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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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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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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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Fenner BJ, Jamshidi F, Bhuyan R, Fortenbach CR, Jin HD, Boyce TM, Binkley EM, Han IC, Sohn EH, Boldt HC, Folk JC, Russell SR, Stone EM, Russell JF. Vitreoretinal Procedures in Patients with Inherited Retinal Disease. Ophthalmol Retina 2024; 8:307-309. [PMID: 37918655 DOI: 10.1016/j.oret.2023.10.020] [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: 10/11/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 11/04/2023]
Affiliation(s)
- Beau J Fenner
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa; Institute for Vision Research, University of Iowa, Iowa City, Iowa; Singapore National Eye Centre, Singapore. Singapore Eye Research Institute, Singapore Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore.
| | - Farzad Jamshidi
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Rupak Bhuyan
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Christopher R Fortenbach
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Haoxing D Jin
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Timothy M Boyce
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa; Institute for Vision Research, University of Iowa, Iowa City, Iowa
| | - Elaine M Binkley
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa; Institute for Vision Research, University of Iowa, Iowa City, Iowa
| | - Ian C Han
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa; Institute for Vision Research, University of Iowa, Iowa City, Iowa
| | - Elliott H Sohn
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa; Institute for Vision Research, University of Iowa, Iowa City, Iowa
| | - H Culver Boldt
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa; Institute for Vision Research, University of Iowa, Iowa City, Iowa
| | - James C Folk
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa; Institute for Vision Research, University of Iowa, Iowa City, Iowa
| | - Stephen R Russell
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa; Institute for Vision Research, University of Iowa, Iowa City, Iowa
| | - Edwin M Stone
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa; Institute for Vision Research, University of Iowa, Iowa City, Iowa
| | - Jonathan F Russell
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa; Institute for Vision Research, University of Iowa, Iowa City, Iowa
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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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Taylor K, Su M, Richards Z, Mamawalla M, Rao P, Chang E. Outcomes in Retinal Detachment Repair and Laser Prophylaxis for Syndromes with Optically Empty Vitreous. Ophthalmol Retina 2023; 7:848-856. [PMID: 37356493 DOI: 10.1016/j.oret.2023.06.012] [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: 02/13/2023] [Revised: 06/13/2023] [Accepted: 06/16/2023] [Indexed: 06/27/2023]
Abstract
PURPOSE To evaluate and compare surgical outcomes for syndromes with optically empty vitreous (SOEV)-associated rhegmatogenous retinal detachments. DESIGN A retrospective, cross-sectional, 2-arm study of a single pediatric vitreoretinal surgeon's patients from a quaternary referral center with SOEV was performed to examine visual and anatomical outcomes of rhegmatogenous retinal detachment and laser prophylaxis. SUBJECTS Patients identified either through slit-lamp examination (presence of an optically empty or void space in the vitreous gel structure) or genetic testing. Fifty-six eyes of 49 patients were identified in the retinal detachment arm. Sixty eyes of 48 patients were identified in the laser prophylaxis arm. METHODS Comparison of initial retinal detachment (RD) surgical repair via pars plana vitrectomy (PPV), scleral buckle (SB), or PPV-SB with final anatomical success, best-corrected visual acuity (BCVA), and number of surgical procedures. Secondary analysis was performed looking at eyes failing their initial SB, eyes with a giant retinal tear at presentation, eyes failing RD repair within specific time intervals, and eyes where hyaloid was elevated during initial vitrectomy. An additional study arm examined the outcomes of final BCVA and the presence and timing of developing a retinal tear or RD in eyes who received laser prophylaxis. MAIN OUTCOME MEASURES Visual acuity, surgical repair techniques (PPV, SB, PPV-SB), number of surgeries, anatomical retinal reattachment success. RESULTS Initial SB had statistically significant better final BCVA (P < 0.01) and better final anatomical success (P < 0.01). No statistical difference in the number of surgeries needed to achieve anatomical success between the initial SB versus initial PPV-SB/PPV. Hyaloidal elevation during the initial vitrectomy was associated with improved final BCVA and higher final anatomical success without the use of silicone oil (P < 0.01 and 0.04 respectively). Lastly, eyes that developed RDs after laser prophylaxis had better final BCVA than untreated eyes (P < 0.05). CONCLUSION Initial SB yields better overall outcomes in SOEV presenting with rhegmatogenous retinal detachment. Stickler Type-1 patients had similar outcomes compared with other SOEV, suggesting both populations should be treated with similar approaches. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Kirby Taylor
- Texas A&M School of Medicine, Bryan, Texas; Mitchel & Shannon Wong Eye Institute, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Maxwell Su
- Baylor Scott & White Pavilion Eye Center, Dallas, Texas
| | | | | | - Prethy Rao
- Retina and Vitreous of Texas, Houston, Texas; Blanton Eye Institute, Methodist Hospital, Houston, Texas; Cullen Eye Institute, Baylor College of Medicine, Houston, Texas
| | - Emmanuel Chang
- Retina and Vitreous of Texas, Houston, Texas; Blanton Eye Institute, Methodist Hospital, Houston, Texas; Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.
