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Nassrallah EI, Nassrallah GB, Mastromonaco C, Denis R, Dias AB, Saheb N, Burnier MN. Clinical and anatomic correlates of objectively measured zonular dehiscence in 427 postmortem pseudophakic eyes. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024; 59:e193-e199. [PMID: 36966817 DOI: 10.1016/j.jcjo.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 02/07/2023] [Accepted: 03/03/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVE This study aims to objectively measure the degree of zonular dehiscence in postmortem eyes and to assess for clinical and anatomic correlates. DESIGN Cross-sectional study. MATERIALS Four hundred and twenty-seven postmortem pseudophakic human eyes. METHODS Eyes were obtained from the Lions Gift of Sight Eye Bank. Microscope photographs were taken of the eyes in Miyake-Apple view, and region-of-interest analysis was performed using ImageJ to measure the area, circumference, and diameter of the capsular bag, the ciliary ring, and the capsulorhexis. Clinical and anatomic parameters were assessed using simple linear regression analysis and one-way analysis of variance with post hoc Bonferroni testing. Zonular dehiscence was measured via 2 surrogates: capsule area over ciliary ring area ratio (CCR) and capsule-ciliary ring decentration (CCD). Low CCR and high CCD indicate more zonular dehiscence. RESULTS CCR was significantly inversely correlated with smaller capsulorhexi (p = 0.012), lower intraocular lens power (p < 0.00001), younger age at death (p = 0.00002), and a longer cataract-to-death time (p = 0.00786). CCR also was significantly lower in glaucomatous cases (p = 0.0291). CCD was significantly correlated with longer cataract-to-death time (p = 0.000864), larger ciliary ring area (p = 0.001), more posterior capsule opacification (p = 0.0234), and higher Soemmering's ring opacity (p = 0.0003). There was also significantly more decentration in male eyes than in female eyes (p = 0.00852). CONCLUSIONS CCR and CCD are novel measures of zonular dehiscence in postmortem eyes, with many interesting correlates. An enlarged ciliary ring area is possibly associated with zonular dehiscence in pseudophakic eyes and may be a quantifiable surrogate in vivo.
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Affiliation(s)
| | - Georges B Nassrallah
- Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, ON
| | | | - Raphaelle Denis
- From the Research Institute of the McGill University Health Centre, Montreal, QC
| | - Ana Beatriz Dias
- From the Research Institute of the McGill University Health Centre, Montreal, QC
| | - Nabil Saheb
- From the Research Institute of the McGill University Health Centre, Montreal, QC
| | - Miguel N Burnier
- From the Research Institute of the McGill University Health Centre, Montreal, QC
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Adhikari S, Thakur N, Shrestha U, Shrestha MK, Manshrestha M, Thapa B, Poudel M, Kunwar A. Genetic analysis of children with congenital ocular anomalies in three ecological regions of Nepal: a phase II of Nepal pediatric ocular diseases study. BMC MEDICAL GENETICS 2020; 21:185. [PMID: 32962661 PMCID: PMC7510079 DOI: 10.1186/s12881-020-01116-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/31/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Genetic eye diseases constitute a large and heterogeneous group of childhood ocular morbidity. Individual diseases may cause multiple structural anomalies and developmental features. Nepal Pediatric Ocular Disease Study (NPODS) was a population-based epidemiological study conducted across three ecological regions of Nepal to determine the prevalence and etiology of childhood ocular morbidity and blindness. In Phase II of this study, genetic analysis was performed for children who were found to have congenital ocular anomalies. METHOD It was a cross sectional descriptive study. A total of 10,270 children across three different ecological regions in Nepal (Low lands, hills, and mountains) underwent ocular examinations in NPODS. Out of 374 (3.6%) of children with ocular abnormalities, 30 were thought to be congenital in nature. Targeted genetic analysis, including genotyping for genes specific to presenting phenotype, was performed for 25 children using serum samples. RESULTS Out of 25 children, 18 had meaningful genetic results. Analysis revealed one missense alteration G12411T of Zinc Finger Homeobox 4 (ZFHX4) gene in one participant among 10 with congenital ptosis and another missense variation T > C P. Y374 C of Signaling Receptor and Transporter Retinol 6 (STRA6) gene in one participant among 3 with microphthalmos. CONCLUSION The study is first of its kind from Nepal and mutant genes were unique to Nepalese Population. Further analysis of genetic factors is crucial to better understand genetic association with ocular diseases and conditions. This helps further in genetic counseling and probably gene therapy to prevent blindness from these conditions.
