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Kunisetty B, Martin-Giacalone BA, Zhao X, Luna PN, Brooks BP, Hufnagel RB, Shaw CA, Rosenfeld JA, Agopian AJ, Lupo PJ, Scott DA. High Clinical Exome Sequencing Diagnostic Rates and Novel Phenotypic Expansions for Nonisolated Microphthalmia, Anophthalmia, and Coloboma. Invest Ophthalmol Vis Sci 2024; 65:25. [PMID: 38502138 PMCID: PMC10959191 DOI: 10.1167/iovs.65.3.25] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/26/2024] [Indexed: 03/20/2024] Open
Abstract
Purpose A molecular diagnosis is only made in a subset of individuals with nonisolated microphthalmia, anophthalmia, and coloboma (MAC). This may be due to underutilization of clinical (whole) exome sequencing (cES) and an incomplete understanding of the genes that cause MAC. The purpose of this study is to determine the efficacy of cES in cases of nonisolated MAC and to identify new MAC phenotypic expansions. Methods We determined the efficacy of cES in 189 individuals with nonisolated MAC. We then used cES data, a validated machine learning algorithm, and previously published expression data, case reports, and animal models to determine which candidate genes were most likely to contribute to the development of MAC. Results We found the efficacy of cES in nonisolated MAC to be between 32.3% (61/189) and 48.1% (91/189). Most genes affected in our cohort were not among genes currently screened in clinically available ophthalmologic gene panels. A subset of the genes implicated in our cohort had not been clearly associated with MAC. Our analyses revealed sufficient evidence to support low-penetrance MAC phenotypic expansions involving nine of these human disease genes. Conclusions We conclude that cES is an effective means of identifying a molecular diagnosis in individuals with nonisolated MAC and may identify putatively damaging variants that would be missed if only a clinically available ophthalmologic gene panel was obtained. Our data also suggest that deleterious variants in BRCA2, BRIP1, KAT6A, KAT6B, NSF, RAC1, SMARCA4, SMC1A, and TUBA1A can contribute to the development of MAC.
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Affiliation(s)
- Bhavana Kunisetty
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, United States
| | - Bailey A. Martin-Giacalone
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, United States
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States
| | - Xiaonan Zhao
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, United States
- Baylor Genetics, Houston, Texas, United States
| | - Pamela N. Luna
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, United States
| | - Brian P. Brooks
- Ophthalmic Genetics & Visual Function Branch, National Eye Institute, NIH, Bethesda, Maryland, United States
| | - Robert B. Hufnagel
- Ophthalmic Genetics & Visual Function Branch, National Eye Institute, NIH, Bethesda, Maryland, United States
| | - Chad A. Shaw
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, United States
| | - Jill A. Rosenfeld
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, United States
| | - A. J. Agopian
- Department of Epidemiology, Human Genetics & Environmental Sciences, UTHealth School of Public Health, Houston, Texas, United States
| | - Philip J. Lupo
- Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States
| | - Daryl A. Scott
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, United States
- Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, Texas, United States
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Harding P, Gore S, Malka S, Rajkumar J, Oluonye N, Moosajee M. Real-world clinical and molecular management of 50 prospective patients with microphthalmia, anophthalmia and/or ocular coloboma. Br J Ophthalmol 2023; 107:1925-1935. [PMID: 36192130 DOI: 10.1136/bjo-2022-321991] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 09/22/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS Microphthalmia, anophthalmia and coloboma (MAC) are clinically and genetically heterogenous rare developmental eye conditions, which contribute to a significant proportion of childhood blindness worldwide. Clear understanding of MAC aetiology and comorbidities is essential to providing patients with appropriate care. However, current management is unstandardised and molecular diagnostic rates remain low, particularly in those with unilateral presentation. To further understanding of clinical and genetic management of patients with MAC, we charted their real-world experience to ascertain optimal management pathways and yield from molecular analysis. METHODS A prospective cohort study of consecutive patients with MAC referred to the ocular genetics service at Moorfields Eye Hospital between 2017-2020. RESULTS Clinical analysis of 50 MAC patients (15 microphthalmia; 2 anophthalmia; 11 coloboma; and 22 mixed) from 44 unrelated families found 44% had additional ocular features (complex) and 34% had systemic involvement, most frequently intellectual/developmental delay (8/17). Molecular analysis of 39 families using targeted gene panels, whole genome sequencing and microarray comparative genomic hybridisation identified genetic causes in, 28% including novel variants in six known MAC genes (SOX2, KMT2D, MAB21L2, ALDH1A3, BCOR and FOXE3), and a molecular diagnostic rate of 33% for both bilateral and unilateral cohorts. New phenotypic associations were found for FOXE3 (bilateral sensorineural hearing loss) and MAB21L2 (unilateral microphthalmia). CONCLUSION This study highlights the importance of thorough clinical and molecular phenotyping of MAC patients to provide appropriate multidisciplinary care. Routine genetic testing for both unilateral and bilateral cases in the clinic may increase diagnostic rates in the future, helping elucidate genotype-phenotype correlations and informing genetic counselling.
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Affiliation(s)
- Philippa Harding
- Institute of Ophthalmology, University College London, London, UK
| | - Sri Gore
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Great Ormond Street Hospital For Children NHS Trust, London, UK
| | - Samantha Malka
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | | | - Ngozi Oluonye
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Great Ormond Street Hospital For Children NHS Trust, London, UK
| | - Mariya Moosajee
- Institute of Ophthalmology, University College London, London, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Great Ormond Street Hospital For Children NHS Trust, London, UK
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Rokohl AC, Trester M, Pine KR, Heindl LM. How to diagnose dry anophthalmic socket syndrome (DASS) in the clinical routine. Graefes Arch Clin Exp Ophthalmol 2023; 261:2713-2715. [PMID: 37103625 PMCID: PMC10432313 DOI: 10.1007/s00417-023-06074-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/12/2023] [Accepted: 04/15/2023] [Indexed: 04/28/2023] Open
Affiliation(s)
- Alexander C Rokohl
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Kerpener Straße 62, 50937, Cologne, Germany.
- Center for Integrated Oncology (CIO) Aachen-Bonn-Cologne-Düsseldorf, Cologne, Germany.
| | - Marc Trester
- Trester-Institute for Ocular Prosthetics and Artificial Eyes, Cologne, Germany
| | - Keith R Pine
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Ludwig M Heindl
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
- Center for Integrated Oncology (CIO) Aachen-Bonn-Cologne-Düsseldorf, Cologne, Germany
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Reyes-Godinez N, Tamez-Tamez VE, Ruiz-Lozano RE, Chavez-Cobian S, Gonzalez-Murillo E, Villarreal-Reyes LA. Congenital Orbital Glial Heterotopia Associated with Clinicopathological Anophthalmia: A Case Report. Klin Monbl Augenheilkd 2023; 240:1103-1106. [PMID: 35253133 DOI: 10.1055/a-1699-2758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Glial heterotopia (GH) is the presence of glial tissue outside the cranial cavity, without communication with the brain. The orbital location usually presents as eyelid swelling, strabismus, and proptosis. This is considered a congenital location that usually presents at birth. Its association with anophthalmia is uncommon. We report the case of a 2-day-old male neonate with left congenital intraorbital lesion presenting with massive proptosis. No eyeball could be seen. Preoperative magnetic resonance imaging disclosed a large and predominantly cystic mass occupying and protruding from the left orbit without intracranial extension. In the operating theatre, a large amount of fluid was aspirated prior to total resection of the mass. Chemical analysis of the fluid was compatible with cerebrospinal fluid. Histologically, the tumor was composed of mature neuroglial tissue and ependymal cells. Despite multiple sections, no choroid plexus or intraocular content was found. The diagnosis of GH with anophthalmia was made.
