1
|
Soh Z, Martin H, Richards AJ, Suri M, Snead MP. Ophthalmic manifestations of Czech dysplasia. Am J Med Genet A 2024; 194:e63480. [PMID: 37982325 DOI: 10.1002/ajmg.a.63480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/21/2023] [Accepted: 11/10/2023] [Indexed: 11/21/2023]
Abstract
Czech dysplasia is an autosomal dominant type 2 collagenopathy that is caused by heterozygosity for the recurrent p.(Arg275Cys) COL2A1 variant. Affected individuals usually present with skeletal abnormalities such as metatarsal hypoplasia of the third and fourth toes and early-onset arthropathy, as well as hearing loss. To date, no ophthalmic findings have been reported in patients with Czech dysplasia even though COL2A1 has been implicated in other ocular conditions such as type 1 Stickler syndrome. For the first time, we report the ocular findings in four families with Czech dysplasia, including type 1 vitreous anomaly, hypoplastic vitreous, retinal tears, and significant refractive error. These novel ocular findings expand the phenotype associated with Czech dysplasia and may aid clinicians as an additional diagnostic feature. Patients with congenital abnormalities of vitreous gel architecture have an increased risk of retinal detachment, and as such, patients may benefit from prophylaxis. Considering that many of the patients did not report any ocular symptoms, vitreous phenotyping is of key importance in identifying the need for counseling with regard to prophylaxis.
Collapse
Affiliation(s)
- Zack Soh
- Vitreoretinal Research Group, John van Geest Centre for Brain Repair, University of Cambridge, Cambridge, UK
| | - Howard Martin
- Vitreoretinal Research Group, John van Geest Centre for Brain Repair, University of Cambridge, Cambridge, UK
| | - Allan J Richards
- Vitreoretinal Research Group, John van Geest Centre for Brain Repair, University of Cambridge, Cambridge, UK
| | - Mohnish Suri
- Nottingham Clinical Genetics Service, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Martin P Snead
- Vitreoretinal Research Group, John van Geest Centre for Brain Repair, University of Cambridge, Cambridge, UK
| |
Collapse
|
2
|
Cicinelli MV, Buchan JC, Nicholson M, Varadaraj V, Khanna RC. Cataracts. Lancet 2023; 401:377-389. [PMID: 36565712 DOI: 10.1016/s0140-6736(22)01839-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/03/2022] [Accepted: 09/15/2022] [Indexed: 12/24/2022]
Abstract
94 million people are blind or visually impaired globally, and cataract is the most common cause of blindness worldwide. However, most cases of blindness are avoidable. Cataract is associated with decreased quality of life and reduced life expectancy. Most cases of cataract occur after birth and share ageing and oxidative stress as primary causes, although several non-modifiable and modifiable risk factors can accelerate cataract formation. In most patients, phacoemulsification with intraocular lens implantation is the preferred treatment and is highly cost-effective. There has been an increase in the use of comprehensive cataract surgical services, including diagnoses, treatment referrals, and rehabilitation. However, global inequity in surgical service quality is still a limitation. Implementation of preoperative risk assessment, risk reduction strategies, and new surgical technologies have made cataract surgery possible at an earlier stage of cataract severity with the expectation of good refractive outcomes. The main challenge is making the service that is currently available to some patients accessible to all by use of universal health coverage.
Collapse
Affiliation(s)
- Maria Vittoria Cicinelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - John C Buchan
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Maneck Nicholson
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | | | - Rohit C Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, Hyderabad, India; Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India; School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia; School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.
