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de Laage de Meux P, Mosbah H, Cotton-Viard A, Cohen SY. FOVEA PLANA AND FUNDUS HYPOPIGMENTATION IN PRADER-WILLI SYNDROME. Retin Cases Brief Rep 2024; 18:647-650. [PMID: 37267630 DOI: 10.1097/icb.0000000000001441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND/PURPOSE To report a case of fovea plana with fundus hypopigmentation in a patient with Prader-Willi syndrome (PWS). METHODS Case report. RESULTS During a routine examination, fovea plana and fundus hypopigmentation were observed in both eyes in a 34-year-old male patient with PWS and documented with fundus photography, spectral domain optical coherence tomography and optical coherence tomography-angiography. CONCLUSION Fovea plana and fundus hypopigmentation may be associated with PWS. Indeed, both PWS and oculocutaneous albinism may be explained by the deletion of the same genomic region on chromosome 15. The present case of a patient with PWS with fundus hypopigmentation supports the genetic and clinical overlap between PWS and oculocutaneous albinism.
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Affiliation(s)
- Priscille de Laage de Meux
- Ophthalmology Center for Imaging and Laser, Paris, France
- Department of Ophthalmology, Intercity Hospital and University Paris Est, Creteil, France
| | - Héléna Mosbah
- Department of Nutrition and Rare Diseases Referral Center PRADORT, Pitié-Salpêtrière Hospital, AP-HP and Sorbonne University, Boulevard de L'Hôpital, Paris Cedex, France; and
| | | | - Salomon Y Cohen
- Ophthalmology Center for Imaging and Laser, Paris, France
- Department of Ophthalmology, Intercity Hospital and University Paris Est, Creteil, France
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Bohonowych JE, Vrana-Diaz CJ, Miller JL, McCandless SE, Strong TV. Incidence of strabismus, strabismus surgeries, and other vision conditions in Prader-Willi syndrome: data from the Global Prader-Willi Syndrome Registry. BMC Ophthalmol 2021; 21:296. [PMID: 34380467 PMCID: PMC8359621 DOI: 10.1186/s12886-021-02057-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/09/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND There is a relative lack of information on the incidence and treatment of vision problems in Prader-Willi syndrome (PWS). Using data from the Global PWS Registry, we performed a cross-sectional study of vision problems in PWS. METHODS Data, reported by caregivers who completed the Vision Survey in the Global PWS Registry between May of 2015 and March of 2020, were analyzed using descriptive statistics. RESULTS There were 908 participants in this survey, with a mean age of 14.5 years (range 0-62 years). The prevalence of strabismus in this population was 40 %, with no statistically significant difference in prevalence by genetic subtype. Ninety-one percent of participants with strabismus were diagnosed before 5 years of age. Of those with strabismus, 42 % went on to have strabismus surgery, with 86 % of those having their first strabismus surgery before 5 years of age and 10.1 % having more than one strabismus surgery. Additional vision issues reported included myopia (41 %), hyperopia (25 %), astigmatism (25 %), and amblyopia (16 %). CONCLUSIONS The prevalence of strabismus, amblyopia, and hyperopia are considerably higher in the PWS population represented in the Global PWS Registry as compared to the general population. People with PWS should be screened early and regularly for vision problems.
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Salvatoni A, Nosetti L, Salvatore S, Agosti M. Benefits of multidisciplinary care in Prader-Willi syndrome. Expert Rev Endocrinol Metab 2021; 16:63-71. [PMID: 33724138 DOI: 10.1080/17446651.2021.1898375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/01/2021] [Indexed: 01/25/2023]
Abstract
Introduction: Prader-Willi syndrome (PWS) is the most well-known condition of genetic obesity. Over the past 20 years, advances have been achieved in the diagnosis and treatment of PWS with a significant improvement in prognosis.Areas covered: This review focuses on the benefits of multidisciplinary approach in children and adolescents with PWS. In particular, the neonatologist and geneticist play a key role in early diagnosis and the clinical follow-up of the PWS patient must be guaranteed by a team including pediatric endocrinologist, psychologist, nutritionist/dietician, neurologist/neuropsychiatrist, sleep specialist, ears, nose and throat specialist (ENT), lung specialist, dentist, orthopedist and ophthalmologist and, eventually, gastroenterologist. We searched PubMed and critically summarized what has been reported in the last 10 years on PWS.Expert opinion: The multidisciplinary care in association with an early diagnosis and GH treatment postpones overweight development and decreases prevalence of obesity in individuals with PWS. Further prognostic improvements are expected through the selection of teams particularly experienced in the management of individuals with PWS and the discovery of new drugs.