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Affiliation(s)
- Natalia Reyes-Godinez
- Department of Ophthalmology, Northeast National Medical Center, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León
| | - Veronica E Tamez-Tamez
- Department of Ophthalmology, Northeast National Medical Center, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León
| | - Raul E Ruiz-Lozano
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Mexico
| | - Stephania Chavez-Cobian
- Department of Ophthalmology, Northeast National Medical Center, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León
| | - Eduardo Gonzalez-Murillo
- Department of Pathological Anatomy, Northeast National Medical Center, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León
| | - Lauro Arturo Villarreal-Reyes
- Department of Orbit and Oculoplastics, Northeast National Medical Center, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León
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Basharat R, Rodenburg K, Rodríguez-Hidalgo M, Jarral A, Ullah E, Corominas J, Gilissen C, Zehra ST, Hameed U, Ansar M, de Bruijn SE. Combined Single Gene Testing and Genome Sequencing as an Effective Diagnostic Approach for Anophthalmia and Microphthalmia Patients. Genes (Basel) 2023; 14:1573. [PMID: 37628625 PMCID: PMC10454697 DOI: 10.3390/genes14081573] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/28/2023] [Accepted: 07/29/2023] [Indexed: 08/27/2023] Open
Abstract
Anophthalmia and microphthalmia (A/M) are among the most severe congenital developmental eye disorders. Despite the advancements in genome screening technologies, more than half of A/M patients do not receive a molecular diagnosis. We included seven consanguineous families affected with A/M from Pakistani cohort and an unknown molecular basis. Single gene testing of FOXE3 was performed, followed by genome sequencing for unsolved probands in order to establish a genetic diagnosis for these families. All seven families were provided with a genetic diagnosis. The identified variants were all homozygous, classified as (likely) pathogenic and present in an A/M-associated gene. Targeted FOXE3 sequencing revealed two previously reported pathogenic FOXE3 variants in four families. In the remaining families, genome sequencing revealed a known pathogenic PXDN variant, a novel 13bp deletion in VSX2, and one novel deep intronic splice variant in PXDN. An in vitro splice assay was performed for the PXDN splice variant which revealed a severe splicing defect. Our study confirmed the utility of genome sequencing as a diagnostic tool for A/M-affected individuals. Furthermore, the identification of a novel deep intronic pathogenic variant in PXDN highlights the role of non-coding variants in A/M-disorders and the value of genome sequencing for the identification of this type of variants.
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Affiliation(s)
- Rabia Basharat
- Department of Biochemistry, Quaid-i-Azam University, Islamabad 45320, Pakistan
- Department of Human Genetics, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Kim Rodenburg
- Department of Human Genetics, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - María Rodríguez-Hidalgo
- Department of Human Genetics, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
- Department of Neuroscience, Biodonostia Health Research Institute, 20014 Donostia-San Sebastián, Spain
| | - Afeefa Jarral
- Department of Biotechnology, Mirpur University of Science and Technology (MUST), Mirpur 10250, AJK, Pakistan
| | - Ehsan Ullah
- Department of Biochemistry, Quaid-i-Azam University, Islamabad 45320, Pakistan
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Jordi Corominas
- Department of Human Genetics, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Christian Gilissen
- Department of Human Genetics, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Syeda Tatheer Zehra
- Department of Biochemistry, Quaid-i-Azam University, Islamabad 45320, Pakistan
| | - Usman Hameed
- Department of Biochemistry, Quaid-i-Azam University, Islamabad 45320, Pakistan
| | - Muhammad Ansar
- Department of Biochemistry, Quaid-i-Azam University, Islamabad 45320, Pakistan
| | - Suzanne E. de Bruijn
- Department of Human Genetics, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
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Mouriaux F. How to analyze conjunctival inflammation in dry anophthalmic socket syndrome (DASS)? Graefes Arch Clin Exp Ophthalmol 2023; 261:629-630. [PMID: 36355084 DOI: 10.1007/s00417-022-05899-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 10/20/2022] [Accepted: 11/03/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Frederic Mouriaux
- Ophthalmology Dept, CHU Rennes, Université Rennes 1, Rennes, France.
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7
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Bussières L, Gobert D, Black DO, Vaillancourt L. Metastatic pulmonary adenocarcinoma to an anophthalmic socket. Canadian Journal of Ophthalmology 2022; 58:e134-e136. [PMID: 36435208 DOI: 10.1016/j.jcjo.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 09/21/2022] [Accepted: 11/09/2022] [Indexed: 11/27/2022]
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Tibrewal S, Subhedar K, Sen P, Mohan A, Singh S, Shah C, Nischal KK, Ganesh S. Clinical spectrum of non-syndromic microphthalmos, anophthalmos and coloboma in the paediatric population: a multicentric study from North India. Br J Ophthalmol 2020; 105:897-903. [PMID: 32829301 DOI: 10.1136/bjophthalmol-2020-316910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/10/2020] [Accepted: 06/23/2020] [Indexed: 11/04/2022]
Abstract
AIMS To describe the clinical features, visual acuity and causes of ocular morbidity in children (0-18 years) with microphthalmos, anophthalmos, and coloboma (MAC) from North India. METHODS A retrospective study conducted between October 2017 and September 2018 in three tertiary eye institutes, part of the Bodhya Eye Consortium with consensus led common pro formas. Children with complete clinical data and without syndromic/systemic involvement were included. The clinical phenotype was divided into isolated ocular coloboma (CB), coloboma with microcornea (CBMC), colobomatous microphthalmos (CBMO), non-colobomatous microphthalmos (MO) and anophthalmos (AO). RESULTS A total of 532 children with MAC were examined. Seventeen records were excluded due to incomplete data (0.2%). 515 children (845 eyes) were included: 54.4% males and 45.6% females. MAC was unilateral in 36% and bilateral in 64%. CB, CBMC, CBMO, MO and AO were seen in 26.4%, 31%, 22%, 8% and 12.5% of eyes, respectively. Nystagmus was found in 40%, strabismus in 23%, cataract in 18.7% and retinal detachment in 15%. Best-corrected visual acuity (BCVA) of <3/60 was seen in 62.4% eyes. Blindness (BCVA <3/60 in better eye) was seen in 42.8% of bilateral patients. Those with microcornea or microphthalmos with coloboma had worse BCVA (p<0.001). There were regional differences in the type of MAC phenotype presenting to the three institutes. CONCLUSION The MAC group of disorders cause significant ocular morbidity. The presence of microcornea or microphthalmos with coloboma predicts worse BCVA. The variation of the MAC phenotype with the district of origin of the patient raises questions of aetiology and is subject to further studies.
