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Kim DA, Kim J. Ophthalmic findings in Cohen syndrome patient without subjective ophthalmic complaints: A case report. Medicine (Baltimore) 2023; 102:e35945. [PMID: 37986394 PMCID: PMC10659637 DOI: 10.1097/md.0000000000035945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/13/2023] [Indexed: 11/22/2023] Open
Abstract
RATIONALE Cohen syndrome is a rare genetic disorder that can cause various symptoms, including ophthalmic manifestations that can significantly impact a patient's visual health and quality of life. PATIENT CONCERNS We present the case of a 12-year-old boy diagnosed with Cohen syndrome who exhibited retinal degeneration and macular edema but could not express ophthalmic symptoms due to a developmental disability. DIAGNOSES The patient was diagnosed with Cohen syndrome by a heterozygous mutation in the VPS13B gene by whole exome sequencing and referred to ophthalmology for an ophthalmic examination. INTERVENTION Ophthalmologic tests, including visual acuity, intraocular pressure, slit lamp examination, fundus photography, and optical coherence tomography, were performed. OUTCOMES Visual acuity and intraocular pressure were not measured due to poor cooperation, and no abnormal findings were observed on the slit lamp examination. However, peripheral retinal degeneration was observed in the fundus examination, and cystoid macular edema was observed in both eyes on optical coherence tomography. LESSONS Regular ophthalmologic examination is important for patients with Cohen syndrome, especially those with developmental disabilities who may not be able to express their symptoms. Clinicians should be aware of the potential ophthalmologic manifestations of Cohen syndrome and the importance of timely diagnosis and management.
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Affiliation(s)
- Do Ah Kim
- Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Joonhyung Kim
- Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
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Kehinde TA, Bhatia A, Olarewaju B, Shoaib MZ, Mousa J, Osundiji MA. Syndromic obesity with neurodevelopmental delay: Opportunities for targeted interventions. Eur J Med Genet 2022; 65:104443. [DOI: 10.1016/j.ejmg.2022.104443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/09/2022] [Accepted: 01/22/2022] [Indexed: 01/01/2023]
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Gabrielle PH, Faivre L, Audo I, Zanlonghi X, Dollfus H, Thiadens AAHJ, Zeitz C, Mancini GMS, Perdomo Y, Mohand-Saïd S, Lizé E, Lhussiez V, Nandrot EF, Acar N, Creuzot-Garcher C, Sahel JA, Ansar M, Thauvin-Robinet C, Duplomb L, Da Costa R. Cystoid maculopathy is a frequent feature of Cohen syndrome-associated retinopathy. Sci Rep 2021; 11:16412. [PMID: 34385517 PMCID: PMC8361024 DOI: 10.1038/s41598-021-95743-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/30/2021] [Indexed: 01/14/2023] Open
Abstract
Cohen syndrome (CS) is a rare syndromic form of rod-cone dystrophy. Recent case reports have suggested that cystoid maculopathy (CM) could affect CS patients with an early onset and high prevalence. Our study aims at improving our understanding and management of CM in CS patients through a retrospective case series of ten CS patients with identified pathogenic variants in VPS13B. Longitudinal optical coherence tomography (OCT) imaging was performed and treatment with carbonic anhydrase inhibitors (CAI) was provided to reduce the volume of cystoid spaces. CM affected eight out of ten patients in our cohort. The youngest patient showed a strong progression of macular cysts from the age of 4.5 to 5 years despite oral CAI medication. Other teenage and young adult patients showed stable macular cysts with and without treatment. One patient showed a moderate decrease of cystoid spaces in the absence of treatment at 22 years of age. Through a correlative analysis we found that the volume of cystoid spaces was positively correlated to the thickness of peripheral and macular photoreceptor-related layers. This study suggests that CAI treatments may not suffice to improve CM in CS patients, and that CM may resolve spontaneously during adulthood as photoreceptor dystrophy progresses.
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Affiliation(s)
- Pierre-Henry Gabrielle
- Department of Ophthalmology, University Hospital, 14 rue Paul Gaffarel, 21079, Dijon, France
| | - Laurence Faivre
- Inserm, UMR1231, Equipe GAD, Université de Bourgogne Franche Comté, Bâtiment B3, 15 Boulevard du Maréchal de Lattre de Tassigny, 21079, Dijon Cedex, France.,FHU TRANSLAD, CHU Dijon, 21000, Dijon, France.,Centre de Référence Anomalies du Développement et Syndromes Malformatifs, CHU Dijon, 21000, Dijon, France
| | - Isabelle Audo
- Sorbonne Université, INSERM, CNRS, Institut de La Vision, 17 rue Moreau, 75012, Paris, France.,CHNO Des Quinze-Vingts, DHU Sight Restore, INSERM-DGOS CIC 1423, 75012, Paris, France
| | - Xavier Zanlonghi
- Maladies Rares, Service d'Ophtalmologie, CHU Rennes, 2 rue Henri Le Guilloux, 35033, Rennes, France
| | - Hélène Dollfus
- Centre de Référence Pour Les Affections Rares en Génétique Ophtalmologique (CARGO), FSMR SENSGENE, ERN-EYE, Hôpitaux Universitaires de Strasbourg, 67000, Strasbourg, France.,Laboratoire de Génétique Médicale, Inserm, UMR1112, Institut de Génétique Médicale D'Alsace, Université de Strasbourg, 67000, Strasbourg, France
| | | | - Christina Zeitz
- Sorbonne Université, INSERM, CNRS, Institut de La Vision, 17 rue Moreau, 75012, Paris, France
| | - Grazia M S Mancini
- Department of Clinical Genetics, Erasmus MC, 3015, Rotterdam, The Netherlands
| | - Yaumara Perdomo
- Centre de Référence Pour Les Affections Rares en Génétique Ophtalmologique (CARGO), FSMR SENSGENE, ERN-EYE, Hôpitaux Universitaires de Strasbourg, 67000, Strasbourg, France.,Laboratoire de Génétique Médicale, Inserm, UMR1112, Institut de Génétique Médicale D'Alsace, Université de Strasbourg, 67000, Strasbourg, France
| | - Saddek Mohand-Saïd
- Sorbonne Université, INSERM, CNRS, Institut de La Vision, 17 rue Moreau, 75012, Paris, France.,CHNO Des Quinze-Vingts, DHU Sight Restore, INSERM-DGOS CIC 1423, 75012, Paris, France
