1
|
Jin G, Zou M, Li L, Liu Z, Young C, Qi H, Zheng D. Corneal biomechanics and their association with severity of lens dislocation in Marfan syndrome. Int Ophthalmol 2024; 44:148. [PMID: 38502381 DOI: 10.1007/s10792-024-03079-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/16/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE To investigate corneal biomechanical properties and its associations with the severity of lens dislocation in patients with Marfan syndrome. METHODS A total of 30 patients with Marfan syndrome and 30 age-, sex- and axial length (AL)-matched controls were recruited. Corneal biomechanical parameters of both groups were measured by CorVis ST and were compared between groups. Potential associations between corneal biomechanical parameters and severity of lens dislocation were also investigated. RESULTS Lower applanation 1 velocity (A1V) (0.13 ± 0.004 vs. 0.15 ± 0.003, P = 0.016), shorter applanation 2 time (A2T)(22.64 ± 0.11 vs. 22.94 ± 0.11, P = 0.013), longer peak distance (PD) (5.03 ± 0.07 vs. 4.81 ± 0.05, P = 0.008), longer radius (R) of highest concavity (7.44 ± 0.16 vs. 6.93 ± 0.14, P = 0.012), greater Ambrosio relational thickness horizontal (ARTh) (603 ± 20 vs. 498 ± 12, P < 0.001), and integrated radius (IR) (8.32 ± 0.25 vs. 8.95 ± 0.21, P = 0.033) were detected among Marfan eyes compared with controls (all P < 0.05). Marfan individuals with more severe lens dislocation tended to have increased stiffness parameter as longer A1T, slower A1V, shorter A2T, slower application 2 velocity (A2V), smaller PD and smaller Distance Amplitude (DA) (P < 0.05). CONCLUSION Marfan patients were detected to have increased corneal stiffness compared with normal subjects. Corneal biomechanical parameters were significantly associated with the severity of lens dislocation in Marfan patients.
Collapse
Affiliation(s)
- Guangming Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Minjie Zou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Longhui Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Charlotte Young
- Albany Medical College, 49 New Scotland Ave, Albany, NY, USA
| | - Haotian Qi
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Danying Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.
| |
Collapse
|
2
|
Unni P, Tijerina J, Hoyek S, Cotton C, Salazar H, Fan KC, Patel NA. In-Office Lens Repositioning for Anterior Crystalline Lens Dislocation. Ophthalmic Surg Lasers Imaging Retina 2024:1-6. [PMID: 38270569 DOI: 10.3928/23258160-20240116-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
BACKGROUND AND OBJECTIVE We describe an in-office lens repositioning technique for anterior crystalline lens dislocation. PATIENTS AND METHODS We present a case series of four patients with spontaneous or traumatic anterior crystalline lens dislocation. RESULTS The technique included supine patient positioning, gentle pressure with a cotton swab on the peripheral cornea to guide the lens into the posterior chamber, and the use of a miotic agent afterward to prevent subsequent subluxation. In the four cases described, the in-office technique successfully restored the lens to the posterior chamber, improved vision, and decreased intraocular pressure in most instances by resolving the angle closure secondary to pupillary block. CONCLUSIONS The in-office lens repositioning technique is appropriate as an acute non-surgical intervention or temporizing measure for anterior crystalline lens dislocation. [Ophthalmic Surg Lasers Imaging Retina 2024;55:XX-XX.].