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Chacón Camacho OF, Arce-González R, Rodríguez Uribe G. Newborn transient patterned hyperpigmentation and anophthalmia. Bol Med Hosp Infant Mex 2020; 77:146-148. [PMID: 32496470 DOI: 10.24875/bmhim.19000191] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
Abstract
BACKGROUND Transient pigmentary lines of the newborn are uncommon cutaneous lesions of unknown etiology. To date, only a few cases have been described. CASE REPORT A patient with a combination of transient pigmentary lines and ocular malformation is described. Molecular analysis of the SRY-box 2 (SOX2) and MIFT genes was conducted to rule out any monogenetic etiology. CONCLUSIONS Worldwide, this is the eighth case of transient pigmentary lines of the newborn reported, and the first associated with anophthalmia. No mutations in the analyzed genes (SOX2 and MIFT) were identified. Therefore, somatic mutations could be responsible for this anomaly.
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Affiliation(s)
- Oscar F Chacón Camacho
- Departamento de Genética, Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico
- Departamento de Genética y Biología Molecular, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, State of Mexico, Mexico
| | - Rocío Arce-González
- Departamento de Genética, Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico
| | - Genaro Rodríguez Uribe
- Facultad de Medicina y Psicología, Universidad Autónoma de Baja California-Campus Tijuana, Tijuana, Baja California. Mexico
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Dave TV, Tiple S, Vempati S, Palo M, Ali MJ, Kaliki S, Naik MN. Low-cost three-dimensional printed orbital template-assisted patient-specific implants for the correction of spherical orbital implant migration. Indian J Ophthalmol 2018; 66:1600-1607. [PMID: 30355870 PMCID: PMC6213664 DOI: 10.4103/ijo.ijo_472_18] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 07/13/2018] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To describe the outcomes of a patient-specific implant (PSI), fabricated using a three-dimensional (3D) printed orbital template and placed in the basin of the inferior orbital fissure to correct inferotemporally migrated spherical orbital implant. METHODS This is a single-center, prospective, consecutive, interventional, case series of six patients, with non-porous, spherical, orbital implant migration that underwent implant recentration surgically with a novel technique. Migration was subclassified either as decentration that did not affect the prosthetic retention or as displacement that affected the prosthetic retention in the eye socket. Only implant displacements were treated. The primary outcome measure was centration of the implant clinically and radiologically, with ability to retain the prosthesis. RESULTS At a mean follow-up of 21 months, all six orbital spherical implants remained centered. There were no cases of extrusion, exposure, or migration of either implants. There were no cases of PSI displacement. Additional procedures to optimize the aesthetic outcome of the customized ocular prosthesis (COP) required were simultaneous fornix formation suture in three patients, subsequent fornix formation with mucus membrane graft in two patients, and levator resection and sulcus hyaluronic acid gel injection in one patient each. The mean PSI implant weight was 2.66 ± 0.53 g. The mean COP weight was 2.2 ± 0.88 g postoperatively. The median patient satisfaction with the procedure was 9 on 10. CONCLUSION A 3D printing-assisted PSI placed in the basin of the inferior orbital fissure allows recentration of the migrated implant over a follow-up of 21 months without complications.
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Affiliation(s)
- Tarjani Vivek Dave
- Socket, Anophthalmia and Orbito-facial Prosthesis Service, LV Prasad Eye Institute, Hyderabad, Telangana, India
- Ophthalmic Plastic Surgery Service, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sweety Tiple
- Socket, Anophthalmia and Orbito-facial Prosthesis Service, LV Prasad Eye Institute, Hyderabad, Telangana, India
- Ophthalmic Plastic Surgery Service, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sandeep Vempati
- Srujana Center for Innovation, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Mansha Palo
- Socket, Anophthalmia and Orbito-facial Prosthesis Service, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Mohammad Javed Ali
- Ophthalmic Plastic Surgery Service, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Swathi Kaliki
- Ophthalmic Plastic Surgery Service, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Milind N Naik
- Ophthalmic Plastic Surgery Service, LV Prasad Eye Institute, Hyderabad, Telangana, India
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Abstract
RATIONALE Pentalogy of Cantrell, a very rare congenital condition, has an estimated incidence of 5.5 per 1 million live births. It includes five defects: a midline supraumbilical wall defect, a diaphragmatic defect, a cleft distal sternum, a defect in the diaphragmatic pericardium, and an intracardiac defect. Very few cases of this condition have been reported in the literature, most of them diagnosed in the second or third trimester of pregnancy. PATIENT CONCERNS We present a case of pentalogy of Cantrell associated with cranioschisis and unilateral anophthalmia diagnosed at 14 weeks of amenorrhea. DIAGNOSES The combination of abdominal and vaginal sonography established the diagnosis of 14 weeks of amenorrhea with a plurimalformative syndrome including: ectopia cordis, large suprambilical anterior abdominal wall defect, omphalocele, anomaly of the shape of the skull, and anomalies of the brain. INTERVENTIONS After counseling the parents, the pregnancy was interrupted, as requested by the family. OUTCOMES Pathological examination of the fetus after the therapeutic abortion confirmed the diagnosis. LESSONS Because of the poor prognosis of Cantrell's pentalogy, early antenatal sonographic detection is important and allows for elective abortion before viability.
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Affiliation(s)
- Mihaela Grigore
- Department of Obstetrics and Gynecology Department of Anatomy Department of Internal Medicine, University of Medicine and Pharmacy, "Grigore T. Popa" Iasi, Romania
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Cubuk PO, Ho L, Reversade B, Perçin EF. MATTHEW-WOOD SYNDROME: A CASE WITH DEXTROCARDIA AND STREAK GONADS. Genet Couns 2016; 27:405-410. [PMID: 30204971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Matthew-Wood syndrome (MWS), also termed Microphthalmia, syndrome 9 (MCOPS9, MIM 601186), Spear syndrome, or pulmonary hypoplasia, diaphragmatic hernia, anophthalmia and cardiac defects syndrome (PDAC syndrome), is an autosomal recessive disorder characterised by ocular, respiratory and cardiac abnormalities. Mutations in retinoic acid 6 gene (STRA6) have been reported in clinically diagnosed patients with MWS. Here we presented a case with MWS, who has characteristic findings of the syndrome as well as dextrocardia as an undescribed feature, and bilateral streak gonads which was described only in one patient previously. Molecular analysis showed a homozygous exonic missense mutation in the STRA6 gene.
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Jugård Y, Odersjö M, Topa A, Lindgren G, Andersson Grönlund M. [Anophthalmia and microphthalmia requires multidisciplinary care. Many of the children also have other medical problems]. Lakartidningen 2015; 112:DERF. [PMID: 26173131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Anophthalmia/microphthalmia (A/M) are rare congenital eye malformations. Early intervention with ocular prosthesis can stimulate orbital growth and prevent facial asymmetry. We reviewed medical records from 18 individuals with A/M (0.8-31 years) treated with ocular prosthesis at Sahlgrenska University Hospital between 2000 and 2012. A majority had other ocular findings. Seven had subnormal visual acuity in the fellow eye, one third were in contact with vision support services and half of the group wore glasses. Eleven individuals had extra-ocular findings such as cardiac defect, hearing impairment and neuropsychiatric disorders, possibly indicating syndromic conditions. We suggest that investigation of A/M children should include ultrasound of the eye, optionally visual evoked potential and magnetic resonance imaging of the CNS. The ophthalmologist should initiate treatment with prosthesis, pediatric assessment, hearing tests and genetic counseling, but should also monitor visual development of the fellow eye.
