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Snead MP, Lovicu FJ, Nixon TR, Richards AJ, Martin H. Pathobiology of the crystalline lens in Stickler syndrome. Prog Retin Eye Res 2024:101304. [PMID: 39349161 DOI: 10.1016/j.preteyeres.2024.101304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 09/21/2024] [Accepted: 09/23/2024] [Indexed: 10/02/2024]
Abstract
PURPOSE The Stickler syndromes are a group of connective tissue disorders characterised by congenital myopia, giant retinal tear and retinal detachment, cleft palate, hearing loss and premature arthropathy. Patients with Stickler syndrome are also susceptible to abnormalities of the crystalline lens. Since neither type II or type XI collagen (those typically affected in the vast majority of Stickler patients) are highly expressed in the lens, this observational cohort study explores potential alternative mechanisms to explain why patients frequently exhibit such unusual but characteristic types of cataract. METHODS Author observations drawn from a cohort of over 1,800 patients with genetically confirmed Stickler syndrome. RESULTS 3 distinct lens pathologies were identified. Firstly, a congenital quadrantic lamellar opacity. This can be present in both type 1 (COL2A1) and type 2 (COL11A1) Stickler syndrome. Secondly, early onset Pantone 557 C blue-green nuclear cataract. Thirdly, congenital lens coloboma associated with localised zonule deficiency. CONCLUSIONS The characteristic quadrantic lamellar lens opacity can be helpful in alerting to the possible diagnosis, particularly in sub-groups with an ocular-only phenotype. Temporal and spatial signalling pathways shared embryologically by both the developing vitreous body and crystalline lens suggest an ancillary role of the fibrillar collagens in cell signalling beyond their basic structural function. A common pathway of TGFb/BMP super-family dysregulation may be shared with allied disorders associated with both retinal detachment and cataract as well as the pathobiology linking retinal detachment and cataract in the population at large. Congenital lens coloboma associated with localised zonule deficiency can increase the difficulty and risks of cataract surgery. Strategies to mitigate such risks are presented.
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Affiliation(s)
- Martin P Snead
- Vitreoretinal Research Group, John van Geest Centre for Brain Repair, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0PY, United Kingdom.
| | - Frank J Lovicu
- Save Sight Institute and Molecular and Cellular Biomedicine, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Thomas Rw Nixon
- Vitreoretinal Research Group, John van Geest Centre for Brain Repair, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0PY, United Kingdom
| | - Allan J Richards
- Vitreoretinal Research Group, John van Geest Centre for Brain Repair, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0PY, United Kingdom
| | - Howard Martin
- Vitreoretinal Research Group, John van Geest Centre for Brain Repair, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0PY, United Kingdom
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Choovuthayakorn J, Rajsirisongsri P, Patikulsila D, Nanegrungsunk O, Chaikitmongkol V, Seetasut S, Tantivit Y, Krisanuruks N, Sangkaew A, Tangkitchot P, Apivatthakakul A, Kunavisarut P. Characteristics and surgical outcomes of giant retinal tear associated rhegmatogenous retinal detachment. Sci Rep 2024; 14:19943. [PMID: 39198536 PMCID: PMC11358328 DOI: 10.1038/s41598-024-70898-2] [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: 03/30/2024] [Accepted: 08/22/2024] [Indexed: 09/01/2024] Open
Abstract
Giant retinal tear-associated rhegmatogenous retinal detachment (GRT-RRD) presents a significant surgical challenge. Trauma stands out as one of the risk factors. This retrospective case series aims to assess the outcomes of GRT-RRD patients treated with pars plana vitrectomy (PPV), distinguishing between non-trauma and blunt ocular trauma cases. The medical records and relevant retinal imaging of 60 GRT-RRD patients undergoing PPV and followed with a mean (SD) of 21.2 (13.4) months were reviewed (47 were non-trauma-related and 13 were trauma-related). Both the non-trauma and trauma groups exhibited comparable distribution of proliferative vitreoretinopathy grade (P = 0.067). Following the primary operation, there was no statistically significant difference in the proportion of patients achieving single surgery anatomical success between the non-trauma group (27/47 patients, 57.5%) and the trauma-related group (9/13 patients, 69.2%) (P = 0.534). At the final follow-up, 17 patients remained tamponade with silicone oil. Among the remaining 43 patients, 33/34 patients (97.1%) in the non-trauma group and 9/9 patients (100%) in the non-trauma group (P = 0.661) achieved comparable final surgical anatomical success. Additionally the final vision was comparable between the two trauma categories (Snellen equivalent of 20/125 for the non-trauma group and 20/200 for the trauma group, P = 0.331). In multivariable regression, no significant factors related to primary reattachment rate or final vision were identified. Non-penetrating ocular trauma did not emerge as a significant risk factor for recurrent detachment post-surgery. This study supports that PPV outcomes in GRT-RRD patients are unaffected by the ocular trauma association and reports the effectiveness of PPV in managing these patients.
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Affiliation(s)
- Janejit Choovuthayakorn
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand.
| | - Pongthep Rajsirisongsri
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand
| | - Direk Patikulsila
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand
| | - Onnisa Nanegrungsunk
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand
| | - Voraporn Chaikitmongkol
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand
| | - Sutheerada Seetasut
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand
| | - Yaowaret Tantivit
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand
| | - Napatsorn Krisanuruks
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand
| | - Apisara Sangkaew
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand
| | - Pavinee Tangkitchot
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand
| | - Atitaya Apivatthakakul
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand
| | - Paradee Kunavisarut
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intavaroros Road, Maung, Chiang Mai, 50200, Thailand
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Boysen KB, Tümer Z, Bach-Holm D, Bisgaard AM, Kessel L. Microphthalmia and congenital cataract in two patients with Stickler syndrome type II: a case report. Ophthalmic Genet 2024; 45:313-318. [PMID: 38299479 DOI: 10.1080/13816810.2024.2309700] [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: 08/31/2023] [Revised: 01/12/2024] [Accepted: 01/19/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Stickler syndrome (STL) is a collagenopathy caused by pathogenic variants in collagen-coding genes, mainly COL2A1 or COL11A1 associated with Stickler syndrome type 1 (STL1) or type 2 (STL2), respectively. Affected individuals manifest ocular, auditory, articular, and craniofacial findings in varying degrees. Previous literature and case reports describe high variability in clinical findings for patients with STL. With this case report, we broaden the clinical spectrum of the phenotype. MATERIALS AND METHODS Case report on two members of a family (mother and son) including clinical examination and genetic testing using targeted trio whole exome sequencing (trio-WES). RESULTS A boy and his mother presented with microphthalmia, congenital cataract, ptosis, and moderate-to-severe sensorineural hearing loss. Trio-WES found a novel heterozygote missense variant, c.4526A>G; p(Gln1509Arg) in COL11A1 in both affected individuals. CONCLUSIONS We report a previously undescribed phenotype associated with a COL11A1-variant in a mother and son, expanding the spectrum for phenotype-genotype correlation in STL2, presenting with microphthalmia, congenital cataract, and ptosis not normally associated with Stickler syndrome.
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Affiliation(s)
- Kirstine Bolette Boysen
- Department of Ophthalmology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Zeynep Tümer
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Genetics, Kennedy Center, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Daniella Bach-Holm
- Department of Ophthalmology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Marie Bisgaard
- Department of Paediatrics and Adolescent Medicine, Center for Rare Disease, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Line Kessel
- Department of Ophthalmology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Khatib TZ, Safi A, Nixon TRW, Georgoulas S, Montesano G, Martin H, Richards AJ, McNinch A, Poulson AV, Alexander P, Snead MP. Peripapillary Hyperreflective Ovoid Mass-Like Structures in Stickler Syndrome. Ophthalmol Retina 2024:S2468-6530(24)00235-5. [PMID: 38750936 DOI: 10.1016/j.oret.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/07/2024] [Accepted: 05/07/2024] [Indexed: 06/28/2024]
Abstract
PURPOSE To report a previously undescribed finding of peripapillary hyperreflective ovoid mass-like structures (PHOMS) in Stickler syndrome. DESIGN Noncomparative case series. SUBJECTS Twenty-two eyes with anomalous optic disc from 11 Stickler syndrome patients were identified and imaged. METHODS Peripapillary hyperreflective ovoid mass-like structures were graded using enhanced-depth imaging OCT (EDI-OCT) according to the consensus recommendations of the Optic Disc Drusen Studies Consortium. All EDI-OCT scans were obtained using the Heidelberg Spectralis (Heidelberg Engineering) with a dense horizontal raster (15 × 10°, 97 sections) centered on the optic nerve head and graded by 2 independent assessors. In case of disagreement, the image was graded by a third assessor. The presence of any coexisting optic disc drusen was also assessed using EDI-OCT and autofluorescence. MAIN OUTCOME MEASURES The presence of PHOMS, clinical characteristics and genetic mutations. RESULTS A pilot sample of 22 eyes with phenotypic optic disc abnormalities from 11 Stickler syndrome patients were identified and imaged. Eight patients were female and 3 were male. The mean age was 31 years (13-58 years). Peripapillary hyperreflective ovoid mass-like structures were present in 91% (n = 20) of imaged eyes. Seventy percent (n = 14) were type 1 Stickler syndrome and 30% (n = 6) were type 2 Stickler syndrome. All eyes were myopic and the degree of myopia did not seem to affect whether or not PHOMS was present in this cohort. One eye with PHOMS had retinal detachment, and 77.3% (n = 17) of eyes had undergone 360o prophylactic retinopexy. Thirty-two percent (n = 7) of eyes with PHOMS were present in patients with coexisting hearing loss and 22.7% (n = 5) had orofacial manifestation of Stickler syndrome in the form of a cleft palate. Seventy-seven percent (n = 15) of eyes with PHOMS were present in patients who reported joint laxity or symptoms of arthritis. No coexisting optic disc drusen were identified and raised intracranial pressure was also excluded after neurological investigation. CONCLUSIONS These data suggest that PHOMS are a novel finding in Stickler syndrome patients and should be considered when evaluating the optic nerves of these patients. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Tasneem Z Khatib
- Department of Ophthalmology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; Department of Clinical Neurosciences, Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom; Vitreoretinal Research Group, Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom
| | - Antoine Safi
- Department of Ophthalmology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Thomas Ralph William Nixon
- Department of Ophthalmology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; Vitreoretinal Research Group, Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom
| | - Stylianos Georgoulas
- Department of Ophthalmology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Giovanni Montesano
- Optometry and Visual Sciences, City University of London, London, London, United Kingdom; NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
| | - Howard Martin
- Department of Clinical Neurosciences, Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom; Vitreoretinal Research Group, Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom
| | - Allan J Richards
- Department of Clinical Neurosciences, Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom; Vitreoretinal Research Group, Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom
| | - Annie McNinch
- Department of Ophthalmology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; Department of Clinical Neurosciences, Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom; Vitreoretinal Research Group, Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom
| | - Arabella V Poulson
- Department of Ophthalmology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Philip Alexander
- Department of Ophthalmology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Martin P Snead
- Department of Ophthalmology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; Department of Clinical Neurosciences, Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom; Vitreoretinal Research Group, Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom.
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Ghiam BK, Murali S, Echegaray JJ, Örge FH. Nonperfusion of the Far Peripheral Retina in Highly Myopic Stickler Syndrome. JOURNAL OF VITREORETINAL DISEASES 2024; 8:307-311. [PMID: 38770077 PMCID: PMC11102723 DOI: 10.1177/24741264241237019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Purpose: To describe the clinical course of 3 patients with Stickler syndrome found on fluorescein angiography (FA) to have nonperfusion of the peripheral retina. Methods: Three patients with confirmed Stickler syndrome were examined under anesthesia. Genetic testing and FA were performed. Results: Each patient had characteristic ocular findings of Stickler syndrome, including high myopia with vitreoretinal degeneration. FA was performed on each patient and showed 360 degrees of nonperfusion of the retinal periphery in all eyes, with mild leakage in Case 3. Conclusions: The current series presents evidence of peripheral retinal nonperfusion in 3 consecutive patients with Stickler syndrome. Based on these findings, the authors recommend adopting FA as a standard imaging modality and using laser photocoagulation to treat the areas of retinal nonperfusion for all patients with Stickler syndrome.
