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Mekiten O, Zvulunov A, Ben Simon G, Charas H, Ben-David M, Shelly S, Greenbaum L, Dori A, Benyamini L, Zur D, Levi N, Landau Prat D, Zloto O. Ocular manifestations and outcomes of OPMD- a report from the national IsrOPMD registry. Eur J Ophthalmol 2024:11206721241259145. [PMID: 38809679 DOI: 10.1177/11206721241259145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
PURPOSE This study aims to describe the ocular manifestations, treatment, and prognosis of OPMD patients registered in the national Israel OPMD(IsrOPMD) registry. METHODS Data was prospectively collected from patients referred to the IsrOPMD registry from January 2022 to March 2023. This included patient demographics, medical and ocular history, eye exams, eyelid evaluations, visual field exams, and orthoptic evaluations. RESULTS 30 patients (15 males, mean age 53 years) were treated in the ocular OPMD clinic, predominantly of Bukhari descent (86.6%). The mean visual acuity was 0.06 logMAR. Twenty-one patients (70%) had eye movement problem, mostly in horizontal gaze. 6(20%) patients' complaint about diplopia. Ptosis surgery was performed in 21(70%) patients, with 17(56.7%) patients underwent frontalis sling surgery and 4(13.3%) patients undergoing levator advancement. The mean Margin reflex distance (MRD1) improved post-surgery (2.28 mm vs. 1.58 mm), but 11(36.6%) patients required more than one ptosis surgery. CONCLUSIONS The study contributes valuable insights into the ocular aspects of OPMD. It reveals that OPMD patients often experience a range of ocular symptoms, such as ptosis, abnormalities in eye movements, strabismus, and potentially diplopia, which can significantly impact their quality of life. The findings underscore the importance of regular ophthalmological follow-up for these patients to address these symptoms effectively. The study is significant in contributing to the limited but growing knowledge about the ocular manifestations of OPMD and the management of these symptoms to improve the quality of life for patients suffering from this condition.
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Affiliation(s)
- Ori Mekiten
- Department of Ophthalmology, Sheba Medical Center, Tel-Hashomer, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alex Zvulunov
- Multidisciplinary service for OPMD patients, Sheba Medical Center, Tel Hashomer, Israel
- The non-profit organization for promotion of health and cure of OPMD, Tel Hashomer, Israel
| | - Guy Ben Simon
- Department of Ophthalmology, Sheba Medical Center, Tel-Hashomer, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Multidisciplinary service for OPMD patients, Sheba Medical Center, Tel Hashomer, Israel
| | - Hagit Charas
- Multidisciplinary service for OPMD patients, Sheba Medical Center, Tel Hashomer, Israel
| | - Merav Ben-David
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Multidisciplinary service for OPMD patients, Sheba Medical Center, Tel Hashomer, Israel
| | - Shahar Shelly
- Department of Neurology, Rambam Medical Center, Haifa, Israel
- Ruth and Bruce Rapaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, 3525408, Israel
| | - Lior Greenbaum
- Multidisciplinary service for OPMD patients, Sheba Medical Center, Tel Hashomer, Israel
- The Danek Gertner Institute of Human Genetics, Sheba Medical Center, Tel Hashomer, Israel
| | - Amir Dori
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Multidisciplinary service for OPMD patients, Sheba Medical Center, Tel Hashomer, Israel
| | - Limor Benyamini
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Multidisciplinary service for OPMD patients, Sheba Medical Center, Tel Hashomer, Israel
| | - Dinah Zur
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Ophthalmology Division, Tel Aviv Sourask Medical Center, Tel Aviv, Israel
| | - Niv Levi
- Department of Ophthalmology, Sheba Medical Center, Tel-Hashomer, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daphna Landau Prat
- Department of Ophthalmology, Sheba Medical Center, Tel-Hashomer, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Multidisciplinary service for OPMD patients, Sheba Medical Center, Tel Hashomer, Israel
| | - Ofira Zloto
- Department of Ophthalmology, Sheba Medical Center, Tel-Hashomer, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Multidisciplinary service for OPMD patients, Sheba Medical Center, Tel Hashomer, Israel