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Affiliation(s)
- Srijana Adhikari
- Tilganga Institute of Ophthalmology, PO Box 561, Kathmandu, Nepal.
| | - Neelam Thakur
- National Academy of Medical Sciences NAMS, Bir Hospital, Kathmandu, Nepal
| | | | - Mohan K Shrestha
- Tilganga Institute of Ophthalmology, PO Box 561, Kathmandu, Nepal
| | | | - Bijay Thapa
- Patan Academy of Health Sciences, Patan, Nepal
| | - Manish Poudel
- Tilganga Institute of Ophthalmology, PO Box 561, Kathmandu, Nepal
| | - Ajaya Kunwar
- The Kathmandu Centre for Genomics and Research Laboratory, Kathmandu, Nepal
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Wu S, Yu X, Dai Q, Fu Y, Lin X. Corneal decompensation due to spontaneous absorption of lens and anterior dislocation of lens capsule: A case report. Medicine (Baltimore) 2019; 98:e18417. [PMID: 31852166 PMCID: PMC6922511 DOI: 10.1097/md.0000000000018417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Spontaneous absorption of lenses or cataracts is rare. However, lens capsule attachment to the endothelium combined with corneal decompensation can still occur. PATIENT CONCERNS An 81-year-old male presented with left eye pain and bulbar conjunctival injection for 6 months. Diffuse corneal edema and inferior bullous lesions were observed by slit-lamp microscopy. Following examination with swept-source optical coherence tomography, we could clearly identify a membrane structure adherent to the corneal endothelium, as well as a lens not in situ. In vivo confocal microscopy found decreased corneal endothelial density of 745 ± 46 cells per mm in the left eye. DIAGNOSIS Lens dislocation and spontaneous absorption, combined with corneal decompensation were diagnosed. INTERVENTIONS Surgical removal of the membrane structure combined with anterior vitrectomy was performed. OUTCOMES The patient's symptoms were partly relieved. However, the corneal endothelial decompensation could not be entirely reversed. In vivo confocal microscopy verified that corneal endothelium was in situ and the density was not significantly changed in the left eye. LESSONS This case study reports a rare dislocation and spontaneous absorption of lens without any trauma or subsequent surgery. Moreover, it demonstrates corneal endothelial decompensation due to the lens capsule adhering to the corneal endothelium. Timely intervention is required to remove the dislocated lens and prevent complications.
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Affiliation(s)
- Shuangqing Wu
- Department of Ophthalmology, Zhejiang Provincial Integrated Chinese and Western Medicine Hospital, Hangzhou
- Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Xiaoyu Yu
- Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Qi Dai
- Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Yana Fu
- Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Xiaolei Lin
- Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
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Systematic evaluation of a targeted gene capture sequencing panel for molecular diagnosis of retinitis pigmentosa. PLoS One 2018; 13:e0185237. [PMID: 29641573 PMCID: PMC5894961 DOI: 10.1371/journal.pone.0185237] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 09/08/2017] [Indexed: 01/09/2023] Open
Abstract
Background Inherited eye diseases are major causes of vision loss in both children and adults. Inherited eye diseases are characterized by clinical variability and pronounced genetic heterogeneity. Genetic testing may provide an accurate diagnosis for ophthalmic genetic disorders and allow gene therapy for specific diseases. Methods A targeted gene capture panel was designed to capture exons of 283 inherited eye disease genes including 58 known causative retinitis pigmentosa (RP) genes. 180 samples were tested with this panel, 68 were previously tested by Sanger sequencing. Systematic evaluation of our method and comprehensive molecular diagnosis were carried on 99 RP patients. Results 96.85% targeted regions were covered by at least 20 folds, the accuracy of variants detection was 99.994%. In 4 of the 68 samples previously tested by Sanger sequencing, mutations of other diseases not consisting with the clinical diagnosis were detected by next-generation sequencing (NGS) not Sanger. Among the 99 RP patients, 64 (64.6%) were detected with pathogenic mutations, while in 3 patients, it was inconsistent between molecular diagnosis and their initial clinical diagnosis. After revisiting, one patient’s clinical diagnosis was reclassified. In addition, 3 patients were found carrying large deletions. Conclusions We have systematically evaluated our method and compared it with Sanger sequencing, and have identified a large number of novel mutations in a cohort of 99 RP patients. The results showed a sufficient accuracy of our method and suggested the importance of molecular diagnosis in clinical diagnosis.