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Affiliation(s)
- Benjamin Kambiz Ghiam
- Department of Ophthalmology and Visual Sciences, University Hospitals Rainbow Babies and Children’s Hospital, Case Western Reserve University, Cleveland, OH, USA
| | - Sanjana Murali
- Department of Ophthalmology and Visual Sciences, University Hospitals Rainbow Babies and Children’s Hospital, Case Western Reserve University, Cleveland, OH, USA
| | - Jose J. Echegaray
- Department of Ophthalmology and Visual Sciences, University Hospitals Rainbow Babies and Children’s Hospital, Case Western Reserve University, Cleveland, OH, USA
| | - Faruk H. Örge
- Department of Ophthalmology and Visual Sciences, University Hospitals Rainbow Babies and Children’s Hospital, Case Western Reserve University, Cleveland, OH, USA
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Britten-Jones AC, Ayton LN, Graydon K, Boyce JO, Braden R, Dawkins R, Cham KM. Clinician Awareness of Stickler Syndromes Among Australian Allied Health Care Professionals. J Multidiscip Healthc 2024; 17:1755-1768. [PMID: 38680875 PMCID: PMC11049161 DOI: 10.2147/jmdh.s454428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/08/2024] [Indexed: 05/01/2024] Open
Abstract
Purpose Stickler Syndromes are multisystem collagenopathies affecting 1 in 7500-9000 individuals and are associated with craniofacial, ocular, auditory, and musculoskeletal complications. Prophylactic retinopexy treatment reduces the risk of retinal detachment, emphasising the need for early detection and multidisciplinary referral. This study evaluated knowledge and awareness of Stickler Syndromes among allied health professionals and their perceived needs for targeted education to improve multidisciplinary care. Methods A cross-sectional survey was undertaken among audiologists, speech pathologists, optometrists, orthoptists, and physiotherapists in Australia. Survey questions included practitioner demographics, awareness and knowledge of Stickler Syndromes, confidence managing Stickler Syndromes, and perception of multidisciplinary care needs for Stickler Syndromes. Results Of 180 healthcare professions who participated (79% female; 78% aged between 25 and 44 years), 55% indicated that they had heard of Stickler Syndrome, and 14% had directly worked with patients known to have Stickler Syndromes. Practitioners who had were either optometrists, orthoptists, or audiologists. The most recognised clinical sign of Stickler Syndromes was retinal detachment (selected by 66% of optometrists and orthoptists and 16% of other professions), but only 41% of optometrists and orthoptists (27% all respondents) selected cryopexy as a potential management strategy. Vitreous anomaly was recognised as a clinical feature by 20% of all respondents. Overall, 69% of allied health professionals did not feel confident managing Stickler Syndromes, and a similar number of practitioners (69%) indicated that they were willing to attend professional development courses for complex conditions such as Stickler Syndromes. Conclusion This study provides meaningful insights on awareness and knowledge of Stickler Syndromes among allied healthcare professionals. Targeted clinician education, enhanced communication between healthcare entities, and multidisciplinary care programs can significantly improve the integrated care of Stickler Syndromes leading to better patient outcomes.
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Affiliation(s)
- Alexis Ceecee Britten-Jones
- Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Department of Surgery (Ophthalmology), University of Melbourne, Melbourne, Victoria, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Lauren N Ayton
- Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Department of Surgery (Ophthalmology), University of Melbourne, Melbourne, Victoria, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Kelley Graydon
- Department of Audiology and Speech Pathology, University of Melbourne, Melbourne, Victoria, Australia
| | - Jessica O Boyce
- Department of Audiology and Speech Pathology, University of Melbourne, Melbourne, Victoria, Australia
| | - Ruth Braden
- Department of Audiology and Speech Pathology, University of Melbourne, Melbourne, Victoria, Australia
| | - Rosie Dawkins
- Department of Surgery (Ophthalmology), University of Melbourne, Melbourne, Victoria, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Kwang Meng Cham
- Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - On behalf of The Stickler Syndrome Awareness Study Group
- Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Department of Surgery (Ophthalmology), University of Melbourne, Melbourne, Victoria, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
- Department of Audiology and Speech Pathology, University of Melbourne, Melbourne, Victoria, Australia
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Chen T, Fooladi M, Alabek M, Scanga H, Tripi K, Nischal K, Martel J. Recurrent Retinal Detachment in Stickler Syndrome. RESEARCH SQUARE 2024:rs.3.rs-3941698. [PMID: 38645110 PMCID: PMC11030509 DOI: 10.21203/rs.3.rs-3941698/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Objective To assess clinical factors leading to recurrent retinal detachment (RD) and characteristics of recurrence in patients with Stickler Syndrome. Methods Retrospective case series study of patients with clinical diagnosis of Stickler Syndrome who underwent rhegmatogenous RD repair. Recurrent RD after initial surgery was categorized as "early" if the recurrence was within 1 year or "late" if greater than 1 year. Results Thirty eyes from 22 patients underwent rhegmatogenous RD repair. For initial repair, 13 eyes underwent pars plana vitrectomy combined with scleral buckling (PPV/SB), 16 eyes underwent primary scleral buckling (SB), and 1 eye underwent pneumatic retinopexy (PnR). Recurrent RD occurred in 6 (46%) PPV/SB eyes (5 early and 1 late), 10 (63%) SB eyes (3 early and 7 late), and 0 (0%) PnR eyes (p = 0.61). PPV/SB was preferred for eyes presenting with total detachment (82%), giant retinal tears (100%), and proliferative vitreoretinopathy (PVR) (80%). For eyes with early recurrent RD, 6 (75%) developed PVR leading to recurrence. For eyes with late recurrent RD, 7 (87.5%) developed a new retinal break leading to recurrence, including 4 with a break posterior to the buckle indentation apex. At last follow-up, median LogMAR visual acuity was 0.68 for eyes with recurrent RD compared to 0.29 for eyes without recurrence (p = 0.27). Conclusions Early recurrent RD was mostly caused by PVR, while late recurrent RD was mostly due to new retinal breaks. Eyes with seemingly uncomplicated rhegmatogenous RD repair with primary SB remained at high risk for late re-detachment.
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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.
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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
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Liu G, Hu M, Cai C, Jiang X, Lu F. Retinal detachment with multiple macrocysts in Stickler syndrome: case report and review of the literature. Front Med (Lausanne) 2024; 11:1367281. [PMID: 38596790 PMCID: PMC11002087 DOI: 10.3389/fmed.2024.1367281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 02/26/2024] [Indexed: 04/11/2024] Open
Abstract
Background Stickler syndrome is a hereditary connective tissue disorder associated with ocular, orofacial, musculoskeletal, and auditory impairments. Its main clinical characteristics include retinal detachment, hearing loss, and midface underdevelopment. In clinical practice, macrocyst is rarely reported in retinal detachment cases with Stickler syndrome. Case presentation We report the case of a 7-year-old child who developed a rhegmatogenous retinal detachment (RRD) in the right eye, accompanied by multiple peripheral macrocysts. The detachment was successfully surgically repaired with vitrectomy, retinal laser photocoagulation, cryotherapy and silicone oil tamponade. During the operation, a mini-retinectomy in the outer layer of each macrocyst was made for vesicular drainage and retinal reattachment. Genetic testing identified a pathogenic point mutation variant (c.1693C>T; p.Arg565Cys) in exon 26 of the COL2A1 gene. Six-months after the operation, the retina remained attached with improvement of best corrected visual acuity to 20/200. Conclusion Patients with Stickler syndrome may develop RRD of different severity. Macrocyst is rarely reported in previous literature of Stickler syndrome. In this case report, we share our experience in treating with multiple macrocysts in RRD and emphasize the importance of periodic follow-up for patients with Stickler syndrome.
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Affiliation(s)
| | | | | | | | - Fang Lu
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
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Akhtar S, Wasif M, Afzal Y, Shahab I, Dhanani R, Shaikh AR. Syndromic Piere Robbin Sequence- A Rare Presentation in Association with Multiple Heart Defects and Type III Stickler Syndrome. Indian J Otolaryngol Head Neck Surg 2024; 76:1325-1327. [PMID: 38440550 PMCID: PMC10909042 DOI: 10.1007/s12070-023-04307-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 03/06/2024] Open
Abstract
Pierre Robin Sequence (PRS), a rare congenital disorder, is a triad of micrognathia, glossoptosis, and tongue based airway obstruction (TBSO). It may occur as isolated anomaly (iPRS) or as a part of a syndrome (sPRS), like that seen in association with Stickler Syndrome. Approximately 20% of children with PRS have congenital heart diseases. To the best of our knowledge this case of a one-day old infant is the first one to be reported as having two heart defects; patent ductus arteriosus and patent foramen ovale in Pierre Robbin Sequence child.
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Affiliation(s)
| | | | - Yumna Afzal
- Dr Ziauddin University hospital, Karachi, Pakistan
| | - Iqra Shahab
- Dr Ziauddin University hospital, Karachi, Pakistan
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Tian R, Tong P, He Y, Zang L, Zhou S, Tian Q. Exome sequencing-aided precise diagnosis of four families with type I Stickler syndrome. Mol Genet Genomic Med 2024; 12:e2331. [PMID: 38073514 PMCID: PMC10767595 DOI: 10.1002/mgg3.2331] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 03/11/2023] [Accepted: 11/28/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Stickler syndrome is a multisystemic disorder characterized by ophthalmological and non-ophthalmological abnormalities, frequently misdiagnosed due to high clinical heterogeneity. Stickler syndrome type I (STL1) is predominantly caused by mutations in the COL2A1 gene. METHODS Exome sequencing and co-segregation analysis were utilized to scrutinize 35 families with high myopia, and pathogenic mutations were identified. Mutant COL2A1 was overexpressed in cells for mechanistic study. A retrospective genotype-phenotype correlation analysis was further conducted. RESULTS Two novel pathogenic mutations (c.2895+1G>C and c.3505G>A (p.Val1169Ile)) and two reported mutations (c.1597C>T (p.Arg533*) and c.1693C>T (p.Arg565Cys)) in COL2A1 were identified causing STL1. These mutations are all in the G-X-Y triplet, and c.2895+1G>C contributed to aberrant RNA splicing. COL2A1 mutants tended to form large aggregates in the endoplasmic reticulum (ER) and elevated ER stress. Additionally, mutations c.550G>A (p.Ala184Thr) and c.2806G>A (p.Gly936Ser) in COL2A1 were found in high myopia families, but were likely benign, although c.2806G>A (p.Gly936Ser) is on G-X-Y triplet. Moreover, genotype-phenotype correlation analysis revealed that mutations in exon 2 mainly contribute to retinal detachment, whereas mutations in the collagen alpha-1 chain region of COL2A1 tend to cause non-ophthalmologic symptoms. CONCLUSION This study broadens the COL2A1 gene mutation spectrum, provides evidence for ER stress caused by pathogenic COL2A1 mutations and highlights the importance of non-ophthalmological examination in clinical diagnosis of high myopia.
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Affiliation(s)
- Runyi Tian
- Center for Medical Genetics, School of Life SciencesCentral South UniversityChangshaChina
- Institute of Molecular Precision MedicineXiangya Hospital, Central South UniversityChangshaChina
| | - Ping Tong
- Department of Ophthalmology, The Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Yuhong He
- Institute of Molecular Precision MedicineXiangya Hospital, Central South UniversityChangshaChina
| | - Liyu Zang
- Center for Medical Genetics, School of Life SciencesCentral South UniversityChangshaChina
- Hunan Key Laboratory of Medical Genetics, School of Life SciencesCentral South UniversityChangshaChina
- Hunan Key Laboratory of Animal Models for Human Disease, School of Life SciencesCentral South UniversityChangshaChina
| | - Shimin Zhou
- Center for Medical Genetics, School of Life SciencesCentral South UniversityChangshaChina
- Hunan Key Laboratory of Medical Genetics, School of Life SciencesCentral South UniversityChangshaChina
- Hunan Key Laboratory of Animal Models for Human Disease, School of Life SciencesCentral South UniversityChangshaChina
| | - Qi Tian
- Center for Medical Genetics, School of Life SciencesCentral South UniversityChangshaChina
- Hunan Key Laboratory of Medical Genetics, School of Life SciencesCentral South UniversityChangshaChina
- Hunan Key Laboratory of Animal Models for Human Disease, School of Life SciencesCentral South UniversityChangshaChina
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Stanbury K, Stavinohova R, Pettitt L, Dixon C, Schofield EC, Mclaughlin B, Pettinen I, Lohi H, Ricketts SL, Oliver JA, Mellersh CS. Multiocular defect in the Old English Sheepdog: A canine form of Stickler syndrome type II associated with a missense variant in the collagen-type gene COL11A1. PLoS One 2023; 18:e0295851. [PMID: 38153936 PMCID: PMC10754463 DOI: 10.1371/journal.pone.0295851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 11/30/2023] [Indexed: 12/30/2023] Open
Abstract
Multiocular defect has been described in different canine breeds, including the Old English Sheepdog. Affected dogs typically present with multiple and various ocular abnormalities. We carried out whole genome sequencing on an Old English Sheepdog that had been diagnosed with hereditary cataracts at the age of five and then referred to a board-certified veterinary ophthalmologist due to owner-reported visual deterioration. An ophthalmic assessment revealed that there was bilateral vitreal degeneration, macrophthalmos, and spherophakia in addition to cataracts. Follow-up consultations revealed cataract progression, retinal detachment, uveitis and secondary glaucoma. Whole genome sequence filtered variants private to the case, shared with another Old English Sheepdog genome and predicted to be deleterious were genotyped in an initial cohort of six Old English Sheepdogs (three affected by multiocular defect and three control dogs without evidence of inherited eye disease). Only one of the twenty-two variants segregated correctly with multiocular defect. The variant is a single nucleotide substitution, located in the collagen-type gene COL11A1, c.1775T>C, that causes an amino acid change, p.Phe1592Ser. Genotyping of an additional 14 Old English Sheepdogs affected by multiocular defect revealed a dominant mode of inheritance with four cases heterozygous for the variant. Further genotyping of hereditary cataract-affected Old English Sheepdogs revealed segregation of the variant in eight out of nine dogs. In humans, variants in the COL11A1 gene are associated with Stickler syndrome type II, also dominantly inherited.
