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Liu Y, Ju Y, Chen TH, Jiang YX. Genotype-phenotype Correlations of Ocular Posterior Segment Abnormalities in Marfan Syndrome. OPHTHALMOLOGY SCIENCE 2024; 4:100526. [PMID: 38840780 PMCID: PMC11152728 DOI: 10.1016/j.xops.2024.100526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/25/2024] [Accepted: 04/01/2024] [Indexed: 06/07/2024]
Abstract
Purpose Marfan syndrome (MFS) is a connective tissue disorder caused by mutations in the fibrillin-1 ( (FBN1). In addition to typical phenotypes such as ectopia lentis (EL) and aortic dilation, patients with MFS are prone to ocular posterior segment abnormalities, including retinal detachment (RD), maculopathy, and posterior staphyloma (PS). This study aims to investigate the correlations between FBN1 genotype and posterior segment abnormalities within a Chinese cohort of MFS. Design Retrospective study. Participants One hundred twenty-one eyes of 121 patients with confirmed FBN1 mutations between January 2015 and May 2023 were included. Methods Comprehensive ophthalmic examination findings were reviewed, and the incidence of RD, atrophic, tractional, and neovascular maculopathy (ATN classification system), and PS was analyzed between different genotype groups. Only the more severely affected eye from each patient was included. Main Outcome Measures Clinical features and risk factors. Results Of 121 patients, 60 eyes (49.59%) exhibited posterior segment abnormalities, including RD (4, 3.31%), maculopathy (47, 38.84%), and PS (54, 44.63%). The mean age was 11.53 ± 11.66 years, with 79.34% of patients <20 years old. The location and region of mutations were found to be associated with the incidence of maculopathy (P = 0.013, P = 0.033) and PS (P = 0.043, P = 0.036). Mutations in the middle region had a lower incidence of maculopathy and PS (P = 0.028 and P = 0.006, respectively) than those in C-terminal region. Mutations in the transforming growth factor-β (TGF-β) regulating sequence exhibited a higher incidence of maculopathy and PS (P = 0.020, P = 0.040). Importantly, the location and region of mutations were also associated with the incidence of atrophic maculopathy (P = 0.013 and P = 0.033, respectively). Mutations in the middle region had a significantly lower probability of atrophic maculopathy (P = 0.006), while mutations in the TGF-β regulating region had a higher incidence of atrophic maculopathy (P = 0.020). Conclusions Maculopathy and PS were associated with the location and region of FBN1 mutations. Patients with mutations in the TGF-β regulating region faced an increased risk of developing retinopathy. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Yan Liu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yuqiao Ju
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Tian-hui Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yong-xiang Jiang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
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Jia WN, Chen ZX, Wang YL, Shen X, Chen XY, Chen TH, Sun Y, Liu Y, Song LH, Huo QY, Jiang YX. Genotype Associated With Visual Prognosis in Patients With Congenital Ectopia Lentis Following Lens Surgery: A Prospective Cohort Study. Am J Ophthalmol 2024; 268:285-295. [PMID: 39121940 DOI: 10.1016/j.ajo.2024.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 08/01/2024] [Accepted: 08/01/2024] [Indexed: 08/12/2024]
Abstract
PURPOSE To investigate the relationship between visual prognosis and genotype in patients undergoing lens surgery for congenital ectopia lentis (EL). DESIGN Prospective clinical cohort study. METHODS Patients with congenital EL who underwent lens removal and intraocular lens implantation received panel-based next-generation sequencing. Patients were grouped into children and adolescents/adults based on the age at surgery. The visual prognosis, including best-corrected visual acuity (BCVA) and amblyopia, was stratified into short-term and medium to long-term. RESULTS This study included 329 probands with congenital EL, with a median age at lens surgery of 7.00 years (interquartile range [IQR] = 5.00, 12.50 years). Children with the non-FBN1 mutation exhibited inferior medium to long-term postoperative BCVA (0.26 [IQR: 0.14, 0.33] vs 0.15 [IQR: 0.10, 0.22], P = .034) and a higher prevalence of amblyopia (44.4% vs 16.8%, P = .012) compared to those with FBN1 mutation. Multivariable analysis showed that genotype (FBN1 vs non-FBN1 mutation) was significantly associated with medium to long-term postoperative BCVA (b = -0.128, 95% CI -0.214 to -0.042, P = .004) and amblyopia (OR = 0.20, 95% CI 0.05-0.78, P = .020) in children. Further classification of FBN1 genotype did not yield significant correlations with visual prognosis. However, no significant correlation was observed between genotype and short-term visual prognosis in the children. Children with less severe EL (OR = 0.13, 95% CI 0.02-0.85, P = .033) had lower risks of amblyopia in the short-term follow-up. For adolescent and adult patients with congenital EL, those with poor preoperative BCVA and long axial length should be informed of suboptimal visual prognosis. CONCLUSIONS Genotype significantly influences the medium to long-term visual prognosis in children with congenital EL. Genotype, along with preoperative BCVA, may assist in establishing reasonable expectations for patients regarding their visual outcomes after the lens surgery.