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Affiliation(s)
- Ylva Jugård
- Ögonkliniken, Södra Älvsborgs Sjukhus - Borås, Sweden - Borås, Sweden
| | - Marie Odersjö
- Titanenheten, Öron- näs- och halskliniken, Sahlgrenska Universitetssjukhuset - Göteborg, Sweden Titanenheten, Öron- näs- och halskliniken, Sahlgrenska Universitetssjukhuset - Göteborg, Sweden
| | - Alexandra Topa
- Klinisk Genetik, Sahlgrenska Universitetssjukhuset - Göteborg, Sweden Klinisk Genetik, Sahlgrenska Universitetssjukhuset - Göteborg, Sweden
| | - Gun Lindgren
- Ögonverksamheten, Sahlgrenska Universitetssjukhuset - Mölndal, Sweden Ögonverksamheten, Sahlgrenska Universitetssjukhuset - Mölndal, Sweden
| | - Marita Andersson Grönlund
- Ögonmottagningen för barn, Drottning Silvias barn- och ungdomssjukhus Sahlgrenska Universitetssjukhuset - Göteborg, Sweden Ögonmottagningen för barn, Drottning Silvias barn- och ungdomssjukhus, Sahlgrenska universitetssjukhuse - Göteborg, Sweden
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14
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Fahnehjelm KT, Dafgård Kopp E. [Anophthalmia and microphthalmia are rare eye malformations. Important with early care for normalized development of the facial skeleton]. Lakartidningen 2015; 112:DH39. [PMID: 26173134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Kristina Teär Fahnehjelm
- Klinisk Neurovetenskap - Ögon och syn Stockholm, Sweden Klinisk Neurovetenskap - Ögon och syn Stockholm, Sweden
| | - Eva Dafgård Kopp
- Karolinska Institutet - Institutionen för Klinisk Neurovetenskap Stockholm, Sweden Karolinska Institutet - Institutionen för Klinisk Neurovetenskap Stockholm, Sweden
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15
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Bozkurt O, Bidev D, Sari FN, Dizdar EA, Ulu HO, Uras N, Oguz SS, Canpolat FE, Dilmen U. Fryns anophthalmia-plus syndrome: two rare cases. Genet Couns 2014; 25:395-398. [PMID: 25804017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Fryns anophthalmia-plus syndrome is a rare syndrome with clinical diversity primarily including anophthalmia/microphthalmia, facial clefts, cleft lip/palate, ear and nasal deformities. Here we present two different cases of APS with anopthalmia/microphthalmia, cleft palate, low set ears, ventriculomegaly and one of which had intestinal non-fixation anomaly not described in the literature before.
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Cayir A, Tasdemir S, Eroz R, Yuce I, Orbak Z, Tatar A. Anophthalmia-plus syndrome with unusual findings. A clinical report and review of the literature. Genet Couns 2013; 24:307-312. [PMID: 24341146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We present a male child at 3 years old with Anophthalmia-Plus Syndrome (APS). He has asymmetry of the face and head, left choanal atresia, a sunken facial appearance, microphthalmia in the right eye, severe microphthalmia in the left eye, bilateral low-set ears, scarring from cleft palate surgery. Magnetic resonance imaging (MRI) sections revealed decreased right globe volume, an undeveloped left globe, decreased left optical nerve thickness, Chiari type 2 malformation, left choanal atresia and cleft palate. Echocardiography and abdominal ultrasonography were normal. The patient has a 45 dB conductive hearing loss in the left ear. Repeated thyroid function tests were evaluated as compatible with central hypothyroidism. We report a Fryns Anophthalmia-Plus Syndrome in a child with unusual findings including central hypothyroidism, chiari type 2 malformation, conductive hearing loss and developmental regression. Summary of the features reported in the present case and all 14 previous cases that might be defined as APS.
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Affiliation(s)
- A Cayir
- Department of Pediatrics, Division of Pediatric Endocrinology, Ataturk University, Erzurum, Turkey
| | - S Tasdemir
- Department of Medical Genetics, Ataturk University, Erzurum, Turkey
| | - R Eroz
- Department of Medical Genetics, Duzce University, Duzce, Turkey
| | - I Yuce
- Department of Radiology, Ataturk University, Erzurum, Turkey
| | - Z Orbak
- Department of Pediatrics, Division of Pediatric Endocrinology, Ataturk University, Erzurum, Turkey
| | - A Tatar
- Department of Medical Genetics, Ataturk University, Erzurum, Turkey
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17
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Lemaire A, Dakpé S, Lafitte J, Sorrel-Déjerine E, Testelin S. [Enophtalmos of the anophtalmic socket: incidence of the orbital morphology and therapeutic implications. Clinical study of 86 cases]. ANN CHIR PLAST ESTH 2012; 57:549-57. [PMID: 22841413 DOI: 10.1016/j.anplas.2012.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 05/30/2012] [Indexed: 11/18/2022]
Abstract
AIM OF THE STUDY From a light asymmetry to a sunken eye aspect, a great disparity between the results after anophtalmic socket rehabilitation is noticeable: what are the factors involved in the degree of residual enophtalmos following excision of the eye? The litterature's response is based on physiopathological considerations around intraorbital architectural disturbance. We propose a geometrical approach related to the existence of different morphological types of orbit. PATIENTS AND METHOD Eighty-six records of eviscerated and enucleated patients have been studied and submitted to a statistical analysis. A preliminary study has defined four types of orbit depending on the shape and operture of the orbital "window": two opposite types IA and III, a type II intermediate and a particular one, the type IB. A classification of enophtalmos' degree allows to analyze the parameters chosen and to identify the predictive factors. RESULTS The statistical analysis confirms the incidence of the orbital morphology on the degree of enophtalmos but do not support the theories based on the intraorbital septal architecture changes. Depending on the orbital shape and the container-content relation, the volume loss is more visible on the whole orbitopalpebral surface of opened and high orbit but remains centered on the anteroposterior position of the implant of a closed and lengthened orbit. At the contrary to the type III, the type IA is not favorable for the anophtalmic patient and predispose to a higher degree of enophtalmos. This new approach has therapeutic implications on primary and secondary surgery for volume loss replacement. CONCLUSION The success of anophtalmic socket rehabilitation is influenced by the orbital morphological type that has to be considered in the therapeutic strategy.
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Affiliation(s)
- A Lemaire
- Service de chirurgie maxillo-faciale et stomatologie, CHU d'Amiens, place Victor-Pauchet, Amiens, France.
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18
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Ragge NK, Quaghebeur G, Stewart H. SOX2 anophthalmia syndrome in adulthood - a neurodegenerative picture? Clin Genet 2012; 83:482-4. [PMID: 22834934 DOI: 10.1111/j.1399-0004.2012.01922.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2012] [Revised: 06/05/2012] [Accepted: 06/21/2012] [Indexed: 10/28/2022]
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19
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Pachajoa H, Isaza C. Sirenomelia and cyclopia in the same patient after a cluster of cyclopia and sirenomelia in Cali (South America). Am J Med Genet A 2012; 158A:1808-10. [PMID: 22628363 DOI: 10.1002/ajmg.a.35411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Accepted: 03/14/2012] [Indexed: 11/11/2022]
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20
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Roos LS, Grønskov K, Jensen H, Tümer Z. [The genetic background for the eye malformations anophthalmia and microphthalmia]. Ugeskr Laeger 2012; 174:713-716. [PMID: 22409892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Anophthalmia and microphthalmia (AO/MO) are rare congenital eye malformations, in which the eyeball is apparently absent or smaller than normal, which causes various degrees of visual impairment. Over 200 different AO/MO-related syndromes have been described, but the genetic background is unknown in many cases. The aim of this article is to give an overview of AO/MO, focusing on the genetic background. It is illustrated that the future identification of new AO/MO related genes will benefit in the genetic counseling of AO/MO patients, and in the understanding of eye development and congenital eye malformations.