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Affiliation(s)
- Katherine Stanbury
- Kennel Club Genetics Centre, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | | | - Louise Pettitt
- Kennel Club Genetics Centre, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | | | - Ellen C. Schofield
- Kennel Club Genetics Centre, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Bryan Mclaughlin
- Kennel Club Genetics Centre, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Inka Pettinen
- Department of Veterinary Biosciences, Department of Medical and Clinical Genetics, University of Helsinki and Folkhälsan Research Center, Helsinki, Finland
| | - Hannes Lohi
- Department of Veterinary Biosciences, Department of Medical and Clinical Genetics, University of Helsinki and Folkhälsan Research Center, Helsinki, Finland
| | - Sally L. Ricketts
- Kennel Club Genetics Centre, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | | | - Cathryn S. Mellersh
- Kennel Club Genetics Centre, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
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Yu X, Yuan J, Chen ZJ, Li K, Yao Y, Xing S, Xue Z, Zhang Y, Peng H, An G, Yu X, Qu J, Su J. Whole-Exome Sequencing Among School-Aged Children With High Myopia. JAMA Netw Open 2023; 6:e2345821. [PMID: 38039006 PMCID: PMC10692858 DOI: 10.1001/jamanetworkopen.2023.45821] [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] [Received: 05/26/2023] [Accepted: 10/17/2023] [Indexed: 12/02/2023] Open
Abstract
Importance High myopia (HM) is one of the leading causes of visual impairment worldwide. Genetic factors are known to play an important role in the development of HM. Objective To identify risk variants in a large HM cohort and to examine the implications of genetic testing of schoolchildren with HM. Design, Setting, and Participants This cohort study retrospectively reviewed whole-exome sequencing (WES) results in 6215 schoolchildren with HM who underwent genetic testing between September 2019 and July 2020 in Wenzhou City, China. HM is defined as a spherical equivalent refraction (SER) of -6.00 diopters (D) or less. The study setting was a genetic testing laboratory and a multicenter school census. Data were analyzed from July 2021 to June 2022. Main Outcomes and Measures The frequency and distribution of positive germline variants, the percentage of individuals with HM in both eyes, and subsequent variant yield for common high myopia (CHM; -8.00 D ≤ SER ≤ -6.00 D), ultra myopia (UM; -10.00 D ≤ SER < -8.00 D), and extreme myopia (EM; SER < -10.00 D). Results Of the 6215 schoolchildren with HM, 3278 (52.74%) were male. Their mean (SD) age was 14.87 (2.02) years, including 355 students in primary school, 1970 in junior high school, and 3890 in senior high school. The mean (SD) SER was -7.51 (-1.36) D for the right eye and -7.46 (-1.34) D for the left eye. Among schoolchildren with HM, genetic testing yielded 271 potential pathogenic variants in 75 HM candidate genes in 964 diagnoses (15.52%). A total of 36 known variants were found in 490 HM participants (7.88%) and 235 protein-truncating variants (PTVs) in 506 participants (8.14%). Involved variant yield was significantly positively associated with SER (Cochran-Armitage test for trend Z = 2.5492; P = .01), which ranged from 7.66% in the CHM group, 8.70% in the UM group, to 11.90% in the EM group. We also found that primary school students with EM had the highest variant yield of PTVs (8 of 35 students [22.86%]), which was 1.77 and 4.78 times that of the UM and CHM, respectively. Conclusions and Relevance In this cohort study of WES for HM, several potential pathogenic variants were identified in a substantial number of schoolchildren with HM. The high variation frequency in younger students with EM can provide clues for genetic screening and clinical examinations of HM to promote long-term follow-up assessment.
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Affiliation(s)
- Xiangyi Yu
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jian Yuan
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Zhen Ji Chen
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Oujiang Laboratory, Zhejiang Laboratory for Regenerative Medicine, Vision and Brain Health, Wenzhou, Zhejiang, China
| | - Kai Li
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, China
| | - Yinghao Yao
- Oujiang Laboratory, Zhejiang Laboratory for Regenerative Medicine, Vision and Brain Health, Wenzhou, Zhejiang, China
| | - Shilai Xing
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Institute of PSI Genomics, Wenzhou, China
| | - Zhengbo Xue
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yue Zhang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Hui Peng
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Gang An
- Institute of PSI Genomics, Wenzhou, China
| | | | - Jia Qu
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Oujiang Laboratory, Zhejiang Laboratory for Regenerative Medicine, Vision and Brain Health, Wenzhou, Zhejiang, China
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, China
| | - Jianzhong Su
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Oujiang Laboratory, Zhejiang Laboratory for Regenerative Medicine, Vision and Brain Health, Wenzhou, Zhejiang, China
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, China
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Wallsh J, Bhatnagar P. Reply. Ophthalmology 2023; 130:e45. [PMID: 37737812 DOI: 10.1016/j.ophtha.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 08/15/2023] [Indexed: 09/23/2023] Open
Affiliation(s)
- Josh Wallsh
- Retina Macula Institute, Torrance, California
| | - Pawan Bhatnagar
- Retina Consultants PLLC, Slingerlands, New York; Albany Medical College, Department of Ophthalmology, Albany, New York
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15
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Fan J, da Cruz NFS, Fan KC, Negron CI, Amescua G, Grajewski AL, Chang TC, Berrocal AM. A patient with concurrent Axenfeld-Rieger and Stickler syndromes verified by molecular genetics. Am J Ophthalmol Case Rep 2023; 32:101931. [PMID: 37822332 PMCID: PMC10562680 DOI: 10.1016/j.ajoc.2023.101931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 07/25/2023] [Accepted: 09/09/2023] [Indexed: 10/13/2023] Open
Abstract
Purpose To report a case of Axenfeld-Rieger and Stickler Syndrome in a pediatric patient. Observations A 3-month-old male was referred to the glaucoma clinic after he was noted to have elevated intraocular pressures in both eyes. His family history was notable for infantile glaucoma on his maternal side and retinal detachment on his paternal side. He was found to have anterior segment dysgenesis with iris strands, iridocorneal adhesions, and corectopia, as well as veil-like vitreous in both eyes. He required trabeculotomy, goniotomy, and multiple Baerveldt glaucoma implants in both eyes to achieve intraocular pressure control. Furthermore, the patient later developed macula-involving retinal detachments in both eyes, requiring pars plana vitrectomy with silicone oil tamponade. Genetic analysis confirmed heterozygous pathogenic variants in both the FOXC1 and COL2A1 genes, leading to the concurrent diagnoses of Axenfeld-Rieger and Stickler syndromes. Conclusions and importance This is a rare case of a patient with concurrent Axenfeld-Rieger and Stickler syndromes. The severity of pathology in both the anterior and posterior segments required a collaborative multidisciplinary approach. In the diagnostic evaluation of congenital eye diseases, if there is strong family history of atypical findings for a given diagnosis, concurrent syndromes should be considered and ruled out. A comprehensive eye genetics panel may be a useful tool in these cases.
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Affiliation(s)
- Jason Fan
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA
| | | | - Kenneth C. Fan
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA
| | - Catherin I. Negron
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA
| | - Guillermo Amescua
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA
| | - Alana L. Grajewski
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA
| | - Ta C. Chang
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA
| | - Audina M. Berrocal
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA
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16
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Zhu X, Xing X, Li D, Yu B. Restoration of vision in Kniest dysplasia patient characterized by retinal detachment with dialysis of the ora serrata: A case report. Medicine (Baltimore) 2023; 102:e36090. [PMID: 38013291 PMCID: PMC10681563 DOI: 10.1097/md.0000000000036090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 10/23/2023] [Indexed: 11/29/2023] Open
Abstract
INTRODUCTION Congenital eye diseases have a significant impact on children and young adults. Retinal detachment associated with Kniest dysplasia represents the most severe ocular complication, which is challenging to diagnose and treat effectively. Genetic testing has emerged as an invaluable tool for diagnosing hereditary diseases. CASE PRESENTATION A 23-year-old male presented to our Ophthalmology Clinic with retinal detachment involving dialysis of the ora serrata in his left eye. High-throughput exon sequencing enabled a definitive diagnosis of Kniest dysplasia resulting from a mutation in the COL2A1 gene. The patient subsequently underwent pars plana vitrectomy with silicone oil injection to reattach the retina. This surgical intervention successfully reattached the retina and restored vision to 20/25 in the affected eye. CONCLUSION Retinal detachment represents the most serious ocular complication associated with Kniest dysplasia. To prevent permanent blindness, early diagnosis through genetic testing and regular ophthalmological examinations are imperative. Advances in genetic screening have improved the management of retinal detachment risk in Kniest dysplasia patients.
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Affiliation(s)
- Xinlei Zhu
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
- Medical College, Qingdao University, Qingdao, China
| | - Xiaoli Xing
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Dongfang Li
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
- Medical College, Qingdao University, Qingdao, China
| | - Bin Yu
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
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Govers BM, van Huet RAC, Roosing S, Keijser S, Los LI, den Hollander AI, Klevering BJ. The genetics and disease mechanisms of rhegmatogenous retinal detachment. Prog Retin Eye Res 2023; 97:101158. [PMID: 36621380 DOI: 10.1016/j.preteyeres.2022.101158] [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: 08/25/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 01/07/2023]
Abstract
Rhegmatogenous retinal detachment (RRD) is a sight threatening condition that warrants immediate surgical intervention. To date, 29 genes have been associated with monogenic disorders involving RRD. In addition, RRD can occur as a multifactorial disease through a combined effect of multiple genetic variants and non-genetic risk factors. In this review, we provide a comprehensive overview of the spectrum of hereditary disorders involving RRD. We discuss genotype-phenotype correlations of these monogenic disorders, and describe genetic variants associated with RRD through multifactorial inheritance. Furthermore, we evaluate our current understanding of the molecular disease mechanisms of RRD-associated genetic variants on collagen proteins, proteoglycan versican, and the TGF-β pathway. Finally, we review the role of genetics in patient management and prevention of RRD. We provide recommendations for genetic testing and prophylaxis of at-risk patients, and hypothesize on novel therapeutic approaches beyond surgical intervention.
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Affiliation(s)
- Birgit M Govers
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ramon A C van Huet
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Susanne Roosing
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Sander Keijser
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Leonoor I Los
- Department of Ophthalmology, University Medical Center Groningen, Groningen, the Netherlands
| | - Anneke I den Hollander
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands; AbbVie, Genomics Research Center, Cambridge, MA, USA
| | - B Jeroen Klevering
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands.
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Kasetty VM, Regan KR, Aye J, Looysen T, Patel N, Hamad AE. CHRONIC PEDIATRIC RETINAL DETACHMENT WITH MULTIPLE MACROCYSTS. Retin Cases Brief Rep 2023; 17:758-762. [PMID: 35972836 PMCID: PMC10597435 DOI: 10.1097/icb.0000000000001288] [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] [Indexed: 06/15/2023]
Abstract
PURPOSE To describe a case of chronic pediatric retinal detachment with multiple macrocysts, its surgical management, and a review of the literature. METHODS Case report with fundus photography and optical coherence tomography. RESULTS We describe a case of an asymptomatic, 11-year-old boy with a chronic rhegmatogenous retinal detachment with multiple peripheral macrocysts. The patient had counting fingers visual acuity on presentation. The detachment was successfully surgically repaired with scleral buckling, subretinal fluid drainage, cryotherapy, and a SF6 tamponade. At the 12-month follow-up, the retina remained attached with improvement of visual acuity to 20/100 with resolution of the cysts. Optical coherence tomography revealed loss of macular ellipsoid zone. Genetic testing revealed a heterozygous dominant COL11A1 mutation. CONCLUSION To the authors' knowledge, this is the first reported case of chronic retinal detachment presenting with multiple peripheral macrocysts in a pediatric patient with Stickler syndrome. More research is needed into the cause and significance of retinal macrocysts, particularly in the pediatric population.
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Affiliation(s)
| | | | - Jennifer Aye
- Department of Ophthalmology, Henry Ford Health System, Detroit, Michigan; and
| | - Tyler Looysen
- Department of Ophthalmology, Henry Ford Health System, Detroit, Michigan; and
| | - Nish Patel
- Department of Ophthalmology, Henry Ford Health System, Detroit, Michigan; and
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Tang XH, Yu MT, Hu Y, He MG, Yang X. Axial length shortening in myopic children with Stickler syndrome after repeated low-level red-light therapy. Int J Ophthalmol 2023; 16:1712-1717. [PMID: 37854367 PMCID: PMC10559035 DOI: 10.18240/ijo.2023.10.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 08/04/2023] [Indexed: 10/20/2023] Open
Abstract
AIM To report the myopia-controlling effect of repeated low-level red-light (RLRL) therapy in patients with Stickler syndrome (STL), an inherited collagenic disease typically presenting with early onset myopia. METHODS Three STL children, aged 3, 7, and 11y, received RLRL therapy throughout the follow-up period of 17, 3, and 6mo, respectively after exclusion of fundus anomalies. Data on best-corrected visual acuity (BCVA), intraocular pressure, cycloplegic subjective refraction, ocular biometrics, scanning laser ophthalmoscope, optical coherence tomography, genetic testing, systemic disease history, and family history were recorded. RESULTS At the initiation of the RLRL therapy, the spherical equivalent (SE) of 6 eyes from 3 patients ranged from -3.75 to -20.38 D, axial length (AL) were from 23.88 to 30.68 mm, and BCVA were from 0.4 to 1.0 (decimal notation). Myopia progression of all six eyes slowed down after RLRL therapy. AL in five out of the six eyes shortened -0.07 to -0.63 mm. No side effects were observed. CONCLUSION Three cases of STL whose progression of myopic shift and AL elongation are successfully reduced and even reversed after RLRL therapy.