Collapse
|
3
|
Jing J, Meng Q, Gu W, Cheng H, Li K, Li Y, Liu Q. Initial screening for occult congenital ectopia lentis based on ocular biological parameters in preschool children. BMC Ophthalmol 2023; 23:485. [PMID: 38008718 PMCID: PMC10680347 DOI: 10.1186/s12886-023-03230-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 11/20/2023] [Indexed: 11/28/2023] Open
Abstract
BACKGROUND This study aimed to identify an initial screening tool for congenital ectopia lentis (CEL) by comparing ocular biological parameters in children with myopia. METHODS A retrospective case-control study was conducted at one tertiary referral centre, from October 2020 to June 2022. Axial length (AL), corneal curvature (CC), refractive astigmatism (RA), corneal astigmatism (CA), internal astigmatism (IA), the difference between the axis of RA and CA [AXIS(RA-CA)], white-to-white corneal diameter (WTW), and axial length-corneal radius ratio (AL/CR) were compared in 28 eyes of CEL patients, and 60 eyes of myopic patients matched for age and refraction. The spherical equivalent of each eye was < -3.00 D. Area under the curve (AUC) of the receiver operating characteristic curves were calculated. RESULTS The differences in RA, AL, mean keratometry (Kmed), maximum keratometry (Kmax), minimum keratometry (Kmin), CA, IA, AXIS(RA-CA), WTW, and AL/CR between the CEL and myopic groups were statistically significant (p < 0.05; p < 0.001; p < 0.001; p < 0.001; p < 0.001; p < 0.05; p < 0.001; p < 0.001; p < 0.001; p < 0.001, respectively). In logistic regression analysis RA, IA, AXIS(RA-CA), and AL/CR were significantly associated with CEL (p < 0.05). AUCs for RA, IA, AXIS(RA-CA), and AL/CR were 0.694, 0.853, 0.814, and 0.960, respectively. AUCs for AL/CR in SE< -6.00 D subgroup was 0.970, and 0.990 in -6.00 D ≤ SE < -3.00 D group. An AL/CR < 3.024 was the optimal cut-off point differentiating the CEL and control groups (sensitivity, 92.9%; specificity, 88.30%). CONCLUSIONS A smaller AL/CR could identify CEL in children with myopia. An AL/CR cut-off value of 3.024 may be the most sensitive and specific parameter for the differential diagnosis of CEL in patients with mild to high myopia.
Collapse
Affiliation(s)
- Jiaona Jing
- Department of Ophthalmology, Children's Hospital of Nanjing Medical University, Nanjing, China.
| | - Qingwei Meng
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Wei Gu
- Department of Medical, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Haixia Cheng
- Department of Ophthalmology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Kun Li
- Department of Ophthalmology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Yuming Li
- Harris Laboratory, Boston Children's Hospital, Harvard Medical School, Boston, USA
| | - Qinghuai Liu
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| |
Collapse
|
4
|
Hassani M, Taghizadeh S, Farahzad Broujeni A, Habibi M, Banitalebi S, Kasiri M, Sadeghi A, Nozari A. A Novel Missense Mutation in the TGF-β-binding Protein-Like Domain 3 of FBN1 Causes Weill-Marchesani Syndrome with Intellectual Disability. Adv Biomed Res 2023; 12:114. [PMID: 37288014 PMCID: PMC10241635 DOI: 10.4103/abr.abr_138_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: 04/30/2022] [Revised: 07/26/2022] [Accepted: 08/22/2022] [Indexed: 06/09/2023] Open
Abstract
Background Weill-Marchesani syndrome (WMS) is a rare connective tissue disorder characterized by locus heterogeneity and variable expressivity. Patients suffering from WMS are described by short stature, brachydactyly, joint stiffness, congenital heart defects, and eye abnormalities. This disorder is inherited in two different modes; the autosomal dominant form of the disease occurs due to a mutation in FBN1, and the recessive form results from mutations in ADAMTS10, ADAMTS17, or LTP2 genes. Materials and Methods The family recruited in this study was a consanguineous Iranian family with an intellectually disabled girl referred to the Sadra Genetics laboratory, Shahrekord, Iran. The clinical history of family members was investigated. Whole-Exome Sequencing (WES) for the proband was performed. Sanger sequencing was used to assess the segregation of candidate variants in the other family members. Results Whole-exome sequencing analysis revealed a novel heterozygote mutation in the proband located at the third TGF-β-binding protein-like (TB) domain of the FBN1 gene (NM000138: c.2066A>G: (p. Glu689Gly), NP_000129.3, in exon 17 of the gene). Co-segregation analysis with Sanger sequencing confirmed this mutation in the affected members of the pedigree. Conclusion Our findings represent an autosomal dominant form of specific WMS resulting from a substitution mutation in the FBN1 gene. In addition to the typical manifestations of the disorder, mild intellectual disability (ID) was identified in the 8-year-old proband. Given the fact that ID is primarily reported in ADAMTS10 mutated cases, this family was clinically and genetically a novel case.