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Guandalini A, Di Girolamo N, Corvi R, Santillo D, Andreani V, Pinzo B. Epidemiology of ocular disorders presumed to be inherited in three small Italian dog breeds in Italy. Vet Ophthalmol 2017; 21:524-529. [PMID: 29284193 DOI: 10.1111/vop.12542] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To describe the prevalence and the types of eye disorders that are known or presumed to be inherited (KP-HED) in three small Italian dog breeds. ANIMALS Three small Italian dog breeds: Maltese, Bolognese, and Italian Greyhound. PROCEDURES All dogs of the breeds selected for this prospective observational study that underwent a complete ophthalmic examination between 1994 and 2015 were included. General and proportional KP-HED prevalence with 95% confidence intervals were reported. RESULTS Three hundred and six of 462 dogs were affected by at least one KP-HED (66.2%; 95% CI: 61.8%-70.4%). In the entire population, the five most common KP-HED were cataract (n = 122; rate on the total number of KP-HED: 31.4%), entropion (n = 56; 14.4%), keratoconjunctivitis sicca (n = 33; 8.5%), retinal dysplasia (n = 24; 6.2%), and persistent pupillary membrane (iris to iris) (n = 21; 5.4%). The most common KP-HED in each breed were cataracts in the Maltese (35.1%) and in the Bolognese (24.2%), and presentation of vitreous in the anterior chamber in the Italian Greyhound (46.7%). CONCLUSIONS Clinicians should be aware of KP-HED that commonly affect three small Italian dog breeds. Breed standards should be reconsidered, and breeding programs should be directed at limiting such disorders.
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Affiliation(s)
- Adolfo Guandalini
- Department of Ophthalmology, Centro Veterinario Specialistico (CVS), Via Sandro Giovannini 51/53, 00137, Rome, Italy
| | - Nicola Di Girolamo
- Department of Ophthalmology, Centro Veterinario Specialistico (CVS), Via Sandro Giovannini 51/53, 00137, Rome, Italy.,EBMVet, Via Sigismondo Trecchi 20, Cremona, Italy
| | - Roberta Corvi
- Department of Ophthalmology, Centro Veterinario Specialistico (CVS), Via Sandro Giovannini 51/53, 00137, Rome, Italy
| | - Daniele Santillo
- Department of Ophthalmology, Centro Veterinario Specialistico (CVS), Via Sandro Giovannini 51/53, 00137, Rome, Italy
| | - Valentina Andreani
- Department of Ophthalmology, Centro Veterinario Specialistico (CVS), Via Sandro Giovannini 51/53, 00137, Rome, Italy
| | - Barbara Pinzo
- Department of Ophthalmology, Centro Veterinario Specialistico (CVS), Via Sandro Giovannini 51/53, 00137, Rome, Italy
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Hu R, Wang X, Wang Y, Sun Y. Occult lens subluxation related to laser peripheral iridotomy: A case report and literature review. Medicine (Baltimore) 2017; 96:e6255. [PMID: 28272229 PMCID: PMC5348177 DOI: 10.1097/md.0000000000006255] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Laser peripheral iridotomy (LPI) is commonly performed as a primary treatment for acute primary angle closure glaucoma after administration of anti-glaucoma medications or for prevention of this condition. Minor complications may occur following LPI and most of them do not have deleterious consequences. We report a rare case of lens subluxation that has a possible relationship with LPI treatment. PATIENT CONCERNS A 54-year-old female patient was initially referred for surgical treatment of medication-uncontrollable angle closure glaucoma in her left eye. The patient had undergone Neodymium:YAG LPI at an outside hospital 2 months prior to the presentation due to an episode of elevated intraocular pressure (IOP). About 5 days after the LPI, she had spontaneous blurred vision, redness, and pain in the left eye. Her IOP was found to re-rise and was not controlled well even with maximum tolerated anti-glaucoma medications during the following 2 months. On slit-lamp examination, the significant shallowing of both peripheral and central anterior chamber was noted in the left eye. Ultrasound biomicroscopy examination revealed the lens tilting towards the iris and the inferior zonular dehiscence corresponding to the iridotomy site. DIAGNOSES Lens subluxation secondary to LPI treatment in the left eye. INTERVENTIONS Phacoemulsification combined with in-the-bag intraocular lens implantation was performed in the left eye. The zonular weakness corresponding to the iridotomy site was further confirmed during surgery. OUTCOMES The patient's IOP remained stable in the first postoperative 3 months without additional anti-glaucoma medications. LESSONS Laser peripheral iridotomy may cause structural zonular damage, and ophthalmologists should be aware of this potential complication and proceed with caution.