| |
Collapse
|
3
|
Boysen KB, La Cour M, Kessel L. Ocular complications and prophylactic strategies in Stickler syndrome: a systematic literature review. Ophthalmic Genet 2020; 41:223-234. [PMID: 32316871 DOI: 10.1080/13816810.2020.1747092] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Stickler syndrome is a collagenopathy caused by mutations in the genes COL2A1 (STL1) or COL11A1 (STL2). Affected patients manifest ocular, auditory, articular, and craniofacial manifestations in varying degrees. Ocular symptoms include myopia, retinal detachment, cataract, and glaucoma. The aim of this systematic review was to evaluate the prevalence of ocular manifestations and the outcome of prophylactic treatment on reducing the risk of retinal detachment. METHOD A systematic literature search was performed in the PubMed database. Information on the cross-study prevalence of myopia, retinal detachment, cataract, glaucoma, visual impairment, severity and age of onset of myopia and retinal detachments. Studies that reported on the outcome of prophylactic treatment against a control group were explored. RESULTS 37 articles with 2324 individual patients were included. Myopia was found in 83% of patients, mostly of a moderate to severe degree. Retinal detachments occurred in 45% of patients. Generally, the first detachment occurred in the second decade of life in STL1 patients and later in STL2. Cataracts were more common in STL2 patients, 59% versus 36% in STL1. Glaucoma (10%) and visual impairment (blind: 6%; vision loss in one eye: 10%) were rare. Three studies reported on the effect of prophylactic treatment being protective. CONCLUSION Ocular manifestations are common in Stickler patients, but the comparison between studies was difficult because of inconsistencies in diagnostic and inclusion criteria by different studies. Sight-threatening complications such as retinal detachments are common but although prophylactic therapy is reported to be effective in retrospective studies, evidence from randomized trials is missing.
Collapse
Affiliation(s)
| | - Morten La Cour
- Department of Ophtalmology, Rigshospitalet , Glostrup, Denmark.,Department of Clinical Medicine, University of Copenhagen , Copenhagen, Denmark
| | - Line Kessel
- Department of Ophtalmology, Rigshospitalet , Glostrup, Denmark.,Department of Clinical Medicine, University of Copenhagen , Copenhagen, Denmark
| |
Collapse
|
4
|
Alshahrani ST, Ghazi NG, Al-Rashaed S. Rhegmatogenous retinal detachments associated to Stickler syndrome in a tertiary eye care center in Saudi Arabia. Clin Ophthalmol 2015; 10:1-6. [PMID: 26730175 PMCID: PMC4697790 DOI: 10.2147/opth.s91444] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate the clinical findings and outcomes of rhegmatogenous retinal detachment (RRD) in Stickler syndrome on affected and fellow eyes that underwent prophylactic retinopexy. Patients and methods Chart review of 70 eyes (62 patients). Incidence of RRD, postoperative visual acuity, and risk factors were evaluated. Results Twenty-two patients (35%) had RRD in the fellow eye, 37% of the eyes had cataract, 93% had macular detachment, 50% had proliferative vitreoretinopathy, and 41% had posterior vitreous detachment. Success rates were: 60% of patients after scleral buckling; 57.1% after pars plana vitrectomy; and 75% after combined scleral buckling and pars plana vitrectomy. Sixty-one (93.8%) of patients had successful surgery (including second surgery). Silicone oil tamponade was significantly associated with final anatomic outcome, with a protective odds ratio of 0.11 (P=0.027). Visual acuity improved in 54% of eyes and decreased in 5%. Statistically significant associations were present for eyes with final visual acuity ≥20/200, and total retinal detachment (P<0.001); preoperative cataract (P=0.023); and proliferative vitreoretinopathy (P<0.001). RRD developed in 16/44 eyes despite laser prophylaxis. Conclusion Prophylactic retinopexy was not beneficial for Stickler syndrome patients. Success of primary surgery for RRD remains low. The primary surgery should be vitrectomy combined with scleral buckling and silicone oil tamponade.
Collapse
Affiliation(s)
- Saeed T Alshahrani
- Ophthalmology Department, King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia
| | - Nicola G Ghazi
- Vitreoretinal Department, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia
| | - Saba Al-Rashaed
- Vitreoretinal Department, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia
| |
Collapse
|
5
|
Conart JB, Baron D, Berrod JP. [Degenerative lesions of the peripheral retina]. J Fr Ophtalmol 2013; 37:73-80. [PMID: 24239217 DOI: 10.1016/j.jfo.2013.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Accepted: 09/25/2013] [Indexed: 11/17/2022]
Abstract
Degenerative lesions of the peripheral retina are present from teenage years onwards and increase with age. These abnormabilities are frequent, some of them being benign while others predispose to retinal tears and detachment. In the latter case, the lesions are rhegmatogenous and may justify prophylactic treatment by laser photocoagulation. We distinguish congenital lesions of the peripheral retina and intraretinal, chorioretinal and vitreoretinal degenerations. The holes and tears observed in 2% of the population consist of round atrophic holes, "horseshoe" tears, oral dialyses and giant tears.