| | - Eléonore Lizé
- Inserm, UMR1231, Equipe GAD, Université de Bourgogne Franche Comté, Bâtiment B3, 15 Boulevard du Maréchal de Lattre de Tassigny, 21079, Dijon Cedex, France
| | - Vincent Lhussiez
- Inserm, UMR1231, Equipe GAD, Université de Bourgogne Franche Comté, Bâtiment B3, 15 Boulevard du Maréchal de Lattre de Tassigny, 21079, Dijon Cedex, France
| | - Emeline F Nandrot
- Sorbonne Université, INSERM, CNRS, Institut de La Vision, 17 rue Moreau, 75012, Paris, France
| | - Niyazi Acar
- Centre Des Sciences du Goût Et de L'Alimentation, AgroSup Dijon, CNRS, INRA, Université Bourgogne Franche-Comté, 9E Boulevard Jeanne d'Arc, 21000, Dijon, France
| | - Catherine Creuzot-Garcher
- Department of Ophthalmology, University Hospital, 14 rue Paul Gaffarel, 21079, Dijon, France.,Centre Des Sciences du Goût Et de L'Alimentation, AgroSup Dijon, CNRS, INRA, Université Bourgogne Franche-Comté, 9E Boulevard Jeanne d'Arc, 21000, Dijon, France
| | - José-Alain Sahel
- Sorbonne Université, INSERM, CNRS, Institut de La Vision, 17 rue Moreau, 75012, Paris, France.,CHNO Des Quinze-Vingts, DHU Sight Restore, INSERM-DGOS CIC 1423, 75012, Paris, France.,Department of Ophthalmology, The University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Muhammad Ansar
- Institute of Molecular and Clinical Ophthalmology Basel, 4031, Basel, Switzerland.,Department of Ophthalmology, Jules-Gonin Eye Hospital, University of Lausanne, 1004, Lausanne, Switzerland
| | - Christel Thauvin-Robinet
- Inserm, UMR1231, Equipe GAD, Université de Bourgogne Franche Comté, Bâtiment B3, 15 Boulevard du Maréchal de Lattre de Tassigny, 21079, Dijon Cedex, France.,FHU TRANSLAD, CHU Dijon, 21000, Dijon, France.,Centre de Référence Déficiences Intellectuelles de Causes Rares, CHU Dijon, 21000, Dijon, France
| | - Laurence Duplomb
- Inserm, UMR1231, Equipe GAD, Université de Bourgogne Franche Comté, Bâtiment B3, 15 Boulevard du Maréchal de Lattre de Tassigny, 21079, Dijon Cedex, France.,FHU TRANSLAD, CHU Dijon, 21000, Dijon, France
| | - Romain Da Costa
- Inserm, UMR1231, Equipe GAD, Université de Bourgogne Franche Comté, Bâtiment B3, 15 Boulevard du Maréchal de Lattre de Tassigny, 21079, Dijon Cedex, France. .,FHU TRANSLAD, CHU Dijon, 21000, Dijon, France.
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Sevik MO, Aykut A, Şahin Ö. Resolution of cystoid macular edema with topical carbonic anhydrase inhibitor in a patient with retinal dystrophy associated with Cohen syndrome. Ophthalmic Genet 2021; 42:619-623. [PMID: 33974487 DOI: 10.1080/13816810.2021.1925928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Cohen Syndrome (CS) is an autosomal recessive multisystemic disorder characterized by various ophthalmologic findings, including retinal dystrophy and associated cystoid macular edema (CME), in which there was no known effective treatment approach.Material and Methods: We describe a CS patient with a homozygous c.62 T > G, p.(Leu21*) mutation in the VPS13B gene with a topical carbonic anhydrase inhibitor (CAI; brinzolamide %1, thrice daily) responding CME.Case Description: A seven-year-old girl with an established diagnosis of CS was referred with a primary complaint of nyctalopia. On ophthalmologic examination, bilateral decreased visual acuity and normal-appearing macula with mild optic disc pallor were present. However, the detailed evaluation revealed bilateral blunted foveal reflexes, barely visible foveal pigmentation, and slightly attenuated retinal vessels without any peripheral retinal pigmentary changes in dilated fundus examination, and CME on optical coherence tomography. Bilateral topical brinzolamide thrice daily was initiated for CME. Visual acuity increased, and CME was resolved except for minimal schisis at the inner nuclear layer level at the third-month follow-up visit and remained stable up to one-year follow-up. CME reappeared after five months of self-discontinuation of the patient's therapy but resolved again with treatment resumption.Conclusion: We report the first case of CME secondary to rod-cone dystrophy associated with CS showing improvement in anatomy and visual acuity with a topical CAI.
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Affiliation(s)
- Mehmet Orkun Sevik
- Department of Ophthalmology, Marmara University School of Medicine, Istanbul, Turkey
| | - Aslan Aykut
- Department of Ophthalmology, Marmara University School of Medicine, Istanbul, Turkey
| | - Özlem Şahin
- Department of Ophthalmology, Marmara University School of Medicine, Istanbul, Turkey
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Diverse Genetic Landscape of Suspected Retinitis Pigmentosa in a Large Korean Cohort. Genes (Basel) 2021; 12:genes12050675. [PMID: 33946315 PMCID: PMC8146864 DOI: 10.3390/genes12050675] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/27/2021] [Accepted: 04/27/2021] [Indexed: 12/29/2022] Open
Abstract
We conducted targeted next-generation sequencing (TGS) and/or whole exome sequencing (WES) to assess the genetic profiles of clinically suspected retinitis pigmentosa (RP) in the Korean population. A cohort of 279 unrelated Korean patients with clinically diagnosed RP and available family members underwent molecular analyses using TGS consisting of 88 RP-causing genes and/or WES with clinical variant interpretation. The combined genetic tests (TGS and/or WES) found a mutation in the 44 RP-causing genes and seven inherited retinal disease (IRD)-causing genes, and the total mutation detection rate was 57%. The mutation detection rate was higher in patients who experienced visual deterioration at a younger age (75.4%, age of symptom onset under 10 years) and who had a family history of RP (70.7%). The most common causative genes were EYS (8.2%), USH2A (6.8%), and PDE6B (4.7%), but mutations were dispersed among the 51 RP/IRD genes generally. Meanwhile, the PDE6B mutation was the most common in patients experiencing initial symptoms in their first decade, EYS in their second to third decades, and USH2A in their fifth decades and older. Of note, WES revealed some unexpected genotypes: ABCC6, CHM, CYP4V2, RS1, TGFBI, VPS13B, and WDR19, which were verified by ophthalmological re-phenotyping.