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Affiliation(s)
- Xiang-Hua Tang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, Guangdong Province, China
| | - Meng-Ting Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, Guangdong Province, China
| | - Yin Hu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, Guangdong Province, China
| | - Ming-Guang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, Guangdong Province, China
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria 3004, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria 3004, Australia
| | - Xiao Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, Guangdong Province, China
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Belin PJ, Naravane AV, Lu S, Li C, Lum F, Quiram PA. Vitreoretinopathy-Associated Pediatric Retinal Detachment Treatment Outcomes: IRIS® Registry (Intelligent Research in Sight) Analysis. OPHTHALMOLOGY SCIENCE 2023; 3:100273. [PMID: 36950302 PMCID: PMC10025276 DOI: 10.1016/j.xops.2023.100273] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 01/22/2023]
Abstract
Purpose To determine the treatment patterns and outcomes of pediatric retinal detachments (RDs) associated with hereditary vitreoretinopathies. Design Retrospective cohort analysis using IRIS® Registry (Intelligent Research in Sight) database. Participants Patients < 18 years old with a rhegmatogenous RD and a systemic disorder associated with vitreoretinal degeneration (e.g., Stickler syndrome) or other malformation of the vitreous from 2013-2019. Methods Cases were identified using International Classification of Diseases, Ninth and Tenth Revisions (ICD-9, ICD-10) diagnostic codes from the IRIS® Registry cohort. Other hereditary vitreoretinopathies that are not encoded by specific ICD code(s) were captured by text search. Nonspecific vitreous abnormality ICD codes were also included. Exclusion criteria included traumatic retinal detachments using ICD codes for ocular trauma and serous or exudative retinal detachment. Surgical procedures were identified using Current Procedural Terminology (CPT) codes for repair of retinal detachment. Baseline demographic information collected included age, gender, race/ethnicity, geographic region of the provider location, and health insurance status. Main Outcome Measures Main outcomes measured in this study were average time to first surgery, number of eyes presenting with bilateral detachments, and choice of initial surgical procedure. Results A total of 2115 eyes of 1722 patients were identified (mean age, 10.4 years; 58% male). The median time to first surgery was 7 days (interquartile range, 40 days). One thousand four hundred seven eyes of 1134 patients had ≥ 1 year of follow-up, with 506 eyes (36%) developing a fellow eye RD. Thirty-three percent of patients presenting with bilateral detachments, and 349 eyes had initial RD surgery within 1 year of the index date documented by CPT code. Fellow eye detachment occurred a mean of 32 days after initial presentation. The mean number of surgeries per eye within 1 year was 1.68. Best-corrected visual acuity did not improve from a baseline 20/54 to 20/62. The initial procedure was most commonly complex RD repair (n = 176), followed by scleral buckle (n = 102), pars plana vitrectomy (n = 89), laser (n = 59), cryotherapy (n = 5), and pneumatic retinopexy (n = 5). There were 51 new diagnoses of glaucoma and 37 new diagnoses of aphakia within 1 year after the surgical procedure. Conclusions IRIS Registry data provide insight into rare pediatric vitreoretinopathy-associated RDs, which have a high rate of reoperation and fellow eye involvement. Financial Disclosures Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Peter J. Belin
- VitreoRetinal Surgery, PA, Edina, Minnesota
- Correspondence: Peter J. Belin, MD, Retina Consultants of Minnesota, 3601 West 76th Street, Suite 300, Edina, MN 55435
| | - Ameay V. Naravane
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota
| | - Siying Lu
- American Academy of Ophthalmology, San Francisco, California
| | - Charles Li
- American Academy of Ophthalmology, San Francisco, California
| | - Flora Lum
- American Academy of Ophthalmology, San Francisco, California
| | - Polly A. Quiram
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota
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21
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Su Y, Ran CQ, Liu ZL, Yang Y, Yuan G, Hu SH, Yu XF, He WT. Case report: Autosomal recessive type 3 Stickler syndrome caused by compound heterozygous mutations in COL11A2. Front Genet 2023; 14:1154087. [PMID: 37347055 PMCID: PMC10279880 DOI: 10.3389/fgene.2023.1154087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/25/2023] [Indexed: 06/23/2023] Open
Abstract
Background: Stickler syndrome (SS) is a group of hereditary collagenopathies caused by a variety of collagen and non-collagen genes. Affected patients have characteristic manifestations involving ophthalmic, articular, craniofacial and auditory disorders. SS is classified into several subtypes according to clinical and molecular features. Type 3 SS is an ultra-rare disease, known as non-ocular SS or otospondylomegaepiphyseal dysplasia (OSMED) with only a few pathogenic COL11A2 variants reported to date. Case presentation: A 29-year-old Chinese male was referred to our hospital for hearing loss and multiple joint pain. He presented a phenotype highly suggestive of OSMED, including progressive sensorineural deafness, spondyloepiphyseal dysplasia with large epiphyses, platyspondyly, degenerative osteoarthritis, and sunken nasal bridge. We detected compound heterozygous mutations in COL11A2, both of which were predicted to be splicing mutations. One is synonymous mutation c.3774C>T (p.Gly1258Gly) supposed to be a splice site mutation, the other is a novel intron mutation c.4750 + 5 G>A, which is a highly conservative site across several species. We also present a review of the current known pathogenic mutation spectrum of COL11A2 in patients with type 3 SS. Conclusion: Both synonymous extonic and intronic variants are easily overlooked by whole-exome sequencing. For patients with clinical manifestations suspected of SS syndrome, next-generation whole-genome sequencing is necessary for precision diagnosis and genetic counseling.
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Affiliation(s)
- Ying Su
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, China
| | - Chun-Qiong Ran
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, China
| | - Zhe-Long Liu
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, China
| | - Yan Yang
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, China
| | - Gang Yuan
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, China
| | - Shu-Hong Hu
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, China
| | - Xue-Feng Yu
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, China
| | - Wen-Tao He
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Branch of National Clinical Research Center for Metabolic Diseases, Wuhan, China
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22
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Nguyen J, Singh P, Gajjar T. Streptococcal pyomyositis in asplenia and underlying connective tissue disease. Proc AMIA Symp 2023; 36:518-520. [PMID: 37334073 PMCID: PMC10269408 DOI: 10.1080/08998280.2023.2210483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 05/01/2023] [Accepted: 05/02/2023] [Indexed: 06/20/2023] Open
Abstract
Pyomyositis is an infection of skeletal muscles, commonly affecting deep longitudinal muscles of the lower extremities. Primary pyomyositis is uncommon in the United States. Staphylococcus aureus is the most common cause of pyomyositis, but Streptococcus pneumoniae is the most common cause of life-threatening bacterial infection in asplenic patients. Most cases of S. pneumoniae pyomyositis occur in immunocompromised patients. We describe a 31-year-old man with S. pneumoniae pyomyositis whose diagnosis and hospital course were complicated by an immunocompromised state from asplenia and an underlying connective tissue disease, Stickler syndrome. Underlying connective tissue diseases such as systemic lupus erythematosus and polymyositis can predispose patients to infection, but susceptibility with Stickler syndrome is less known. While pyomyositis is only seen in up to 0.2% of US hospital admissions, it remains a pertinent differential for patients with asplenia and connective tissue disease.
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Affiliation(s)
- John Nguyen
- Department of Internal Medicine, Baylor Scott & White Medicine Center – Round Rock, Round Rock, Texas
| | - Pardeep Singh
- Department of Internal Medicine, Baylor Scott & White Medicine Center – Round Rock, Round Rock, Texas
| | - Tapas Gajjar
- Department of Internal Medicine, Baylor Scott & White Medicine Center – Round Rock, Round Rock, Texas
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23
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Flitcroft I, Ainsworth J, Chia A, Cotter S, Harb E, Jin ZB, Klaver CCW, Moore AT, Nischal KK, Ohno-Matsui K, Paysse EA, Repka MX, Smirnova IY, Snead M, Verhoeven VJM, Verkicharla PK. IMI-Management and Investigation of High Myopia in Infants and Young Children. Invest Ophthalmol Vis Sci 2023; 64:3. [PMID: 37126360 PMCID: PMC10153576 DOI: 10.1167/iovs.64.6.3] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
Purpose The purpose of this study was to evaluate the epidemiology, etiology, clinical assessment, investigation, management, and visual consequences of high myopia (≤-6 diopters [D]) in infants and young children. Findings High myopia is rare in pre-school children with a prevalence less than 1%. The etiology of myopia in such children is different than in older children, with a high rate of secondary myopia associated with prematurity or genetic causes. The priority following the diagnosis of high myopia in childhood is to determine whether there is an associated medical diagnosis that may be of greater overall importance to the health of the child through a clinical evaluation that targets the commonest features associated with syndromic forms of myopia. Biometric evaluation (including axial length and corneal curvature) is important to distinguishing axial myopia from refractive myopia associated with abnormal development of the anterior segment. Additional investigation includes ocular imaging, electrophysiological tests, genetic testing, and involvement of pediatricians and clinical geneticists is often warranted. Following investigation, optical correction is essential, but this may be more challenging and complex than in older children. Application of myopia control interventions in this group of children requires a case-by-case approach due to the lack of evidence of efficacy and clinical heterogeneity of high myopia in young children. Conclusions High myopia in infants and young children is a rare condition with a different pattern of etiology to that seen in older children. The clinical management of such children, in terms of investigation, optical correction, and use of myopia control treatments, is a complex and often multidisciplinary process.
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Affiliation(s)
- Ian Flitcroft
- Children's Health Ireland (CHI) at Temple Street, Dublin, Ireland
- Centre for Eye Research Ireland, Technological University of Dublin, Dublin, Ireland
| | - John Ainsworth
- Birmingham Children's Hospital, Steelhouse Lane Birmingham, United Kingdom
| | | | - Susan Cotter
- Southern California College of Optometry, Marshall B Ketchum University, Fullerton, California, United States
| | - Elise Harb
- Wertheim School Optometry and Vision Science, Berkeley, California, United States
- University of California - San Francisco, School of Medicine, San Francisco, California, United States
| | - Zi-Bing Jin
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Caroline C W Klaver
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Anthony T Moore
- University of California - San Francisco, School of Medicine, San Francisco, California, United States
| | - Ken K Nischal
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | | | - Evelyn A Paysse
- Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, United States
| | - Michael X Repka
- Wilmer Eye Institute, The John Hopkins University School of Medicine, Baltimore, Maryland, United States
| | | | - Martin Snead
- Department of Vitreoretinal Research, John van Geest Centre for Brain Repair, University of Cambridge, United Kingdom
| | - Virginie J M Verhoeven
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
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24
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Alexander P, Fincham GS, Brown S, Collins D, McNinch AM, Poulson AV, Richards A, Martin H, Wareham N, Snead MP. Cambridge Prophylactic Protocol, Retinal Detachment, and Stickler Syndrome. N Engl J Med 2023; 388:1337-1339. [PMID: 37018499 DOI: 10.1056/nejmc2211320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Affiliation(s)
| | | | - Senjah Brown
- Addenbrooke's Hospital, Cambridge, United Kingdom
| | - David Collins
- University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Annie M McNinch
- University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | | | - Allan Richards
- University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Howard Martin
- University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Nick Wareham
- University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Martin P Snead
- University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
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25
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Liu Z, Mo F, Dong X, Chen G, Gao J, Zhang J. Progressive degeneration of the retina in Loxl3 mutant mouse model of Stickler syndrome. Dev Biol 2023; 495:54-62. [PMID: 36610533 DOI: 10.1016/j.ydbio.2023.01.002] [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: 08/27/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 01/06/2023]
Abstract
Stickler syndrome is a multisystem collagenopathy with affected individuals exhibiting a high rate of ocular complications. Lysyl oxidase-like 3 (LOXL3) is a human disease gene candidate with a critical role in catalyzing collagen crosslinking. A homozygous missense variant of LOXL3 was reported in Stickler syndrome with severe myopia. However, the underlying mechanisms of the LOXL3 missense mutation that causes Stickler syndrome are unknown. In this study, a mouse model of Stickler syndrome induced by LOXL3 mutation (c.2027G > A, p.Cys676Try) was obtained using CRISPR/Cas9 gene editing techniques. The Loxl3 mutant mice exhibited perinatal death, spinal deformity, and cleft palate, and Loxl3 mutation also induced skeletal dysplasia and progressive visual degeneration. Furthermore, we observed the damage of the bruch's membrane (BrM) and an increase in the levels of glial fibrillary acidic protein (GFAP) and Rpe65 in the Loxl3 mutant mice. Thus, we provided the critical in vivo evidence that Loxl3 possibly has a pivotal role in maintaining the eye function.
