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Correia Barão R, Santos M, Marques RE, Quintas AM, Guerra P. Keratoconus tomographic indices in osteogenesis imperfecta. Graefes Arch Clin Exp Ophthalmol 2023; 261:2585-2592. [PMID: 37074408 PMCID: PMC10432331 DOI: 10.1007/s00417-023-06059-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/28/2023] [Accepted: 04/04/2023] [Indexed: 04/20/2023] Open
Abstract
PURPOSE Osteogenesis imperfecta (OI) is a rare inherited disease affecting collagen-rich tissues. Ocular complications have been reported such as thin corneas, low ocular rigidity, keratoconus, among others. The purpose of this study is to characterize corneal tomographic features in OI patients compared to unaffected patients, with particular focus on commonly studied keratoconus indices. METHODS Cross-sectional case-control study including 37 OI patients and 37 age-matched controls. Patients and controls underwent comprehensive ophthalmological examination including corneal Scheimpflug tomography with a Pentacam HR device (Oculus Optikgeräte GmbH, Wetzlar, Germany) to analyse and compare topometric, tomographic, pachymetric and Belin-Ambrósio Enhanced Ectasia Display III (BAD-D) data of both eyes of each patient. RESULTS Most OI patients had type I disease (n = 24; 65%) but type III-VII patients were also included. Two patients had clinically overt bilateral keratoconus. OI patients had significantly higher maximum keratometry (45.2 ± 2.1 vs. 43.7 ± 1.2; p = 0.0416), front and back elevation (3.0 ± 3.3 vs. 2.1 ± 1.3, p = 0.0201; 11.1 ± 8.2 vs. 5.0 ± 3.7, p < 0.0001), index of surface variance (25.5 ± 13 vs. 17.4 ± 8.3; p = 0.0016), index of vertical asymmetry (0.21 ± 0.14 vs. 0.15 ± 0.06; p = 0.0215), index of height asymmetry (9.2 ± 14 vs. 6.0 ± 4.5; p = 0.0421), index of height decentration (0.02 ± 0.01 vs. 0.01 ± 0.01; p < 0.0001) and average pachymetric progression (1.01 ± 0.19 vs. 0.88 ± 0.14; p < 0.0001) readings. Thinnest corneal thickness and maximum Ambrósio relational thickness were significantly lower (477 ± 52 vs. 543 ± 26; 387 ± 95 vs. 509 ± 49; p < 0.0001). Two-thirds of OI patients had corneas with a minimum thickness < 500 µm. BAD-D value was significantly higher in OI patients (2.1 ± 1.4 vs. 0.9 ± 0.2; p < 0.0001). CONCLUSION OI patients showed significant changes in corneal profiles compared with healthy subjects. A high proportion of patients had tomographically suspect corneas when using keratoconus diagnostic indices. Further studies are warranted to assess the true risk of corneal ectasia in OI patients.
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Affiliation(s)
- Rafael Correia Barão
- Department of Ophthalmology, Hospital de Santa Maria, CHULN, Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal.
- Visual Sciences Study Center, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
| | - Miguel Santos
- Department of Ophthalmology, Hospital de Santa Maria, CHULN, Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal
| | - Raquel Esteves Marques
- Visual Sciences Study Center, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Ana Miguel Quintas
- Department of Ophthalmology, Hospital de Santa Maria, CHULN, Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal
- Visual Sciences Study Center, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Paulo Guerra
- Department of Ophthalmology, Hospital de Santa Maria, CHULN, Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal
- Visual Sciences Study Center, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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Ling C, Zhang D, Zhang J, Sun H, Du Q, Li X. Updates on the molecular genetics of primary congenital glaucoma (Review). Exp Ther Med 2020; 20:968-977. [PMID: 32742340 PMCID: PMC7388405 DOI: 10.3892/etm.2020.8767] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 04/01/2020] [Indexed: 12/14/2022] Open
Abstract
Primary congenital glaucoma (PCG) is one of the primary causes of blindness in children and is characterized by congenital trabecular meshwork and anterior chamber angle dysplasia. While being a rare condition, PCG severely impairs the quality of life of affected patients. However, the pathogenesis of PCG remains to be fully elucidated. It has previously been indicated that genetic factors serve a critical role in the pathogenesis of PCG, although patients with PCG exhibit significant genetic heterogeneity. Mutations in the cytochrome P450 family 1 subfamily B member 1 gene have been implicated in PCG and further genes that have been reported to be involved in PCG are myocilin, forkhead box C1, collagen type I α1 chain and latent transforming growth factor β binding protein 2. The present review aims to provide an up to date understanding of the genes associated with PCG and the use of molecular technologies in the identification of such genes and mutations. This may pave the way for the development of preventative methods, early diagnosis and improved therapeutic strategies in PCG.