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Affiliation(s)
- Laura Sønderberg Roos
- Center for Applied Human Molecular Genetics, Kennedy Centret, Gamle Landevej 7, 2600 Glostrup, Denmark.
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Shah SP, Taylor AE, Sowden JC, Ragge N, Russell-Eggitt I, Rahi JS, Gilbert CE. Anophthalmos, microphthalmos, and Coloboma in the United kingdom: clinical features, results of investigations, and early management. Ophthalmology 2012; 119:362-8. [PMID: 22054996 DOI: 10.1016/j.ophtha.2011.07.039] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2011] [Revised: 07/11/2011] [Accepted: 07/21/2011] [Indexed: 10/15/2022] Open
Abstract
PURPOSE To describe the clinical features of children with anophthalmos, microphthalmos, and typical coloboma (AMC). DESIGN Descriptive, observational, cross-sectional study of the United Kingdom. PARTICIPANTS A total of 135 children with AMC newly diagnosed over an 18-month period beginning in October 2006. METHODS Cases were identified using active surveillance through an established ophthalmic surveillance system. Eligible cases were followed up 6 months after first notification. MAIN OUTCOME MEASURES Phenotypic characteristics, both ocular and systemic, clinical investigations, causes, and interventions. RESULTS A total of 210 eyes (of 135 children) were affected by AMC, of which 153 had isolated coloboma or coloboma with microphthalmos. The most common colobomatous anomaly was a chorioretinal defect present in 109 eyes (71.2%). Some 44% of children were bilaterally visually impaired. Systemic abnormalities were present in 59.7% of children, with craniofacial anomalies being the most common. Children with bilateral disease had a 2.7 times higher odds (95% confidence interval, 1.3-5.5, P = 0.006) of having systemic involvement than unilaterally affected children. Neurologic imaging was the most frequent investigation (58.5%) performed. Less than one third (30.3%) of the children with microphthalmos had ocular axial lengths measured. Eight children had confirmed genetic mutations. Approximately half (49.2%) of the children required ocular intervention. CONCLUSIONS Colobomatous defects were the most common phenotype within this spectrum of anomalies in the United Kingdom. The high frequency of posterior segment colobomatous involvement means that a dilated fundal examination should be made in all cases. The significant visual and systemic morbidity in affected children underlines the importance of a multidisciplinary approach to management.
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Affiliation(s)
- Shaheen P Shah
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
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22
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Sredzińska-Kita D, Mrugacz M, Bakunowicz-Łazarczyk A. [Estimation of the quality of life 8-year-old child with bilateral anophthalmia]. Klin Oczna 2009; 111:354-356. [PMID: 20169896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
PURPOSE The main aim of our work was to estimate the physical and psychomotor development and the arrangement to the daily life for a 8-year-old girl with inborn bilateral anophthalmia. MATERIAL AND METHODS The basic ophthalmic, pediatric and neurological examinations were performed with additional genetic and radiological examinations. RESULTS The ophthalmic and MRI examination find out the absence of the eyeballs, optic nerves, optic chiasm, optic tracts and optic radiation. CONCLUSIONS Anophthalmia limits in a big grade an independent life of the child. However, currently the girl's development indicates for good intellectual abilities what is promising for future independent life and professional work.
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Affiliation(s)
- Dorota Sredzińska-Kita
- Z Kliniki Okulistyki Dzieciecej Uniwersyteckiego Dzieciecego Szpitala Klinicznego w Białymstoku
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Affiliation(s)
- Maria L Teiber
- Genetic Department, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina
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24
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Abstract
Congenital anophthalmia and microphthalmia are rare developmental defects of the globe. They often arise in conjunction with other ocular defects such as coloboma and orbital cyst. They may also be part of more generalised syndromes, such as CHARGE syndrome. Anophthalmia, microphthalmia, and coloboma are likely to be caused by disturbances of the morphogenetic pathway that controls eye development, either as a result of primary genetic defect, or external gestational factors, including infection or drugs that can influence the smooth processes of morphogenesis. The ophthalmologist is often the primary carer for children with anophthalmia and microphthalmia, and as such can coordinate the multidisciplinary input needed to offer optimal care for these individuals, including vision and family support services. They are able to assess the vision and maximise the visual potential of the child and they can also ensure that the cosmetic and social impact of anophthalmia or microphthalmia is minimised by starting socket expansion or referring to a specialist oculoplastics and prosthetics unit. A coordinated approach with paediatrics is necessary to manage any associated conditions. Genetic diagnosis and investigations can greatly assist in providing a diagnosis and informed genetic counselling.
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Affiliation(s)
- N K Ragge
- Department of Ophthalmology, Moorfields Eye Hospital, London, UK.
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25
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Makhoul IR, Soudack M, Kochavi O, Guilburd JN, Maimon S, Gershoni-Baruch R. Anophthalmia-plus syndrome: a clinical report and review of the literature. Am J Med Genet A 2007; 143A:64-8. [PMID: 17152069 DOI: 10.1002/ajmg.a.31566] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We describe a term male infant of healthy non-consanguineous parents, born with congenital malformations, including bilateral cleft palate and lip, mild microphthalmia with iris coloboma and glaucoma of the right eye, and blepharophimosis with severe microphthalmia of the left eye. Spine radiograph and MRI showed first sacral hemivertebra with spina bifida, and agenesis of the 2nd, 3rd, 4th, and 5th sacral vertebrae and coccyx. Spine MRI showed caudal tethering of spinal cord at L(3) level, filum terminalis lipoma and a syringomyelia. Brain ultrasound and MRI showed hypoplasia of corpus callosum with mild dilatation of the lateral ventricles. Orbital MRI showed bilateral microphthalmia-distorted small left eyeball with posteriorly located lens, and a split vitreous body in the right eye, suggestive of primary hyperplastic vitreous. The karyotype was normal. Summary of the findings in nine cases (our case and eight published cases) support the notion that anophthalmia-plus syndrome (APS) is a distinct syndrome. Gene locus of APS is yet to be identified.
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Affiliation(s)
- Imad R Makhoul
- Department of Neonatology, Meyer Children's Hospital, Rambam Health Care Campus, and the Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
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26
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Wenbin Z, Hanjiang W, Xiaoli C, Zhonglin L. Tessier 3 cleft with clinical anophthalmia: two case reports and a review of the literature. Cleft Palate Craniofac J 2007; 44:102-5. [PMID: 17214533 DOI: 10.1597/05-155] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Tessier 3 cleft with clinical anophthalmia is one of the rarest craniofacial clefts, and hence little has been published about its management and treatment. This article presents two cases of Tessier 3 cleft with clinical anophthalmia. A review of the literature helps to diagnose these complex facial deformities. The treatment and etiopathogenesis are discussed.
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Affiliation(s)
- Zhang Wenbin
- Oral and Maxillofacial Surgery Department, Xiamen Zhongshan Hospital, Xiamen, China.