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Affiliation(s)
| | - Luana Nosetti
- Pediatric Department, Insubria University, Varese, Italy
| | | | - Massimo Agosti
- Pediatric Department, Insubria University, Varese, Italy
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Can ME, Kızıltoprak H, Buluş AD, Özkoyuncu D, Koç M, Özdemir Yıldız Z. Corneal Biomechanical Properties in Childhood Obesity. J Pediatr Ophthalmol Strabismus 2020; 57:103-107. [PMID: 32203594 DOI: 10.3928/01913913-20200131-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/30/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate corneal biomechanical properties in patients with childhood obesity. METHODS The study included 47 patients with childhood obesity (study group) and 39 healthy patients (control group). Corneal hysteresis, corneal resistance factor, corneal compensated intraocular pressure (IOPcc), and Goldmann-correlated IOP (IOPg) were measured with the Ocular Response Analyzer (Reichert, Ophthalmic Instruments, Buffalo, NY) in each eye. Central corneal thickness (CCT), anterior chamber angle (ACA), anterior chamber volume (ACV), and anterior chamber depth (ACD) measurements were obtained by the Pentacam rotating Scheimpflug camera (Oculus Optikgeräte GmBh, Wetzlar, Germany). RESULTS The mean corneal hysteresis was 10.56 ± 1.52 mm Hg in the study group and 11.16 ± 1.92 mm Hg in the control group (P = .022). The mean IOP was 14.9 ± 2.0 mm Hg in the study group and 14.1 ± 1.3 mm Hg in the control group (P = .003). Corneal hysteresis showed a significant, positive correlation with corneal resistance factor (P < .001, r = 0.851), IOPg (P = .044, r = 0.213), CCT (P < .001, r = 0.477), and IOP (P = .005, r = 0.295). Corneal hysteresis showed a significant, negative correlation with IOPcc (P = .001, r = -0.355), ACA (P = .005, r = -0.294), ACV (P = .019, r = -0.246), and ACD (P = .046, r = -0.211). CONCLUSIONS Patients with childhood obesity have lower corneal hysteresis and higher IOPcc measurements when compared with healthy patients. Corneal tissue changes may occur in early life in childhood obesity, which could lead to ocular disease in the future. [J Pediatr Ophthalmol Strabismus. 2020;57(2):103-107.].
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Kanclerz P. Accommodative insufficiency in a patient with Prader-Willi syndrome and SNRPN gene mutation. Saudi J Ophthalmol 2020; 34:56-58. [PMID: 33542990 PMCID: PMC7849860 DOI: 10.4103/1319-4534.301291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 05/15/2019] [Indexed: 11/30/2022] Open
Abstract
Accommodative insufficiency (AI) is common in children, however, has not been described in Prader–Willi syndrome (PWS). This case report presents severe AI in a child with PWS and a rare mutation on chromosome 15 (methylation at locus SNRPN). A 15-year-old boy with PWS presented with the complaint about needing to remove distance glasses while reading. The visual acuity in his right eye was 20/20 with −2.0 D, and in his left eye 20/20 with −2.75/−0.25/173°. The defocus curve manifested with severe AI, and no other abnormal ocular findings were noted. Progressive glasses were recommended. Molecular genetic analysis at the age of two years revealed altered methylation at locus SNRPN on chromosome 15. As muscular hypotonia is common in PWS, the function of smooth muscles, including the ciliary muscle might be altered, as demonstrated in this case report.