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Affiliation(s)
- Chen Ling
- Sichuan Provincial Key Laboratory for Genetic Disease, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 611731, P.R. China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, 610072, P.R. China
| | - Dingding Zhang
- Sichuan Provincial Key Laboratory for Genetic Disease, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 611731, P.R. China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, 610072, P.R. China
| | - Jing Zhang
- Department of Thoracic Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan 611731, P.R. China
| | - Huanxin Sun
- Department of Immunology, North Sichuan Medical College, Nanchong, Sichuan 637100, P.R. China
| | - Qiu Du
- College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610072, P.R. China
| | - Xuefei Li
- College of Medical Technology, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610072, P.R. China
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Hald JD, Folkestad L, Swan CZ, Wanscher J, Schmidt M, Gjørup H, Haubek D, Leonhard CH, Larsen DA, Hjortdal JØ, Harsløf T, Duno M, Lund AM, Jensen JEB, Brixen K, Langdahl B. Osteogenesis imperfecta and the teeth, eyes, and ears-a study of non-skeletal phenotypes in adults. Osteoporos Int 2018; 29:2781-2789. [PMID: 30143849 DOI: 10.1007/s00198-018-4663-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 08/12/2018] [Indexed: 12/11/2022]
Abstract
UNLABELLED Osteogenesis imperfecta (OI) is a disease causing bone fragility; however, it potentially affects all organs with a high content of collagen, including ears, teeth, and eyes. The study is cross-sectional and compares non-skeletal characteristics in adults with OI that clinicians should be aware of when caring for patients with OI. INTRODUCTION Osteogenesis imperfecta (OI) is a hereditary connective tissue disorder. The skeletal fragility is pronounced; however, OI leads to a number of extra-skeletal symptoms related to the ubiquity of collagen type 1 throughout the human body. The vast majority of knowledge is derived from studies performed in the pediatric population. Thus, we aimed to investigate the nature and prevalence of ophthalmologic, odontologic, and otologic phenotypes in an adult population with OI. METHODS The study population comprises 85 Danish OI patients (age 44.9 ± 15.9 years). Fifty-eight patients had OI type I, 12 OI type III, and 15 OI type IV according to the classification by Sillence. Audiometric evaluations and dental examinations were performed in 62 and 73 patients, respectively. Ophthalmologic investigations were performed in 64 patients, including measurements of the central corneal thickness. RESULTS All patients, except two, had corneal thickness below the normal reference value. Patients with OI type I and patients with a quantitative collagen defect had thinner corneas compared to patients with OI type III and other patients with a qualitative collagen defect. One patient in this cohort was diagnosed with and treated for acute glaucoma. Dentinogenesis imperfecta was diagnosed in one fourth of the patients, based on clinical and radiographic findings. This condition was predominately seen in patients with moderate to severe OI. Hearing loss requiring treatment was found in 15 of 62 patients, of whom three were untreated. The most prevalent type of hearing loss (HL) was sensorineural hearing loss, whereas conductive HL was solely seen in patients with OI type III. The patients with the most severe degrees of HL were patients with mild forms of OI. Age was associated with increased HL. CONCLUSION Although significant health problems outside the skeleton are frequent in adult patients with OI, the patients are not consistently monitored and treated for their symptoms. Clinicians treating adult patients with OI should be aware of non-skeletal health issues and consider including regular interdisciplinary check-ups in the management plan for adult OI patients.