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Ocular involvement in two siblings with Cohen's syndrome. J Fr Ophtalmol 2021; 44:e437-e440. [PMID: 33814305 DOI: 10.1016/j.jfo.2020.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 10/12/2020] [Accepted: 10/21/2020] [Indexed: 11/22/2022]
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Lhussiez V, Dubus E, Cesar Q, Acar N, Nandrot EF, Simonutti M, Audo I, Lizé E, Nguyen S, Geissler A, Bouchot A, Ansar M, Picaud S, Thauvin-Robinet C, Olivier-Faivre L, Duplomb L, Da Costa R. Cohen Syndrome-Associated Cataract Is Explained by VPS13B Functions in Lens Homeostasis and Is Modified by Additional Genetic Factors. Invest Ophthalmol Vis Sci 2021; 61:18. [PMID: 32915983 PMCID: PMC7488618 DOI: 10.1167/iovs.61.11.18] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Purpose Cohen syndrome (CS) is a rare genetic disorder caused by variants of the VPS13B gene. CS patients are affected with a severe form of retinal dystrophy, and in several cases cataracts also develop. The purpose of this study was to investigate the mechanisms and risk factors for cataract in CS, as well as to report on cataract surgeries in CS patients. Methods To understand how VPS13B is associated with visual impairments in CS, we generated the Vps13b∆Ex3/∆Ex3 mouse model. Mice from 1 to 3 months of age were followed by ophthalmoscopy and slit-lamp examinations. Phenotypes were investigated by histology, immunohistochemistry, and western blot. Literature analysis was performed to determine specific characteristic features of cataract in CS and to identify potential genotype–phenotype correlations. Results Cataracts rapidly developed in 2-month-old knockout mice and were present in almost all lenses at 3 months. Eye fundi appeared normal until cataract development. Lens immunostaining revealed that cataract formation was associated with the appearance of large vacuoles in the cortical area, epithelial–mesenchymal transition, and fibrosis. In later stages, cataracts became hypermature, leading to profound retinal remodeling due to inflammatory events. Literature analysis showed that CS-related cataracts display specific features compared to other forms of retinitis pigmentosa-related cataracts, and their onset is modified by additional genetic factors. Corroboratively, we were able to isolate a subline of the Vps13b∆Ex3/∆Ex3 model with delayed cataract onset. Conclusions VPS13B participates in lens homeostasis, and the CS-related cataract development dynamic is linked to additional genetic factors.
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Affiliation(s)
- Vincent Lhussiez
- INSERM UMR1231, Equipe GAD, Université de Bourgogne Franche Comté, Dijon, France
| | - Elisabeth Dubus
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France.,Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, Dijon, France
| | - Quénol Cesar
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Niyazi Acar
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, Dijon, France
| | - Emeline F Nandrot
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Manuel Simonutti
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Isabelle Audo
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Eléonore Lizé
- INSERM UMR1231, Equipe GAD, Université de Bourgogne Franche Comté, Dijon, France
| | - Sylvie Nguyen
- INSERM UMR1231, Equipe GAD, Université de Bourgogne Franche Comté, Dijon, France
| | - Audrey Geissler
- Plateforme d'Imagerie Cellulaire DImaCell (site CellImaP), INSERM LNC UMR1231, Dijon, France
| | - André Bouchot
- Plateforme d'Imagerie Cellulaire DImaCell (site CellImaP), INSERM LNC UMR1231, Dijon, France
| | - Muhammad Ansar
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland.,Department of Genetic Medicine and Development, University of Geneva Medical School, Geneva, Switzerland
| | - Serge Picaud
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Christel Thauvin-Robinet
- INSERM UMR1231, Equipe GAD, Université de Bourgogne Franche Comté, Dijon, France.,FHU-TRANSLAD, CHU Dijon Bourgogne, Dijon, France.,Centre de Référence Déficiences Intellectuelles de Causes Rares, CHU Dijon Bourgogne, Dijon, France
| | - Laurence Olivier-Faivre
- INSERM UMR1231, Equipe GAD, Université de Bourgogne Franche Comté, Dijon, France.,FHU-TRANSLAD, CHU Dijon Bourgogne, Dijon, France.,Centre de Référence Anomalies du Développement et Syndromes Malformatifs, CHU Dijon Bourgogne, Dijon, France
| | - Laurence Duplomb
- INSERM UMR1231, Equipe GAD, Université de Bourgogne Franche Comté, Dijon, France.,FHU-TRANSLAD, CHU Dijon Bourgogne, Dijon, France
| | - Romain Da Costa
- INSERM UMR1231, Equipe GAD, Université de Bourgogne Franche Comté, Dijon, France.,FHU-TRANSLAD, CHU Dijon Bourgogne, Dijon, France
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Rakusiewicz K, Kanigowska K, Hautz W, Wicher D, Młynek M, Wyszyńska M, Rogowska A, Jędrzejczak-Młodziejewska J, Danowska M, Czeszyk A. Coexistence of bilateral macular edema and pale optic disc in the patient with Cohen syndrome. Open Med (Wars) 2021; 16:156-160. [PMID: 33542958 PMCID: PMC7819545 DOI: 10.1515/med-2021-0208] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 12/12/2020] [Accepted: 12/14/2020] [Indexed: 11/15/2022] Open
Abstract
Background Cohen syndrome (Q87.8;ORPHA:193; OMIM#216550) is an autosomal recessive inherited genetic disorder caused by mutation in the VPS13B/COH1 gene. It is characterized by variable clinical symptoms such as deformity of the head, face, hands and feet, eye abnormalities, abdominal obesity, neutropenia and nonprogressive intellectual disability. The typical lesions in the eyeball in Cohen syndrome include high myopia, retinal dystrophy, strabismus, maculopathy and lens subluxation. The present study describes the coexistence of bilateral macular edema with pale optic disc in a patient with a homozygous deletion in the VPS13B/COH1 gene. Material and methods A 6-year-old Caucasian girl with facial dysmorphism, microcephaly, prominent upper incisors, narrow hands with slender fingers, congenital heart defect and ophthalmic symptoms was subjected to genetic testing. The genetic evaluation revealed a homozygous deletion on the long arm of chromosome 8 encompassing 20-25 exons of the VPS13 gene, as confirmed by Cohen syndrome. She underwent a full ophthalmological examination with the assessment of slit lamp examination of anterior segment and fundoscopy, refraction error, biometry, central corneal thickness and additionally electroretinography, optical coherence tomography and fundus photography. Results In the ophthalmologic examination, the girl had bilateral astigmatism accompanied by myopia and a marked reduction in central corneal thickness. Fundus examination showed pale optic nerve discs and "salt and pepper" retinopathy. Bilateral cystic macular edema was revealed in handheld optical coherence tomography. Electroretinography showed a reduced response amplitude of cones and rods. Conclusion In a patient with high myopia, macular edema, pale optic disc and facial dysmorphism, Cohen syndrome should be considered in the differential diagnosis. The severity of individual clinical features in patients with Cohen syndrome varies. It can be assumed that the type of mutation affects the occurrence and severity of individual symptoms.