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Accommodative insufficiency in a patient with Prader–Willi syndrome and SNRPN gene mutation. Saudi J Ophthalmol 2019. [DOI: 10.1016/j.sjopt.2019.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Hamid MA, Mehta MC, Kuppermann BD. Multimodal imaging in a patient with Prader-Willi syndrome. Int J Retina Vitreous 2018; 4:45. [PMID: 30519487 PMCID: PMC6267888 DOI: 10.1186/s40942-018-0147-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 11/17/2018] [Indexed: 11/10/2022] Open
Abstract
Background Prader-Willi syndrome (PWS) is a genetic disease caused by loss of expression of the paternally inherited copy of several genes on the long arm of chromosome 15. Ophthalmic manifestations of PWS include strabismus, amblyopia, nystagmus, hypopigmentation of the iris and choroid, diabetic retinopathy, cataract and congenital ectropion uvea. An overlap between PWS and oculocutaneous albinism (OCA) has long been recognized and attributed to deletion of OCA2 gene located in PWS critical region (PWCR). Case report A 30-year-old male patient with PWS presented with vision loss in his left eye. His right eye had normal visual acuity. Multimodal imaging revealed absence of a foveal depression and extremely reduced diameter of the foveal avascular zone in the right eye and an inactive type 2 macular neovascular lesion in the left eye. Conclusions We report a presumed association of fovea plana and choroidal neovascularization with PWS. The use of multimodal imaging revealed novel findings in a PWS patient that might enrich our current understanding of the overlap between PWS and OCA.
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Affiliation(s)
- Mohamed A Hamid
- Gavin Herbert Eye Institute, University of California Irvine, 850 Health Sciences Road, Irvine, CA 92697 USA
| | - Mitul C Mehta
- Gavin Herbert Eye Institute, University of California Irvine, 850 Health Sciences Road, Irvine, CA 92697 USA
| | - Baruch D Kuppermann
- Gavin Herbert Eye Institute, University of California Irvine, 850 Health Sciences Road, Irvine, CA 92697 USA
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Hurren BJ, Flack NAMS. Prader-Willi Syndrome: A spectrum of anatomical and clinical features. Clin Anat 2016; 29:590-605. [PMID: 26749552 DOI: 10.1002/ca.22686] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 01/04/2016] [Indexed: 12/26/2022]
Abstract
Prader-Willi Syndrome (PWS) is estimated to affect 400,000 people worldwide. First described clinically in 1956, PWS is now known to be a result of a genetic mutation, involving Chromosome 15. The phenotypical appearance of individuals with the syndrome follows a similar developmental course. During infancy, universal hypotonia accompanied by feeding problems, hypogonadism, and dolichocephaly are evident. Characteristic facial features such as narrow bifrontal diameter, almond-shaped eyes, and small mouth (with downturned corners and thin upper lip) may also be evident at this stage. In early childhood, the craniofacial features become more obvious and a global developmental delay is observed. Simultaneously, individuals develop hyperphagia that leads to excessive or rapid weight gain, which, if untreated, exists throughout their lifespan and may predispose them to numerous, serious health issues. The standard tool for differential diagnosis of PWS is genetic screening; however, clinicians also need to be aware of the characteristic features of this disorder, including differences between the genetic subtypes. As the clinical manifestations of the syndrome vary between individuals and become evident at different developmental time points, early assessment is hindered. This article focuses on the clinical and anatomical manifestations of the syndrome and highlights the areas of discrepancy and limitations within the existing literature. Clin. Anat. 29:590-605, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Bradley J Hurren
- Department of Anatomy, University of Otago, Dunedin, 9016, New Zealand
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Hodge JC, Mitchell E, Pillalamarri V, Toler TL, Bartel F, Kearney HM, Zou YS, Tan WH, Hanscom C, Kirmani S, Hanson RR, Skinner SA, Rogers C, Everman DB, Boyd E, Mullegama SV, Keelean-Fuller D, Powell CM, Elsea SH, Morton CC, Gusella JF, DuPont B, Chaubey A, Lin AE, Talkowski ME, Talkowski ME. Disruption of MBD5 contributes to a spectrum of psychopathology and neurodevelopmental abnormalities. Mol Psychiatry 2014; 19:368-79. [PMID: 23587880 PMCID: PMC4756476 DOI: 10.1038/mp.2013.42] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 02/11/2013] [Accepted: 03/06/2013] [Indexed: 01/11/2023]
Abstract
Microdeletions of chromosomal region 2q23.1 that disrupt MBD5 (methyl-CpG-binding domain protein 5) contribute to a spectrum of neurodevelopmental phenotypes; however, the impact of this locus on human psychopathology has not been fully explored. To characterize the structural variation landscape of MBD5 disruptions and the associated human psychopathology, 22 individuals with genomic disruption of MBD5 (translocation, point mutation and deletion) were identified through whole-genome sequencing or cytogenomic microarray at 11 molecular diagnostic centers. The genomic impact ranged from a single base pair to 5.4 Mb. Parents were available for 11 cases, all of which confirmed that the rearrangement arose de novo. Phenotypes were largely indistinguishable between patients with full-segment 2q23.1 deletions and those with intragenic MBD5 rearrangements, including alterations confined entirely to the 