Collapse
Affiliation(s)
- Mahdieh Hassani
- Department of Medical Genetics, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Sara Taghizadeh
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Farahzad Broujeni
- Shahrekord Neuroscience Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mahvash Habibi
- Department of Medical Genetics, Sadra Medical Genetics Lab, Shahrekord, Iran
| | - Setareh Banitalebi
- Department of Medical Genetics, Sadra Medical Genetics Lab, Shahrekord, Iran
| | - Mahbubeh Kasiri
- Department of Medical Genetics, Medical Genetics Laboratory, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Alireza Sadeghi
- Department of Medical Genetics, Sadra Medical Genetics Lab, Shahrekord, Iran
| | - Ahoura Nozari
- Department of Medical Genetics, Sadra Medical Genetics Lab, Shahrekord, Iran
- Department of Medical Genetics, Medical Genetics Laboratory, Shahrekord University of Medical Sciences, Shahrekord, Iran
| |
Collapse
|
5
|
Shen R, Li VSW, Wong MOM, Chan PPM. Pediatric Glaucoma-From Screening, Early Detection to Management. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020181. [PMID: 36832310 PMCID: PMC9954748 DOI: 10.3390/children10020181] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/10/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
Pediatric glaucoma (PG) covers a rare and heterogeneous group of diseases with variable causes and presentations. Delayed diagnosis of PG could lead to blindness, bringing emotional and psychological burdens to patients' caregivers. Recent genetic studies identified novel causative genes, which may provide new insight into the etiology of PG. More effective screening strategies could be beneficial for timely diagnosis and treatment. New findings on clinical characteristics and the latest examination instruments have provided additional evidence for diagnosing PG. In addition to IOP-lowering therapy, managing concomitant amblyopia and other associated ocular pathologies is essential to achieve a better visual outcome. Surgical treatment is usually required although medication is often used before surgery. These include angle surgeries, filtering surgeries, minimally invasive glaucoma surgeries, cyclophotocoagulation, and deep sclerectomy. Several advanced surgical therapies have been developed to increase success rates and decrease postoperative complications. Here, we review the classification and diagnosis, etiology, screening, clinical characteristics, examinations, and management of PG.
Collapse
Affiliation(s)
- Ruyue Shen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Venice S. W. Li
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Eye Hospital, Kowloon, Hong Kong, China
| | - Mandy O. M. Wong
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Eye Hospital, Kowloon, Hong Kong, China
| | - Poemen P. M. Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Eye Hospital, Kowloon, Hong Kong, China
- Lam Kin Chung. Jet King-Shing Ho Glaucoma Treatment and Research Centre, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Department of Ophthalmology and Visual Sciences, The Prince of Wales Hospital, Hong Kong, China
- Correspondence: ; Tel.: +852-3943-5807
| |
Collapse
|
6
|
Jing Q, Chen T, Chen Z, Lan L, Zhao C, Jiang Y. Ocular Manifestations of Acute Secondary Angle Closure Associated With Lens Subluxation. Front Med (Lausanne) 2022; 8:738745. [PMID: 35096854 PMCID: PMC8794948 DOI: 10.3389/fmed.2021.738745] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To evaluate the clinical characteristics and ocular features of patients with acute secondary angle closure, associated with lens subluxation (ASAC-LS). Methods: We performed a retrospective study at the EENT Hospital of Fudan University, Shanghai, China. A total of 41 affected eyes from 41 patients were enrolled in this study. Furthermore, 20 affected eyes were part of the ASAC-LS cohort and 21 affected eyes were included in the acute primary angle closure (APAC) cohort. The best-corrected visual acuity (BCVA), intraocular pressure (IOP), axial length (AL), minimum corneal curvature (K1), maximum corneal curvature (K2), and anterior chamber depth (ACD) were measured and compared between the 2 cohorts. In addition, inter-eye (intraindividual) comparison