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Rana RS, Bajracharya L, Gurung R. Recurrence of Avellino Corneal Dystrophy Following Penetrating Keratoplasty: A Case Report. JNMA J Nepal Med Assoc 2021; 59:406-408. [PMID: 34508535 PMCID: PMC8369580 DOI: 10.31729/jnma.5726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 05/07/2021] [Indexed: 11/05/2022] Open
Abstract
Granular - lattice (Avellino) corneal dystrophy is inherited in an autosomal dominant fashion which affects stroma of the cornea with recurrent erosions and decreased vision due to clouding of cornea in later stage. We reported a case of 53-year old woman presented with pain and blurring of vision of left eye for 10 days with history of right eye deep anterior lamellar dystrophy and Left eye penetrating keratoplasty 5years back for Avellino dystrophy. On examination right eye graft was clear and left eye showed circular edges of irregular epithelium with patchy stains and epithelial defect suggestive of recurrence of dystrophy. A patient with recurrent corneal erosions and opacity in cornea has to be examined carefully so as not to overlook Avellino corneal dystrophy. Being a rare disorder this case has been reported to draw the attention of ophthalmologists about its recurrence following keratoplasty.
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Affiliation(s)
| | | | - Reeta Gurung
- Tilganga Institute of Ophthalmology, Gaushala, Nepal
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Malkondu F, Arıkoğlu H, Erkoç Kaya D, Bozkurt B, Özkan F. Investigation of TGFBI (transforming growth factor beta-induced) Gene Mutations in Families with Granular Corneal Dystrophy Type 1 in the Konya Region. Turk J Ophthalmol 2020; 50:64-70. [PMID: 32366062 PMCID: PMC7204905 DOI: 10.4274/tjo.galenos.2019.55770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objectives: Granular corneal dystrophies (GCD) are characterized by small, discrete, sharp-edged, grayish-white opacities in the corneal stroma. Among the genes responsible for the development of GCD, the most strongly related gene is transforming growth factor beta-induced (TGFBI), located in the 5q31.1 locus. Studies show that R124H in exon 4 and R555W in exon 12 are hot-spot mutations in the TGFBI gene that lead to GCD development. In this study, we aimed to investigate these two hot-spot mutations in exons 4 and 12 of the TGFBI gene and other possible mutations in the same regions, which code important functional regions of the protein, in Turkish families with GCD1 and to determine the relationship between the mutations and disease and related phenotypes. Materials and Methods: The study included, 16 individuals diagnosed with GCD type 1 (GCD1), 11 of these patients’ healthy relatives, and 28 unrelated healthy individuals. DNA was obtained from peripheral blood samples taken from each individual and polymerase chain reaction was used to amplify target gene regions. Genotyping studies were done by sequence analysis. Results: The R124S mutation in exon 4 of TGFBI was not detected in the patients or healthy individuals in our study. However, all individuals diagnosed as having GCD1 were found to be heterozygous carriers of the R555W mutation in exon 12 of TGFBI. This mutation was not detected in healthy family members or control individuals unrelated to these families. In addition, we detected the silent mutation F540F in exon 12 and c.32924 G>A substitution in an intronic region of the gene in a few patients and healthy individuals. Conclusion: Our study strongly supports the association of GCD1 with R555W mutation in exon 12 region of the TGFBI gene, as reported in the literature.
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Affiliation(s)
- Fatma Malkondu
- Selçuk University Faculty of Medicine, Department of Medical Biology, Konya, Turkey
| | - Hilal Arıkoğlu
- Selçuk University Faculty of Medicine, Department of Medical Biology, Konya, Turkey
| | - Dudu Erkoç Kaya
- Selçuk University Faculty of Medicine, Department of Medical Biology, Konya, Turkey
| | - Banu Bozkurt
- Selçuk University Faculty of Medicine, Department of Ophtalmology, Konya, Turkey
| | - Fehmi Özkan
- Konya Numune Hospital, Clinic of Ophtalmology, Konya, Turkey
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Choi SI, Kim EK. Autophagy in granular corneal dystrophy type 2. Exp Eye Res 2016; 144:14-21. [DOI: 10.1016/j.exer.2015.09.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 08/28/2015] [Accepted: 09/15/2015] [Indexed: 01/07/2023]
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Kim EK, Lee H, Choi SI. Molecular Pathogenesis of Corneal Dystrophies: Schnyder Dystrophy and Granular Corneal Dystrophy type 2. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2015; 134:99-115. [PMID: 26310152 DOI: 10.1016/bs.pmbts.2015.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The International Committee for Classification of Corneal Dystrophies (IC3D) provides updated data to ophthalmologists by incorporating traditional definitions of corneal dystrophies with new genetic, clinical, and pathologic information. Recent advances in the genetics of corneal dystrophies facilitate more precise classifications and elucidate each classification's molecular mechanisms. Unfortunately, the molecular mechanisms and underlying pathogenic mechanisms have remained obscure, with the exception of Schnyder corneal dystrophy (CD), granular CD type 2 (GCD2), and Fuch's endothelial CD. Here, we review the pathogenesis of Schnyder CD and GCD2.