5'-untranslated region, confirming the critical impact of non-coding sequence at this locus. We identified heterogeneous, multisystem pathogenic effects of MBD5 disruption and characterized the associated spectrum of psychopathology, including the novel finding of anxiety and bipolar disorder in multiple patients. Importantly, one of the unique features of the oldest known patient was behavioral regression. Analyses also revealed phenotypes that distinguish MBD5 disruptions from seven well-established syndromes with significant diagnostic overlap. This study demonstrates that haploinsufficiency of MBD5 causes diverse phenotypes, yields insight into the spectrum of resulting neurodevelopmental and behavioral psychopathology and provides clinical context for interpretation of MBD5 structural variations. Empirical evidence also indicates that disruption of non-coding MBD5 regulatory regions is sufficient for clinical manifestation, highlighting the limitations of exon-focused assessments. These results suggest an ongoing perturbation of neurological function throughout the lifespan, including risks for neurobehavioral regression.
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Affiliation(s)
- Jennelle C. Hodge
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA,Department of Medical Genetics, Mayo Clinic, Rochester, 55905, USA
| | - Elyse Mitchell
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Vamsee Pillalamarri
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA
| | - Tomi L. Toler
- Medical Genetics, MassGeneral Hospital for Children, Boston, MA, USA
| | | | | | - Ying S. Zou
- Clinical Cytogenetics Laboratory, Pathology Associates Medical Laboratories, Spokane, WA, USA
| | - Wen-Hann Tan
- Division of Genetics, Boston Children’s Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - Carrie Hanscom
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA
| | - Salman Kirmani
- Department of Medical Genetics, Mayo Clinic, Rochester, 55905, USA
| | - Rae R. Hanson
- Child Neurology, Department of Neurosciences, Mayo Clinic Health System, Eau Claire, WI, USA
| | | | | | | | - Ellen Boyd
- Fullerton Genetic Center, Mission Health, Asheville, NC, USA
| | - Sureni V. Mullegama
- Department of Human and Molecular Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Debra Keelean-Fuller
- Department of Pediatrics and Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Cynthia M. Powell
- Department of Pediatrics and Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sarah H. Elsea
- Department of Human and Molecular Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA,Department of Pediatrics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Cynthia C. Morton
- Harvard Medical School, Boston, MA, USA,Departments of Obstetrics, Gynecology and Reproductive Biology and of Pathology, Brigham and Women’s Hospital, Boston, MA, USA,Program in Medical and Population Genetics, Broad Institute of Harvard and M.I.T., Cambridge, MA, USA
| | - James F. Gusella
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA,Program in Medical and Population Genetics, Broad Institute of Harvard and M.I.T., Cambridge, MA, USA,Departments of Genetics and Neurology, Harvard Medical School, Cambridge, MA, USA
| | | | | | - Angela E. Lin
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA,Medical Genetics, MassGeneral Hospital for Children, Boston, MA, USA
| | - Michael E. Talkowski
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA,Program in Medical and Population Genetics, Broad Institute of Harvard and M.I.T., Cambridge, MA, USA,Departments of Genetics and Neurology, Harvard Medical School, Cambridge, MA, USA
| | - M E Talkowski
- 1] Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA [2] Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA [3] Departments of Genetics and Neurology, Harvard Medical School, Cambridge, MA, USA
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Abstract
The human eye, as an organ, can offer critical clues to the diagnosis of various systemic illnesses. Ocular changes are common in various endocrine disorders such as diabetes mellitus and Graves' disease. However there exist a large number of lesser known endocrine disorders where ocular involvement is significant. Awareness of these associations is the first step in the diagnosis and management of these complex patients. The rare syndromes involving the pituitary hypothalamic axis with significant ocular involvement include Septo-optic dysplasia, Kallman's syndrome, and Empty Sella syndrome all affecting the optic nerve at the optic chiasa. The syndromes involving the thyroid and parathyroid glands that have ocular manifestations and are rare include Mc Cune Albright syndrome wherein optic nerve decompression may occur due to fibrous dysplasia, primary hyperparathyroidism that may present as red eye due to scleritis and Ascher syndrome wherein ptosis occurs. Allgrove's syndrome, Cushing's disease, and Addison's disease are the rare endocrine syndromes discussed involving the adrenals and eye. Ocular involvement is also seen in gonadal syndromes such as Bardet Biedl, Turner's, Rothmund's, and Klinefelter's syndrome. This review also highlights the ocular manifestation of miscellaneous syndromes such as Werner's, Cockayne's, Wolfram's, Kearns Sayre's, and Autoimmune polyendocrine syndrome. The knowledge of these relatively uncommon endocrine disorders and their ocular manifestations will help an endocrinologist reach a diagnosis and will alert an ophthalmologist to seek specialty consultation of an endocrinologist when encountered with such cases.