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27
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Martinovic-Bouriel J, Bernabé-Dupont C, Golzio C, Grattagliano-Bessières B, Malan V, Bonnière M, Esculpavit C, Fallet-Bianco C, Mirlesse V, Le Bidois J, Aubry MC, Vekemans M, Morichon N, Etchevers H, Attié-Bitach T, Encha-Razavi F, Benachi A. Matthew-Wood syndrome: Report of two new cases supporting autosomal recessive inheritance and exclusion ofFGF10 andFGFR2. Am J Med Genet A 2007; 143A:219-28. [PMID: 17236193 DOI: 10.1002/ajmg.a.31599] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We describe two fetal cases of microphthalmia/anophthalmia, pulmonary agenesis, and diaphragmatic defect. This rare association is known as Matthew-Wood syndrome (MWS; MIM 601186) or by the acronym "PMD" (Pulmonary agenesis, Microphthalmia, Diaphragmatic defect). Fewer than ten pre- and perinatal diagnoses of Matthew-Wood syndrome have been described to date. The cause is unknown, and the mode of transmission remains unclear. Most cases have been reported as isolated and sporadic, although recurrence among sibs has been observed once. Our two cases both occurred in consanguineous families, further supporting autosomal recessive transmission. In addition, in one family at least one of the elder sibs presented an evocatively similar phenotype. The spatiotemporal expression pattern of the FGF10 and FGFR2 genes in human embryos and the reported phenotypes of knockout mice for these genes spurred us to examine their coding sequences in our two cases of MWS. While in our patients, no causative sequence variations were identified in FGF10 or FGFR2, this cognate ligand-receptor pair and its downstream effectors remain functional candidates for MWS and similar associations of congenital ocular, diaphragmatic and pulmonary malformations.
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Affiliation(s)
- Jelena Martinovic-Bouriel
- Assistance Publique - Hôpitaux de Paris, Hôpital Necker - Enfants Malades, Department of Genetics, Embryo-Fetal Pathology Unit, Paris, France.
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Abstract
The authors describe the uncommon clinical presentation and treatment of a neonate with progressive proptosis, which turned out to be an ectopic cerebral rest in the orbit in the absence of a formed eye. The discussion examines the theories regarding the genesis of the condition, different locations in the body (including the orbit and the eye) in which ectopic cerebral rests have been described in the literature, and the management of the condition.
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Affiliation(s)
- Ashok Kumar Grover
- Oculoplasty Services, Department of Ophthalmology, Sir Ganga Ram Hospital, New Delhi, India
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29
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Abstract
BACKGROUND After presenting two sisters with the rare form of congenital arrhinia, this syndrome is reviewed, an explanation of the pathogenesis is offered and the therapeutic options of the functional and aesthetic reconstruction are discussed. DISCUSSION In cases of congenital arrhinia different degrees of respiratory distress, cyanotic episodes, and impaired food intake are described. Therefore after birth respiration and food intake need to be monitored to alleviate the situation through intubation or tracheotomy. The following conclusions could be made based on the literature overview. Little is known about the pathophysiology and a great variety of therapeutic interventions and reconstruction solutions with a wide spectrum of complications are described. Due to the numerous forms of complications, which need to be compared with the reconstructive results, indications for surgical reconstruction of the airway and plastic reconstruction of the nose during childhood must be defined very stringently. CONCLUSION One method to achieve a satisfactory plastic result is with an osseointegrated prosthesis. This facial prosthesis can be inserted without complications and can guarantee an adequate result, whereas no impairment of maxillofacial development was noted.
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Affiliation(s)
- C-H Cho
- Klinik für Strahlenheilkunde, Charité Campus Virchow-Klinikum, Universitätsmedizin Berlin, Berlin.
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Abstract
Congenital anophthalmos with contracted socket can occasionally present in the second or third decade for cosmetic correction of the deformity. Placement of ocular prosthesis is not possible due to reduced dimensions of the palpebral aperture and contracture of the bony socket. Horizontal widening of the palpebral aperture using an eyelid switch flap technique followed by placement of ocular prosthesis anterior to the hypoplastic orbit achieves good cosmetic correction of this deformity.
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Affiliation(s)
- Milind N Naik
- Division of Ophthalmic Plastic Surgery, L.V. Prasad Eye Institute, Hyderabad, India.
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Zenteno JC, Perez-Cano HJ, Aguinaga M. Anophthalmia-esophageal atresia syndrome caused by an SOX2 gene deletion in monozygotic twin brothers with markedly discordant phenotypes. Am J Med Genet A 2006; 140:1899-903. [PMID: 16892407 DOI: 10.1002/ajmg.a.31384] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The clinical combination of anophthalmia/microphthalmia and esophageal atresia was first recognized in 1988 as a distinct variable multi-system malformation syndrome and since then at least 17 cases of the disease have been described, all of them sporadic in occurrence. We report a heterozygous SOX2 gene mutation underlying the syndrome of anophthalmia/microphthalmia-esophageal atresia and demonstrate that this entity can be associated to considerable clinical variability as shown by the discordant ocular phenotype observed in monozygotic twin brothers carrying an SOX2 deletion. This is the first report describing a strikingly discordant eye phenotype in monozygotic twins with the condition, with one of our patients being the first reported individual carrying an SOX2 lesion associated with unilateral eye defect. We discuss the probable sources for this remarkable phenotypic heterogeneity of the anophthalmia/microphthalmia syndrome in individuals with an identical genetic constitution.
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Affiliation(s)
- Juan Carlos Zenteno
- Department of Genetics, Institute of Ophthalmology "Conde de Valenciana," Mexico City, Mexico.
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Abstract
We present the clinical and radiologic findings of two cases of clinical anophthalmia in one eye and optic nerve hypoplasia in the other eye. We propose possible causes of this rare finding.
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Affiliation(s)
- Dogan Ceyhan
- Department of Pediatric Ophthalmology, Wills Eye Hospital, Philadelphia, Pennsylvania, USA
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33
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Abstract
INTRODUCTION The purpose of this study is to report orbital volume measurement results in patients with congenital clinical anophthalmia before and after therapy and to compare them with normal values. PATIENTS AND METHOD Normal values were obtained from 35 healthy children (22 boys, 13 girls; aged 3 month to 7 years) in whom MRI was done for non-ophthalmological reasons. 18 patients with congenital anophthalmos could be included, 9 with bilateral, 8 with unilateral disease and 1 microphthalmos. 6 of them had MRI follow-up (more than one examination). RESULTS Orbital volume at birth is 7 ml and it increases with age: Orbital volume = 7.701 x age (month) (0.2484) ml. It is around 14.2 ml at the age 1 year, 17 ml with 2 years and reaches 23 ml with 7 years. In unilateral clinical anophthalmos orbital volume is 35 to 58 % compared with the healthy side and 31 to 65 % compared with the normal values. In bilateral cases the volume is 43 to 70 % of the normal value. During treatment it develops in parallel to the normal values. CONCLUSIONS The normal values measured by our group are in accordance with the only published study by Bentley . MRI orbital volumetry is a reliable method without using radiation. It allows us to quantify the bony asymmetry and is suitable for therapy control when using orbital expanders. The congenital missing eye might be the most important reason why the orbit does not develop in the normal way to a normal size. Self-inflating high, hydrophilic hydrogel expanders do not seem to be able to compensate this, in spite of the fact that they work very well to prepare the socket for a prosthesis.