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Affiliation(s)
- Eung Kweon Kim
- Department of Ophthalmology, Vision Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; BK21 Plus Project for Medical Science and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Hun Lee
- Department of Ophthalmology, Vision Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung-Il Choi
- Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
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Abstract
PURPOSE Both granular and lattice deposits are present in Avellino corneal dystrophy (ACD), primarily associated with the R124H mutation of transforming growth factor-β-induced (TGFBIp). We investigated the presence of these deposits in other TGFBI mutations and the use of Thioflavin-T (ThT), a fluorescent amyloid stain for characterizing corneal amyloid deposits. METHODS Surgical corneal specimens of 3 unrelated patients clinically diagnosed with ACD were studied. Corneal sections from normal individuals and patients with prior lattice corneal dystrophy (LCD) were used as controls. Histochemical studies were performed with Congo red and Masson trichrome stains, and fluorescent imaging with scanning laser confocal microscopy was performed for ThT and anti-TGFBIp antibody staining. RESULTS Clinical and histopathological findings supported the diagnoses of ACD in these 3 cases in whom granular deposits stained with Masson trichrome and lattice deposits stained with ThT and Congo red showed birefringence and dichroism as expected. However, genotyping revealed a heterozygous R124C mutation in each case. In addition to classical stromal deposits, unique subepithelial TGFBIp aggregates, which stain with neither ThT nor trichrome, were observed. In control LCD sections, stromal deposits were stained with ThT but not with trichrome, confirming lack of granular deposits. CONCLUSIONS Our results demonstrate that both granular and lattice corneal deposits can be associated with R124C mutation in addition to the more common R124H mutation. An additional feature of nonhyaline, nonamyloid, TGFBIp subepithelial deposits might substantiate the categorization of such cases as a variant form of ACD. This study further validates ThT staining for detection of amyloid TGFBIp deposits.
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Alavi A, Elahi E, Rahmati-Kamel M, Karimian F, Rezaei-Kanavi M. Mutation screening of TGFBI in two Iranian Avellino corneal dystrophy pedigrees. Clin Exp Ophthalmol 2008; 36:26-30. [PMID: 18290950 DOI: 10.1111/j.1442-9071.2007.01649.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE Genetic analysis and phenotypic features of Avellino corneal dystrophy patients from Japan and some European countries have been published. We report for the first time the genetic analysis and phenotypic features of two Avellino corneal dystrophy pedigrees from the Middle East. METHODS Slit-lamp biomicroscope photographs of cornea were obtained, and corneal tissue sections were stained with masson-trichrome and Congo red. DNA was isolated from peripheral blood leucocytes and exons 4 and 12 of TGFBI were screened for mutations by direct sequencing. RESULTS The probands of the pedigrees had phenotypic features consistent with diagnosis of Avellino corneal dystrophy. They were homozygous for the same R124H mutation in TGFBI as previously reported in Avellino patients from Japan and European countries. Heterozygous carriers of the mutation were identified in the pedigree and shown to have symptoms of disease milder than those of the probands. CONCLUSION The finding of R124H in the Middle Eastern (Iranian) population supports the proposal that perhaps only substitution of histidine for arginine at position 124 of tumour growth factor beta induced protein results in the Avellino corneal dystrophy phenotype. As both probands were originally diagnosed with granular corneal dystrophy, and as heterozygous carriers of R124H were unaware of their disease status prior to genetic analysis, the importance of genetic analysis is emphasized.