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Affiliation(s)
- Klaudia Rakusiewicz
- Department of Pediatric Ophthalmology, Children's Memorial Health Institute, Warsaw, Poland
| | - Krystyna Kanigowska
- Department of Pediatric Ophthalmology, Children's Memorial Health Institute, Warsaw, Poland
| | - Wojciech Hautz
- Department of Pediatric Ophthalmology, Children's Memorial Health Institute, Warsaw, Poland
| | - Dorota Wicher
- Department of Medical Genetics, Children's Memorial Health Institute, Warsaw, Poland
| | - Marlena Młynek
- Department of Medical Genetics, Children's Memorial Health Institute, Warsaw, Poland
| | - Marta Wyszyńska
- Department of Pediatric Ophthalmology, Children's Memorial Health Institute, Warsaw, Poland
| | - Anna Rogowska
- Department of Pediatric Ophthalmology, Children's Memorial Health Institute, Warsaw, Poland
| | | | - Małgorzata Danowska
- Department of Pediatric Ophthalmology, Children's Memorial Health Institute, Warsaw, Poland
| | - Agnieszka Czeszyk
- Department of Pediatric Ophthalmology, Children's Memorial Health Institute, Warsaw, Poland
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Huang LC, Kelly JP, Cabrera MT, Olmos de Koo LC, Weiss AH, Herlihy EP. Optical coherence tomography findings in Cohen syndrome. J AAPOS 2020; 24:306-309. [PMID: 32919079 DOI: 10.1016/j.jaapos.2020.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/06/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
Abstract
Cohen syndrome is a rare disease that causes myopia and retinal degeneration in the setting of developmental delay and characteristic craniofacial features. We report optical coherence tomography (OCT) abnormalities in 4 patients with Cohen syndrome, 2 of whom have longitudinal follow-up. All subjects had schisis-like changes, with cystoid spaces in the inner retina as well as diffuse outer retinal atrophy sparing the subfoveal region. Ophthalmologic findings in 1 patient led to the work-up that resulted in a diagnosis of Cohen syndrome, suggesting that characteristic retinal abnormalities visualized by fundus examination and OCT may represent distinguishing features of this syndrome.
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Affiliation(s)
- Laura C Huang
- Department of Ophthalmology, University of Washington, Seattle, Washington; Division of Pediatric Ophthalmology, Seattle Children's Hospital, Seattle, Washington
| | - John P Kelly
- Department of Ophthalmology, University of Washington, Seattle, Washington; Roger H. Johnson Vision Clinic, Division of Ophthalmology, Seattle Children's Hospital, Seattle, Washington
| | - Michelle T Cabrera
- Department of Ophthalmology, University of Washington, Seattle, Washington; Division of Pediatric Ophthalmology, Seattle Children's Hospital, Seattle, Washington
| | | | - Avery H Weiss
- Department of Ophthalmology, University of Washington, Seattle, Washington; Division of Pediatric Ophthalmology, Seattle Children's Hospital, Seattle, Washington
| | - Erin P Herlihy
- Department of Ophthalmology, University of Washington, Seattle, Washington; Division of Pediatric Ophthalmology, Seattle Children's Hospital, Seattle, Washington.
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A novel VPS13B mutation in Cohen syndrome: a case report and review of literature. BMC MEDICAL GENETICS 2020; 21:140. [PMID: 32605629 PMCID: PMC7325105 DOI: 10.1186/s12881-020-01075-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 06/23/2020] [Indexed: 01/14/2023]
Abstract
Background Cohen syndrome, an autosomal recessive syndrome, is a rare syndrome with diverse clinical manifestations including failure to thrive, hypotonia, hypermobile joints, microcephaly, intellectual disabilities, craniofacial and limb anomalies, neutropenia and a friendly character. It is associated with mutations of the vacuolar protein sorting 13 homolog B (VPS13B) gene, which is involved in the development of the ocular, hematological and central nervous systems. This gene encodes a transmembrane protein playing a crucial role in preserving the integrity of the Golgi complex. To date, more than 150 mutations of VPS13B have been reported in over 200 Cohen syndrome patients. Missense or nonsense mutations are the most common mutations. Case presentation A 4-year-old girl, born to consanguineous parents, was referred to the pediatric clinical immunology outpatient clinic for investigation of recurrent neutropenia with a history of recurrent infections in the past year. On physical examination, she had the characteristic facial features of Cohen syndrome, developmental delay and speech disorder. She had a cheerful disposition, and her mother gave a history of feeding difficulties in her first months of life. She did not present any ophthalmologic or cardiac abnormalities. Her lab results revealed moderate neutropenia. Serum IgG, IgM, IgA and IgE levels were normal. She fulfilled the clinical diagnostic criteria for Cohen syndrome. WES revealed a novel homozygous frameshift variant in VPS13B (LRG_351t1: c.7095del; p.Ser2366AlafsTer49). Currently, she is not experiencing any severe problem, and she undergoes irregular medical treatment once her neutrophil count decreases under the normal limit. Her verbal and motor abilities have improved as a result of speech and occupational therapies. Conclusion We reported a novel homozygous frameshift variant in VPS13B (LRG_351t1: c.7095del; p.Ser2366AlafsTer49) in a 4-year-old girl with Cohen syndrome. Cohen syndrome should be considered in differential diagnosis of any child with intellectual disability and neutropenia.
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Liles CA, Tensmeyer MS, York JM, Ekanayake LS, Lew J. Cystoid Macular Edema in a 10-Year-Old Boy With Cohen Syndrome. Cureus 2020; 12:e8443. [PMID: 32642357 PMCID: PMC7336604 DOI: 10.7759/cureus.8443] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Cohen syndrome is an extremely rare disease with characteristic somatic and multi-system features that severely affect vision. Ophthalmologists must consider Cohen syndrome when developmental delay, high-grade myopia, and retinal dystrophy are present in a child. Here we report a case of Cohen syndrome in a 10-year-old boy presenting with cystoid macular edema (CME), only the second reported case of its kind. This case illustrates the phenotypic variability that can occur in Cohen syndrome, with rare features in addition to CME including trace posterior subcapsular cataracts, growth hormone deficiency, mild vermian hypoplasia, a nasolacrimal cyst, hearing loss, and high-functioning intelligence quotient (IQ). Our patient did not have an identifiable second mutation even after extensive genetic testing, which raises questions about whether the patient has a novel gene variant for the disease or an autosomal dominant mode of inheritance exists for Cohen syndrome. In addition to peripheral vision loss, the rare appearance of macular edema can threaten the remaining vision and requires intervention. This case also demonstrates that, without a high index of suspicion, there can be considerable delay in diagnosing Cohen syndrome. Though little is known about the prevalence of many of the clinical features seen in our case in the Cohen syndrome population, this case raises awareness of the syndrome and the need to recognize various clinical features, perform genetic testing, and direct appropriate treatment to prevent complications and help improve quality of life.