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Affiliation(s)
- Ziyi Liu
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, China
| | - Fan Mo
- School of Life Science, Shandong University, Qingdao, China
| | - Xinyu Dong
- School of Life Science, Shandong University, Qingdao, China
| | - Ge Chen
- School of Life Science, Shandong University, Qingdao, China
| | - Jiangang Gao
- School of Life Science, Shandong University, Qingdao, China.
| | - Jian Zhang
- School of Life Science, Shandong University, Qingdao, China.
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26
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Magliyah MS, Almarek F, Nowilaty SR, Al-Abdi L, Alkuraya FS, Alowain M, Schatz P, Alfaadhel T, Khan AO, Alsulaiman SM. LEPREL1 -RELATED GIANT RETINAL TEAR DETACHMENTS MIMIC THE PHENOTYPE OF OCULAR STICKLER SYNDROME. Retina 2023; 43:498-505. [PMID: 36729830 DOI: 10.1097/iae.0000000000003691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE To describe the features of retinal detachments and high myopia in patients with novel pathogenic variants in LEPREL1 and report a possible association with nephropathy. METHODS Retrospective study of 10 children with biallelic LEPREL1 pathogenic variants. Data included ophthalmic features, surgical interventions, and genetic and laboratory findings. RESULTS 10 patients (8 females) from three families with homozygous (2) or compound heterozygous (1) variants in LEPREL1 were included. At presentation, mean age was 9.9 ± 2.6 years. Mean axial length was 28.9 ± 1.9 mm and mean refraction was -13.9 ± 2.8 diopters. Bilateral posterior subcapsular cataracts were present in eight patients (80%), with lens subluxation in five eyes of three patients (30%). Rhegmatogenous retinal detachments (RRD), associated with giant retinal tears (GRT), developed in seven eyes of five patients (50%) at a mean age of 14.14 ± 5.9 years. Six were successfully reattached with mean Snellen best-corrected visual acuity improving from 20/120 preoperatively to 20/60 at last follow-up. Urinalysis in nine patients revealed microhematuria and/or mild proteinuria in six patients (67%). CONCLUSION LEPREL1 -related high myopia confers a high risk of early-onset GRT-related RRD. The ocular phenotype may be confused with that of ocular Stickler syndrome if genetic testing is not performed. Further investigations into a potential association with renal dysfunction are warranted.
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Affiliation(s)
- Moustafa S Magliyah
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Department of Ophthalmology, Prince Mohammed Medical City, AlJouf, Saudi Arabia
| | - Faisal Almarek
- Department of Ophthalmology, Imam Mohammed Bin Saud Islamic University, Riyadh, Saudi Arabia
| | - Sawsan R Nowilaty
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Lama Al-Abdi
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- Department of Anatomy and Cell Biology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Fowzan S Alkuraya
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- Department of Anatomy and Cell Biology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Mohammed Alowain
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Patrik Schatz
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Department of Ophthalmology, Clinical Sciences, Skane University Hospital, Lund University, Lund, Sweden
| | - Talal Alfaadhel
- Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Arif O Khan
- Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates; and
- Department of Ophthalmology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
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27
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Trinh MV, Lee JG, Ferrone PJ. Stickler and Wagner Syndrome in African Americans. Ophthalmic Surg Lasers Imaging Retina 2023; 54:97-101. [PMID: 36780631 DOI: 10.3928/23258160-20221118-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
BACKGROUND Stickler (STL) and Wagner (WGN) syndromes are rare inherited vitreoretinopathies associated with retinal detachments (RD). There is a paucity of case reports describing these diseases in African American patients. METHODS An IRB-approved, retrospective chart review of African American patients with genetically proven ocular-only STL or WGN was performed, and 6 patients were identified. RESULTS Three patients had a COL2A1 mutation, two had a COL11A1 mutation, and one had a VCAN mutation. None had Pierre Robin facies. All were myopes with lattice degeneration and five had RD. Three underwent RD repair with vitrectomy (PPV), scleral buckle (SB), endolaser (EL), and silicone oil (SO). Two received laser retinopexy for localized RD and one received a prophylactic SB with 360° peripheral laser retinopexy. CONCLUSION STL and WGN should be considered in myopic African American patients with lattice degeneration, giant retinal tears, abnormal vitreous, or spontaneous RD. Prophylactic laser treatment and aggressive surgical treatment of RD should be considered. [Ophthalmic Surg Lasers Imaging Retina 2023;54:97-101.].
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28
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Naravane AV, Belin PJ, Quiram PA. Retinal Detachment Prophylaxis for Patients With Stickler Syndrome: A Survey of Pediatric Retinal Specialist Treatment Preferences. Ophthalmic Surg Lasers Imaging Retina 2023; 54:102-107. [PMID: 36780636 DOI: 10.3928/23258160-20230119-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
BACKGROUND AND OBJECTIVE Stickler syndrome is the most common inherited cause of pediatric rhegmatogenous retinal detachment. The purpose of this study was to survey pediatric retinal surgeon preferences for prophylactic treatment of Stickler syndrome patients. STUDY DESIGN A voluntary, anonymous 27-question survey was developed by RedCap and distributed to the Association of Pediatric Retinal Surgeons. The survey was distributed on March 17, 2021. Results were tabulated on April 12, 2021 in Microsoft Excel. All surveys returned were included. RESULTS Thirty-four (76% response rate) respondents completed the survey. Twenty-six (76%) reported primarily using prophylactic laser retinopexy, four (12%) preferred use of cryotherapy, and 12% reported using prophylactic scleral buckle. CONCLUSIONS The majority of the United States. and international pediatric retinal surgeons use laser retinopexy as the primary method of prophylactic treatment. These results may serve as a benchmark for retinal surgeons less familiar with prophylactic treatment approaches. [Ophthalmic Surg Lasers Imaging Retina 2023;54:102-107.].
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Burdová MČ, Štěpánková J, Pourová RK, Mahelková G, Hložánek M, Kožner P, Dotřelová D. Long-term anatomical and functional outcomes of surgical treatment of retinal complications in children and adolescents with Stickler syndrome between 2004 and 2021. Graefes Arch Clin Exp Ophthalmol 2023; 261:1723-1729. [PMID: 36595051 DOI: 10.1007/s00417-022-05960-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/30/2022] [Accepted: 12/21/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Stickler syndrome (STL) is an inherited progressive connective tissue collagen disorder. STL is the most common hereditary cause of retinal complications, retinal tears, and the development of retinal detachment (RD) in childhood. The aim of the study was to evaluate the long-term anatomical and functional results of surgical treatment of retinal complications in children and adolescents affected by STL. METHODS A retrospective, single-center study was performed a cohort of children with STL who underwent retinal surgery between 2004 and 2021. RESULTS The study group consisted of nine children; the mean age at the time of the retinal tear with/without retinal detachment was 7.2 (2-10) years, and the mean follow-up period was 9.6 (5-16) years. Pathogenic variants COL2A1 (5 children) and COL11A1 (3 children) were confirmed in our cohort. In total, we operated on 13 eyes, 11 eyes with complicated RD and two eyes with multiple retinal defects, but without RD. At the end of the follow-up period, an attached retina was achieved 77% (10 eyes) with or without silicone oil tamponade: cryopexy alone was successful in one eye (10%), scleral buckling (EB) in five eyes (50%), and vitrectomy with silicone oil tamponade combined with EB in four eyes (40%). The mean number of surgeries was 2.3 per eye. The resulting best corrected visual acuity ranged from 0.03 to 0.1 in one eye, from 0.16 to 0.4 in two eyes, and from 0.5 to 1.0 in 7 eyes. CONCLUSION Repair of retinal tears with/without retinal detachment in patients with Stickler syndrome often requires multiple surgeries with combinations of cryopexy, scleral buckling, and/or vitrectomy with silicone oil tamponade. Treatment of the ocular complications arising from STL requires long-term comprehensive care.
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Affiliation(s)
- Marie Česká Burdová
- Department of Ophthalmology, Charles University, 2nd Faculty of Medicine and University Hospital in Motol, V Úvalu 84/1, 150 06, Prague, Czech Republic.
| | - Jana Štěpánková
- Department of Ophthalmology, Charles University, 2nd Faculty of Medicine and University Hospital in Motol, V Úvalu 84/1, 150 06, Prague, Czech Republic
| | - Radka Kremlíková Pourová
- Department of Biology and Medical Genetics, Charles University, 2nd Faculty of Medicine, Prague, Czech Republic
| | - Gabriela Mahelková
- Department of Ophthalmology, Charles University, 2nd Faculty of Medicine and University Hospital in Motol, V Úvalu 84/1, 150 06, Prague, Czech Republic.,Department of Physiology, Charles University, 2nd Faculty of Medicine, Prague, Czech Republic
| | - Martin Hložánek
- Department of Ophthalmology, Charles University, 2nd Faculty of Medicine and University Hospital in Motol, V Úvalu 84/1, 150 06, Prague, Czech Republic
| | - Pavel Kožner
- Department of Ophthalmology, Charles University, 2nd Faculty of Medicine and University Hospital in Motol, V Úvalu 84/1, 150 06, Prague, Czech Republic
| | - Dagmar Dotřelová
- Department of Ophthalmology, Charles University, 2nd Faculty of Medicine and University Hospital in Motol, V Úvalu 84/1, 150 06, Prague, Czech Republic
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30
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Linton E, Jalil A, Sergouniotis P, Moussa G, Black G, Charles S, Ivanova T. LASER PROPHYLAXIS IN STICKLER SYNDROME: The Manchester Protocol. Retina 2023; 43:88-93. [PMID: 36165842 DOI: 10.1097/iae.0000000000003634] [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: 07/03/2022] [Accepted: 09/17/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Patients with Stickler syndrome are at high risk of giant retinal tears (GRTs) and detachments. Vitreoretinal interventions can reduce this risk, but there is presently no consensus about the optimal prophylactic approach. The aim of our study was to determine whether 360° laser prophylaxis is a safe and effective procedure to prevent GRT detachments in patients with Stickler syndrome. METHODS Study subjects were recruited retrospectively through the databases of the vitreoretinal and ophthalmic genetic tertiary services in Manchester, United Kingdom. Clinical data were collected including on prophylactic intervention, the occurrence of retinal detachment, and the presence/type of retinal breaks. RESULTS One hundred thirteen eyes from 63 patients with Stickler syndrome were studied; 72.6% (82/113) of these eyes received 360° laser prophylaxis. Of these, 9% had a retinal detachment, but no GRTs occurred. Among the 27.4% (31/113) of eyes that had no prophylactic treatment, 23% suffered a retinal detachment and 42.9% of these were associated with a GRT. CONCLUSION Patients who underwent laser prophylaxis had fewer retinal detachments and no GRTs during an average of 6.1 years of follow-up (median 5 years), suggesting that this is a safe and effective approach for individuals with Stickler syndrome.
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Affiliation(s)
- Emma Linton
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Assad Jalil
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Panagiotis Sergouniotis
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
- Division of Evolution, Infection & Genomics, School of Biological Sciences, Faculty of Biology, Medicines and Health, University of Manchester, Manchester, United Kingdom; and
- Manchester Centre for Genomic Medicine, Saint Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - George Moussa
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Graeme Black
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
- Division of Evolution, Infection & Genomics, School of Biological Sciences, Faculty of Biology, Medicines and Health, University of Manchester, Manchester, United Kingdom; and
- Manchester Centre for Genomic Medicine, Saint Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Stephen Charles
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Tsveta Ivanova
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
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Fernández-Pérez JJ, Mascaraque-Ruiz P, Martín-Gómez C, Martínez-Caballero I, Otón T, Carmona L, Lerma-Lara S. Musculoskeletal and Gait Characteristics in Patients with Stickler Syndrome: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121895. [PMID: 36553338 PMCID: PMC9777477 DOI: 10.3390/children9121895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/24/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Stickler syndrome (SS) is a connective tissue disorder of fibrillary collagen with very variable clinical manifestations, including premature osteoarthritis and osteopenia. This musculoskeletal alteration may affect gait maturity or produce strength difficulties. OBJECTIVE Our aim was to describe the musculoskeletal characteristics, bone stiffness, gait kinematics, and kinetics of SS patients. METHODS This is a cross-sectional study of children and youngsters with SS recruited by telephone calls through the Spanish SS Association. All participants underwent an analysis of musculoskeletal characteristics, including a 3D gait analysis. RESULTS The sample included 26 SS patients, mainly boys (65.4%) with a median age of 11 (IQR 5-14). The manual muscle testing was normal in 88.5% of patients. The median distance covered in the 6-min walking test was 560.1 ± 113.4 m. Bone stiffness index scores were 70.9 ± 19.7 for children under 10 years and 88.3 ± 17.5 for children older than 10 years. The gait indicators GPS and GDI were: 7.4 ± 1.9 and 95.3 ± 9.7, respectively, for the left side and 6.8 ± 2.0 and 97.7 ± 9.5 for the right side, respectively. CONCLUSIONS In our series of patients with SS, we found muscle-articular involvement does not have a high impact on strength or gait problems. More work is needed to understand the effect of SS on the musculoskeletal system.