Collapse
Affiliation(s)
- J-B Conart
- Département d'ophtalmologie, hôpital de Brabois, CHU de Nancy, avenue Morvan 54511 Vandœuvre-lès-Nancy cedex, France
| | - D Baron
- Polyclinique de l'atlantique, avenue Claude-Bernard, 44819 Saint-Herblain cedex, France
| | - J-P Berrod
- Département d'ophtalmologie, hôpital de Brabois, CHU de Nancy, avenue Morvan 54511 Vandœuvre-lès-Nancy cedex, France.
| |
Collapse
|
6
|
Meier P, Wiedemann P. Surgery for Pediatric Vitreoretinal Disorders. Retina 2013. [DOI: 10.1016/b978-1-4557-0737-9.00115-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
7
|
Wenick AS, Barañano DE. Evaluation and management of pediatric rhegmatogenous retinal detachment. Saudi J Ophthalmol 2012; 26:255-63. [PMID: 23961003 DOI: 10.1016/j.sjopt.2012.04.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 04/28/2012] [Indexed: 11/28/2022] Open
Abstract
Pediatric rhegmatogenous retinal detachments are rare, accounting for less than ten percent of all rhegmatogenous retinal detachments. While most retinal detachments in the adult population are related to posterior vitreous detachment, pediatric retinal detachment are often related to trauma or an underlying congenital abnormalities or genetic syndrome. The anatomy of pediatric eyes, the often late presentation of the disease, and the high incidence of bilateral pathology in children all pose significant challenges in the management of these patients. We discuss the epidemiology of pediatric rhegmatogenous retinal detachment, review the genetic syndromes associated with a high incidence of retinal detachment, and examine other common causes of retinal detachment in this age group. We then outline an approach to evaluation and management and describe the expected outcomes of repair of retinal detachment in the pediatric population.
Collapse
Affiliation(s)
- Adam S Wenick
- Department of Ophthalmology, Wilmer Eye Institute, John Hopkins University, Baltimore, MD, United States
| | | |
Collapse
|
8
|
Al Kaissi A, Roschger P, Nawrot-Wawrzyniak K, Krebs A, Grill F, Klaushofer K. Evidence of reduced bone turnover and disturbed mineralization process in a boy with Stickler syndrome. Calcif Tissue Int 2010; 86:126-31. [PMID: 20012270 DOI: 10.1007/s00223-009-9324-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2009] [Accepted: 11/05/2009] [Indexed: 11/25/2022]
Abstract
We describe a tall-statured 14-year-old boy who illustrated the full phenotypic and radiographic features of Stickler syndrome type I. A bone biopsy showed evidence of reduced bone mass and bone turnover, such as reduced BV/TV (-43%), TbTh (-29%), and OS/BS (-48%), Ob.S/BS (-27%), and Oc/BS (-47%) compared to "age-matched" controls. Moreover, there was evidence that the mineralization process was severely disturbed. Quantitative backscattered electron imaging revealed that the bone mineralization density distribution (BMDD) of cancellous (Cn) as well as cortical (Ct) bone was shifted toward lower mineralization compared to a young control reference cohort. BMDD parameters of mean degree of mineralization, Cn Ca (-9.8%) and Ct Ca (-18.0%), were dramatically decreased. To the best of our knowledge this is the first clinical report describing bone biopsy findings in a boy with Stickler syndrome. Such a severe undermineralization of bone matrix might essentially contribute to the compromised mechanical competence of the skeleton found in this patient.
Collapse
Affiliation(s)
- A Al Kaissi
- Ludwig-Boltzmann Institute of Osteology, Hanusch Hospital of WGKK, 4th Medical Department, Vienna, Austria.