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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: 1] [Impact Index Per Article: 1.0] [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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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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Sparks ME, Davila PJ, He YG, Wang AL. Pediatric Rhegmatogenous Retinal Detachments: Etiologies, Clinical Course, and Surgical Outcomes. JOURNAL OF VITREORETINAL DISEASES 2023; 7:139-143. [PMID: 37006670 PMCID: PMC10037755 DOI: 10.1177/24741264221150595] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Purpose: To describe the predisposing factors, clinical course, and surgical methods of pediatric rhegmatogenous retinal detachment (RRD) and determine which factors affect anatomic success. Methods: Data of patients 18 years or younger who had surgical repair for RRD from January 1, 2004, to June 31, 2020, with a minimum of 6 months of follow-up were retrospectively analyzed. Results: The study evaluated 101 eyes of 94 patients. Of the eyes, 90% had at least 1 predisposing factor to pediatric RRD, including trauma (46%), myopia (41%), prior intraocular surgery (26%), and congenital anomaly (23%); 81% had macula-off detachments and 34% had proliferative vitreoretinopathy (PVR) grade C or worse at presentation. The presence of PVR grade C or worse (P = .0002), total RRD (P = .014), and vitrectomy alone at first surgery (P = .0093) were associated with worse outcomes. Patients who had scleral buckle (SB) alone at the first surgery had statistically higher rates of anatomic success than those who had vitrectomy alone or combined with SB (P = .0002). After the final surgery, 74% of patients achieved anatomic success. Discussion: The majority of cases in this study were associated with 1 of the 4 risk factors predisposing to pediatric RRD. These patients often present late with macula-off detachments and PVR grade C or worse. The majority of patients achieved anatomic success after surgical repair using SB, vitrectomy, or a combination.