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Affiliation(s)
- Rupali Chopra
- Department of Ophthalmology, Christian Medical College, Ludhiana, India
| | - Ashish Chander
- Department of Ophthalmology, Christian Medical College, Ludhiana, India
| | - Jubbin J. Jacob
- Department of Medicine, Christian Medical College, Ludhiana, India
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Lai YH, Hsu HT, Wang HZ, Chang CH, Chang SJ. Astigmatism in preschool children in Taiwan. J AAPOS 2010; 14:150-4. [PMID: 20451858 DOI: 10.1016/j.jaapos.2009.12.168] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2009] [Revised: 12/29/2009] [Accepted: 12/29/2009] [Indexed: 12/12/2022]
Abstract
PURPOSE To elucidate the prevalence of astigmatism and its corneal component, the association between the amount of astigmatism and its axis, and the association between the axis of astigmatism and body mass index (BMI) in Taiwanese preschool children. METHODS In this population-based study we analyzed 2 data sets, one obtained by retrospective review of vision-screening data and another obtained in a prospective observational study. Each study collected data for age, sex, and refraction status. Autokeratometry, height, and weight measurements were obtained only in the observational study. Astigmatism was classified as with-the-rule, against-the-rule, or oblique. RESULTS The prevalence of astigmatism was unassociated with age or sex in both data sets. The retrospective study (1,094 subjects; mean age, 5 years; range, 2.19-7.32 years) revealed that 13.3% of the subjects had astigmatism > or = 1.00 D, and most of them had with-the-rule astigmatism; 4.0% had high astigmatism (>1.50 D). Children with with-the-rule astigmatism had greater mean cylinder power than those with against-the-rule or oblique astigmatism. In the prospective study (190 subjects; mean age, 5.65 years; range, 3.79-6.68 years) astigmatism correlated with its corneal component. Preschoolers with with-the-rule astigmatism and with-the-rule corneal astigmatism had greater BMI and heavier weight than those with against-the-rule or oblique type. CONCLUSIONS Astigmatism is common in Taiwanese preschool children. The predominant types are with-the-rule and oblique astigmatism. Most patients with high astigmatism and high corneal astigmatism have with-the-rule type. High BMI or weight is associated with with-the-rule astigmatism and with with-the-rule corneal astigmatism.
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Affiliation(s)
- Yu-Hung Lai
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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13
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Abstract
The prevalence of obesity has reached epidemic proportions in many countries. Although its impact on overall health is well documented, less is known about the ocular manifestations of obesity. Among different eye diseases, obesity has been linked with age-related cataract, glaucoma, age-related maculopathy, and diabetic retinopathy. Numerous population-based and prospective studies support an association between obesity and risk of age-related cataract. However, the nature and strength of these associations, particularly with the different cataract subtypes, remains to be determined. There is strong evidence that obesity is associated with elevated intraocular pressure, but there is no convincing data to support a more direct association between obesity and glaucomatous optic neuropathy. Studies to date have not found a consistent pattern of association between obesity and risk of age-related maculopathy or diabetic retinopathy. Thus, although obesity may be a risk factor for many ocular conditions, the present literature is inadequate to establish any convincing associations. Furthermore, whether weight loss reduces the risk of eye diseases remains unresolved. Because of the potential public health impact of obesity, there is a greater need to understand its ocular effects.