| | | | | | | | | | | |
Collapse
|
9
|
Alvarez BV, Gilmour GS, Mema SC, Martin BT, Shull GE, Casey JR, Sauvé Y. Blindness caused by deficiency in AE3 chloride/bicarbonate exchanger. PLoS One 2007; 2:e839. [PMID: 17786210 PMCID: PMC1950688 DOI: 10.1371/journal.pone.0000839] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2007] [Accepted: 08/14/2007] [Indexed: 12/02/2022] Open
Abstract
Background Vision is initiated by phototransduction in the outer retina by photoreceptors, whose high metabolic rate generates large CO2 loads. Inner retina cells then process the visual signal and CO2. The anion exchanger 3 gene (AE3/Slc4a3) encodes full-length AE3 (AE3fl) and cardiac AE3 (AE3c) isoforms, catalyzing plasma membrane Cl−/HCO3− exchange in Müller (AE3fl) and horizontal (AE3c) cells. AE3 thus maintains acid-balance by removing photoreceptor-generated CO2 waste. Methodology/Principal Findings We report that Slc4a3−/− null mice have inner retina defects (electroretinogram b-wave reduction, optic nerve and retinal vessel anomalies). These pathologic features are common to most human vitreoretinal degenerations. Immunobloting analysis revealed that Na+/HCO3− co-transporter (NBC1), and carbonic anhydrase II and CAXIV, protein expression were elevated in Slc4a3−/− mouse retinas, suggesting compensation for loss of AE3. TUNEL staining showed increased numbers of apoptotic nuclei from 4–6 months of age, in Slc4a3−/− mice, indicating late onset photoreceptor death. Conclusions/Significance Identification of Slc4a3 as underlying a previously unrecognized cause of blindness suggests this gene as a new candidate for a subset of hereditary vitreoretinal retinal degeneration.
Collapse
Affiliation(s)
- Bernardo V. Alvarez
- Membrane Protein Research Group, Department of Biochemistry, University of Alberta, Edmonton, Canada
- Department of Physiology, University of Alberta, Edmonton, Canada
| | | | - Silvina C. Mema
- Department of Ophthalmology, University of Alberta, Edmonton, Canada
| | - Brent T. Martin
- Department of Physiology, University of Alberta, Edmonton, Canada
| | - Gary E. Shull
- Departments of Molecular Genetics, Biochemistry and Microbiology, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
| | - Joseph R. Casey
- Membrane Protein Research Group, Department of Biochemistry, University of Alberta, Edmonton, Canada
- Department of Physiology, University of Alberta, Edmonton, Canada
| | - Yves Sauvé
- Department of Physiology, University of Alberta, Edmonton, Canada
- Department of Ophthalmology, University of Alberta, Edmonton, Canada
- * To whom correspondence should be addressed. E-mail:
| |
Collapse
|
10
|
Abeysiri P, Bunce C, da Cruz L. Outcomes of surgery for retinal detachment in patients with Stickler syndrome: a comparison of two sequential 20-year cohorts. Graefes Arch Clin Exp Ophthalmol 2007; 245:1633-8. [PMID: 17579881 DOI: 10.1007/s00417-007-0609-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2005] [Revised: 03/15/2007] [Accepted: 05/08/2007] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Stickler syndrome is a hereditary oculo-systemic disorder where patients are predisposed to retinal detachments which are often complex and challenging to manage. Significant progress has been made regarding the molecular genetics of the condition; however, there is little recent literature on surgery for retinal detachment in Stickler syndrome. Our aim is to describe a population of Stickler patients presenting to Moorfields Eye Hospital with detachment from 1986 to 2003. We looked at patient characteristics, characteristics of detachment, management and anatomical and functional outcomes. We also aim to compare this group from 1986 to 2003 with a past group of Stickler patients treated at Moorfields between 1965 and 1985, reported by (Billington et al. in Trans Ophthalmol Soc UK 104:875-879, 1985). This comparison of 20-year matched cohorts examined patient characteristics, features of detachment, management and anatomical outcome in the two groups using the same definitions as the earlier authors. RESULTS In the Stickler group from 1986 to 2003, complete re-attachment rate was 67% for primary scleral-buckle surgery, 84.2% for primary vitrectomy and 78.57% for all surgery in 30 eyes of 23 patients. Overall in this group there was an average increase in Logmar visual acuity of 0.33 and 0.32 in patients undergoing primary cryo-buckle and primary vitrectomy surgery respectively. When comparing the two groups using Fisher's exact test, we found that the group from 1986 to 2003 had significant improvement in re-attachment for detachments with multiple tears and for vitrectomy surgery, compared with the group from 1965 to 1985. CONCLUSIONS This study shows that despite complicated surgery and often multiple procedures, good anatomical outcomes were achieved as well as useful functional visual results after retinal detachment surgery in Stickler patients. It would also appear that when comparing the group of Stickler patients from 1986 to 2003 with the group from 1965 to 1985 improvements were seen in outcome from vitrectomy surgery and surgery for multiple breaks probably due to advances in technique and technology in vitreoretinal surgery, over the past 4 decades.