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Affiliation(s)
- Madeline E. Sparks
- University of Texas Southwestern
Medical Center, Dallas, TX, USA
- Children’s Health, Dallas, TX,
USA
| | - Pedro J. Davila
- University of Texas Southwestern
Medical Center, Dallas, TX, USA
- Children’s Health, Dallas, TX,
USA
| | - Yu-Guang He
- University of Texas Southwestern
Medical Center, Dallas, TX, USA
- Children’s Health, Dallas, TX,
USA
| | - Angeline L. Wang
- University of Texas Southwestern
Medical Center, Dallas, TX, USA
- Children’s Health, Dallas, TX,
USA
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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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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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12
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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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Prasad M, Xu J, Agranat JS, Xia W, Daley S, Ness S, Chen X, Siegel NH, Stein TD, Chung J, Subramanian ML. Upregulation of Neuroinflammatory Protein Biomarkers in Acute Rhegmatogenous Retinal Detachments. LIFE (BASEL, SWITZERLAND) 2022; 13:life13010118. [PMID: 36676067 PMCID: PMC9862737 DOI: 10.3390/life13010118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/20/2022] [Accepted: 12/26/2022] [Indexed: 01/04/2023]
Abstract
The purpose of this study is to characterize the inflammatory cytokine profile in rhegmatogenous retinal detachments (RRDs) compared to surgical controls. Vitreous humor was collected from patients undergoing vitrectomy for RRD and noninflammatory vitreoretinal diseases. A quantitative immunoassay was used to measure the levels of 36 cytokine markers. Linear regression analysis with the duration of detachment as the predictor and log-transformed cytokine levels as the outcome was conducted for normally distributed cytokines as determined by the Shapiro-Wilk test. The analysis was adjusted for age, sex, and race. The Kruskal-Wallis test was used for cytokines not normally distributed. Twenty-seven RRD cases and thirteen control cases were studied. Between all RRDs and controls, fibroblast growth factor 2 (FGF2) (p = 0.0029), inducible protein-10(IP-10) (p = 0.0021), monocyte chemoattractant protein-1 (MCP-1) (p = 0.0040), interleukin (IL)-16 (p = 0.018), IL-8 (p = 0.0148), IL-6 (p = 0.0071), eotaxin (p = 0.0323), macrophage inflammatory protein (MIP)-1 alpha (p = 0.0149), MIP-1 beta (p = 0.0032), and the thymus and activation regulated cytokine (TARC) (p = 0.0121) were elevated in RRD cases. Between acute RRDs (n = 16) and controls, FGF2 (p = 0.0001), IP10 (p = 0.0027), MCP-1 (p = 0.0015), MIP-1β (p = 0.0004), IL-8 (p = 0.0146), and IL-6 (p = 0.0031) were elevated. Determining alterations in inflammatory cytokine profiles may aid in understanding their impact on RRD development, clinical course, and complications before and after surgical repair.
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Affiliation(s)
- Minali Prasad
- Department of Ophthalmology, Boston University School of Medicine & Boston Medical Center, Boston, MA 02118, USA
| | - Jia Xu
- Department of Ophthalmology, Boston University School of Medicine & Boston Medical Center, Boston, MA 02118, USA
| | - Joshua S. Agranat
- Department of Ophthalmology, Boston University School of Medicine & Boston Medical Center, Boston, MA 02118, USA
| | - Weiming Xia
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, 72 East Concord Street, Boston, MA 02118, USA
- Geriatric Research Education and Clinical Center, VA Bedford Healthcare System, Bedford, MA 01730, USA
| | - Sarah Daley
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, 72 East Concord Street, Boston, MA 02118, USA
- Geriatric Research Education and Clinical Center, VA Bedford Healthcare System, Bedford, MA 01730, USA
| | - Steven Ness
- Department of Ophthalmology, Boston University School of Medicine & Boston Medical Center, Boston, MA 02118, USA
| | - Xuejing Chen
- Department of Ophthalmology, Boston University School of Medicine & Boston Medical Center, Boston, MA 02118, USA
| | - Nicole H. Siegel
- Department of Ophthalmology, Boston University School of Medicine & Boston Medical Center, Boston, MA 02118, USA
| | - Thor D. Stein
- Laboratory Medicine, Department of Pathology, Boston University School of Medicine, Boston, MA 02118, USA
- VA Bedford Healthcare System, Bedford, MA 01730, USA
- VA Boston Healthcare System, Boston, MA 02130, USA
| | - Jaeyoon Chung
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, 72 East Concord Street, Boston, MA 02118, USA
| | - Manju L. Subramanian
- Department of Ophthalmology, Boston University School of Medicine & Boston Medical Center, Boston, MA 02118, USA
- Correspondence: ; Tel.: +617-414-2020
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Huang F, Wang TJ, Cho WH, Chen YH, Wu PC, Kuo HK. Mutation survey in Taiwanese patients with Stickler syndrome. Taiwan J Ophthalmol 2022; 12:423-429. [PMID: 36660125 PMCID: PMC9843582 DOI: 10.4103/tjo.tjo_3_22] [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] [Received: 10/21/2021] [Accepted: 01/06/2022] [Indexed: 01/22/2023] Open