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Affiliation(s)
- Juan José Fernández-Pérez
- Toledo Physiotherapy Research Group (GIFTO), Faculty of Physiotherapy and Nursing, Castilla la Mancha University, 45004 Toledo, Spain
| | | | - Carlos Martín-Gómez
- Facultad de Ciencias de la Salud, CSEU La Salle, UAM, 28023 Madrid, Spain
- Fundación Hospital Universitario Niño Jesús, 28009 Madrid, Spain
| | | | - Teresa Otón
- Instituto de Salud Musculoesquelética, 28045 Madrid, Spain
| | - Loreto Carmona
- Instituto de Salud Musculoesquelética, 28045 Madrid, Spain
| | - Sergio Lerma-Lara
- Facultad de Ciencias de la Salud, CSEU La Salle, UAM, 28023 Madrid, Spain
- Correspondence:
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32
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Wang A, Snead M. Comment on: Managing paediatric giant retinal tears. Eye (Lond) 2022; 36:2219. [PMID: 35197563 PMCID: PMC9581959 DOI: 10.1038/s41433-022-01983-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/03/2022] [Accepted: 02/09/2022] [Indexed: 11/08/2022] Open
Affiliation(s)
- Aijing Wang
- Royal Glamorgan Hospital, Cwm Taf Morgannwg UHB, Pontyclun, Wales
| | - Martin Snead
- Vitreoretinal Research Group, van Geest Centre for Brain Repair, University of Cambridge, Cambridge, UK.
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Zaheer HA, Parameswarappa DC, Zaheer MA, Chhablani J, Patil-Chhablani P. Ocular Manifestations in Patients with Sensorineural Hearing Loss. J Ophthalmic Vis Res 2022; 17:551-573. [PMID: 36620710 PMCID: PMC9806326 DOI: 10.18502/jovr.v17i4.12321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 08/30/2022] [Indexed: 12/02/2022] Open
Abstract
Identification of ocular manifestations in patients with sensorineural hearing loss (SNHL) can have a large impact on the outcome and treatment of pediatric patients. Due to the common co-incidence of ocular manifestations and SNHL in children, both ophthalmologic and hearing loss screening and routine examinations must be conducted to minimize adverse outcomes and worsening of pathology. Early evaluation and diagnosis is imperative for intervention and further development of the patient. Co-incidence requires a thorough evaluation that includes a comprehensive history, examination, and diagnostic testing. In this article, a literature review was conducted to analyze the presentations of various diseases and syndromes, such as Alport Syndrome, Waardenburg Syndrome, Norrie Disease, Usher Disease, Stickler Syndrome, Marfan Syndrome, Congenital Rubella, and Hereditary Optic Neuropathies. We divided the various ocular pathologies into anterior and posterior segment presentations and associated systemic findings for better understanding. Additionally, this review aims to include an update on the management of patients with both ocular and hearing loss manifestations.
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Affiliation(s)
- Haniah A. Zaheer
- Department of Ophthalmology, University of Pittsburgh School of Medicine,
Pittsburgh, PA, USA
| | | | - Myra A. Zaheer
- School of Medicine and Health Sciences, George Washington University,
Washington DC, USA
| | - Jay Chhablani
- UPMC Eye Center, University of Pittsburgh, Pittsburgh, PA, USA
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Snead MP, Richards AJ, McNinch AM, Alexander P, Martin H, Nixon TRW, Bale P, Shenker N, Brown S, Blackwell AM, Poulson AV. Stickler syndrome - lessons from a national cohort. Eye (Lond) 2022; 36:1966-1972. [PMID: 34611315 PMCID: PMC8491173 DOI: 10.1038/s41433-021-01776-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 09/14/2021] [Accepted: 09/14/2021] [Indexed: 11/17/2022] Open
Abstract
In 2011 NHS England commissioned a new national specialist MDT service for patients and families affected by Stickler syndrome. The Stickler syndromes form part of the spectrum of inherited vitreoretinopathies and are the most common cause of retinal detachment in childhood and the most common cause of familial retinal detachment. Now in its 10th year, the Stickler Highly Specialised Service (HSS) has assessed 1673 patients from 785 families. Using a combination of accurate phenotyping and molecular genetic analysis it is possible to identify the underlying genetic mutation in over 95% of cases including those with deep intronic mutations likely to be missed by conventional exome panel analysis and which require whole gene sequencing and supplementary functional analysis to confirm pathogenicity. The vast majority that presents to ophthalmologists will be from one of three autosomal dominant sub-groups with a high associated risk of retinal detachment but the diagnosis is often overlooked, especially in adults. In contrast to many other blinding retinal conditions, blindness through giant retinal tear detachment particularly in children is largely preventable provided these high-risk groups are identified and appropriate evidence-based prophylaxis offered. This article summarises ten selected briefcase histories from the national dataset with key learning points from each.
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Affiliation(s)
- M P Snead
- NHS England Highly Specialised Stickler Syndrome Diagnostic Service, Cambridge University NHS Foundation Trust, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK.
- Vitreoretinal Research Group, John van Geest Centre for Brain Repair, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0PY, UK.
| | - A J Richards
- NHS England Highly Specialised Stickler Syndrome Diagnostic Service, Cambridge University NHS Foundation Trust, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK
- Vitreoretinal Research Group, John van Geest Centre for Brain Repair, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0PY, UK
| | - A M McNinch
- NHS England Highly Specialised Stickler Syndrome Diagnostic Service, Cambridge University NHS Foundation Trust, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK
- Vitreoretinal Research Group, John van Geest Centre for Brain Repair, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0PY, UK
| | - P Alexander
- NHS England Highly Specialised Stickler Syndrome Diagnostic Service, Cambridge University NHS Foundation Trust, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK
| | - H Martin
- NHS England Highly Specialised Stickler Syndrome Diagnostic Service, Cambridge University NHS Foundation Trust, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK
- Vitreoretinal Research Group, John van Geest Centre for Brain Repair, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0PY, UK
| | - T R W Nixon
- NHS England Highly Specialised Stickler Syndrome Diagnostic Service, Cambridge University NHS Foundation Trust, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK
| | - P Bale
- Department of Rheumatology Cambridge University NHS Foundation Trust, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK
| | - N Shenker
- Department of Rheumatology Cambridge University NHS Foundation Trust, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK
| | - S Brown
- NHS England Highly Specialised Stickler Syndrome Diagnostic Service, Cambridge University NHS Foundation Trust, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK
| | - A M Blackwell
- NHS England Highly Specialised Stickler Syndrome Diagnostic Service, Cambridge University NHS Foundation Trust, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK
| | - A V Poulson
- NHS England Highly Specialised Stickler Syndrome Diagnostic Service, Cambridge University NHS Foundation Trust, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK
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Quality of Life in Children and Adolescents with Stickler Syndrome in Spain. CHILDREN 2022; 9:children9081255. [PMID: 36010145 PMCID: PMC9406814 DOI: 10.3390/children9081255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/02/2022] [Accepted: 08/13/2022] [Indexed: 11/26/2022]
Abstract
Objective: To describe the quality of life and daily functioning of Spanish children and adolescents living with Stickler syndrome (SS) and to estimate the prevalence of associated disease features in a representative sample. Methods: A cross-sectional study of children and adolescents with SS were recruited via telephone calls through the Spanish SS Association. All participants underwent a structured clinical interview and filled in questionnaires reporting their quality of life (EuroQol-5D, TSK-11, CHAQ and PedsQoL). The prevalence of the main features associated with the syndrome and the mean scores of the questionnaires were estimated with 95% confidence intervals (95% CI). Results: The recruited sample included 26 persons who were mainly children (mean age 10.4 ± 4.5 (SD) range: 5–14) and male (65.4%). The prevalence estimates of SS features were as follows: the presence of moderate pain (52%), hearing loss 67% (95% CI: 54.8 to 91.3) and myopia 96% (95% CI: 87.2 to 104.4). The mean scores of the QoL indices were as follows: 22.4 (95% CI: 19.2 to 25.5) (±7.5) for TSK-11; 76.2 (95% CI: 68.8 to 83.6) (±17.1) for PedsQoL, 0.8 (95% CI: 0.7 to 0.9) (±0.3) for EQ-5D and 0.61 (95% CI: 0.24 to 1.0) (±0.9) for the cHAQ functional index. Conclusions: Our results confirmed a high variability in syndrome-related manifestations, with a large prevalence of visual and hearing deficits, pain and maxillofacial alterations. These findings may facilitate the detection of the most prevalent problems in this population, which could be a target to be addressed during the treatment of children and adolescents with SS.
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Gupta V, Somarajan BI, Gupta S, Mahalingam K, Kumar M, Singh A. Association of EFEMP1 with juvenile-onset open angle glaucoma in a patient with concomitant COL11A1-related Stickler syndrome. Ophthalmic Genet 2022; 44:281-285. [PMID: 35946471 DOI: 10.1080/13816810.2022.2109682] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
BACKGROUND Juvenile onset open-angle glaucoma is described as a primary open-angle glaucoma, with an age of onset before 40 years. These patients have a higher prevalence of myopia. PURPOSE We describe the phenotype of juvenile onset open-angle glaucoma in a patient with a rare variant in EFEMP1 gene, who was also detected to have Stickler syndrome(STL). METHODS Whole exome sequencing (WES) was undertaken in 40 unrelated families where the proband had juvenile onset open-angle glaucoma (JOAG). RESULTS Out of these, eight were autosomal dominant, while the rest did not have any other affected first-degree relative. Out of the 8 autosomal dominant JOAG families, MYOC mutations were detected in 3(37.5%) and LTBP2 in 1(12.5%). One family (12.5%) had a rare EFEMP1 sequence variant in both affected father and daughter. The daughter also had high myopia and a pathogenic COL11A1 sequence variant that led to a coincidental diagnosis of STL in her. CONCLUSIONS This is a rare association of EFEMP1 and COL11A1 sequence variants in a JOAG patient with STL. The study also reiterates the association of JOAG with EFEMP1, which should be looked for, especially in families with autosomal dominant JOAG.
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Affiliation(s)
- Viney Gupta
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Bindu I Somarajan
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Shikha Gupta
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Karthikeyan Mahalingam
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Manoj Kumar
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi, India
| | - Abhishek Singh
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Kandeeban S, Kandale K, Periyasamy P, Bhende M, Bhende P, Sinnakaruppan M, Sarangapani S. Genetic testing in four Indian families with suspected Stickler syndrome. Indian J Ophthalmol 2022; 70:2578-2583. [PMID: 35791160 PMCID: PMC9426114 DOI: 10.4103/ijo.ijo_1833_21] [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] [Indexed: 11/06/2022] Open
Abstract
Purpose: Stickler syndrome is associated with the development of rhegmatogenous retinal detachment (RRD), and often presents with ocular, auditory, skeletal, and orofacial abnormalities. Molecular analysis has proven effective in diagnosis, confirmation and classification of the disease. We aimed to describe the utility of next-generation sequencing (NGS) in genetic analysis of four Indian families with suspected Stickler syndrome. Methods: The index cases presented with retinal detachment with family history. Genetic analysis in the index case was performed by next-generation sequencing of inherited retinal degeneration genes, and validated by Sanger sequencing followed by co-segregation analysis in the other family members. Results: Twenty patients were included for the genetic analysis (15 males and 5 females from four families). Clinical details were available for 15 patients (30 eyes). Fourteen eyes (11 patients) developed RRD. In the 16 eyes without RRD, 8 underwent barrage laser to lattice degeneration and 8 were under observation. Disease segregating heterozygous mutations with pathogenic/likely pathogenic effect was identified in COL2A1 (c.4318-1G>A, c.141G>A, c.1221+1G>A for 3 families) and COL11A1 (c.1737+1 G>A for 1 family) gene. In addition to the mutation in the COL2A1 gene, a pathogenic heterozygous variant associated with risk for arrhythmogenic right ventricular cardiomyopathy (ARVC) was identified in one member. Conclusion: NGS testing confirmed the presence of the causative gene for Stickler syndrome in the index case followed by evaluation of family members and confirmation of genetic and ocular findings. We believe that this may be the first such report of families with RRD from India.