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Affiliation(s)
- Caleb A Liles
- Ophthalmology, Ohio University Heritage College of Osteopathic Medicine, Athens, USA
| | - Michael S Tensmeyer
- Neuroscience, Ohio University Heritage College of Osteopathic Medicine, Athens, USA
| | - Justin M York
- General Surgery, Ohio University Heritage College of Osteopathic Medicine, Athens, USA
| | - Lakmal S Ekanayake
- Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, USA
| | - Julie Lew
- Ophthalmology, Holzer Health System, Athens, USA
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12
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Nasser F, Kurtenbach A, Biskup S, Weidensee S, Kohl S, Zrenner E. Ophthalmic features of retinitis pigmentosa in Cohen syndrome caused by pathogenic variants in the VPS13B gene. Acta Ophthalmol 2020; 98:e316-e321. [PMID: 31580008 DOI: 10.1111/aos.14255] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 09/06/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE The aim of this study is to report on the phenotype and genotype of five patients diagnosed with Cohen syndrome, an extremely rare autosomal recessive disorder manifesting with mental and physiological defects. METHODS Five patients from three German families and one Syrian family underwent a comprehensive ophthalmological examination. The scheduled visual acuity measurements, fundus ophthalmoscopy, spectral domain optical coherence tomography (OCT), full-field electrophysiological recordings of scotopic and photopic electroretinograms (ERGs) and colour vision testing could not be carried out in all subjects, because of the mental and physical retardation. The genetic diagnosis was achieved by next-generation sequencing. RESULTS The ophthalmic and systemic phenotype of the patients is typical for Cohen syndrome including myopia, night blindness, photophobia, fundus pigmentary changes and bull's eye maculopathy. Electroretinograms (ERGs) were extinguished in the four patients, whose recording was possible. Genetic testing revealed homozygous or two heterozygous bi-allelic mutations in the VPS13B (COH1) gene in all five patients, with five different allelic variants observed. The homozygous mutation c.6055_6056delGA; p.Asp2019Glnfs*15 in two sibling patients as well as the homozygous nonsense mutation c.8112C>G;p.Tyr2704* have not previously been reported. CONCLUSIONS The phenotype of the five patients reported here is typical for Cohen syndrome; however, their genotype is heterogeneous. Two new allelic variants were found to be the causative mutation.
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Affiliation(s)
- Fadi Nasser
- Centre for Ophthalmology University of Tuebingen Tuebingen Germany
| | - Anne Kurtenbach
- Centre for Ophthalmology University of Tuebingen Tuebingen Germany
| | | | | | - Susanne Kohl
- Centre for Ophthalmology University of Tuebingen Tuebingen Germany
| | - Eberhart Zrenner
- Centre for Ophthalmology University of Tuebingen Tuebingen Germany
- Werner Reichardt Centre for Integrative Neuroscience (CIN) University of Tuebingen Tuebingen Germany
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13
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Defining the clinical phenotype of Saul-Wilson syndrome. Genet Med 2020; 22:857-866. [PMID: 31949312 PMCID: PMC7205587 DOI: 10.1038/s41436-019-0737-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 11/29/2022] Open
Abstract
Purpose: Four patients with Saul-Wilson syndrome were reported between 1982 and 1994, but no additional individuals were described until 2018, when the molecular etiology of the disease was elucidated. Hence, the clinical phenotype of the disease remains poorly defined. We address this shortcoming by providing a detailed characterization of its phenotype. Methods: Retrospective chart reviews were performed and primary radiographs assessed for all 14 individuals. Four individuals underwent detailed ophthalmologic examination by the same physician. Two individuals underwent gynecologic evaluation. Z-scores for height, weight, head circumference and BMI were calculated at different ages. Results: All patients exhibited short stature, with sharp decline from the mean within the first months of life, and a final height Z-score between −4 and −8.5 standard deviations. The facial and radiographic features evolved over time. Intermittent neutropenia was frequently observed. Novel findings included elevation of liver transaminases, skeletal fragility, rod-cone dystrophy, and cystic macular changes. Conclusion: Saul-Wilson syndrome presents a remarkably uniform phenotype, and the comprehensive description of our cohort allows for improved understanding of the long-term morbidity of the condition, establishment of follow-up recommendations for affected individuals, and documentation of the natural history into adulthood for comparison with treated patients, when therapeutics become available.
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14
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Nonleaking cystoid macular edema in Cohen syndrome. J AAPOS 2019; 23:38-39.e1. [PMID: 30144585 DOI: 10.1016/j.jaapos.2018.05.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 04/02/2018] [Accepted: 05/01/2018] [Indexed: 11/27/2022]
Abstract
An 11-year-old girl with a history of neutropenia, developmental delay, hypotonia, and intellectual disability was diagnosed with Cohen syndrome after genetic testing discovered homozygous mutation in the VPS13B gene. She was referred to a retinal specialist with a chief complaint of decreased peripheral vision. On examination, decreased visual acuity, pigmentary changes, and nonleaking cystoid macular edema were present in both eyes.
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15
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Rodrigues JM, Fernandes HD, Caruthers C, Braddock SR, Knutsen AP. Cohen Syndrome: Review of the Literature. Cureus 2018; 10:e3330. [PMID: 30473963 PMCID: PMC6248805 DOI: 10.7759/cureus.3330] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Cohen syndrome was initially described as a syndrome including obesity, hypotonia, mental deficiency, and facial, oral, ocular and limb anomalies. Leukopenia, especially neutropenia, was later described as a feature of Cohen syndrome. Cohen syndrome is caused by an autosomal recessive (AR) mutation of the vacuolar protein sorting 13 homolog B (VPS13B, also referred to as COH1) gene on chromosome 8q22.2.
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Affiliation(s)
- Jonathan M Rodrigues
- Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Bismarck, USA
| | - Hermina D Fernandes
- Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Bismarck, USA
| | | | | | - Alan P Knutsen
- Pediatrics, Saint Louis University School of Medicine, Saint Louis, USA
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16
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Uyhazi KE, Binenbaum G, Carducci N, Zackai EH, Aleman TS. Early photoreceptor outer segment loss and retinoschisis in Cohen syndrome. Ophthalmic Genet 2018; 39:399-404. [DOI: 10.1080/13816810.2018.1459735] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Katherine E. Uyhazi
- Scheie Eye Institute at the Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Gil Binenbaum
- Scheie Eye Institute at the Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Ophthalmology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Nicholas Carducci
- Scheie Eye Institute at the Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Elaine H. Zackai
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Tomas S. Aleman
- Scheie Eye Institute at the Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Ophthalmology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
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17
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Zhao L, Wang F, Wang H, Li Y, Alexander S, Wang K, Willoughby CE, Zaneveld JE, Jiang L, Soens ZT, Earle P, Simpson D, Silvestri G, Chen R. Next-generation sequencing-based molecular diagnosis of 82 retinitis pigmentosa probands from Northern Ireland. Hum Genet 2014; 134:217-30. [PMID: 25472526 DOI: 10.1007/s00439-014-1512-7] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 11/20/2014] [Indexed: 11/24/2022]
Abstract
Retinitis pigmentosa (RP) is a group of inherited retinal disorders characterized by progressive photoreceptor degeneration. An accurate molecular diagnosis is essential for disease characterization and clinical prognoses. A retinal capture panel that enriches 186 known retinal disease genes, including 55 known RP genes, was developed. Targeted next-generation sequencing was performed for a cohort of 82 unrelated RP cases from Northern Ireland, including 46 simplex cases and 36 familial cases. Disease-causing mutations were identified in 49 probands, including 28 simplex cases and 21 familial cases, achieving a solving rate of 60 %. In total, 65 pathogenic mutations were found, and 29 of these were novel. Interestingly, the molecular information of 12 probands was neither consistent with their initial inheritance pattern nor clinical diagnosis. Further clinical reassessment resulted in a refinement of the clinical diagnosis in 11 patients. This is the first study to apply next-generation sequencing-based, comprehensive molecular diagnoses to a large number of RP probands from Northern Ireland. Our study shows that molecular information can aid clinical diagnosis, potentially changing treatment options, current family counseling and management.