Abstract
PURPOSE The purpose of this study was to identify gene mutation and phenotype correlations in a cohort of Taiwanese patients with Stickler syndrome. MATERIALS AND METHODS Patients clinically diagnosed with Stickler syndrome or suspected Stickler syndrome were enrolled. DNA was extracted from venous blood samples. For the targeted next-generation sequencing (NGS) approach, specific primers were designed for all COL2A1, COL11A1, COL11A2, COL9A1, and COL9A2 exons and flanking intron sequences. RESULTS Twenty-three patients from 12 families were enrolled in this study. The myopia power in these 23 cases (35 eyes) ranged from -4.625 to -25.625 D, with a median of -10.00 D. Four patients had retinal detachment. Fourteen patients had a cleft palate. These 23 patients and 13 healthy controls were enrolled in the NGS study. Three families had significant single nucleotide variants (SNVs) in COL2A1. The mutation rates in this survey were 25% (3/12 families) and 35% (8/23 cases). The SNV of family #1, located at exon 27, c.1753G >T, p. Gly585Val, was novel and has not yet been reported in the ClinVar database. Families #10 and #11 had the same SNV, located in exon 33, c.2101C >T, p. Arg701X. Both variants were classified as likely pathogenic according to the American College of Medical Genetics and Genomics guidelines. CONCLUSION Genetic mutations in COL2A1 were found in 25% of Taiwanese families with Stickler syndrome. One novel variant was identified using NGS, which expanded the COL2A1 mutation spectrum. Molecular genetic analysis is helpful to confirm the clinical diagnosis of patients with suspected Stickler syndrome.
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Affiliation(s)
- Faye Huang
- Department of Plastic and Reconstructive Surgery, Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung, Taiwan,School of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Tzu-Jou Wang
- School of Medicine, Chang Gung University, Taoyuan City, Taiwan,Department of Pediatrics, Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Wan-Hua Cho
- Department of Ophthalmology, Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Yi-Hao Chen
- School of Medicine, Chang Gung University, Taoyuan City, Taiwan,Department of Ophthalmology, Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Pei-Chang Wu
- School of Medicine, Chang Gung University, Taoyuan City, Taiwan,Department of Ophthalmology, Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Hsi-Kung Kuo
- School of Medicine, Chang Gung University, Taoyuan City, Taiwan,Department of Ophthalmology, Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung, Taiwan,Address for correspondence: Dr. Hsi-Kung Kuo, Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niao-Sung District, Kaohsiung, Taiwan. E-mail:
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15
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Traboulsi EI. Preventing Retinal Detachment in Patients with Stickler Syndrome: The Effects of Preemptive Laser Photocoagulation. Ophthalmol Retina 2022; 6:261-262. [PMID: 35393073 DOI: 10.1016/j.oret.2021.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
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16
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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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Khanna S, Rodriguez SH, Blair MA, Wroblewski K, Shapiro MJ, Blair MP. Laser Prophylaxis in Patients with Stickler Syndrome. Ophthalmol Retina 2021; 6:263-267. [PMID: 34774838 DOI: 10.1016/j.oret.2021.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To evaluate the association between laser prophylaxis, retinal detachment, and visual acuity among patients with Stickler syndrome DESIGN: Retrospective comparative case series PARTICIPANTS: Patients with Stickler syndrome INTERVENTION: Patients received extended vitreous base laser (EVBL), non-protocol laser (NPL), or no laser prophylaxis of any kind MAIN OUTCOME MEASURES: The two main outcome measures that were examined were rates of retinal detachment and visual acuity in these patients. RESULTS 230 eyes of 115 patients were included in this study. 59 patients were female (51%). The median age at laser prophylaxis was 9.5 years old (6-13), and the median age of patients with RD was 11 years old (7-18). 92 of those eyes did not undergo any laser, 9 received NPL, and 129 received EVBL. Of the 129 eyes who underwent EVBL, 4 (3%) had an RD, compared to the 74 eyes (73%) which had an RD that did not receive laser treatment or had NPL (P<0.001). Eyes with EVBL had about 8 lines better vision, on average, compared to those without laser or NPL (-0.86 logMAR, 95% CI -1.1- -0.64, P< 0.001). CONCLUSIONS EVBL appears to reduce the rate of subsequent RD and is associated with better visual acuity in patients with Stickler syndrome.