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Affiliation(s)
- Ning Cheung
- Centre for Eye Research Australia, University of Melbourne, Victoria, Australia
- Royal Melbourne Hospital, Victoria, Australia
| | - Tien Y. Wong
- Centre for Eye Research Australia, University of Melbourne, Victoria, Australia
- Singapore Eye Research Institute, National University of Singapore, Singapore
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Van Splunder J, Stilma JS, Evenhuis HM. Visual performance in specific syndromes associated with intellectual disability. Eur J Ophthalmol 2003; 13:566-74. [PMID: 12948316 DOI: 10.1177/112067210301300610] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
PURPOSE To report visual performance in adults with specific causes of intellectual disability (ID) and to compare the test results to published reports. METHODS In a large-scale multicenter epidemiologic study of sensory impairments in 1598 adults with ID, the authors performed ocular assessments in 1539 persons. They compared the test results of those with five specific genetic disorders (Angelman syndrome, Prader-Willi syndrome, fragile X syndrome, Williams-Beuren syndrome, and tuberous sclerosis). RESULTS An overrepresentation of strabismus, low vision, and refractive errors was found. Apart from fragile X syndrome and Prader-Willi syndrome (with in general mild to moderate ID), the other syndrome groups contained one or more subjects with visual impairment or blindness. A number of them had never been seen by an ophthalmologist. CONCLUSIONS The authors confirm a number of ocular features previously reported by other studies and suggest some additional ocular features. They found increased frequencies of treatable ophthalmologic conditions in the subgroups. Because reliable ocular assessment is feasible for 85% of persons with ID, the results are an incentive to address visual functioning in people with ID in order to correct ocular problems and maximize their possibilities.
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Affiliation(s)
- J Van Splunder
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands
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Abstract
PURPOSE Prader-Willi syndrome (PWS) refers to a genetic disorder induced by an anomaly on chromosome 15 occurring with a frequency of one in 10,000 to 20,000. It is characterized by a unique set of features including infantile hypotonia, obesity in childhood, small hands and feet, hypogonadism, and mental retardation. Reported here are the results of ophthalmic examinations of persons with PWS, together with results from controls comparable in age, percentage of body fat, and intelligence. These data bear on the hypothesis that the ocular anomalies in PWS are unique to this syndrome. METHOD A comprehensive investigation of PWS brought children and adults to Vanderbilt University for extended testing, which included an ophthalmic examination. Genetic analysis determined unequivocally the PWS diagnosis and identified subgroups-deletion and maternal disomy. A group of persons without PWS but generally comparable in age, body composition, and intelligence served as controls. RESULTS Significant differences between the deletion and disomy subgroups were not found for the clinical ophthalmic measures. The incidence of anomalies in the combined PWS was similar to those reported in previous studies. A similar pattern was present in the control group except for myopia and stereopsis. An effect of genetic subgroup, however, was observed for random element stereopsis with the maternal disomy group having a greater degree of impairment. CONCLUSION The overall similarity between the PWS and control groups on all measures except myopia and stereopsis suggest that many of the anomalies in PWS found in prior studies are due to factors inherent in a general dysfunctional population, rather than reflective of an ocular signature unique to PWS.
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Affiliation(s)
- R Fox
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
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Abstract
The etiology of strabismus has long been observed to have a genetic component. Recent advances in genetic methodology may provide insight into the genetic basis for several types of inherited strabismus, including those associated with genetic multisystem disorders such as Moebius syndrome, Prader-Willi syndrome, craniofacial dysostoses, and mitochondrial myopathies. Inheritance of primary forms of strabismus, such as congenital ocular fibrosis, Brown syndrome and Duane syndrome, has been reported, but less is known of the defective genetic sites. The genetic basis for isolated strabismus that clusters in families, such as infantile esotropia syndrome, is also not yet known, but new techniques of molecular biology may now permit linkage detection in these families. By identifying affected families, clinicians will take part in unraveling the genetic basis of hereditary strabismus syndromes.
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Affiliation(s)
- T O Paul
- Smith-Kettlewell Eye Research Institute, San Francisco, CA 94115
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