was performed. Results: The ASAC-LS cohort exhibited younger ages, more frequent trauma history (35%), lower IOP (27.43 ± 13.86 mmHg vs. 41.27 ± 10.36 mmHg), longer AL (23.96 ± 2.60 vs. 22.49 ± 0.77 mm), shallower ACD (1.28 ± 0.38 vs. 1.58 ± 0.23 mm), and bigger ACD differences (0.99 ± 0.52 vs. 0.15 ± 0.19 mm), as compared with the APAC cohort (all p < 0.05). Moreover, eyes from the lens subluxation cohort experienced worse BCVA, higher IOP, and shallower ACD than their matched unaffected eyes (all p < 0.05). Although longer AL, shallower ACD, and bigger ACD differences were strongly correlated with lens subluxation in a univariate logistic regression analysis, only the ACD difference remained significant in the multivariate model (p = 0.004, OR = 1,510.50). Additionally, according to the receiver operating characteristic (ROC) curve analysis, both ACD and ACD differences had greater value in the differential diagnosis of ASAC-LS and APAC, with a cut-off value of 1.4 and 0.63 mm, respectively. Conclusions: Shallower ACD and larger ACD differences provide the promising diagnostic potential for patients with ASAC-LS.
Collapse
Affiliation(s)
- Qinghe Jing
- Department of Ophthalmology and Vision Science, Eye & Ear Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China
| | - Tianhui Chen
- Department of Ophthalmology and Vision Science, Eye & Ear Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China
| | - Zexu Chen
- Department of Ophthalmology and Vision Science, Eye & Ear Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China
| | - Lina Lan
- Department of Ophthalmology and Vision Science, Eye & Ear Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China
| | - Chen Zhao
- Department of Ophthalmology and Vision Science, Eye & Ear Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China
| | - Yongxiang Jiang
- Department of Ophthalmology and Vision Science, Eye & Ear Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China
| |
Collapse
|
7
|
Shi Y, Jones W, Beatty W, Tan Q, Mecham RP, Kumra H, Reinhardt DP, Gibson MA, Reilly MA, Rodriguez J, Bassnett S. Latent-transforming growth factor beta-binding protein-2 (LTBP-2) is required for longevity but not for development of zonular fibers. Matrix Biol 2020; 95:15-31. [PMID: 33039488 DOI: 10.1016/j.matbio.2020.10.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 10/04/2020] [Accepted: 10/04/2020] [Indexed: 01/06/2023]
Abstract
Latent-transforming growth factor beta-binding protein 2 (LTBP-2) is a major component of arterial and lung tissue and of the ciliary zonule, the system of extracellular fibers that centers and suspends the lens in the eye. LTBP-2 has been implicated previously in the development of extracellular microfibrils, although its exact role remains unclear. Here, we analyzed the three-dimensional structure of the ciliary zonule in wild type mice and used a knockout model to test the contribution of LTBP-2 to zonule structure and mechanical properties. In wild types, zonular fibers had diameters of 0.5-1.0 micrometers, with an outer layer of fibrillin-1-rich microfibrils and a core of fibrillin-2-rich microfibrils. LTBP-2 was present in both layers. The absence of LTBP-2 did not affect the number of fibers, their diameters, nor their coaxial organization. However, by two months of age, LTBP-2-depleted fibers began to rupture, and by six months, a fully penetrant ectopia lentis phenotype was present, as confirmed by in vivo imaging. To determine whether the seemingly normal fibers of young mice were compromised mechanically, we compared zonule stress/strain relationships of wild type and LTBP-2-deficient mice and developed a quasi-linear viscoelastic engineering model to analyze the resulting data. In the absence of LTBP-2, the ultimate tensile strength of the zonule was reduced by about 50%, and the viscoelastic behavior of the fibers was altered significantly. We developed a harmonic oscillator model to calculate the forces generated during saccadic eye movement. Model simulations suggested that mutant fibers are prone to failure during rapid rotation of the eyeball. Together, these data indicate that LTBP-2 is necessary for the strength and longevity of zonular fibers, but not necessarily for their formation.