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Affiliation(s)
- Saira Khanna
- Department of Ophthalmology and Visual Sciences, University of Chicago Medical Center, Chicago, IL
| | - Sarah H Rodriguez
- Department of Ophthalmology and Visual Sciences, University of Chicago Medical Center, Chicago, IL
| | | | - Kristen Wroblewski
- Department of Public Health Sciences, University of Chicago, Chicago, IL
| | | | - Michael P Blair
- Department of Ophthalmology and Visual Sciences, University of Chicago Medical Center, Chicago, IL; Retina Consultants, Ltd, Des Plaines, IL.
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Abstract
Retinal detachments are a potentially sight-threatening ophthalmic emergency that may result in significant, irreversible vision loss. The risk of developing retinal detachment increases with advancing age, myopia and trauma. Pre-existing retinal degenerations can precipitate a pre-detachment symptomatic period of photopsia or floaters, allowing clinicians to intervene early and prevent detachments. Novel imaging techniques, such as spectral-domain optical coherence tomography, and well-established topographic modalities, such as B scan, can help to elucidate the type of detachment and any underlying causes, and help with surgical management. The overarching goal of treatment is to identify and seal all retinal holes, relieve vitreoretinal traction and prevent further recurrence. Prompt prophylactic retinopexy of retinal holes and tears is crucial in preventing retinal detachment, the main treatments of which are pars plana vitrectomy, tamponading agents and silicone scleral buckle.
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Affiliation(s)
- Ahmed Ibrar
- Ophthalmology Department, Great Western Hospital, Swindon, UK
| | - Maghsoudlou Panayiotis
- Ophthalmology Department, Great Western Hospital, Swindon, UK.,Department of Stem Cells and Regenerative Medicine, University College London, London, UK
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19
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Morris RE, Parma ES, Robin NH, Sapp MR, Oltmanns MH, West MR, Fletcher DC, Schuchard RA, Kuhn F. Stickler Syndrome (SS): Laser Prophylaxis for Retinal Detachment (Modified Ora Secunda Cerclage, OSC/SS). Clin Ophthalmol 2021; 15:19-29. [PMID: 33447008 PMCID: PMC7802593 DOI: 10.2147/opth.s284441] [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: 09/29/2020] [Accepted: 11/11/2020] [Indexed: 12/03/2022] Open
Abstract
Purpose To introduce a novel technique of encircling laser prophylaxis (ora secunda cerclage Stickler syndrome, OSC/SS) to prevent rhegmatogenous retinal detachment (RRD) in Stickler syndrome eyes. Patients and Methods After first eye RRD at age 50 and at age 18, respectively, a 53-year-old father and his 22-year-old son with type 2 SS (STL2) gave informed consent and underwent OSC/SS prophylaxis, performed in each fellow eye. A 26-year-old STL2 daughter then suffered first eye retinal detachment and similarly chose fellow eye OSC/SS prophylaxis. A second son, 28 years of age with STL2, chose OSC/SS prophylaxis in both eyes. Results The three OSC/SS treated fellow eyes have gone 12 years, 11 years, and 8 years without RRD. STL1 and less common STL2 eyes are known to have a similar rate of RRD, and 80% of STL1 fellow eyes develop RRD at a median of 4 years in the absence of prophylaxis. Moreover, five of six (83%) known STL2 family members suffered RRD, only the STL2 son with bilateral OSC/SS remaining bilaterally attached. All five OSC/SS treated eyes (average 8.7 years post-prophylaxis) retained preoperative visual acuity of 20/20 to 20/30, with an average, asymptomatic reduction of meridional field in each eye to 50 degrees. In contrast, in the three eyes having suffered RRD prior to presentation, visual acuity ranged from 20/125 to 8/200 and average meridional field was 29 degrees. Conclusion Encircling grid laser (OSC) modified in Stickler eyes to encompass the ora serrata and extend posteriorly to and between the vortex vein ampullae (OSC/SS) is a reasonable RRD prophylaxis option to offer STL1 and STL2 patients as an alternative to no treatment or less effective prophylaxis. Because of rarity and severity, the ultimate proof of safety and efficacy will likely come not from randomized trials, but from a non-randomized, prospective, cohort comparison study of such individual efforts. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/AzHz4xYUV_w
