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Kim HS, Sarrafpour S, Teng CC, Liu J. External Disruption of Ocular Development in Utero. Yale J Biol Med 2024; 97:41-48. [PMID: 38559457 PMCID: PMC10964818 DOI: 10.59249/rrmm8911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
The intricate steps of human ocular embryology are impacted by cellular and genetic signaling pathways and a myriad of external elements that can affect pregnancy, such as environmental, metabolic, hormonal factors, medications, and intrauterine infections. This review focuses on presenting some of these factors to recognize the multifactorial nature of ocular development and highlight their clinical significance. This review is based on English-language articles sourced from PubMed, Web of Science, and Google Scholar; keywords searched included "ocular development in pregnancy," "ocular embryology," "maternal nutrition," "ophthalmic change," and "visual system development." While some animal models show the disruption of ocular embryology from these external factors, there are limited post-birth assessments in human studies. Much remains unknown about the precise mechanisms of how these external factors can disrupt normal ocular development in utero, and more significant research is needed to understand the pathophysiology of these disruptive effects further. Findings in this review emphasize the importance of additional research in understanding the dynamic association between factors impacting gestation and neonatal ocular development, particularly in the setting of limited resources.
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Affiliation(s)
- Hyun Sue Kim
- Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
- Department of
Ophthalmology and Visual Science, Yale School of Medicine, New Haven, CT,
USA
| | - Soshian Sarrafpour
- Department of
Ophthalmology and Visual Science, Yale School of Medicine, New Haven, CT,
USA
| | - Christopher C. Teng
- Department of
Ophthalmology and Visual Science, Yale School of Medicine, New Haven, CT,
USA
| | - Ji Liu
- Department of
Ophthalmology and Visual Science, Yale School of Medicine, New Haven, CT,
USA
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Abstract
While conducting medical aid in Mozambique, a 41 year old African male presented to our eye clinic complaining of visual impairment. The male was found to have Peters’ anomaly type 2, a rare congenital ocular malformation leading to sensory amblyopia and glaucoma.
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Flanigan EY, Aros S, Bueno MF, Conley M, Troendle JF, Cassorla F, Mills JL. Eye malformations in children with heavy alcohol exposure in utero. J Pediatr 2008; 153:391-5. [PMID: 18571671 PMCID: PMC2570183 DOI: 10.1016/j.jpeds.2008.04.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2007] [Revised: 03/19/2008] [Accepted: 04/04/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To determine whether children who do not develop fetal alcohol syndrome (FAS) despite heavy alcohol exposure are at risk for eye abnormalities. STUDY DESIGN We screened 9628 pregnant women and identified 101 women who were drinking >/= 2 oz of absolute alcohol per day and 101 nondrinking control women. We followed 43 exposed and 55 control offspring between age 4 and 9 years, performing masked standardized ophthalomologic examinations. RESULTS The groups did not differ in their rates of impaired visual acuity, refractory errors, ptosis, epicanthal folds, or short palpebral fissures. Biomicroscopy examination was normal in all exposed subjects; cataracts were detected in 2 control subjects (4%) but in no exposed subjects. Arterial tortuosity was seen in 7 exposed subjects (16%) and in 8 control subjects (15%). Optic nerve hypoplasia was not detected in any subject. CONCLUSIONS Previous research has found that children with FAS have a high incidence of serious ophthalmologic defects; our data indicate that the risk is limited to children with FAS and does not extend to children exposed to high levels of alcohol prenatally who do not develop FAS. Eye examinations are unlikely to clarify the diagnosis in children suspected of having alcohol-related damage.
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Affiliation(s)
- Elizabeth Y. Flanigan
- Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA,Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA and Department of Pediatrics, Walter Reed Army Medical Center, Washington, DC
| | - Sofia Aros
- Department of Pediatrics, School of Medicine, University of Chile, San Borja Arriaran Clinical Hospital, Santiago, Chile
| | | | - Mary Conley
- Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - James F. Troendle
- Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - Fernando Cassorla
- Institute of Maternal and Child Research (IDIMI), School of Medicine, University of Chile, Santiago, Chile
| | - James L. Mills
- Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
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