Collapse
Affiliation(s)
- Y Shi
- Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, 660 S. Euclid Ave, Box 8096, St. Louis, MO 63110, USA
| | - W Jones
- Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, 660 S. Euclid Ave, Box 8096, St. Louis, MO 63110, USA
| | - W Beatty
- Department of Molecular Microbiology, Washington University, St. Louis, MO, USA
| | - Q Tan
- Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, 660 S. Euclid Ave, Box 8096, St. Louis, MO 63110, USA
| | - R P Mecham
- Department of Cell Biology & Physiology, Washington University, St. Louis, MO, USA
| | - H Kumra
- Department of Anatomy & Cell Biology, and Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - D P Reinhardt
- Department of Anatomy & Cell Biology, and Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - M A Gibson
- Department of Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - M A Reilly
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA; Department of Ophthalmology and Visual Science, The Ohio State University, Columbus, OH, USA
| | - J Rodriguez
- Department of Basic Sciences, St. Louis College of Pharmacy, St. Louis, MO, USA
| | - S Bassnett
- Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, 660 S. Euclid Ave, Box 8096, St. Louis, MO 63110, USA; Department of Cell Biology & Physiology, Washington University, St. Louis, MO, USA.
| |
Collapse
|
8
|
Mannino G, Abdolrahimzadeh B, Calafiore S, Anselmi G, Mannino C, Lambiase A. A review of the role of ultrasound biomicroscopy in glaucoma associated with rare diseases of the anterior segment. Clin Ophthalmol 2016; 10:1453-9. [PMID: 27536058 PMCID: PMC4975163 DOI: 10.2147/opth.s112166] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Ultrasound biomicroscopy is a non-invasive imaging technique, which allows high-resolution evaluation of the anatomical features of the anterior segment of the eye regardless of optical media transparency. This technique provides diagnostically significant information in vivo for the cornea, anterior chamber, chamber angle, iris, posterior chamber, zonules, ciliary body, and lens, and is of great value in assessment of the mechanisms of glaucoma onset. The purpose of this paper is to review the use of ultrasound biomicroscopy in the diagnosis and management of rare diseases of the anterior segment such as mesodermal dysgenesis of the neural crest, iridocorneal endothelial syndrome, phakomatoses, and metabolic disorders.
Collapse
Affiliation(s)
- Giuseppe Mannino
- Ophthalmology Unit, Saint Andrea Hospital, Department of Neurosciences, Mental Health and Sense Organs, University of Rome "Sapienza", Rome, Italy
| | | | - Silvia Calafiore
- Ophthalmology Unit, Saint Andrea Hospital, Department of Neurosciences, Mental Health and Sense Organs, University of Rome "Sapienza", Rome, Italy
| | - Gianmario Anselmi
- Ophthalmology Unit, Saint Andrea Hospital, Department of Neurosciences, Mental Health and Sense Organs, University of Rome "Sapienza", Rome, Italy
| | - Cristina Mannino
- Ophthalmology Unit, Saint Andrea Hospital, Department of Neurosciences, Mental Health and Sense Organs, University of Rome "Sapienza", Rome, Italy
| | - Alessandro Lambiase
- Department of Sense Organs, Ophthalmology Unit, University of Rome "Sapienza", Rome, Italy
| |
Collapse
|
9
|
Abdolrahimzadeh S, Fameli V, Mollo R, Contestabile MT, Perdicchi A, Recupero SM. Rare Diseases Leading to Childhood Glaucoma: Epidemiology, Pathophysiogenesis, and Management. BIOMED RESEARCH INTERNATIONAL 2015; 2015:781294. [PMID: 26451378 PMCID: PMC4588342 DOI: 10.1155/2015/781294] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 04/22/2015] [Indexed: 11/17/2022]