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Affiliation(s)
- Rongrong Hu
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaoyu Wang
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yang Wang
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yang Sun
- Byers Eye Institute, Department of Ophthalmology at Stanford University, CA, USA
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Guandalini A, Di Girolamo N, Santillo D, Andreani V, Corvi R, Bandini M, Peruccio C. Epidemiology of ocular disorders presumed to be inherited in three large Italian dog breeds in Italy. Vet Ophthalmol 2016; 20:420-426. [PMID: 27860098 DOI: 10.1111/vop.12442] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe the epidemiology and the types of eye disorders that are presumed to be inherited (PIED) in three large Italian dog breeds. ANIMALS Three large Italian dog breeds: Neapolitan Mastiff (FCI code: 197), Maremma Sheepdog (FCI code: 201), and Italian Corso dog (FCI code: 343). PROCEDURES All dogs that underwent a complete ophthalmic examination between 1992 and 2012 were included in this prospective observational study. The prevalence of eye disorders with 95% confidence intervals was reported for presumed healthy dogs and for dogs referred to a veterinary center for an ophthalmic consultation. Univariate and multivariate logistic regression techniques were used to generate odds ratios. RESULTS Of 605 dogs examined during the study period, 351 dogs were affected by at least one PIED (58%; 95% CI: 54-62%). The prevalence of PIED was significantly lower in dogs presented for ophthalmic examination (53.8%) as compared to presumed healthy dogs (62.2%)(OR: 1.4; 95% CI: 1.02-1.9; P = 0.037). Also after multivariate adjustment for the period of observation, the odds of Neapolitan Mastiff (92.1%; OR: 21.4; 95% CI: 11.1-41.4) and of Cane Corso (57.7%; OR: 2.5; 95% CI: 1.7-3.6) suffering a PIED were greater than the Maremma Sheepdog (35.4%). The most common PIED in each breed were entropion (24.3% of all the PIED) in the Neapolitan Mastiff, ectropion (36.6%) in the Corso dog, and cataract (27.9%) in the Maremma Sheepdog. CONCLUSIONS Clinicians should be aware that three large Italian dog breeds frequently suffer PIED. Breed standards should be reconsidered, and breeding programs should be directed at limiting such disorders.
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Affiliation(s)
- Adolfo Guandalini
- Department of Ophthalmology, Centro Veterinario Specialistico (CVS), Via Sandro Giovannini 53, Rome, 00137, Italy
| | - Nicola Di Girolamo
- Department of Ophthalmology, Centro Veterinario Specialistico (CVS), Via Sandro Giovannini 53, Rome, 00137, Italy.,Department of Veterinary Sciences, University of Bologna, Via Tolara di Sopra, 50, Ozzano dell'Emilia, Bologna, 40064, Italy
| | - Daniele Santillo
- Department of Ophthalmology, Centro Veterinario Specialistico (CVS), Via Sandro Giovannini 53, Rome, 00137, Italy
| | - Valentina Andreani
- Department of Ophthalmology, Centro Veterinario Specialistico (CVS), Via Sandro Giovannini 53, Rome, 00137, Italy
| | - Roberta Corvi
- Department of Ophthalmology, Centro Veterinario Specialistico (CVS), Via Sandro Giovannini 53, Rome, 00137, Italy.,Department of Veterinary Sciences, University of Teramo, Strada Provinciale 18 snc, Piano d'Accio, Teramo, 64100, Italy
| | - Marina Bandini
- Department of Ophthalmology, Centro Veterinario Specialistico (CVS), Via Sandro Giovannini 53, Rome, 00137, Italy
| | - Claudio Peruccio
- Ophthalmology, Centro Veterinario Torinese, Lungo Dora Pietro Colletta 147, Torino, 10153, Italy
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Errais K, Ammous I, Kamoun R, Mili Boussen I, Anene R, Zhioua R, Meddeb Ouertani A. [Familial exudative vitreoretinopathy associated with persistence of hyaloid artery]. J Fr Ophtalmol 2008; 31:e3. [PMID: 18401292 DOI: 10.1016/s0181-5512(08)70335-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Familial exudative vitreoretinopathy (FEVR) is a well-defined inherited disorder of retinal vessel development. Association of FEVR with other congenital ocular diseases has already been described. We report the first clinical case of FEVR associated with hyaloid artery persistence. An 18-year-old Tunisian woman and four members of her family (mother, two brothers, and sister) presented signs of FEVR. Examination of this patient also revealed functional hyaloid artery persistence in her right eye. These two disorders have many common aspects in their pathological process, in particular vascular endothelial growth factor expression, which can explain this association.