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Affiliation(s)
- Suganya Kandeeban
- SNONGC Department of Genetics and Molecular Biology, Vision Research Foundation, Chennai, Tamil Nadu, India
| | - Kaustubh Kandale
- Shri Bhagwan Mahavir Department of VitroRetinal Services, Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Porkodi Periyasamy
- SNONGC Department of Genetics and Molecular Biology, Vision Research Foundation, Chennai, Tamil Nadu, India
| | - Muna Bhende
- Shri Bhagwan Mahavir Department of VitroRetinal Services, Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Pramod Bhende
- Shri Bhagwan Mahavir Department of VitroRetinal Services, Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Mathavan Sinnakaruppan
- SNONGC Department of Genetics and Molecular Biology, Vision Research Foundation, Chennai, Tamil Nadu, India
| | - Sripriya Sarangapani
- Shri Bhagwan Mahavir Department of VitroRetinal Services, Medical Research Foundation, Chennai, Tamil Nadu, India
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Alexander P, Snead MP. Prevention of Blindness in Stickler Syndrome. Genes (Basel) 2022; 13:genes13071150. [PMID: 35885933 PMCID: PMC9318672 DOI: 10.3390/genes13071150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 12/04/2022] Open
Abstract
Stickler syndromes are inherited conditions caused by abnormalities of structural proteins in the eye, inner ear and cartilage. The risk of retinal detachment, particularly due to the development of giant retinal tears, is high. Stickler syndrome is the most common cause of childhood retinal detachment. Although retinal detachment surgery in the general population has a high success rate, outcomes from surgical repair in Stickler syndrome patients are notoriously poor, providing a strong argument for prophylactic intervention. Variable case selection, absence of molecular genetic sub-typing and inconsistent treatment strategies have all contributed to the historic uncertainty regarding the safety and efficacy of prophylactic treatment. This paper reviews the major published clinical studies that have evaluated different methods and strategies for prophylaxis. Based on the current body of literature, there is extremely strong evidence from cohort comparison studies demonstrating the efficacy and safety of prophylactic retinopexy to reduce, but not eliminate, the risk of retinal detachment in Stickler syndrome patients. It is vital that this body of evidence is provided to Stickler syndrome patients, to enable them to make their own fully informed choice about whether to receive prophylaxis for themselves and particularly on behalf of their affected children, to reduce the risk of retinal detachment.
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Affiliation(s)
- Philip Alexander
- NHS England Stickler Syndrome Highly Specialised Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK;
- Vitreoretinal Service, Addenbrooke’s Hospital, Hills Road, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
- Correspondence: ; Tel.: +44-(0)-1223-216106
| | - Martin P. Snead
- NHS England Stickler Syndrome Highly Specialised Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK;
- Vitreoretinal Service, Addenbrooke’s Hospital, Hills Road, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
- Vitreoretinal Research Group, John van Geest Centre for Brain Repair, University of Cambridge, Forvie Site, Cambridge CB2 0PY, UK
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39
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Autosomal Recessive Stickler Syndrome. Genes (Basel) 2022; 13:genes13071135. [PMID: 35885918 PMCID: PMC9324312 DOI: 10.3390/genes13071135] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 02/04/2023] Open
Abstract
Stickler syndrome (SS) is a genetic disorder with manifestations in the eye, ear, joints, face and palate. Usually inherited in a dominant fashion due to heterozygous pathogenic variants in the collagen genes COL2A1 and COL11A1, it can rarely be inherited in a recessive fashion from variants in COL9A1, COL9A2, and COL9A3, COL11A1, as well as the non-collagen genes LRP2, LOXL3 and GZF1. We review the published cases of recessive SS, which comprise 40 patients from 23 families. Both homozygous and compound heterozygous pathogenic variants are found. High myopia is near-universal, and sensorineural hearing loss is very common in patients with variants in genes for type IX or XI collagen, although hearing appears spared in the LRP2 and LOXL3 patients and is variable in GZF1. Cleft palate is associated with type XI collagen variants, as well as the non-collagen genes, but is so far unreported with type IX collagen variants. Retinal detachment has occurred in 18% of all cases, and joint pain in 15%. However, the mean age of this cohort is 11 years old, so the lifetime incidence of both problems may be underestimated. This paper reinforces the importance of screening for SS in congenital sensorineural hearing loss, particularly when associated with myopia, and the need to warn patients and parents of the warning signs of retinal detachment, with regular ophthalmic review.
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40
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Soh Z, Richards AJ, McNinch A, Alexander P, Martin H, Snead MP. Dominant Stickler Syndrome. Genes (Basel) 2022; 13:1089. [PMID: 35741851 PMCID: PMC9222743 DOI: 10.3390/genes13061089] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 02/04/2023] Open
Abstract
The Stickler syndromes are a group of genetic connective tissue disorders associated with an increased risk of rhegmatogenous retinal detachment, deafness, cleft palate, and premature arthritis. This review article focuses on the molecular genetics of the autosomal dominant forms of the disease. Pathogenic variants in COL2A1 causing Stickler syndrome usually result in haploinsufficiency of the protein, whereas pathogenic variants of type XI collagen more usually exert dominant negative effects. The severity of the disease phenotype is thus dependent on the location and nature of the mutation, as well as the normal developmental role of the respective protein.
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Affiliation(s)
- Zack Soh
- John van Geest Centre for Brain Repair, Vitreoretinal Research Group, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0PY, UK; (Z.S.); (A.J.R.); (A.M.); (H.M.)
| | - Allan J. Richards
- John van Geest Centre for Brain Repair, Vitreoretinal Research Group, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0PY, UK; (Z.S.); (A.J.R.); (A.M.); (H.M.)
- NHS England Highly Specialised Stickler Syndrome Diagnostic Service, Cambridge University, NHS Foundation Trust, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 0QQ, UK;
| | - Annie McNinch
- John van Geest Centre for Brain Repair, Vitreoretinal Research Group, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0PY, UK; (Z.S.); (A.J.R.); (A.M.); (H.M.)
- NHS England Highly Specialised Stickler Syndrome Diagnostic Service, Cambridge University, NHS Foundation Trust, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 0QQ, UK;
| | - Philip Alexander
- NHS England Highly Specialised Stickler Syndrome Diagnostic Service, Cambridge University, NHS Foundation Trust, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 0QQ, UK;
| | - Howard Martin
- John van Geest Centre for Brain Repair, Vitreoretinal Research Group, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0PY, UK; (Z.S.); (A.J.R.); (A.M.); (H.M.)
- NHS England Highly Specialised Stickler Syndrome Diagnostic Service, Cambridge University, NHS Foundation Trust, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 0QQ, UK;
| | - Martin P. Snead
- John van Geest Centre for Brain Repair, Vitreoretinal Research Group, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0PY, UK; (Z.S.); (A.J.R.); (A.M.); (H.M.)
- NHS England Highly Specialised Stickler Syndrome Diagnostic Service, Cambridge University, NHS Foundation Trust, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 0QQ, UK;
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Zhang Z, Tang Q, Wang Q, Nie F, Sun L, Luo D, Chen W, Ding X. HODD: A Manually Curated Database of Human Ophthalmic Diseases with Symptom Characteristics and Genetic Variants Towards Facilitating Quick and Definite Diagnosis. Interdiscip Sci 2022; 14:385-393. [PMID: 34846641 DOI: 10.1007/s12539-021-00494-9] [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: 10/11/2021] [Revised: 11/14/2021] [Accepted: 11/16/2021] [Indexed: 06/13/2023]
Abstract
Ophthalmic diseases are disorders that affect the eyes. Hundreds of causal genes and biological pathways have been reported to be closely correlated with ophthalmic diseases. However, these information are scattered across various resources, which has hindered a thorough and deep understanding of ophthalmic diseases. In the present work, we proposed the Human Ophthalmic Diseases Database (HODD), which currently deposits 730 ophthalmic diseases and 653 related genes and is available at http://bio-bigdata.cn/HODD/ . The disease-related information and genes related to ophthalmic diseases were collected from the several well-known databases. To comprehensively understand the ophthalmic diseases, the basic information was provided for each disease, including disease description, related genes, gene location, ocular and extraocular effect of the disease, protein-protein interaction and disease-associated pathways. All these data were reorganized and made accessible through multiple entrances. We hope that HODD will facilitate studies on ophthalmic diseases. The workflow for the construction of the HODD (Human Ophthalmic Diseases Database, http://bio-bigdata.cn/HODD/ ) database.
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Affiliation(s)
- Zhaotian Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China
| | - Qiang Tang
- Innovative Institute of Chinese Medicine and Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Qiong Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China
| | - Fulei Nie
- School of Life Sciences, North China University of Science and Technology, Tangshan, 063210, China
| | - Limei Sun
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China
| | - Delun Luo
- Innovative Institute of Chinese Medicine and Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
- Chengdu Jingze Biopharmaceutical Co., Ltd, Chengdu, 611137, China
| | - Wei Chen
- Innovative Institute of Chinese Medicine and Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China.
- School of Life Sciences, North China University of Science and Technology, Tangshan, 063210, China.
| | - Xiaoyan Ding
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China.
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42
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Askarian S, Gholami M, Khalili-Tanha G, Tehrani NC, Joudi M, Khazaei M, Ferns GA, Hassanian SM, Avan A, Joodi M. The genetic factors contributing to the risk of cleft lip-cleft palate and their clinical utility. Oral Maxillofac Surg 2022:10.1007/s10006-022-01052-3. [PMID: 35426585 DOI: 10.1007/s10006-022-01052-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/03/2022] [Indexed: 10/18/2022]
Abstract
Cleft lip and cleft palate (CL/P) are among the most common congenital malformations in neonates and have syndromic or nonsyndromic forms. Nonsyndromic forms of malformation are being reported to be associated with chromosomal DNA modification by teratogenic exposure and to complex genetic contributions of multiple genes. Syndromic forms are shown to be related to chromosomal aberrations or monogenic diseases. There is a growing body of data illustrating the association of several genes with risk of developing this malformation, including genetic defects in T-box transcription factor-22 (TBX22), interferon regulatory factor-6 (IRF6), and poliovirus receptor-like-1 (PVRL1), responsible for X-linked cleft palate, cleft lip/palate-ectodermal dysplasia syndrome, and Van der Woude and popliteal pterygium syndromes, respectively. Genetic variants in MTR, PCYT1A, ASS1, SLC 25A13, GSTM1, GSTT1, SUMO1 BHMT1, and BHMT2 are being reported to be linked with CL/P risk. The etiology of nonsyndromic CLP is still remained to be unknown, although mutations in candidate genes have been found. Here, we provide an overview about the potential variants to be associated with CL/P for identification of the relative risk of CLP with respect to the basis of genetic background and environmental factors (e.g., dietary factors, alcohol use).
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Affiliation(s)
- Saeedeh Askarian
- Department of Medical Biotechnology, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Department of Physiology, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Masoumeh Gholami
- Department of Physiology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Ghazaleh Khalili-Tanha
- Metabolic syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Negin Chaeichi Tehrani
- Metabolic syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mona Joudi
- Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Khazaei
- Metabolic syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, Brighton & Sussex Medical School, Falmer, Brighton, BN1 9PH, Sussex, UK
| | - Seyed Mahdi Hassanian
- Metabolic syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Avan
- Metabolic syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. .,Basic Sciences Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran. .,Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Marjan Joodi
- Endoscopic and Minimally Invasive Surgery Research Center, Sarvar Children's Hospital, Mashhad, Iran. .,Department of Pediatric Surgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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43
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Chong C, Webber AL, Dai S. Ocular manifestations of systemic diseases in children. Clin Exp Optom 2022; 106:238-248. [PMID: 35296228 DOI: 10.1080/08164622.2022.2048999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Knowledge of ocular diseases and understanding of the complex interplay between eye and systemic health have increased over the years. This knowledge is particularly important when caring for our youngest and most vulnerable paediatric patients when ophthalmic manifestations may provide an insight to underlying systemic diseases and can act as the first indicator of an undiagnosed systemic condition. Further, the visual system can be vulnerable to manifestations of known systemic disease, with vigilant ophthalmic examination generally aiding early identification of ocular complications for collaborative multidisciplinary care to prevent avoidable vision loss. The potential ocular signs and complications of the following developmental, genetic or acquired childhood systemic disorders are presented: premature birth, trisomy 21, albinism, Marfan's syndrome, Stickler's syndrome, septo-optic dysplasia, aniridia, neurofibromatosis 1, Sturge-Weber syndrome, papilloedema, juvenile idiopathic arthritis and vitamin A deficiency. Rather than providing an exhaustive list of diseases, this review offers an overview of the more commonly encountered congenital or acquired childhood systemic conditions that have associated childhood ophthalmic disorders and presents referral and ongoing surveillance recommendations.
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Affiliation(s)
- Cheefoong Chong
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Ann L Webber
- School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Shuan Dai
- Department of Ophthalmology, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
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Naravane AV, Belin PJ, Pierce B, Quiram PA. Risk and Prevention of Retinal Detachments in Patients with Stickler Syndrome. Ophthalmic Surg Lasers Imaging Retina 2022; 53:7-11. [PMID: 34982001 DOI: 10.3928/23258160-20211213-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To report the impact of prophylactic laser retinopexy in the prevention of retinal detachments (RDs) in patients with Stickler syndrome. PATIENTS AND METHODS This was a retrospective, comparative case series of patients with Stickler syndrome from the year 2000 to 2019. We compared the rate of RDs between individuals who did and did not receive prophylactic laser therapy. In patients with an RD, we compared the rate of RD in the fellow eye with and without prophylactic laser treatment. RESULTS A total of 95 eyes were identified. Fifty-four percent of the overall population was female. The RD rate was 26.7% among eyes without previous prophylactic laser retinopexy and 4.6% among eyes with previous prophylactic laser retinopexy. A Cox proportional model revealed that laser prophylaxis treatment had a statistically significant effect on the risk of RD or retinal tear during the 25-year survival period from birth (P = .034). Eyes receiving treatment were 70% less likely to experience RD or retinal tear (hazard ratio, 0.297; 95% CI, 0.097 to 0.913). CONCLUSIONS This study's results suggest a potential role for prophylactic laser retinopexy in the prevention of rhegmatogenous RD among patients with a clinical diagnosis of Stickler syndrome. [Ophthalmic Surg Lasers Imaging Retina. 2022;53:7-11.].