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Affiliation(s)
- Afagh Alavi
- National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
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Yi JH, Ha BJ, Kim SW, Kim TI, Kim EK. The Number of Cases, Cause and Treatment of Avellino Corneal Dystrophy Exacerbated After LASIK. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2008. [DOI: 10.3341/jkos.2008.49.9.1415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jeong Ho Yi
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine1, Seoul, Korea
| | | | - Sang Woo Kim
- Department of Ophthalmology, Ulsan University Hospital, Ulsan University School of Medicine, Ulsan, Korea
| | - Tae-im Kim
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine1, Seoul, Korea
| | - Eung Kweon Kim
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine1, Seoul, Korea
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Roh MI, Grossniklaus HE, Chung SH, Kang SJ, Kim WC, Kim EK. Avellino corneal dystrophy exacerbated after LASIK: scanning electron microscopic findings. Cornea 2006; 25:306-11. [PMID: 16633031 DOI: 10.1097/01.ico.0000183536.07275.9a] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the ultrastructure of the cornea of Avellino corneal dystrophy (ACD) exacerbated by LASIK. METHODS Three ACD patients with exacerbation of granular corneal deposits after LASIK underwent surgical removal of the corneal flap. The corneal flap was processed for scanning electron microscopy (SEM). RESULTS SEM of all patients showed abnormal granular clusters in the fibrils of the corneal flap. CONCLUSION Laser in situ keratomileusis induces corneal collagen abnormalities and adhesions of granular material in ACD patients.
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Affiliation(s)
- Mi In Roh
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seodaemun-ku, Seoul, Korea
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Diaper CJM, Schorderet DF, Chaubert P, Munier FL. Clinical and immunopathological corneal phenotype in homozygotes for the BIGH3 R124H mutation. Eye (Lond) 2004; 19:92-6. [PMID: 15094731 DOI: 10.1038/sj.eye.6701398] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
A family was previously reported as suffering from severe granular dystrophy. The phenotypic picture suggested a mix of homozygous and heterozygous family members. Genetic analysis confirms the homozygousity in the patients most severely affected, but shows the disease state to be one of Avellino corneal dystrophy. The previous case reports are extended immunohistological staining using polyclonal antibodies raised against keratofepithelin. This genotype/phenotype correlation study is consistent with incomplete dominance.
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Affiliation(s)
- C J M Diaper
- Southern General Hospital, 1345 Govan Road, Glasgow G51 4TF UK
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Abstract
PURPOSE OF REVIEW Characteristics of corneal dystrophies have been described with regards to such as location in the cornea, morphology, material composition, and recurrence after penetrating keratoplasty. The main goal of this review is to describe the surgical methods in treating corneal dystrophies. RECENT FINDINGS Laser in situ keratomileusis (LASIK) has been shown to aggravate corneal deposits in Avellino dystrophy exacerbation LASIK and hence should be avoided. Phototherapeutic keratectomy (PTK) has shown its usefulness in clearing opacities with visual improvement and prevents painful erosion, resulting in delay or postponement of corneal grafting in some corneal dystrophies. Mitomycin-C may be used topically in conjunction with PTK to reduce the recurrence of the opacities. Topical use of antibody to TGF-beta can also be considered to suppress recurrence of corneal opacities after PTK or lamellar keratectomy. SUMMARY Clinicians must become more adept at choosing a treatment depending on different genotypes and future studies on treatment of corneal dystrophies should be focused on establishing treatment of categorized corneal dystrophies based on their chromosomal mutation.
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Affiliation(s)
- Eun Suk Lee
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
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El-Ashry MF, Abd El-Aziz MM, Larkin DFP, Clarke B, Cree IA, Hardcastle AJ, Bhattacharya SS, Ebenezer ND. A clinical, histopathological, and genetic study of Avellino corneal dystrophy in British families. Br J Ophthalmol 2003; 87:839-42. [PMID: 12812879 PMCID: PMC1771747 DOI: 10.1136/bjo.87.7.839] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS To establish a clinical, histopathological, and genetic diagnosis in two unrelated British families with Avellino corneal dystrophy (ACD). METHODS Genomic DNA was extracted from peripheral blood leucocytes of all members participating in the study. Exons 4 and 12 of the human transforming growth factor beta induced (BIGH3) gene were amplified by polymerase chain reaction. The mutation and polymorphism were identified by direct sequencing and restriction digest analysis. A review of the patients' clinical symptoms and signs was undertaken and a histopathological study on corneal specimen obtained from the proband of one family after keratoplasty was performed. RESULTS A heterozygous G to A transition at the second nucleotide position of codon 124 of BIGH3 gene was detected in all affected members of both families. This mutation changes an arginine residue to a histidine. The clinical diagnosis for ACD was more evident with advancing age. Histopathological study revealed granular deposits in the anterior stroma and occasional positive Congo red areas of amyloid deposition in the mid to deep stroma typical of ACD. CONCLUSIONS This is the first report of ACD families in the United Kingdom and, furthermore, of BIGH3 gene mutation in British patients with this rare type of corneal dystrophy. The results indicate that BIGH3 gene screening along with clinical and histopathological examinations is essential for the diagnosis and clinical management of corneal dystrophies.