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Affiliation(s)
- Li Zhao
- Structural and Computational Biology and Molecular Biophysics, Baylor College of Medicine, Houston, TX, 77030, USA
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18
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Khan AO, Aldahmesh MA, Alsharif H, Alkuraya FS. Recessive Mutations inLEPREL1Underlie a Recognizable Lens Subluxation Phenotype. Ophthalmic Genet 2014; 36:58-63. [DOI: 10.3109/13816810.2014.985847] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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19
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Kuru K, Niranjan M, Tunca Y, Osvank E, Azim T. Biomedical visual data analysis to build an intelligent diagnostic decision support system in medical genetics. Artif Intell Med 2014; 62:105-18. [PMID: 25262492 DOI: 10.1016/j.artmed.2014.08.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Revised: 08/15/2014] [Accepted: 08/16/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND In general, medical geneticists aim to pre-diagnose underlying syndromes based on facial features before performing cytological or molecular analyses where a genotype-phenotype interrelation is possible. However, determining correct genotype-phenotype interrelationships among many syndromes is tedious and labor-intensive, especially for extremely rare syndromes. Thus, a computer-aided system for pre-diagnosis can facilitate effective and efficient decision support, particularly when few similar cases are available, or in remote rural districts where diagnostic knowledge of syndromes is not readily available. METHODS The proposed methodology, visual diagnostic decision support system (visual diagnostic DSS), employs machine learning (ML) algorithms and digital image processing techniques in a hybrid approach for automated diagnosis in medical genetics. This approach uses facial features in reference images of disorders to identify visual genotype-phenotype interrelationships. Our statistical method describes facial image data as principal component features and diagnoses syndromes using these features. RESULTS The proposed system was trained using a real dataset of previously published face images of subjects with syndromes, which provided accurate diagnostic information. The method was tested using a leave-one-out cross-validation scheme with 15 different syndromes, each of comprised 5-9 cases, i.e., 92 cases in total. An accuracy rate of 83% was achieved using this automated diagnosis technique, which was statistically significant (p<0.01). Furthermore, the sensitivity and specificity values were 0.857 and 0.870, respectively. CONCLUSION Our results show that the accurate classification of syndromes is feasible using ML techniques. Thus, a large number of syndromes with characteristic facial anomaly patterns could be diagnosed with similar diagnostic DSSs to that described in the present study, i.e., visual diagnostic DSS, thereby demonstrating the benefits of using hybrid image processing and ML-based computer-aided diagnostics for identifying facial phenotypes.
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Affiliation(s)
- Kaya Kuru
- Department of Communication, Electronics, and Information Systems, Gülhane Military Medical Academy, Etlik, Ankara 06010, Turkey.
| | - Mahesan Niranjan
- School of Electronics and Computer Science, University of Southampton, Southampton SO17 1BF, UK
| | - Yusuf Tunca
- Department of Medical Genetics, Gülhane Military Medical Academy, Etlik, Ankara 06010, Turkey
| | - Erhan Osvank
- Institute of Informatics, Middle East Technical University, Balgat, Ankara 06531, Turkey
| | - Tayyaba Azim
- School of Electronics and Computer Science, University of Southampton, Southampton SO17 1BF, UK
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Khan AO, Bolz HJ, Bergmann C. Results of fibrillin-1 gene analysis in children from inbred families with lens subluxation. J AAPOS 2014; 18:134-9. [PMID: 24698609 DOI: 10.1016/j.jaapos.2013.11.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 11/23/2013] [Accepted: 11/28/2013] [Indexed: 01/13/2023]
Abstract
BACKGROUND Autosomal dominant mutation of the FBN1 gene (fibrillin-1) results in a spectrum of disease (type 1 fibrillopathies) ranging from Marfan syndrome with lens subluxation and cardiovascular complications to milder connective tissues phenotypes. The likelihood of FBN1 mutation in children referred to ophthalmologists because of lens subluxation is unclear. We report the results of routine FBN1 sequencing for children from inbred families referred with nontraumatic lens subluxation without cataract or vitreoretinal degeneration. METHODS Medical records of such patients from 2009 to 2012 were retrospectively reviewed. RESULTS Eight identified probands (3-11 years old; 4 boys) from consanguineous and/or endogamous Saudi Arabian families all harbored FBN1 mutation--7 autosomal dominant and 1 autosomal recessive (homozygous). Four mutations were novel. One child had a family history for lens subluxation. Seven had facial and/or skeletal features suggestive of type 1 fibrillinopathy. The parents of the autosomal recessive case were confirmed to be heterozygous carriers without lens subluxation or other clinical signs of type 1 fibrillinopathy. CONCLUSIONS Autosomal dominant type 1 fibrillinopathy was the major cause for lens subluxation in this cohort despite the fact that families were inbred and thus at higher risk for recessive disease. This highlights the frequency of new mutations in the gene and has important implications for genetic counseling and systemic assessment. The autosomal recessive case represents the fourth such case reported to date. Her heterozygous parents were unaffected carriers, suggesting that some FBN1 mutations can act as hypomorphic alleles rather than exhibiting the dominant negative effect typically attributed to FBN1 mutations.