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Affiliation(s)
- Wan-Nan Jia
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China
| | - Ze-Xu Chen
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China
| | - Ya-Lei Wang
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China
| | - Xin Shen
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China
| | - Xin-Yao Chen
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China
| | - Tian-Hui Chen
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China
| | - Yang Sun
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China
| | - Yan Liu
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China
| | - Ling-Hao Song
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China
| | - Qiu-Yi Huo
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China
| | - Yong-Xiang Jiang
- From the Eye Institute and Department of Ophthalmology (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Eye & ENT Hospital, Fudan University, Shanghai China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (W.N.J., Z.X.C., Y.L.W., X.S., X.Y.C., T.H.C., Y.S., Y.L., L.H.S., Q.Y.H., and Y.X.J.), Shanghai, China.
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Nassisi M, Mainetti C, Sperti A, Galmozzi G, Aretti A, Leone G, Nicotra V, Grilli F, Rinaldi B, Natacci F, Bedeschi MF, Viola F. Optical coherence tomography angiography findings in Williams-Beuren syndrome. Graefes Arch Clin Exp Ophthalmol 2024; 262:1131-1140. [PMID: 38032380 DOI: 10.1007/s00417-023-06323-7] [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: 07/14/2023] [Revised: 10/23/2023] [Accepted: 11/20/2023] [Indexed: 12/01/2023] Open
Abstract
PURPOSE Williams-Beuren syndrome (WBS) is a rare genetic disease characterized by psychomotor delay, cardiovascular, musculoskeletal, and endocrine problems. Retinal involvement, which is not well characterized, has also been described. The purpose of this cross-sectional study is to describe the characteristics in optical coherence tomography (OCT) and OCT-angiography (OCTA) of patients with WBS. METHODS We included patients with WBS confirmed by genetic analysis. The patients underwent OCT (30° × 25°, 61 B-scans) and OCTA (10° × 10° and 20° × 20°) examinations, all centered on the. Data on retinal thickness (total, inner and outer layers) and foveal morphology on OCT and vessel and perfusion density in OCTA (VD and PD, respectively) were collected. These data were compared with an age-matched control group. RESULTS 22 eyes of 22 patients with WBS (10 females, mean age 31.5 years) were included. Retinal thickness (and specifically inner retinal layers) in OCT was significantly reduced in all sectors (central, parafoveal, and perifoveal) compared to the control group (p < 0.001 in all sectors). Fovea in WBS eyes was broader and shallower than controls. The PD and VD in both 10 and 20 degrees of fields in OCTA was significantly reduced in patients with WBS, in all vascular plexa (all p < 0.001). CONCLUSIONS This study is the first to quantify and demonstrate retinal structural and microvascular alterations in patients with WBS. Further studies with longitudinal data will reveal the potential clinical relevance of these alterations.
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Affiliation(s)
- Marco Nassisi
- Ophthalmology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
- Department of Clinical Sciences and Community Health, University of Milan, Via F. Sforza 35, 20100, Milan, Italy.
| | - Claudia Mainetti
- Ophthalmology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Sperti
- Department of Clinical Sciences and Community Health, University of Milan, Via F. Sforza 35, 20100, Milan, Italy
| | - Guido Galmozzi
- Department of Clinical Sciences and Community Health, University of Milan, Via F. Sforza 35, 20100, Milan, Italy
| | - Andrea Aretti
- Department of Clinical Sciences and Community Health, University of Milan, Via F. Sforza 35, 20100, Milan, Italy
| | - Gaia Leone
- Ophthalmology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Valeria Nicotra
- Medical Genetics Unit, Department Woman Child Newborn, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Federico Grilli
- Medical Genetics Unit, Department Woman Child Newborn, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Berardo Rinaldi
- Medical Genetics Unit, Department Woman Child Newborn, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Federica Natacci
- Medical Genetics Unit, Department Woman Child Newborn, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Francesca Bedeschi
- Medical Genetics Unit, Department Woman Child Newborn, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesco Viola
- Ophthalmology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Via F. Sforza 35, 20100, Milan, Italy
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