Collapse
Affiliation(s)
- Poorna Abeysiri
- Western Eye Hospital, 153 Marylebone Road, London NW15QH, UK.
| | | | | |
Collapse
|
11
|
Meier P, Wiedemann P. Surgical Aspects of Vitreoretinal Disease in Children. Retina 2006. [DOI: 10.1016/b978-0-323-02598-0.50151-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
12
|
Ihanamäki T, Pelliniemi LJ, Vuorio E. Collagens and collagen-related matrix components in the human and mouse eye. Prog Retin Eye Res 2004; 23:403-34. [PMID: 15219875 DOI: 10.1016/j.preteyeres.2004.04.002] [Citation(s) in RCA: 108] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The three-dimensional structure of the eye plays an important role in providing a correct optical environment for vision. Much of this function is dependent on the unique structural features of ocular connective tissue, especially of the collagen types and their supramolecular structures. For example, the organization of collagen fibrils is largely responsible for transparency and refraction of cornea, lens and vitreous body, and collagens present in the sclera are largely responsible for the structural strength of the eye. Phylogenetically, most of the collagens are highly conserved between different species, which suggests that collagens also share similar functions in mice and men. Despite considerable differences between the mouse and the human eye, particularly in the proportion of the different tissue components, the difficulty of performing systematic histologic and molecular studies on the human eye has made mouse an appealing alternative to studies addressing the role of individual genes and their mutations in ocular diseases. From a genetic standpoint, the mouse has major advantages over other experimental animals as its genome is better known than that of other species and it can be manipulated by the modern techniques of genetic engineering. Furthermore, it is easy, quick and relatively cheap to produce large quantities of mice for systematic studies. Thus, transgenic techniques have made it possible to study consequences of specific mutations in genes coding for structural components of ocular connective tissues in mice. As these changes in mice have been shown to resemble those in human diseases, mouse models are likely to provide efficient tools for pathogenetic studies on human disorders affecting the extracellular matrix. This review is aimed to clarify the role of collagenous components in the mouse and human eye with a closer look at the new findings of the collagens in the cartilage and the eye, the so-called "cartilage collagens".
Collapse
Affiliation(s)
- Tapio Ihanamäki
- Department of Ophthalmology, Helsinki University Central Hospital, PO Box 220, FIN-00029 HUS Helsinki, Finland.
| | | | | |
Collapse
|
13
|
Abstract
PURPOSE The ocular findings, systemic features, and genetic loci distinguishing known genetic causes of vitreoretinal degenerations were studied in the original Snowflake family. DESIGN Prospective, comparative study and molecular genetic investigation. PARTICIPANTS Members of the original snowflake vitreoretinal degeneration family. METHODS Clinical data were collected on 26 family members by history and examination. Thirteen of the 26 total family members underwent prospective examination. Linkage to known vitreoretinal degeneration loci (COL2A1, COL11A1, and the Wagner disease locus) was evaluated with short tandem repeat markers. MAIN OUTCOME MEASURES Ocular and systemic features of known vitreoretinal degenerations. RESULTS Six of the 13 prospectively examined subjects had snowflake vitreoretinal degeneration. Corneal guttae (4/5; 80%), early onset cataract (5/6; 83%), fibrillar vitreous degeneration (6/6; 100%), and peripheral retinal abnormalities (5/6; 83%), including minute crystallinelike deposits called snowflakes (4/6; 67%), were common. Retinal detachment was seen in 1 of 6 of these prospectively examined subjects (17%). A total of 14 affected subjects were identified within the family, and in 3 (21%), retinal detachment developed. Orofacial features, early-onset hearing loss, and arthritis typical of Stickler syndrome were absent. Linkage to known vitreoretinal degeneration loci was excluded. CONCLUSIONS The absence of vitreous gel in the retrolental space and presence of fibrillar vitreous degeneration were consistent with the vitreous structure reported for collagen 11A1 (COL11A1) but not collagen 2A1 (COL2A1) mutations. The absence of systemic features was characteristic of the vitreoretinopathies linked to chromosome 5q13 (Wagner disease and erosive vitreoretinopathy) and mutations in exon 2 of the COL2A1 gene. Snowflakes in the peripheral retina and the absence of nyctalopia, posterior chorioretinal atrophy, and tractional retinal detachment were inconsistent with the chromosome 5q13 vitreoretinopathies. The association of Fuchs' corneal endothelial dystrophy found in this family has not been reported previously in other vitreoretinal degenerations. These findings and the exclusion of known genetic loci suggest snowflake is a distinct vitreoretinal degeneration.