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Affiliation(s)
- Arif O Khan
- Division of Pediatric Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
| | - Hanno J Bolz
- Center of Human Genetics, Bioscientia, Ingelheim, Germany; Institute of Human Genetics, University of Cologne, Cologne, Germany
| | - Carsten Bergmann
- Center of Human Genetics, Bioscientia, Ingelheim, Germany; Department of Nephrology & Center for Clinical Research, University Hospital Freiburg, Germany
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Abstract
Cohen syndrome (CS) is a rare autosomal recessive condition caused by mutations and/or large rearrangements in the VPS13B gene. CS clinical features, including developmental delay, the typical facial gestalt, chorioretinal dystrophy (CRD) and neutropenia, are well described. CS diagnosis is generally raised after school age, when visual disturbances lead to CRD diagnosis and to VPS13B gene testing. This relatively late diagnosis precludes accurate genetic counselling. The aim of this study was to analyse the evolution of CS facial features in the early period of life, particularly before school age (6 years), to find clues for an earlier diagnosis. Photographs of 17 patients with molecularly confirmed CS were analysed, from birth to preschool age. By comparing their facial phenotype when growing, we show that there are no special facial characteristics before 1 year. However, between 2 and 6 years, CS children already share common facial features such as a short neck, a square face with micrognathia and full cheeks, a hypotonic facial appearance, epicanthic folds, long ears with an everted upper part of the auricle and/or a prominent lobe, a relatively short philtrum, a small and open mouth with downturned corners, a thick lower lip and abnormal eye shapes. These early transient facial features evolve to typical CS facial features with aging. These observations emphasize the importance of ophthalmological tests and neutrophil count in children in preschool age presenting with developmental delay, hypotonia and the facial features we described here, for an earlier CS diagnosis.
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Douzgou S, Samples JR, Georgoudi N, Petersen MB. Ophthalmic findings in the Greek isolate of Cohen syndrome. Am J Med Genet A 2011; 155A:534-9. [PMID: 21344628 DOI: 10.1002/ajmg.a.33797] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Accepted: 09/12/2010] [Indexed: 11/09/2022]
Abstract
A high frequency of the Cohen syndrome has been observed in a Greek island with 2,000 inhabitants and a high degree of inbreeding. All patients were homozygous for a COH1, exon 6-16 deletion suggesting a founder effect. We present the results of their first systematic ophthalmologic assessment. Myopia and chorioretinal atrophy were present in all patients of this cohort. Yet, in contrast to all groups previously reported, the majority presented with corneal changes, independently from age, gender, and family history. A pair of sisters, aged 11 and 15 years old, presented with bilateral keratoconus. More frequently (86%) than in any other ethnic group, Greek patients had cataracts that were bilateral and often graded as high as 3, even at a young age. As a whole, the ophthalmic phenotype of the Greek isolate of Cohen syndrome is characterized by the involvement of both the posterior and the anterior eye segment, bilaterally, in the majority of cases (93%). Greek Cohen patients that share a founder mutation are at a higher risk of developing blindness in respect to those of other ethnicities and genotypes. This study highlighted the need for pachymetry measurement as a means of surveillance and prediction of the visual impairment frequently observed.
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Affiliation(s)
- Sofia Douzgou
- Department of Genetics, Institute of Child Health, "Aghia Sofia" Children's Hospital, Athens, Greece.
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Taban M, Memoracion-Peralta DSA, Wang H, Al-Gazali LI, Traboulsi EI. Cohen syndrome: report of nine cases and review of the literature, with emphasis on ophthalmic features. J AAPOS 2007; 11:431-7. [PMID: 17383910 DOI: 10.1016/j.jaapos.2007.01.118] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2006] [Revised: 01/16/2007] [Accepted: 01/19/2007] [Indexed: 10/23/2022]
Abstract
PURPOSE To review the clinical features of reported cases of Cohen syndrome with a focus on ophthalmic features and report nine new cases. METHODS Retrospective case series and literature review. RESULTS Cohen syndrome is a rare autosomal-recessive condition with about 136 reported cases. The typical phenotype of Cohen syndrome is variable and includes mild to severe psychomotor retardation, microcephaly, a cheerful disposition, characteristic facial features, childhood hypotonia and joint laxity, truncal obesity, intermittent neutropenia, along with a progressive retinal dystrophy and refractive myopia. We present nine cases that illustrate the typical clinical features of the disorder at different ages, including a woman with the less common finding of ectopia lentis. CONCLUSIONS Cohen syndrome remains underdiagnosed or misdiagnosed by ophthalmologists. Awareness of this condition among ophthalmologists is important because the typical systemic and ophthalmologic findings may lead to an accurate diagnosis and counseling. Although diagnostic criteria exist based on clinical studies of patients with confirmed VPS13B (COH1) gene mutations, no minimal clinical diagnostic criteria are widely accepted at this time.
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Affiliation(s)
- Mehryar Taban
- Department of Pediatric Ophthalmology and the Center for Genetic Eye Diseases, Cole Eye Institute, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA
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Seifert W, Holder-Espinasse M, Spranger S, Hoeltzenbein M, Rossier E, Dollfus H, Lacombe D, Verloes A, Chrzanowska KH, Maegawa GHB, Chitayat D, Kotzot D, Huhle D, Meinecke P, Albrecht B, Mathijssen I, Leheup B, Raile K, Hennies HC, Horn D. Mutational spectrum of COH1 and clinical heterogeneity in Cohen syndrome. J Med Genet 2006; 43:e22. [PMID: 16648375 PMCID: PMC2564527 DOI: 10.1136/jmg.2005.039867] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Cohen syndrome (CS) is an autosomal recessive disorder with variability in the clinical manifestations, characterised by mental retardation, postnatal microcephaly, facial dysmorphism, pigmentary retinopathy, myopia, and intermittent neutropenia. Mutations in the gene COH1 have been found in an ethnically diverse series of patients. Brief clinical descriptions of 24 patients with CS are provided. The patients were from 16 families of different ethnic backgrounds and between 2.5 and 60 years of age at assessment. DNA samples from all patients were analysed for mutations in COH1 by direct sequencing. Splice site mutations were characterised using reverse transcriptase PCR analysis from total RNA samples. In this series, we detected 25 different COH1 mutations; 19 of these were novel, including 9 nonsense mutations, 8 frameshift mutations, 4 verified splice site mutations, 3 larger in frame deletions, and 1 missense mutation. We observed marked variability of developmental and growth parameters. The typical facial gestalt was seen in 23/24 patients. Early onset progressive myopia was present in all the patients older than 5 years. Widespread pigmentary retinopathy was found in 12/14 patients assessed over 5 years of age. We present evidence for extended allelic heterogeneity of CS, with the vast majority of mutations leading to premature termination codons in COH1. Our data confirm the broad clinical spectrum of CS with some patients lacking even the characteristic facial gestalt and pigmentary retinopathy at school age.
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Kersey JP, Vivian AJ, Reid E. A report of paracentric inversion of chromosome 8 in Moebius syndrome. Ophthalmic Genet 2006; 27:29-31. [PMID: 16543199 DOI: 10.1080/13816810500481873] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
An eight-year-old girl with bilateral facial paresis and restricted eye movements was diagnosed with Moebius syndrome. A chromosomal analysis showed a paracentric inversion on the long arm of chromosome 8 (46, XX, inv(8) (q21.3q24.13)). Candidate genes have been found on chromosomes 3q21, 10q21, and 13q12. We discuss the genes which are known to have associated ocular movement dysfunction in the 8q21-24 region. We hope this case will add to the current body of knowledge regarding Moebius syndrome and its genetics.