Abstract
Noteworthy heterogeneity exists in the rare diseases associated with childhood glaucoma. Primary congenital glaucoma is mostly sporadic; however, 10% to 40% of cases are familial. CYP1B1 gene mutations seem to account for 87% of familial cases and 27% of sporadic cases. Childhood glaucoma is classified in primary and secondary congenital glaucoma, further divided as glaucoma arising in dysgenesis associated with neural crest anomalies, phakomatoses, metabolic disorders, mitotic diseases, congenital disorders, and acquired conditions. Neural crest alterations lead to the wide spectrum of iridocorneal trabeculodysgenesis. Systemic diseases associated with childhood glaucoma include the heterogenous group of phakomatoses where glaucoma is frequently encountered in the Sturge-Weber syndrome and its variants, in phakomatosis pigmentovascularis associated with oculodermal melanocytosis, and more rarely in neurofibromatosis type 1. Childhood glaucoma is also described in systemic disorders of mitotic and metabolic activity. Acquired secondary glaucoma has been associated with uveitis, trauma, drugs, and neoplastic diseases. A database research revealed reports of childhood glaucoma in rare diseases, which do not include glaucoma in their manifestation. These are otopalatodigital syndrome, complete androgen insensitivity, pseudotrisomy 13, Brachmann-de Lange syndrome, acrofrontofacionasal dysostosis, caudal regression syndrome, and Wolf-Hirschhorn syndrome.
Collapse
Affiliation(s)
- Solmaz Abdolrahimzadeh
- Ophthalmology Unit, DAI Head/Neck, Umberto I Policlinic, University of Rome “Sapienza”, Viale del Policlinico 155, 00161 Rome, Italy
| | - Valeria Fameli
- Ophthalmology Unit, Department of Sense Organs, University of Rome “Sapienza”, Viale del Policlinico 155, 00161 Rome, Italy
| | - Roberto Mollo
- Ophthalmology Unit, DAI Head/Neck, Umberto I Policlinic, University of Rome “Sapienza”, Viale del Policlinico 155, 00161 Rome, Italy
| | - Maria Teresa Contestabile
- Ophthalmology Unit, St. Andrea Hospital, NESMOS Department, University of Rome “Sapienza”, via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Andrea Perdicchi
- Ophthalmology Unit, St. Andrea Hospital, NESMOS Department, University of Rome “Sapienza”, via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Santi Maria Recupero
- Ophthalmology Unit, St. Andrea Hospital, NESMOS Department, University of Rome “Sapienza”, via di Grottarossa 1035-1039, 00189 Rome, Italy
| |
Collapse
|
10
|
Komáromy AM, Petersen-Jones SM. Genetics of Canine Primary Glaucomas. Vet Clin North Am Small Anim Pract 2015; 45:1159-82, v. [PMID: 26277300 DOI: 10.1016/j.cvsm.2015.06.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Primary glaucomas are a leading cause of incurable vision loss in dogs. Based on their specific breed predilection, a genetic cause is suspected to be responsible, and affected dogs should be excluded from breeding. Despite the high prevalence of primary glaucomas in dogs, their genetics have been studied in only a small number of breeds. The identification of canine glaucoma disease genes, and the development of genetic tests, will help to avoid the breeding of affected dogs in the future and will allow for earlier diagnosis and potentially more effective therapy.
Collapse
Affiliation(s)
- András M Komáromy
- Department of Small Animal Clinical Sciences, Veterinary Medical Center, College of Veterinary Medicine, Michigan State University, 736 Wilson Road, Room D-208, East Lansing, MI 48824, USA.