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Renard D, Ferraro A, Lorenzini MC, Jeanjean L, Portal MC, Llinares E, Labauge P, Castelnovo G. Orthoptic and video-oculographic analyses in oculopharyngeal muscular dystrophy. Muscle Nerve 2015; 52:554-8. [PMID: 25677583 DOI: 10.1002/mus.24600] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2015] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Mild ophthalmoparesis can be seen in oculopharyngeal muscular dystrophy (OPMD). METHODS Orthoptic analysis included assessment of phoria/tropia, eye excursion, saccades, pursuit, stereoacuity, and Hess-Lancaster screen test. Video-oculography included fixation, horizontal and vertical saccades, and pursuit. RESULTS Orthoptic abnormalities were: tropia (4 of 6); abnormal eye excursion (4 of 6, 78% involved lateral or superior rectus muscles); abnormal horizontal or vertical saccades (2 of 6); abnormal pursuit (0 of 6); abnormal stereoacuity (2 of 6); and pathological Hess-Lancaster screen (4 of 6). Video-oculographic abnormalities were present for: fixation (1 of 6); saccade latency (1 of 6); horizontal pursuit (3 of 6); and vertical pursuit (0 of 6). For horizontal saccades, mean velocity, peak velocity, and gain were pathological in 5 of 6, 5 of 6 (61% of pathological mean and peak velocities involved abducting eye movements), and 3 of 6, respectively. For vertical saccades, mean velocity, peak velocity, and gain were pathological in 4 of 6, 4 of 6 (53% involved upward movements), and 3 of 6, respectively. CONCLUSION The data indicate preferential involvement of lateral and (to a lesser degree) superior rectus muscles in OPMD.
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Affiliation(s)
- Dimitri Renard
- Department of Neurology, CHU Nîmes, Hôpital Caremeau, Place du Pr Debré, 30029, Nîmes Cedex 4, France
| | - Adelaide Ferraro
- Department of Neurology, CHU Nîmes, Hôpital Caremeau, Place du Pr Debré, 30029, Nîmes Cedex 4, France
| | | | - Luc Jeanjean
- Department of Ophthalmology, CHU Nîmes, Hôpital Caremeau, Nîmes, France
| | - Marie-Claire Portal
- Department of Neurology, CHU Nîmes, Hôpital Caremeau, Place du Pr Debré, 30029, Nîmes Cedex 4, France
| | - Elisabeth Llinares
- Department of Neurology, CHU Nîmes, Hôpital Caremeau, Place du Pr Debré, 30029, Nîmes Cedex 4, France
| | - Pierre Labauge
- Department of Neurology, CHU Nîmes, Hôpital Caremeau, Place du Pr Debré, 30029, Nîmes Cedex 4, France
| | - Giovanni Castelnovo
- Department of Neurology, CHU Nîmes, Hôpital Caremeau, Place du Pr Debré, 30029, Nîmes Cedex 4, France
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Selected case from the Arkadi M. Rywlin International Pathology Slide Series: Mitochondrial myopathy presenting with chronic progressive external ophthalmoplegia (CPEO): a case report. Adv Anat Pathol 2014; 21:461-8. [PMID: 25299315 DOI: 10.1097/pap.0000000000000045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A 43-year-old female patient diagnosed with chronic progressive external ophthalmoplegia (CPEO) because of mitochondrial myopathy documented by muscle biopsy is presented. The chief complaints were represented by blepharoptosis and ophthalmoplegia. The muscle biopsy was evaluated by histology, using the appropriate histochemical and histoenzimological stains. Ragged red fibers with Gomori trichrome stain were seen, which showed cytochrome c oxydase deficiency and abnormal succinate dehydrogenase staining in around 20% of muscle fibres. Electron microscopy was also performed which demonstrated abnormal, hyperplastic, pleomorphic, and hypertrophic mitochondria, characterized by paracrystalline inclusions arranged in parallel rows ("parking-lot" inclusions), consisting of rectangular arrays of mitochondrial membranes in a linear or grid-like pattern. In conclusion, mitochondrial myopathy was definitely diagnosed. Although molecular analysis, which was subsequently carried out, failed to reveal mutations in the mitochondrial DNA or in selected nuclear genes, the pathologic diagnosis was not changed. The differential diagnosis of CPEO with other forms of ocular myopathies as well as the possible association of CPEO with systemic syndromes is discussed. Ophtalmologists and medical internists should always suspect CPEO when dealing with patients affected by ocular myopathy, either in its pure form or in association with other myopathic or systemic signs.
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