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Affiliation(s)
- J D Hald
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, DK-8200, Aarhus N, Denmark.
| | - L Folkestad
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - C Z Swan
- Department of Otorhinolaryngology and Head & Neck Surgery, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - J Wanscher
- Department of ENT Head and Neck Surgery, Odense University Hospital, Odense, Denmark
| | - M Schmidt
- Section for Pediatric Dentistry, Department of Dentistry and Oral Health, Health, Aarhus University, Aarhus, Denmark
| | - H Gjørup
- Centre of Oral Health in Rare Diseases, Department of Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - D Haubek
- Section for Pediatric Dentistry, Department of Dentistry and Oral Health, Health, Aarhus University, Aarhus, Denmark
| | - C-H Leonhard
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - D A Larsen
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - J Ø Hjortdal
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - T Harsløf
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, DK-8200, Aarhus N, Denmark
| | - M Duno
- Centre for Inherited Metabolic Diseases, Departments of Paediatrics and Clinical Genetics, Rigshospitalet, Copenhagen, Denmark
| | - A M Lund
- Centre for Inherited Metabolic Diseases, Departments of Paediatrics and Clinical Genetics, Rigshospitalet, Copenhagen, Denmark
| | - J-E B Jensen
- Department of Endocrinology, Hvidovre Hospital, Hvidovre, Denmark
| | - K Brixen
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - B Langdahl
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, DK-8200, Aarhus N, Denmark
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Mauri L, Uebe S, Sticht H, Vossmerbaeumer U, Weisschuh N, Manfredini E, Maselli E, Patrosso M, Weinreb RN, Penco S, Reis A, Pasutto F. Expanding the clinical spectrum of COL1A1 mutations in different forms of glaucoma. Orphanet J Rare Dis 2016; 11:108. [PMID: 27484908 PMCID: PMC4970237 DOI: 10.1186/s13023-016-0495-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 07/28/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primary congenital glaucoma (PCG) and early onset glaucomas are one of the major causes of children and young adult blindness worldwide. Both autosomal recessive and dominant inheritance have been described with involvement of several genes including CYP1B1, FOXC1, PITX2, MYOC and PAX6. However, mutations in these genes explain only a small fraction of cases suggesting the presence of further candidate genes. METHODS To elucidate further genetic causes of these conditions whole exome sequencing (WES) was performed in an Italian patient, diagnosed with PCG and retinal detachment, and his unaffected parents. Sanger sequencing of the complete coding region of COL1A1 was performed in a total of 26 further patients diagnosed with PCG or early onset glaucoma. Exclusion of pathogenic variations in known glaucoma genes as CYP1B1, MYOC, FOXC1, PITX2 and PAX6 was additionally done per Sanger sequencing and Multiple Ligation-dependent Probe Amplification (MLPA) analysis. RESULTS In the patient diagnosed with PCG and retinal detachment, analysis of WES data identified compound heterozygous variants in COL1A1 (p.Met264Leu; p.Ala1083Thr). Targeted COL1A1 screening of 26 additional patients detected three further heterozygous variants (p.Arg253*, p.Gly767Ser and p.Gly154Val) in three distinct subjects: two of them diagnosed with early onset glaucoma and mild form of osteogenesis imperfecta (OI), one patient with a diagnosis of PCG at age 4 years. All five variants affected evolutionary, highly conserved amino acids indicating important functional restrictions. Molecular modeling predicted that the heterozygous variants are dominant in effect and affect protein stability and thus the amount of available protein, while the compound heterozygous variants act as recessive alleles and impair binding affinity to two main COL1A1 binding proteins: Hsp47 and fibronectin. CONCLUSIONS Dominant inherited mutations in COL1A1 are known causes of connective tissues disorders such as OI. These disorders are also associated with different ocular abnormalities, although recognition of the common pathology for both features is seldom being recognized. Our results expand the role of COL1A1 mutations in different forms of early-onset glaucoma with and without signs of OI. Thus, we suggest including COL1A1 mutation screening in the genetic work-up of glaucoma cases and detailed ophthalmic examinations with fundus analysis in patients with OI.
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Affiliation(s)
- Lucia Mauri
- Medical Genetics, A.O. Niguarda Ca'Granda Hospital, Milan, Italy
| | - Steffen Uebe
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Heinrich Sticht
- Bioinformatics, Institute of Biochemistry, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Urs Vossmerbaeumer
- Augenklinik und Poliklinik, Joahnnes Gutenberg-Universität Mainz, Mainz, Germany
| | - Nicole Weisschuh
- Molecular Genetics Laboratory, Institute for Ophthalmic Research, Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany
| | | | | | | | | | - Silvana Penco
- Medical Genetics, A.O. Niguarda Ca'Granda Hospital, Milan, Italy
| | - André Reis
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Francesca Pasutto
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
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