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Akalin I, Senses DA, Ilgin-Ruhi H, Misirlioğlu E, Yalçiner M, Cetinkaya E, Fryns JP, Tükün A. A novel Fryns "Anophthalmia-plus" syndrome associated with primary hypothyroidism. Genet Couns 2005; 16:145-8. [PMID: 16080293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
A novel Fryns "anophthalmla-plus" syndrome associated with primary hypothyroidism: Here, we report a newborn male with "anophthalmia-plus" syndrome and primary congenital hypothyroidism. To our knowledge this is the first case of 'anophthalmia-plus' syndrome associated with congenital hypothyroidism in the literature up to date.
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Affiliation(s)
- I Akalin
- Ankara University School of Medicine, Department of Medical Genetics, 06100, Sihhiye, Ankara, Turkey
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35
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Abstract
OBJECTIVE The aim of the present work was to establish a method for orbital volume calculation based on MR scanning data for the sake of better radiation hygiene. MATERIALS AND METHODS The orbital volumes of 35 ophthalmologically healthy children were calculated on the basis of MRI scans. After data transfer to a separate workstation, volumetric analysis was carried out by two independent radiologists using semi-automated software. The accuracy of the calculated values was compared with orbital volumes measured by anatomic preparations and given in studies by various authors. RESULTS Volume calculation was possible in all patients using MRI data. There is an acceptable agreement with the presented anatomic facts and the measured values of Bentheley. In the Wilcoxon test there was not a big difference between the courses of the values (p = 0.507). CONCLUSION Even though we can obtain a better image of the bizarre structure of the bony orbits with CT, MR-based volumetry of the orbit is a reliable method and is not burdened by radiation exposure. It can thus be an important condition for the planning and the controlling of modern therapeutic concepts in treating anophthalmos and microphthalmos.
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Affiliation(s)
- V Hingst
- Institut für Diagnostische und Interventionelle Radiologie der Medizinischen Fakultät der Universität Rostock, Rostock.
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Guichet A, Triau S, Lépinard C, Esculapavit C, Biquard F, Descamps P, Encha-Razavi F, Bonneau D. Prenatal diagnosis of primary anophthalmia with a 3q27 interstitial deletion involving SOX2. Prenat Diagn 2004; 24:828-32. [PMID: 15503273 DOI: 10.1002/pd.997] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We report an interstitial deletion of chromosome 3q26-q28 in a fetus in which anophthalmia had been detected prenatally. FISH analysis, using BAC clones encompassing the SOX2 locus, showed that SOX2 gene was involved in the chromosomal breakpoint of the deletion. This case confirms that haploinsufficiency for SOX2 plays a crucial role in human eye development and emphasizes the necessity of careful chromosomal analysis, including FISH analysis of the 3q region, in case of prenatal discovery of anophthalmia.
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Abstract
Congenital anophthalmia and blind microphthalmia are very rare conditions and there is no standard treatment available. Various previously reported therapeutical concepts are reviewed. The clinical picture can be divided into three subgroups with different therapeutical options recommended: in microphthalmia the conjunctival sac size is usually normal or slightly decreased. The use of non-expandable conformers is possible with good results. Patients treated with hydrogel expanders can wear a prosthesis earlier and with better cosmetic results. In congenital anophthalmia the conjunctival sac is very small and contracted and patients cannot wear a prosthesis or even a conformer. Hydrogel expander treatment--first for the conjunctival sac and second for the orbit--is the therapeutical option which may lead to good cosmetic results. Children >5 years of age and/or unsuccessful pre-treated cases may benefit from osteotomy to reduce mid-face asymmetry. To attain the main therapeutical goal in this subgroup, the ability to fit a normal prosthesis, a combination of different techniques like hydrogel expanders, dermis fat graft, lid surgery etc. may be necessary.
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Sterker I, Klapper HU, Wiedemann P, Reiber T. [Clinical anophthalmos. Cosmetic outcome after 2 years therapy with an orbital expander for stimulating orbital growth]. Klin Monbl Augenheilkd 2000; 216:197-203. [PMID: 10820704 DOI: 10.1055/s-2000-10544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
BACKGROUND Congenital anophthalmos is a rare condition in which intervention in an early age can stimulate orbital expansion. The therapeutic goal was to allow retention of a suitable prosthesis and to maximise facial symmetry. METHODS AND PATIENTS We report on 3 anophthalmic newborn male patients, of which one presented with microphthalmos in the other eye as well as associated systemic disorders. Solid moulded shapes were adapted and manufactured out of methylmethacrylate to increase expansion of orbital soft tissue and bone. The moulding of the orbita was performed by silicone made of two components under general anaesthesia during the first two years of life. The following day the solid shapes were fitted in the outpatient department. They were increased in size when they started to rotate within the orbit or when the eyelids were relatively loose around the solid shape. The initial insertion of the orbital expander was performed in the first weeks after birth and was repeated every 3 to 6 weeks within the first year of life. The degree of orbital expansion was determined by measurements of the horizontal eyelid length, the volume of the solid shapes, by measuring the volume in cm3 of water displaced by the shape after submerging it in a cylinder of water and assessment of the cosmetic aspect. RESULTS Within 8 months of therapy a horizontal eyelid lengthening to 10 mm and an increase of the volume of the orbital expander from 1.5 cm3 to 6 cm3 was achieved in patient 1. After 20 months of therapy patient 2 showed symmetry of the face and the horizontal eyelid length. In patient 3 therapy started 3 years late and after 2 years only a horizontal eyelid lengthening of 3 mm and a suboptimal symmetry of the face was achieved. CONCLUSION Our own experience suggests that early prosthetic fittings are necessary for an ideal cosmetic outcome. Motivation and cooperation of the parents is an important factor to achieve optimal results.
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Affiliation(s)
- I Sterker
- Klinik und Poliklinik für Augenheilkunde, Universität Leipzig
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39
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Dufit C, Baggio E, Ruban JM, Buenerd A, Hermier M. [Fetal anophthalmos. Problem of the prenatal diagnosis: a case report]. J Fr Ophtalmol 1999; 22:966-9. [PMID: 10609172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
We report a case of anophthalmia discovered after birth and discuss the need to resolve diagnostic difficulties and determine prognosis. This is an exceptional malformation which is particularly difficult to manage. It often occurs in the context of a complex malformation syndrome. Recent imaging techniques including magnetic resonance imaging help determine the degree of malformation and provide useful information for giving genetic advice to parents.
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Affiliation(s)
- C Dufit
- Service d'ophtalmologie, Centre Hospitalo-Universitaire HEH, Lyon
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40
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Ukponmwan CU. Congenital anophthalmos in Benin city, Nigeria. West Afr J Med 1999; 18:141-3. [PMID: 10504874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Clinical Anophthalmos is a very rare condition and this is illustrated in Benin City, Nigeria where the two cases described are the only cases that have been seen at the University of Benin Teaching Hospital over a period of twenty years. The two cases were unilateral anophthalmos. The first case is a case of primary anophthalmos while the second case is the consecutive or degenerative type of anophthalmos.
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Affiliation(s)
- C U Ukponmwan
- Department of Ophthalmology, School of Medicine, University of Benin, Edo State, Nigeria
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41
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Abstract
Cranial MR imaging examination findings of a three and half year old boy with Waardenburg syndrome are described which consisted of bilateral congenital anophthalmia (secondary type), and a hypothalamic hamartoma.