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Affiliation(s)
- K Errais
- Service d'Ophtalmologie de l'hôpital Charles Nicolle, Tunis, Tunisie
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Ruttum MS, Reis LM, Semina EV. Application of genetic approaches to ocular disease. Pediatr Clin North Am 2006; 53:751-65. [PMID: 16873003 DOI: 10.1016/j.pcl.2006.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The human eye is a complex organ whose development requires extraordinary coordination of developmental processes. Multiple genes responsible for the proper development and maintenance of the vertebrate eye have been identified and shown to be involved in a variety of debilitating ocular conditions. Genetic diseases involving the eye represent a leading cause of blindness in children and adults. This article summarizes current genetic approaches and their application to studies of ocular disease.
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Affiliation(s)
- Mark S Ruttum
- Medical College of Wisconsin, 925 North 87th Street, Milwaukee, WI 53226, USA.
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Abstract
This article presents evaluation and treatment approaches to ophthalmologic conditions that are likely to be encountered in a primary care office. These conditions can be organized by diagnostic category, symptoms, and location of complaint. By using one ora combination of these categories, the practitioner can provide appropriate, timely, and effective ophthalmologic evaluation and treatment. Acute conditions are categorized according to urgency of intervention.
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Affiliation(s)
- Jerry Naradzay
- Emergency Medical Services, Mesa View Regional Hospital, Mesquite, NV, USA
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Ojo y piel. EMC - DERMATOLOGÍA 2006. [PMCID: PMC7164805 DOI: 10.1016/s1761-2896(06)46452-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Las relaciones entre la patología del ojo y de su revestimiento cutáneo son muy numerosas. Debido a las analogías embriológicas e histológicas, sus principales consecuencias oftalmológicas afectan a la superficie ocular en el sentido más amplio: tegumentos de los párpados, conjuntivas y córnea. La exploración clínica dermatológica sospechará estas alteraciones, que confirmará el oftalmólogo. No obstante, algunos trastornos pueden afectar a todos los demás tejidos oculares. Ya se trate de una localización ocular de algunas enfermedades dermatológicas, como las dermatosis infecciosas, o de auténticos síndromes oculocutáneos, la exploración clínica especializada, y a veces repetida, suele orientar el tratamiento. Las consecuencias sobre la función visual de algunas de estas alteraciones pueden ser graves. La epidermólisis tóxica de Lyell constituye el ejemplo extremo que puede provocar una ceguera corneal bilateral de tratamiento temible. La dermatitis atópica es otro ejemplo de enfermedad más frecuente, pero cuyas complicaciones oculares también pueden amenazar la visión si el tratamiento oftalmodermatológico no es correcto. El ojo y la piel se asocian de nuevo en numerosas enfermedades generales, congénitas, hereditarias o no, o bien adquiridas, cuyos síntomas específicos relacionados con ambas especialidades ayudan a establecer el diagnóstico positivo. Los ejemplos más frecuentes son el lupus, la enfermedad de Behçet, la sarcoidosis y las facomatosis. La superficie ocular conjuntivocorneal comparte con la piel una cierta similitud en cuanto al desarrollo de tumores, pigmentados o no. Por último, merecen describirse las consecuencias oculares de algunos tratamientos dermatológicos. También se hará mención a las situaciones inversas, que son más excepcionales.
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