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Affiliation(s)
- M F El-Ashry
- Department of Molecular Genetics, Institute of Ophthalmology, London EC1V 9EL, UK.
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Kocak-Altintas AG, Kocak-Midillioglu I, Akarsu AN, Duman S. BIGH3 gene analysis in the differential diagnosis of corneal dystrophies. Cornea 2001; 20:64-8. [PMID: 11189007 DOI: 10.1097/00003226-200101000-00013] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To identify the mutation in the keratoepithelin gene for proper diagnosis of granular corneal dystrophies. METHODS Four generations of a single family with corneal dystrophy were analyzed. Fourteen family members were examined and 11 were found to be affected by clinical evaluation. Genetic DNA was extracted from proband's leukocytes for molecular analysis. Exons 4 and 12 of the BIGH3 gene were amplified then directly sequenced. RESULTS The clinical appearance of corneas consisted of grayish white granules with sharp borders, fine dots, and radial lines in the superficial part of the central corneal stroma, which resembles granular and Avellino corneal dystrophies. Performing BIGH3 gene analysis, we observed a C-to-T transition at position 1710 (CGG to TGG) producing R555W mutation, which is a hot spot for granular corneal dystrophy. CONCLUSION Direct clinical examination may be insignificant in the proper diagnosis of corneal dystrophies, and molecular genetic approach may be required.
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Affiliation(s)
- A G Kocak-Altintas
- SB Ankara Training and Research Hospital, Hacettepe University Institute of Child Health, Ankara, Turkey.
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Ferry AP, Benson WH, Weinberg RS. Combined granular-lattice ('Avellino') corneal dystrophy. TRANSACTIONS OF THE AMERICAN OPHTHALMOLOGICAL SOCIETY 1997; 95:61-77. [PMID: 9440163 PMCID: PMC1298351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND/PURPOSE In 1988, a report was published describing the histopathologic examination of corneal buttons of 4 patients who had undergone unilateral keratoplasty because of decreased vision caused by what had been diagnosed clinically as granular dystrophy. But on pathologic examination, lesions characteristic of both granular dystrophy and lattice dystrophy were found in each of the 4 corneal buttons. The patients came from 3 different families, each of which traced its origin to the Italian province of Avellino. We studied the clinical and histopathological features of 4 corneas affected by combined granular-lattice dystrophy, adding thereby to the total of 12 other corneas that have been so-described in the literature. METHODS Two women underwent bilateral penetrating keratoplasty for what was diagnosed clinically as Reis-Bücklers dystrophy in the first patient, and as granular dystrophy in the second patient. We studied all 4 corneas pathologically, using both conventional hematoxylin and eosin stains as well as special histochemical techniques. RESULTS All 4 corneas contained lesions characteristic of both granular dystrophy and lattice dystrophy, a circumstance that has given rise to the name "combined granular-lattice dystrophy." The patients are not known to be of Italian ancestry. CONCLUSIONS Three clinical signs characterize combined granular-lattice dystrophy: (1) anterior stromal discrete, grayish-white deposits; (2) lattice lesions located in mid-stroma to posterior stroma; and (3) anterior stromal haze. Both clinically and histopathologically, the lattice lesions are of greater diameter than are those that occur in lattice dystrophy type I. In the past few years, striking advances have been made in understanding the genetics of combined granular-lattice dystrophy. The most recent of these was published just 2 months before the 1997 meeting of the American Ophthalmological Society, and establishes a common molecular origin for granular dystrophy, lattice dystrophy type I, Avellino dystrophy, and Reis-Bücklers dystrophy.
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