| | - Simon M Petersen-Jones
- Department of Small Animal Clinical Sciences, Veterinary Medical Center, College of Veterinary Medicine, Michigan State University, 736 Wilson Road, Room D-208, East Lansing, MI 48824, USA
| |
Collapse
|
11
|
Subbiah S, Thomas PA, Jesudasan CAN. Scleral-fixated intraocular lens implantation in microspherophakia. Indian J Ophthalmol 2014; 62:596-600. [PMID: 24881608 PMCID: PMC4065512 DOI: 10.4103/0301-4738.129787] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: In microspherophakia, abnormal laxity of the lenticular zonules leads to development of a spherical lens and possible subluxation. We evaluated long-term results of lens removal with scleral-fixated intraocular lens (SFIOL) implantation in microspherophakia. Materials and Methods: Case series. SF IOLs were implanted in four consecutive patients with bilateral microspherophakia (eight eyes [three with pupillary block and secondary glaucoma who underwent immediate surgery and five with only subluxation who underwent elective surgery]). Post-operative best-corrected visual acuity (BCVA), intraocular pressure (IOP) and lens position were evaluated periodically from day 1 to 18 months. Results: All patients were females (mean age 28 ± 7.03 years). In group 1 eyes (three eyes that presented with pupillary block), the mean BCVA improved from 0.008 decimals (preoperative) to 0.50 decimals (final post-operative visit); in group 2 eyes (the other five eyes), the mean BCVA improved from 0.12 ± 0.21 decimals to 0.73 ± 0.14 decimals. The preoperative mean IOP (54.53 ± 7.33 mmHg) in group 1 eyes was significantly (P = 0.03) higher than that (16 ± 4.30 mm Hg) in group 2 eyes. At final post-operative visit, the mean IOP (11.67 ± 2.88 mmHg) in group 1 eyes was not significantly different from that in group 2 eyes (13.0 ± 3.08 mmHg). All SFIOLs were well- centred at the final visit. None of the patients encountered any peroperative or postoperative complications. Conclusions: SFIOLs may be an option for surgical management of microspherophakia.
Collapse
Affiliation(s)
- Sujata Subbiah
- Institute of Ophthalmology Joseph eye Hospital, Tiruchirappalli, Tamil Nadu, India
| | | | | |
Collapse
|
12
|
Sowka J, Girgis N. Bilateral phacomorphic angle-closure glaucoma in a highly myopic patient secondary to isolated spherophakia. ACTA ACUST UNITED AC 2010; 81:432-6. [PMID: 20510654 DOI: 10.1016/j.optm.2010.02.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Revised: 01/22/2010] [Accepted: 02/09/2010] [Indexed: 11/18/2022]
Abstract
BACKGROUND Angle closure most commonly occurs in older hyperopic patients as a result of primary relative pupil block. Less frequently, angle closure occurs in highly myopic patients with conditions other than primary relative pupil block. This report presents the diagnosis, pathophysiologic mechanism, and management of a patient with both high myopia and bilateral advanced phacomorphic angle-closure glaucoma caused by isolated spherophakia. CASE A 40-year-old asymptomatic man with very high myopic astigmatism presented with chronic angle closure and an intraocular pressure of 42 mmHg in both eyes. Additionally there was a nonmyopic fundus and 24-mm axial length, with a clear crystalline lens protruding through the pupillary plane in each eye, confirmed by B-scan ultrasonography. Gonioscopy and A-scan and B-scan ultrasonography identified the pathogenesis of intraocular pressure elevation, angle closure, and high myopia to be lenticular in origin. Initial medical therapy and subsequent laser iridotomy relieved the pupil block angle closure and successfully lowered intraocular pressure. CONCLUSION Angle closure can occur in highly myopic eyes. Careful gonioscopy and ultrasonography can lead to the correct diagnosis and tailored management for these eyes. Phacomorphic angle-closure glaucoma from spherophakia is associated with Weill-Marchesani syndrome as well as a few other uncommon syndromes. Isolated pseudophakia is a rarely reported cause of phacomorphic angle closure.
