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Patterson K, Chong JX, Chung DD, Lisch W, Karp CL, Dreisler E, Lockington D, Rohrbach JM, Garczarczyk-Asim D, Müller T, Tuft SJ, Skalicka P, Wilnai Y, Samra NN, Ibrahim A, Mandel H, Davidson AE, Liskova P, Aldave AJ, Bamshad MJ, Janecke AR. Lisch Epithelial Corneal Dystrophy Is Caused by Heterozygous Loss-of-Function Variants in MCOLN1. Am J Ophthalmol 2024; 258:183-195. [PMID: 37972748 DOI: 10.1016/j.ajo.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE To report the genetic etiology of Lisch epithelial corneal dystrophy (LECD). DESIGN Multicenter cohort study. METHODS A discovery cohort of 27 individuals with LECD from 17 families, including 7 affected members from the original LECD family, 6 patients from 2 new families and 14 simplex cases, was recruited. A cohort of 6 individuals carrying a pathogenic MCOLN1 (mucolipin 1) variant was reviewed for signs of LECD. Next-generation sequencing or targeted Sanger sequencing were used in all patients to identify pathogenic or likely pathogenic variants and penetrance of variants. RESULTS Nine rare heterozygous MCOLN1 variants were identified in 23 of 27 affected individuals from 13 families. The truncating nature of 7 variants and functional testing of 1 missense variant indicated that they result in MCOLN1 haploinsufficiency. Importantly, in the homozygous and compound-heterozygous state, 4 of 9 LECD-associated variants cause the rare lysosomal storage disorder mucolipidosis IV (MLIV). Autosomal recessive MLIV is a systemic disease and comprises neurodegeneration as well as corneal opacity of infantile-onset with epithelial autofluorescent lysosomal inclusions. However, the 6 parents of 3 patients with MLIV confirmed to carry pathogenic MCOLN1 variants did not have the LECD phenotype, suggesting MCOLN1 haploinsufficiency may be associated with reduced penetrance and variable expressivity. CONCLUSIONS MCOLN1 haploinsufficiency is the major cause of LECD. Based on the overlapping clinical features of corneal epithelial cells with autofluorescent inclusions reported in both LECD and MLIV, it is concluded that some carriers of MCOLN1 haploinsufficiency-causing variants present with LECD.
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Affiliation(s)
- Karynne Patterson
- From the Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA (K.P., M.J.B.)
| | - Jessica X Chong
- Department of Pediatrics and Brotman-Baty Institute for Precision Medicine, University of Washington, Seattle, WA 98195, USA (J.X.C.)
| | - Doug D Chung
- Department of Ophthalmology, Stein Eye Institute, David Geffen School of Medicine, UCLA, Los Angeles, CA 90095, USA (D.D.C., A.J.A.)
| | - Walter Lisch
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg- University Mainz, 55131 Mainz, Germany (W.L.)
| | - Carol L Karp
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller, School of Medicine, Miami, USA (C.L.K.)
| | - Erling Dreisler
- Independent scholar, N.Jespersensvej 3, DK-2000 Copenhagen, Frederiksberg, Denmark (E.D.)
| | - David Lockington
- Tennent Institute of Ophthalmology, NHS Greater Glasgow and Clyde, Gartnavel General Hospital, 1053 Great Western Road, Glasgow, G12 0YN, UK (D.L.)
| | - Jens M Rohrbach
- Universitäts-Augenklinik, Elfriede-Aulhorn-Str. 7, 72076, Tübingen, Deutschland (J.M.R.)
| | - Dorota Garczarczyk-Asim
- Department of Pediatrics I, Medical University of Innsbruck, 6020 Innsbruck, Austria (D.G.-A., T.M., A.R.J.)
| | - Thomas Müller
- Department of Pediatrics I, Medical University of Innsbruck, 6020 Innsbruck, Austria (D.G.-A., T.M., A.R.J.)
| | - Stephen J Tuft
- Moorfields eye hospital NHS foundation trust, London, UK (S.J.T.); UCL Institute of Ophthalmology, 11-43 Bath Street, London EC1V 9EL, UK (A.E.D.)
| | - Pavlina Skalicka
- Department of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic (P.S., P.L.)
| | - Yael Wilnai
- Genetic Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel (Y.W.)
| | - Nadra Naser Samra
- Genetic Unit, Sieff hospital, Bar Ilan University Faculty of Medicine, Safed, Israel (N.N.S.)
| | - Ali Ibrahim
- Ophthalmology unit, Maccabi and Clalit Health Services, Magdal Shams Medical center, Golan Heights, Israel (A.I.)
| | - Hanna Mandel
- Pediatric Metabolic Clinic, Sieff hospital, Bar Ilan University Faculty of Medicine, Safed, Israel (H.M.)
| | - Alice E Davidson
- UCL Institute of Ophthalmology, 11-43 Bath Street, London EC1V 9EL, UK (A.E.D.)
| | - Petra Liskova
- Department of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic (P.S., P.L.); Department of Paediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic (P.S.,P.L.)
| | - Anthony J Aldave
- Department of Ophthalmology, Stein Eye Institute, David Geffen School of Medicine, UCLA, Los Angeles, CA 90095, USA (D.D.C., A.J.A.)
| | - Michael J Bamshad
- From the Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA (K.P., M.J.B.); Department of Pediatrics and Brotman-Baty Institute for Precision Medicine, University of Washington, Seattle, WA 98195, USA (J.X.C.)
| | - Andreas R Janecke
- Department of Pediatrics I, Medical University of Innsbruck, 6020 Innsbruck, Austria (D.G.-A., T.M., A.R.J.); Division of Human Genetics, Medical University of Innsbruck, 6020 Innsbruck, Austria (A.R.J.).