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Affiliation(s)
- R N Sener
- Department of Radiology, Ege University Hospital, Bornova, Izmir, Turkey.
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42
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Albernaz VS, Castillo M, Hudgins PA, Mukherji SK. Imaging findings in patients with clinical anophthalmos. AJNR Am J Neuroradiol 1997; 18:555-61. [PMID: 9090423 PMCID: PMC8338421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE To review the intracranial and facial imaging features in children with congenital anophthalmos. METHODS We retrospectively studied eight children with anophthalmos with respect to intraorbital, intracranial, and craniofacial anomalies (six had CT examinations, including the face, orbits, and brain, and four had MR imaging, including the orbits and brain). RESULTS Three patients had primary bilateral anophthalmos on CT (n = 1) and MR (n = 3) studies. In these patients, MR images showed hypoplasia of the optic chiasm and posterior visual pathways (n = 3), agenesis (n = 1) or dysgenesis of the corpus callosum (n = 2), and a mass in the tuber cinereum region (n = 1). One patient had incontinentia pigmenti. Five patients had unilateral anophthalmos on CT (n = 5) and MR (n = 1) studies. One of these patients had a contralateral congenital cystic eye and one had contralateral severe microphthalmia and absent optic chiasm. All had craniofacial anomalies that consisted of midline facial clefts (n = 2) and concomitant hemifacial hypoplasia (n = 2). One had a craniosynostosis. All five had normal-appearing brains. CONCLUSION Patients with bilateral anophthalmos represent a distinct group from those with unilateral anophthalmos. In our patients, bilateral anophthalmos was associated with absence of the optic chiasm, diminished size of the posterior optic pathways, and agenesis or dysgenesis of the corpus callosum. Patients with unilateral anophthalmos had severe craniofacial anomalies. Imaging of the face is helpful in patients with unilateral anophthalmos.
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Affiliation(s)
- V S Albernaz
- Department of Radiology, University of North Carolina at Chapel Hill, 27599, USA
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43
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Gundorova RA, Verigo EN, Val'skiĭ VV, Kiriukhina SL. [Clinical, diagnostic and therapeutic aspects of congenital anophthalmos]. Vestn Oftalmol 1996; 112:31-3. [PMID: 9148563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This study was aimed at elucidating the diagnostic potentialities of computer-aided tomography (CAT) in congenital micro- and anophthalmia. Twenty-five young patients with various clinical manifestation of this abnormality were examined. Used in complex with the traditional diagnostic methods, CAT played the key role. It permitted imaging the entire complex of changes in the orbit and its contents, which helped choose adequate therapeutic measures. Surgical treatment was proven to be little effective or useless at all in cases with a more than 4 cm3 deficit of the orbital volume on the involved side; contrary to this, early staged fitting with prostheses is effective and creates favorable conditions for subsequent surgical correction in a less than 4 cm3 deficit of the volume.
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44
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Sandler D, Mancuso A, Becker T, Zori R, Hellrung J, Silverstein J, Burton V, Hamosh A, Williams C. Association of anophthalmia and esophageal atresia. Am J Med Genet 1995; 59:484-91. [PMID: 8585569 DOI: 10.1002/ajmg.1320590415] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We report on a boy and a girl with bilateral anophthalmia and proximal esophageal atresia. In addition to vestigial optic nerves and chiasma, MRI studies showed other central nervous system abnormalities; one had ectopic tissue in the hypothalamic region, and the other hand generalized ventriculomegaly associated with atrophy. Two other cases, both males, have been reported with anophthalmia and esophageal atresia as their only malformations. These 4 cases are reviewed in light of recent advances in the understanding of ocular embryogenesis and of the midbrain as a development field. Concurrence of these defects appears to be non-random.
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Affiliation(s)
- D Sandler
- Department of Pediatrics, University of Florida, Gainesville 32610-0296, USA
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45
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Abstract
In a consanguineous marriage, a woman at 32 weeks' pregnancy presented with intrauterine growth retardation and bilateral renal agenesis. Fraser syndrome (cryptophthalmus syndactyly syndrome) was diagnosed based on cryptophthalmos, atresia of meatus acusticus externus in auricula, syndactyly, hypoplastic larynx, hypoplastic left lung, agenesis of urinary system and aberrant pancreas in duodenum. The syndrome is inherited as a recessive trait and the risk of recurrence is 25%.
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Affiliation(s)
- T Ozgünen
- Department of Obstetrics and Gynecology, Cukurova University Medical Faculty, Adana, Turkey
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46
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Bajwa GS, Thapar K, Dhawan AK, Kapoor A. Complicated anophthalmos. Indian Pediatr 1995; 32:480-2. [PMID: 8635814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- G S Bajwa
- Department of Opthalmology, Government Medical College, E.S.I. Hospital, Amritsar
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47
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Barbuti D, Bergami G, Fortunato M, Di Mario M. [Bilateral congenital anophthalmia with cysts. Description of a case]. Radiol Med 1993; 85:668-70. [PMID: 8327772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- D Barbuti
- Servizio di Radiologia, Ospedale Pediatrico Bambino Gesù, Roma
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48
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Fryns JP, Lemaire J, Timmermans J, Soekarman D, Van den Berghe H. The association of hemifacial microsomia, homolateral micro/anophthalmos, hemihypotrophy, dental anomalies, submucous cleft palate, CNS malformations and hypopigmented skin lesions following Blaschko's lines in two unrelated female patients. Further evidence for a lethal mutation surviving in mosaic form in "hypomelanosis of Ito". Genet Couns 1993; 4:63-67. [PMID: 8471224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- J P Fryns
- Centre for Human Genetics, University of Leuven, Belgium
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49
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Abstract
Congenital anophthalmia (CA) is a rare malformation. Primary forms without development of optic nerves can be differentiated from secondary forms with rudimentary optic nerves and eye bulbi. Neuroradiologic examinations in these children are performed to differentiate primary from secondary forms and to exclude associated cerebral malformations. We report on 2 children with secondary CA, a 9-month-old girl with unilateral CA and a 3-year-old boy with bilateral CA. Magnetic resonance imaging (MRI) was superior to computerized tomography (CT) in the delineation of the rudimentary optic nerves and tracts as well as the intraorbital contents. In addition magnetic resonance images revealed partial agenesis of the corpus callosum and microgyria of the calcarine cortex in the boy. These results suggest that MRI should replace CT in the diagnosis of CA.
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Affiliation(s)
- F Daxecker
- Department of Ophthalmology, University of Innsbruck, Austria
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50
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Arroyo I, García MJ, Cimadevilla CE, Carretero V, Bermejo E, Martínez-Frías ML. Bilateral anophthalmia, esophageal atresia, and right cryptorchidism: A new entity? ACTA ACUST UNITED AC 1992; 43:686-7. [PMID: 1352427 DOI: 10.1002/ajmg.1320430406] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We report on a child with bilateral anophthalmia, esophageal atresia, and cryptorchidism. This is the first case observed in the Spanish Collaborative Study of Congenital Malformations (ECEMC) with this constellation of congenital anomalies, and it is similar to that described in 1988 by Rogers. We think that it may constitute a new syndrome.
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Affiliation(s)
- I Arroyo
- Division of Neonatology, San Pedro de Alcántara Hospital, Cáceres, Spain
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