Collapse
Affiliation(s)
- Mike M Lee
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | | | | | | |
Collapse
|
14
|
Abstract
The objective was to study the expressivity of Stickler syndrome in affected children and adults in the UK and to highlight issues for improving early diagnosis, treatment and counselling. A postal questionnaire survey of the 216 members of the Stickler Syndrome Support Group was carried out. Of the 153 (71%) who responded to the questionnaire, 48 (61%) of adults and 15 (20%) of children had experienced retinal detachment; 36 (49%) of the children and 18 (23%) of the adults were born with a cleft palate. Only 5 (7%) of the children and none of the adults had been diagnosed by a cleft surgeon, although 23 (31%) of the children had been diagnosed originally as having Pierre-Robin sequence. Only a third of the adults had been given any genetic counselling. Stickler syndrome is an under-diagnosed condition with profound consequences, particularly with respect to vision. Earlier diagnosis by the cleft team may help to reduce suffering and increase awareness of the condition.
Collapse
Affiliation(s)
- A C Webb
- Department of Oral and Maxillofacial Surgery, Poole Hospital NHS Trust, Poole, Dorset, UK
| | | |
Collapse
|
15
|
McLeod D, Black GCM, Bishop PN. Vitreous phenotype: genotype correlation in Stickler syndrome. Graefes Arch Clin Exp Ophthalmol 2002; 240:63-5; author reply 66. [PMID: 11954783 DOI: 10.1007/s00417-001-0380-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
16
|
Stickler GB, Hughes W, Houchin P. Clinical features of hereditary progressive arthro-ophthalmopathy (Stickler syndrome): a survey. Genet Med 2001; 3:192-6. [PMID: 11388760 DOI: 10.1097/00125817-200105000-00008] [Citation(s) in RCA: 115] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To define variations in the clinical manifestations of Stickler syndrome. METHODS A questionnaire was sent to 612 persons. RESULTS Of the 316 usable replies, 95% of persons had eye problems (retinal detachment occurred in 60% of patients, myopia in 90%, and blindness in 4%); 84% had problems with facial structures such as a flat face, small mandible, or cleft palate; 70%, hearing loss; and 90%, joint problems, primarily early joint pain from degenerative joint disease. Treatment included cryotherapy and laser therapy for retinal detachment, repair of cleft palate, use of hearing and mobility aids, and joint replacements. CONCLUSIONS There are wide variations of symptoms and signs among affected persons, even within the same family. There are delays in diagnosis, lack of understanding among family members, denial about the risk of serious eye problems, and joint disease.
Collapse
Affiliation(s)
- G B Stickler
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA
| | | | | |
Collapse
|
17
|
Du F, Acland GM, Ray J. Cloning and expression of type II collagen mRNA: evaluation as a candidate for canine oculo-skeletal dysplasia. Gene 2000; 255:307-16. [PMID: 11024291 DOI: 10.1016/s0378-1119(00)00324-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The disease phenotype of oculo-skeletal dysplasia (OSD) detected in Labrador retrievers and Samoyeds shows a large degree of similarity with human Stickler and Kniest dysplasia. Type II collagen (COL2A1) mRNA, which is defective in a larger number of Stickler and Kniest patients, has been cloned and characterized from normal dog. The amino acid sequence of the canine type II procollagen is predicted to contain 1487 residues, with high degree of homology with its human homologue, and maintains all the characteristic structural domains. In addition to cartilage, expression of COL2A1 has also been detected in canine retina and testes. In testes, the N-propeptide region of COL2A1 displayed differential splicing and expressed both splice variants, IIA (with exon 2) and IIB (without exon 2), suggesting the importance of both forms in testis maturation and maintenance. Despite a severe decrease of type II collagen protein in the vitreous of OSD affected Labrador retrievers, COL2A1 gene has been excluded from having any causal association with the disease locus by linkage analysis. Using an intragenic RFLP marker, COL2A1 gene has also been tested as a candidate gene for the non-allelic form of the other canine OSD identified in Samoyeds, and excluded by linkage analysis. Oculo-skeletal dysplastic Labrador retriever and Samoyed provide two animal models for chondrodysplasia with genetic heterogeneity.