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Affiliation(s)
- Robert E Morris
- Retina Specialists of Alabama, Birmingham, AL, USA.,Helen Keller Foundation for Research and Education, Birmingham, AL, USA.,University of Alabama at Birmingham (UAB), Department of Ophthalmology, Birmingham, AL, USA.,UAB Callahan Eye Hospital, Birmingham, AL, USA
| | | | | | - Mathew R Sapp
- Retina Specialists of Alabama, Birmingham, AL, USA.,Helen Keller Foundation for Research and Education, Birmingham, AL, USA.,University of Alabama at Birmingham (UAB), Department of Ophthalmology, Birmingham, AL, USA.,UAB Callahan Eye Hospital, Birmingham, AL, USA
| | - Matthew H Oltmanns
- Retina Specialists of Alabama, Birmingham, AL, USA.,Helen Keller Foundation for Research and Education, Birmingham, AL, USA.,University of Alabama at Birmingham (UAB), Department of Ophthalmology, Birmingham, AL, USA.,UAB Callahan Eye Hospital, Birmingham, AL, USA
| | - Matthew R West
- Retina Specialists of Alabama, Birmingham, AL, USA.,Helen Keller Foundation for Research and Education, Birmingham, AL, USA.,University of Alabama at Birmingham (UAB), Department of Ophthalmology, Birmingham, AL, USA.,UAB Callahan Eye Hospital, Birmingham, AL, USA
| | - Donald C Fletcher
- University of Kansas Medical Center, Department of Ophthalmology and KU Eye Center, Kansas City, KS, USA.,Retina Consultants of Southwest Florida, Ft. Myers, FL, USA
| | | | - Ferenc Kuhn
- Helen Keller Foundation for Research and Education, Birmingham, AL, USA.,Milos Eye Hospital, Belgrade, Serbia.,University of Pécs, Department of Ophthalmology, Pécs, Hungary
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20
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Boothe M, Morris R, Robin N. Stickler Syndrome: A Review of Clinical Manifestations and the Genetics Evaluation. J Pers Med 2020; 10:jpm10030105. [PMID: 32867104 PMCID: PMC7564399 DOI: 10.3390/jpm10030105] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 01/17/2023] Open
Abstract
Stickler Syndrome (SS) is a multisystem collagenopathy frequently encountered by ophthalmologists due to the high rate of ocular complications. Affected individuals are at significantly increased risk for retinal detachment and blindness, and early detection and diagnosis are critical in improving visual outcomes for these patients. Systemic findings are also common, with craniofacial, skeletal, and auditory systems often involved. SS is genotypically and phenotypically heterogenous, which can make recognizing and correctly diagnosing individuals difficult. Molecular genetic testing should be considered in all individuals with suspected SS, as diagnosis not only assists in treatment and management of the patient but may also help identify other at-risk family members. Here we review common clinical manifestation of SS and genetic tests frequently ordered as part of the SS evaluation.
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Affiliation(s)
- Megan Boothe
- Department of Genetics, University of Alabama at Birmingham, Birmingham, AL 35233, USA;
| | - Robert Morris
- Retina Specialists of Alabama, Birmingham, AL 35233, USA;
| | - Nathaniel Robin
- Department of Genetics, University of Alabama at Birmingham, Birmingham, AL 35233, USA;
- Correspondence:
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