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Affiliation(s)
- James P Kersey
- Ophthalmology Department, West Suffolk Hospital, Hardwick Lane, Bury St. Edmunds, Suffolk IP33 2QZ, UK.
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Khan A, Chandler K, Pimenides D, Black GCM, Manson FDC. Corneal ectasia associated with Cohen syndrome: a role for COH1 in corneal development and maintenance? Br J Ophthalmol 2006; 90:390-1. [PMID: 16488969 PMCID: PMC1856973 DOI: 10.1136/bjo.2005.080085] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mrugacz M, Sredzinska-Kita D, Bakunowicz-Lazarczyk A. Pediatric ophthalmologic findings of Cohen syndrome in twins. J Pediatr Ophthalmol Strabismus 2005; 42:54-6. [PMID: 15724900 DOI: 10.3928/01913913-20050101-08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We present the clinical findings and follow-up data of male twins with Cohen syndrome. The most characteristic ophthalmologic findings were down-slanting eyelids, lens opacities, chorioretinal dystrophy, pigmentary retinal deposits, pale disk, and bull's eye maculae.
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Affiliation(s)
- Malgorzata Mrugacz
- Department of Pediatric Ophthalmology Medical University of Bialystok, Bialystok, Poland
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28
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Kolehmainen J, Wilkinson R, Lehesjoki AE, Chandler K, Kivitie-Kallio S, Clayton-Smith J, Träskelin AL, Waris L, Saarinen A, Khan J, Gross-Tsur V, Traboulsi EI, Warburg M, Fryns JP, Norio R, Black GCM, Manson FDC. Delineation of Cohen syndrome following a large-scale genotype-phenotype screen. Am J Hum Genet 2004; 75:122-7. [PMID: 15141358 PMCID: PMC1181995 DOI: 10.1086/422197] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2004] [Accepted: 04/23/2004] [Indexed: 11/04/2022] Open
Abstract
Cohen syndrome is an autosomal recessive condition associated with developmental delay, facial dysmorphism, pigmentary retinopathy, and neutropenia. The pleiotropic phenotype, combined with insufficient clinical data, often leads to an erroneous diagnosis and has led to confusion in the literature. Here, we report the results of a comprehensive genotype-phenotype study on the largest cohort of patients with Cohen syndrome assembled to date. We found 22 different COH1 mutations, of which 19 are novel, in probands identified by our diagnostic criteria. In addition, we identified another three novel mutations in patients with incomplete clinical data. By contrast, no COH1 mutations were found in patients with a provisional diagnosis of Cohen syndrome who did not fulfill the diagnostic criteria ("Cohen-like" syndrome). This study provides a molecular confirmation of the clinical phenotype associated with Cohen syndrome and provides a basis for laboratory screening that will be valuable in its diagnosis.
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Affiliation(s)
- Juha Kolehmainen
- Folkhalsan Institute of Genetics, and Department of Medical Genetics, University of Helsinki, Helsinki, Finland
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Falk MJ, Feiler HS, Neilson DE, Maxwell K, Lee JV, Segall SK, Robin NH, Wilhelmsen KC, Träskelin AL, Kolehmainen J, Lehesjoki AE, Wiznitzer M, Warman ML. Cohen syndrome in the Ohio Amish. Am J Med Genet A 2004; 128A:23-8. [PMID: 15211651 DOI: 10.1002/ajmg.a.30033] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We describe eight members from two large Amish kindreds who share a phenotype characterized by early-onset pigmentary retinopathy and myopia, global developmental delay and mental retardation, microcephaly, short stature, hypotonia, joint hyperextensibility, small hands and feet, common facial appearance, and friendly disposition. Several of the children had intermittent granulocytopenia. The phenotypic occurrence in three siblings coupled with the increased coefficient of inbreeding in the Amish suggested that this disorder is autosomal recessive and due to a single founder allele. Despite similarity to the clinical features of Cohen syndrome, experienced dysmorphologists attending the 23rd David W. Smith Workshop suggested the facial gestalt of the Amish children was inconsistent with this diagnosis. We mapped the locus responsible for these individuals' phenotype to chromosome 8q22-q23, which contains the recently discovered Cohen syndrome gene, COH1. Complete sequencing of the COH1 gene identified a likely disease-causing frameshift mutation and a missense mutation in the Amish patients. A comparison of features among different Cohen syndrome populations with shared linkage to the COH1 locus or known COH1 gene mutations may allow for the determination of improved clinical criteria on which to suspect the diagnosis of Cohen syndrome. We conclude that facial gestalt seems to be an unreliable indicator of Cohen syndrome between ethnic populations, although it is quite consistent among affected individuals within a particular ethnic group. Other features common to almost all individuals with proven COH1 mutations, such as retinal dystrophy, myopia, microcephaly, mental retardation, global developmental delay, hypotonia, and joint hyperextensibility appear to be better clinical indicators of this disorder.
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Affiliation(s)
- Marni J Falk
- Department of Pediatrics, Case Western Reserve University and University Hospitals of Cleveland, Cleveland, Ohio, USA.
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Chandler KE, Kidd A, Al-Gazali L, Kolehmainen J, Lehesjoki AE, Black GCM, Clayton-Smith J. Diagnostic criteria, clinical characteristics, and natural history of Cohen syndrome. J Med Genet 2003; 40:233-41. [PMID: 12676892 PMCID: PMC1735413 DOI: 10.1136/jmg.40.4.233] [Citation(s) in RCA: 95] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Cohen syndrome is a rare, recessively inherited condition associated with facial dysmorphism, developmental delay, and visual disability. A delay in making the diagnosis commonly occurs, contributed to by the lack of a definitive molecular test and the clinical variability of published case reports. A specific clinical phenotype has been delineated in a homogeneous cohort of Finnish Cohen syndrome patients, but the applicability of their diagnostic criteria to non-Finnish patients has been debated. Detailed delineation of Cohen syndrome in patients from outside Finland is therefore warranted. We report on the clinical features of 33 non-Finnish Cohen syndrome patients. Variability within the clinical spectrum is identified and the natural history of Cohen syndrome described. Diagnostic guidelines for facilitating accurate and early diagnosis are discussed. Results from molecular genetic analysis using markers located within the previously mapped COH1 critical region support allelic but not genetic heterogeneity in this UK cohort.
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Affiliation(s)
- K E Chandler
- Academic Unit of Medical Genetics and Regional Genetics Service, St Mary's Hospital, Manchester, UK.
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