BCVA (r = 0.287, P = .046). Many young children with albinism had superior reading skills despite having a BCVA of 20/200 or worse (legal blindness). CONCLUSION This study of cognitively normal children and adults with albinism demonstrates that impaired vision during childhood does not by itself significantly impede a child's ability to acquire normal reading skills. However, the lower reading fluency that occurs in the more visually impaired individuals suggests they would benefit, both in the school system and workplace, with an accommodation involving more time to complete reading tasks.
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Affiliation(s)
- John T MacDonald
- Department of Neurology, Division of Clinical Pediatric Neuroscience, University of Minnesota, 420 Delaware Street S.E., Minneapolis, MN 55455, USA.
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Merrill K, Hogue K, Downes S, Holleschau AM, Kutzbach BR, MacDonald JT, Summers CG. Reading acuity in albinism: evaluation with MNREAD charts. J AAPOS 2011; 15:29-32. [PMID: 21397802 DOI: 10.1016/j.jaapos.2010.12.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2010] [Revised: 12/08/2010] [Accepted: 12/30/2010] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The MNREAD reading acuity (RA) charts use continuous-text reading to measure (1) RA, ie, the smallest size of print that the patient can resolve; (2) maximum reading speed (MRS); and (3) critical print size (CPS), ie, the smallest print that the patient can read with maximum speed. This project used the MNREAD charts to evaluate reading performance in children and adults with albinism to determine the smallest print size recommended to facilitate effortless reading. METHODS A total of 63 subjects with albinism were administered the MNREAD test to determine the critical print size for effortless reading. The subjects read continuous, high-contrast text print until they could no longer discern the words. The MRS and CPS were determined with the MNREAD protocol. Presence or absence of nystagmus and strabismus was recorded. Distance visual acuity was measured with ETDRS charts. RESULTS The sample included 25 male and 38 female subjects with a median age of 16 years. Median MRS was 150 words per minute. The mean CPS was 0.84 logMAR, notably larger than the mean RA of 0.53 logMAR. CONCLUSIONS The MNREAD acuity charts can be used to determine functional reading ability and critical print size for effortless reading in individuals with albinism. The amount of enlargement in print size can be used in educational and vocational recommendations to facilitate reading.
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Affiliation(s)
- Kimberly Merrill
- Department of Ophthalmology, University of Minnesota, Minneapolis, MN 55455, USA
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Bibliography. Current world literature. Curr Opin Ophthalmol 2009; 20:417-22. [PMID: 19684489 DOI: 10.1097/icu.0b013e32833079c5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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