Collapse
Affiliation(s)
- Joseph Sowka
- Nova Southeastern University College of Optometry, Fort Lauderdale, Florida 33328, USA.
| | | |
Collapse
|
13
|
Morales J, Al-Sharif L, Khalil DS, Shinwari JMA, Bavi P, Al-Mahrouqi RA, Al-Rajhi A, Alkuraya FS, Meyer BF, Al Tassan N. Homozygous mutations in ADAMTS10 and ADAMTS17 cause lenticular myopia, ectopia lentis, glaucoma, spherophakia, and short stature. Am J Hum Genet 2009; 85:558-68. [PMID: 19836009 DOI: 10.1016/j.ajhg.2009.09.011] [Citation(s) in RCA: 163] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2009] [Revised: 09/07/2009] [Accepted: 09/21/2009] [Indexed: 01/23/2023] Open
Abstract
Weill-Marchesani syndrome (WMS) is a well-characterized disorder in which patients develop eye and skeletal abnormalities. Autosomal-recessive and autosomal-dominant forms of WMS are caused by mutations in ADAMTS10 and FBN1 genes, respectively. Here we report on 13 patients from seven unrelated families from the Arabian Peninsula. These patients have a constellation of features that fall within the WMS spectrum and follow an autosomal-recessive mode of inheritance. Individuals who came from two families and met the diagnostic criteria for WMS were each found to have a different homozygous missense mutation in ADAMTS10. Linkage analysis and direct sequencing of candidate genes in another two families and a sporadic case with phenotypes best described as WMS-like led to the identification of three homozygous mutations in the closely related ADAMTS17 gene. Our clinical and genetic findings suggest that ADAMTS17 plays a role in crystalline lens zonules and connective tissue formation and that mutations in ADAMTS17 are sufficient to produce some of the main features typically described in WMS.
Collapse
Affiliation(s)
- Jose Morales
- King Khaled Eye Specialist Hospital, and College of Medicine, King Saud University, Riyadh 11462, Saudi Arabia
| | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Razeghinejad MR, Hosseini H, Namazi N. Biometric and corneal topographic characteristics in patients with Weill-Marchesani syndrome. J Cataract Refract Surg 2009; 35:1026-32. [PMID: 19465288 DOI: 10.1016/j.jcrs.2009.01.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2008] [Revised: 01/24/2009] [Accepted: 01/29/2009] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine the biometry of ocular structures and corneal topographic characteristics in patients with Weill-Marchesani syndrome. SETTING Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran. METHODS Patients with Weill-Marchesani syndrome (syndrome group) and age-matched normal subjects (control group) were evaluated. All had a complete ocular examination including refraction and analysis using Fourier transformation, slitlamp biomicroscopy, pachymetry, keratometry, and ocular biometry. The following A-scan parameters were measured: anterior chamber depth (ACD), lens thickness, axial length (AL), lens-AL factor, and relative lens position (RLP). Corneal topography examinations were performed in the syndrome group only. RESULTS The syndrome group comprised 7 female patients and the control group, 20 female subjects. The syndrome group had statistically significantly higher myopia and corneal astigmatism than the control group (P<.0001). Oblique astigmatism was common in the syndrome group, showing a strong right-left specificity (right eyes' axes in the 135-degree meridian, left eyes' axes in the 45-degree meridian). The syndrome group had a statistically significantly shorter AL, shallower ACD, thicker lens, higher calculated lens power, and a higher lens-AL factor (P<.0001). However, there was no statistically significant difference in RLP (P = .32). The syndrome group also had statistically significantly thicker corneas and higher keratometry values (P<.0001). CONCLUSION Characteristic ocular findings in patients with Weill-Marchesani syndrome were a steep, thick cornea with a strong right-left specificity of corneal astigmatism; a thick lens; a short AL; and a shallow ACD.
Collapse
|
15
|
Abstract
PURPOSE OF REVIEW The mechanisms implicated in the clinical manifestations of zonular diseases, especially ectopia lentis, are reviewed. RECENT FINDINGS The molecular mechanisms involve fibrillin in a large spectrum of heritable diseases characterized by zonular stretching. The usual complications are refractive errors, especially myopia, glaucoma (either primary open angle, secondary angle closure and pupil block by anterior displacement of the lens) and retinal detachment. SUMMARY The genetics and molecular understanding provide information for genetic counseling. Treatment of myopia and glaucoma depend on the underlying mechanism, and lens surgery techniques are continuously improved.
Collapse
|