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Cano-Ortiz A, Sánchez-Ventosa Á, González Cruces T, Palacín Miranda E, López Pérez MD, Villarrubia Cuadrado A. Lisch corneal dystrophy: Autologous limbal transplantation as definitive treatment. J Fr Ophtalmol 2023; 46:e91-e92. [PMID: 36577631 DOI: 10.1016/j.jfo.2022.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/08/2022] [Accepted: 07/04/2022] [Indexed: 12/27/2022]
Affiliation(s)
- A Cano-Ortiz
- Department of Anterior Segment, Cornea and Refractive Surgery, Hospital La Arruzafa, avenue de la Arruzafa, 9, 14012 Córdoba, Spain
| | - Á Sánchez-Ventosa
- Department of Anterior Segment, Cornea and Refractive Surgery, Hospital La Arruzafa, avenue de la Arruzafa, 9, 14012 Córdoba, Spain
| | - T González Cruces
- Department of Anterior Segment, Cornea and Refractive Surgery, Hospital La Arruzafa, avenue de la Arruzafa, 9, 14012 Córdoba, Spain.
| | - E Palacín Miranda
- Department of Anterior Segment, Cornea and Refractive Surgery, Hospital La Arruzafa, avenue de la Arruzafa, 9, 14012 Córdoba, Spain
| | - M D López Pérez
- Department of Anterior Segment, Cornea and Refractive Surgery, Hospital La Arruzafa, avenue de la Arruzafa, 9, 14012 Córdoba, Spain
| | - A Villarrubia Cuadrado
- Department of Anterior Segment, Cornea and Refractive Surgery, Hospital La Arruzafa, avenue de la Arruzafa, 9, 14012 Córdoba, Spain
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Topical use of alcohol in ophthalmology - Diagnostic and therapeutic indications. Ocul Surf 2021; 21:1-15. [PMID: 33895368 DOI: 10.1016/j.jtos.2021.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 04/14/2021] [Accepted: 04/16/2021] [Indexed: 01/02/2023]
Abstract
Alcohol (ethanol) has been used in medicine since time immemorial. In ophthalmic practice, besides as an antiseptic, it was given as retrobulbar injections to relieve severe ocular pain. Alcohol can be applied topically to the surface of neoplastic or suspicious lesions to kill cells that might desquamate and seed during surgical excision, to treat epithelial ingrowth that can occur following corneal surgeries, particularly laser in situ keratomileusis (LASIK), and to treat superficial infectious keratitis. In view of its ability to achieve a smooth cleavage plane between the epithelium and the Bowman's layer, alcohol-assisted delamination (ALD) of the corneal epithelium has been used widely and effectively for a variety of diagnostic and therapeutic indications, at times delivering both outcomes. Diagnostically, ALD yields an intact epithelial sheet which can be fixed flat to provide excellent orientation for histopathological evaluation. Therapeutically, it is most commonly used to treat recurrent corneal erosion syndrome, where its efficacy is comparable to that of phototherapeutic keratectomy but with several advantages. It has also been used to treat various forms of epithelial/anterior stromal dystrophies, which can obviate or delay the need for corneal transplantation for several years. In addition, ALD is performed in corneal collagen cross-linking and corneal refractive surgery for relatively atraumatic removal of the epithelium. In this review, we aimed to provide a comprehensive overview of the diagnostic and therapeutic use of topical alcohol in ophthalmology, to describe the surgical and fixation techniques of ALD, and to highlight our experience in ALD over the past decade.
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Le Q, Deng SX. The application of human amniotic membrane in the surgical management of limbal stem cell deficiency. Ocul Surf 2019; 17:221-229. [PMID: 30633967 DOI: 10.1016/j.jtos.2019.01.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 11/12/2018] [Accepted: 01/07/2019] [Indexed: 12/31/2022]
Abstract
The application of human amniotic membrane (AM) has a wide spectrum of indications in the treatment of ocular surface disorders. Transplantation of AM has been incorporated routinely as a component of ocular surface reconstruction in a variety of ocular pathologies. The application of human AM can be combined with nearly all types of limbal transplantation in treating limbal stem cell deficiency (LSCD). AM provides support and possible protection to the transplanted limbal tissues and limbal stem cells owing to its mechanical and biological properties, and these properties are thought to enhance the success rate of LSC transplantation. This paper reviews the current literature on the applications of AM in the surgical management of LSCD and summarizes the outcome of different surgical approaches. The current literature contains mostly low-level evidences in supporting the role of AM. The efficacy of AM in LSC transplantation needs to be confirmed by randomized controlled clinical trials.
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Affiliation(s)
- Qihua Le
- Stein Eye Institute, Cornea Division, David Geffen School of Medicine, University of California, Los Angeles, USA; Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai 200031, China
| | - Sophie X Deng
- Stein Eye Institute, Cornea Division, David Geffen School of Medicine, University of California, Los Angeles, USA.
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