Collapse
Affiliation(s)
- F Du
- The James A. Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | | | | |
Collapse
|
18
|
Black GC, Perveen R, Wiszniewski W, Dodd CL, Donnai D, McLeod D. A novel hereditary developmental vitreoretinopathy with multiple ocular abnormalities localizing to a 5-cM region of chromosome 5q13-q14. Ophthalmology 1999; 106:2074-81. [PMID: 10571340 DOI: 10.1016/s0161-6420(99)90486-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND To undertake a clinical and molecular analysis of a previously unpublished kindred with a phenotypically distinct vitreoretinopathy characterized by associated ocular developmental abnormalities. DESIGN Family genetic study. PARTICIPANTS A total of 23 members, both affected and unaffected, of 1 kindred with vitreoretinopathy. METHOD Individuals within the kindred were examined clinically and blood samples taken for DNA analysis. Genetic analysis was performed for the proximal region of chromosome 5q by means of polymerase chain reaction (PCR). MAIN OUTCOME MEASURES Detection of vitreoretinopathy and associated abnormalities. RESULTS This novel, hereditary vitreoretinopathy, showing the classic features of vitreous pathology and early-onset retinal detachments, was associated with a variety of ocular developmental abnormalities, including posterior embryotoxon, congenital glaucoma, iris hypoplasia, congenital cataract, ectopia lentis, microphthalmia, and persistent hyperplastic primary vitreous. There were no associated systemic features. Genetic mapping with markers from the proximal region of 5q13-q14 showed linkage to a 5-cM region between the markers D5S626 and D5S2103. CONCLUSIONS The 5-cM region is within that implicated in the etiology of both Wagner and erosive vitreoretinopathies. This suggests that this novel condition may be allelic, refines the genetic mapping for vitreoretinopathies that map to 5q13-q14, and implicates a gene important not only in vitreous production but also in early ocular development.
Collapse
Affiliation(s)
- G C Black
- University Department of Medical Genetics and Regional Genetic Service, St. Mary's Hospital, Manchester, England.
| | | | | | | | | | | |
Collapse
|
19
|
Abstract
Stickler syndrome is an autosomal dominant disorder with characteristic ophthalmological and orofacial features, deafness, and arthritis. Abnormalities of vitreous gel architecture are a pathognomonic feature, usually associated with high myopia which is congenital and non-progressive. There is a substantial risk of retinal detachment. Less common ophthalmological features include paravascular pigmented lattice degeneration and cataracts. Non-ocular features show great variation in expression. Children with Stickler syndrome typically have a flat midface with depressed nasal bridge, short nose, anteverted nares, and micrognathia. These features can become less pronounced with age. Midline clefting, if present, ranges in severity from a cleft of the soft palate to Pierre-Robin sequence. There is joint hypermobility which declines with age. Osteoarthritis develops typically in the third or fourth decade. Mild spondyloepiphyseal dysplasia is often apparent radiologically. Sensorineural deafness with high tone loss may be asymptomatic or mild. Occasional findings include slender extremities and long fingers. Stature and intellect are usually normal. Mitral valve prolapse was reported to be a common finding in one series but not in our experience. The majority of families with Stickler syndrome have mutations in the COL2A1 gene and show the characteristic type 1 vitreous phenotype. The remainder with the type 2 vitreous phenotype have mutations in COL11A1 or other loci yet to be identified. Mutations in COL11A2 can give rise to a syndrome with the systemic features of Stickler syndrome but no ophthalmological abnormality.
Collapse
|
20
|
Affiliation(s)
- P Bishop
- Department of Ophthalmology, School of Biological Sciences, University of Manchester, UK
| |
Collapse
|