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Genetic Characteristics and Phenotype of Korean Patients with Stickler Syndrome: A Korean Multicenter Analysis Report No. 1. Genes (Basel) 2021; 12:genes12101578. [PMID: 34680973 PMCID: PMC8536015 DOI: 10.3390/genes12101578] [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: 06/15/2021] [Revised: 09/27/2021] [Accepted: 10/04/2021] [Indexed: 02/06/2023] Open
Abstract
Stickler syndrome is an inherited connective tissue disorder of collagen. There are relatively few reports of East Asian patients, and no large-scale studies have been conducted in Korean patients yet. In this study, we retrospectively analyzed the genetic characteristics and clinical features of Korean Stickler syndrome patients. Among 37 genetically confirmed Stickler syndrome patients, 21 types of gene variants were identified, of which 12 were novel variants. A total of 30 people had variants in the COL2A1 gene and 7 had variants in the COL11A1 gene. Among the types of pathogenic variants, missense variants were found in 11, nonsense variants in 8, and splice site variants in 7. Splicing variants were frequently associated with retinal detachment (71%) followed by missense variants. This is the first large-scale study of Koreans with Stickler syndrome, which will expand the spectrum of genetic variations of Stickler syndrome.
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Balikov DA, Jacobson A, Prasov L. Glaucoma Syndromes: Insights into Glaucoma Genetics and Pathogenesis from Monogenic Syndromic Disorders. Genes (Basel) 2021; 12:genes12091403. [PMID: 34573386 PMCID: PMC8471311 DOI: 10.3390/genes12091403] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/02/2021] [Accepted: 09/08/2021] [Indexed: 11/21/2022] Open
Abstract
Monogenic syndromic disorders frequently feature ocular manifestations, one of which is glaucoma. In many cases, glaucoma in children may go undetected, especially in those that have other severe systemic conditions that affect other parts of the eye and the body. Similarly, glaucoma may be the first presenting sign of a systemic syndrome. Awareness of syndromes associated with glaucoma is thus critical both for medical geneticists and ophthalmologists. In this review, we highlight six categories of disorders that feature glaucoma and other ocular or systemic manifestations: anterior segment dysgenesis syndromes, aniridia, metabolic disorders, collagen/vascular disorders, immunogenetic disorders, and nanophthalmos. The genetics, ocular and systemic features, and current and future treatment strategies are discussed. Findings from rare diseases also uncover important genes and pathways that may be involved in more common forms of glaucoma, and potential novel therapeutic strategies to target these pathways.
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Affiliation(s)
- Daniel A. Balikov
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI 48105, USA; (D.A.B.); (A.J.)
| | - Adam Jacobson
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI 48105, USA; (D.A.B.); (A.J.)
| | - Lev Prasov
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI 48105, USA; (D.A.B.); (A.J.)
- Department of Human Genetics, University of Michigan, Ann Arbor, MI 48109, USA
- Correspondence:
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Ortiz-Salvador M, Montero-Hernández J, Freiría-Barreiro R. Hypoplasic Vitreous in Stickler Syndrome. JAMA Ophthalmol 2021; 139:e213312. [PMID: 34524400 DOI: 10.1001/jamaophthalmol.2021.3312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Wu H, Che S, Li S, Cheng Y, Xiao J, Liu Z. Case report of the first molecular diagnosis of Stickler syndrome with a pathogenic COL2A1 variant in a Mongolia family. Mol Genet Genomic Med 2021; 9:e1781. [PMID: 34405586 PMCID: PMC8580100 DOI: 10.1002/mgg3.1781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/20/2021] [Accepted: 07/08/2021] [Indexed: 12/20/2022] Open
Abstract
Background Stickler syndrome is a group of connective tissue disorders that can affect eye (myopia, cataract, and retinal detachment), skeleton (spondyloepiphyseal dysplasia and precocious arthritis), craniofacies (midfacial under development and cleft palate), and inner ear (conductive and sensorineural); with the degree of symptoms varying among patients. Mutations in the COL2A1, COL11A1, COL11A2, COL9A1, COL9A2, and COL9A3 procollagen genes cause Stickler syndrome. Case presentation A 16‐year‐old Mongolian girl approached our clinics with retinal detachment. The proband had vitreous degeneration in both eyes, rhegmatogenous retinal detachment in her right eye, a large area of retina degeneration in her left eye, and coupled with severe myopia. No obvious hearing disorder was found, no abnormalities in bones and joints, and her communication and learning capability were also normal. Further clinical examination showed that the patient's other five family members across three generations had vitreous and retina degenerations. Exome sequencing showed a heterozygous splicing variant in COL2A1 in all patients. Conclusions In this case report, a pathogenic splicing variant in the COL2A1 gene was identified in a Mongolian family affected with Stickler syndrome type I by exome sequencing. This heterozygous splicing variant in COL2A1 (NM_001844.4:C.2518‐1G>A) that may impair splicing, which was suggested by in silico prediction. Next‐generation sequencing is helpful for the differential diagnosis of this clinically variable and genetically heterogeneous disorder.
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Affiliation(s)
- Hong Wu
- Eye Center of the Second Hospital, Jilin University, Changchun, China
| | - Songtian Che
- Eye Center of the Second Hospital, Jilin University, Changchun, China
| | - Shuchun Li
- Department of Pain, the Second Hospital of Jilin University, Changchun, China
| | - Yan Cheng
- Eye Center of the Second Hospital, Jilin University, Changchun, China
| | - Jun Xiao
- Eye Center of the Second Hospital, Jilin University, Changchun, China
| | - Zaoxia Liu
- Eye Center of the Second Hospital, Jilin University, Changchun, China
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Alexander P, Gomersall P, Stancel-Lewis J, Fincham GS, Poulson A, Richards A, McNinch A, Baguley DM, Snead M. Auditory dysfunction in type 2 Stickler Syndrome. Eur Arch Otorhinolaryngol 2021; 278:2261-2268. [PMID: 32901364 PMCID: PMC8165062 DOI: 10.1007/s00405-020-06306-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/18/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE To present the extent and site of lesion of auditory dysfunction in a large cohort of individuals with type 2 Stickler Syndrome. Type 2 Stickler Syndrome results from a mutation in the gene coding for α-1 type XI pro-collagen, which has been identified in the human vitreous, cartilage and the cochlea of the mouse. The condition is characterised by classic ocular abnormalities, auditory dysfunction, osteoarthropathy and oro-facial dysplasia. METHODS This is a population study which used a combination of audiometric, tympanometric, and self-report measures on a series of 65 individuals (mean age 29.2 years, range 3-70, female 63.1%) with genetically confirmed type 2 Stickler Syndrome. RESULTS Hearing impairment was identified in at least one ear for 69% of individuals. Analysis against age-matched normative data showed that reduced hearing sensitivity was present across all test frequencies. Sensorineural hearing loss was most common (77% of ears), with conductive (3%), mixed (7%) and no hearing loss (13%), respectively. The proportion of hypermobile tympanic membranes (24%) was less than previously documented in type 1 Stickler Syndrome. When present, this appears to arise as a direct result of collagen abnormalities in the middle ear. Self-report measures of speech and spatial hearing in sound were comparable to a non-syndromic cohort with similar audiometric thresholds. CONCLUSIONS Auditory impairment in type 2 Stickler Syndrome is predominantly associated with cochlear hearing loss of varying severities across affected individuals. The impact on hearing thresholds can be seen across the frequency range, suggesting a contribution of defective collagen throughout the cochlea. Self-report questionnaires showed that difficulties understanding speech, and spatial information in sound (such as that used for localisation), were worse than a young, normal-hearing population but comparable to a non-syndromic cohort with similar audiometric thresholds. Therefore, it is likely that hearing loss in type 2 Stickler Syndrome arises in the auditory periphery, without significant central processing deficits.
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Affiliation(s)
- Philip Alexander
- Vitreoretinal Service, Box 41, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
- NHS England Stickler Syndrome Diagnostic Service, Box 153, Cambridge University NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
| | - Philip Gomersall
- Ear, Nose and Throat (ENT) West Wing, Oxford Auditory Implant Programme, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | - Jack Stancel-Lewis
- NHS England and NHS Improvement, Wellington House 33-155 Waterloo Road, London, SE1 8UG, UK
| | - Gregory Scott Fincham
- Vitreoretinal Service, Box 41, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
- NHS England Stickler Syndrome Diagnostic Service, Box 153, Cambridge University NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
| | - Arabella Poulson
- Vitreoretinal Service, Box 41, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
- NHS England Stickler Syndrome Diagnostic Service, Box 153, Cambridge University NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
| | - Allan Richards
- Department of Pathology, University of Cambridge, Cambridge, CB2 1QP, UK
- Regional Molecular Genetics Laboratory, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
| | - Annie McNinch
- NHS England Stickler Syndrome Diagnostic Service, Box 153, Cambridge University NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
- Department of Pathology, University of Cambridge, Cambridge, CB2 1QP, UK
- Regional Molecular Genetics Laboratory, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
| | - David M Baguley
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, NG1 5DU, UK.
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.
- Nottingham Audiology Services, Nottingham University NHS Trust, Nottingham, NG1 3DU, UK.
- Nottingham Biomedical Research Centre, Ropewalk House, 113 Ropewalk, Nottingham, NG1 5DU, UK.
| | - Martin Snead
- Vitreoretinal Service, Box 41, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
- NHS England Stickler Syndrome Diagnostic Service, Box 153, Cambridge University NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK
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Khan AO, AlAbdi L, Patel N, Helaby R, Hashem M, Abdulwahab F, AlBadr FB, Alkuraya FS. Genetic testing results of children suspected to have Stickler syndrome type collagenopathy after ocular examination. Mol Genet Genomic Med 2021; 9:e1628. [PMID: 33951325 PMCID: PMC8172201 DOI: 10.1002/mgg3.1628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 02/10/2021] [Accepted: 02/10/2021] [Indexed: 12/04/2022] Open
Abstract
Purpose Stickler syndrome is a collagenopathy that is typically COL2A1‐related (autosomal dominant) and less commonly related to other collagen gene mutations. Diagnosis is straightforward when a child has myopia or retinal detachment in the setting of classic diagnostic criteria such as hearing impairment, midfacial hypoplasia, and arthropathy. However, some children have primarily ocular disease with mild or no extraocular features. Such children can remain undiagnosed unless suspicion is raised by the ophthalmologist. Methods Retrospective consecutive case series (2014–2016) of children (<12 years old) suspected to have Stickler syndrome type collagenopathy by a single ophthalmologist and able to complete genetic testing for this possibility. Suspicion was based on vitreous abnormalities and myopia or lens opacities in the setting of prior retinal detachment, hearing impairment, or facial flatness. Results Average age of the 12 identified children was 8 years old (range 3–11; five boys). Average spherical equivalent for phakic eyes was −13 (range −3.5 to −30). Nine children had lens opacities or aphakia; two with aphakia also had lens subluxation or iridodonesis. Other recurrent clinical features included flat facies (12/12), hearing impairment (5/12), and prior retinal detachment (4/12). Pathogenic variants for collagenopathy were uncovered in 10/12 children: COL11A1 (heterozygous) in six, COL2A1 (heterozygous) in two, and COL9A1 (homozygous) in two. One child was homozygous for pathogenic variation in LRPAP1. One child had no detectable gene mutations. Conclusions Taken together, these clinical features (particularly vitreous abnormality, myopia, and lens opacity) had a high molecular yield for collagen gene mutation. Ophthalmologists who see such children should suspect Stickler syndrome, even in the absence of overt systemic disease. COL11A1‐related rather than COL2A1‐related autosomal dominant disease may be more common when undiagnosed children are identified based on ocular examination. Biallelic mutations in LRPAP1 can result in a phenotype that may resemble Stickler syndrome.
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Affiliation(s)
- Arif O Khan
- Department of Genetics, KFSHRC, Riyadh, Saudi Arabia.,Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.,Department of Ophthalmology, Cleveland Clinic Lerner College of Medicine of Case Western University, Cleveland, OH, USA
| | - Lama AlAbdi
- Department of Genetics, KFSHRC, Riyadh, Saudi Arabia.,College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Nisha Patel
- Department of Genetics, KFSHRC, Riyadh, Saudi Arabia
| | - Rana Helaby
- Department of Genetics, KFSHRC, Riyadh, Saudi Arabia
| | - Mais Hashem
- Department of Genetics, KFSHRC, Riyadh, Saudi Arabia
| | | | - Fahad B AlBadr
- Department of Radiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fowzan S Alkuraya
- Department of Genetics, KFSHRC, Riyadh, Saudi Arabia.,Department of Anatomy and Cell Biology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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