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Whelan L, Dockery A, Stephenson KAJ, Zhu J, Kopčić E, Post IJM, Khan M, Corradi Z, Wynne N, O' Byrne JJ, Duignan E, Silvestri G, Roosing S, Cremers FPM, Keegan DJ, Kenna PF, Farrar GJ. Detailed analysis of an enriched deep intronic ABCA4 variant in Irish Stargardt disease patients. Sci Rep 2023; 13:9380. [PMID: 37296172 PMCID: PMC10256698 DOI: 10.1038/s41598-023-35889-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
Over 15% of probands in a large cohort of more than 1500 inherited retinal degeneration patients present with a clinical diagnosis of Stargardt disease (STGD1), a recessive form of macular dystrophy caused by biallelic variants in the ABCA4 gene. Participants were clinically examined and underwent either target capture sequencing of the exons and some pathogenic intronic regions of ABCA4, sequencing of the entire ABCA4 gene or whole genome sequencing. ABCA4 c.4539 + 2028C > T, p.[= ,Arg1514Leufs*36] is a pathogenic deep intronic variant that results in a retina-specific 345-nucleotide pseudoexon inclusion. Through analysis of the Irish STGD1 cohort, 25 individuals across 18 pedigrees harbour ABCA4 c.4539 + 2028C > T and another pathogenic variant. This includes, to the best of our knowledge, the only two homozygous patients identified to date. This provides important evidence of variant pathogenicity for this deep intronic variant, highlighting the value of homozygotes for variant interpretation. 15 other heterozygous incidents of this variant in patients have been reported globally, indicating significant enrichment in the Irish population. We provide detailed genetic and clinical characterization of these patients, illustrating that ABCA4 c.4539 + 2028C > T is a variant of mild to intermediate severity. These results have important implications for unresolved STGD1 patients globally with approximately 10% of the population in some western countries claiming Irish heritage. This study exemplifies that detection and characterization of founder variants is a diagnostic imperative.
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Affiliation(s)
- Laura Whelan
- The School of Genetics and Microbiology, Trinity College Dublin, Dublin 2, Ireland.
| | - Adrian Dockery
- The School of Genetics and Microbiology, Trinity College Dublin, Dublin 2, Ireland
- Next Generation Sequencing Laboratory, Pathology Department, The Mater Misericordiae University Hospital, Dublin 7, Ireland
| | - Kirk A J Stephenson
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin 2, Ireland
- Mater Clinical Ophthalmic Genetics Unit, The Mater Misericordiae University Hospital, Dublin 7, Ireland
| | - Julia Zhu
- Mater Clinical Ophthalmic Genetics Unit, The Mater Misericordiae University Hospital, Dublin 7, Ireland
| | - Ella Kopčić
- The School of Genetics and Microbiology, Trinity College Dublin, Dublin 2, Ireland
| | - Iris J M Post
- The School of Genetics and Microbiology, Trinity College Dublin, Dublin 2, Ireland
| | - Mubeen Khan
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
- International Max Planck Research School for Language Sciences, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
| | - Zelia Corradi
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
- Academic Alliance Genetics, Radboud University Medical Center, Nijmegen, and Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Niamh Wynne
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin 2, Ireland
| | - James J O' Byrne
- Mater Clinical Ophthalmic Genetics Unit, The Mater Misericordiae University Hospital, Dublin 7, Ireland
- International Max Planck Research School for Language Sciences, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
- National Centre for Inherited Metabolic Disorders, The Mater Misericordiae University Hospital, Dublin 7, Ireland
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Emma Duignan
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin 2, Ireland
| | - Giuliana Silvestri
- Centre for Experimental Medicine, Queen's University Belfast, Belfast, Northern Ireland, UK
- School of Medicine, University College Dublin, Dublin 4, Ireland
- Department of Ophthalmology, The Royal Victoria Hospital, Belfast, Northern Ireland, UK
| | - Susanne Roosing
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
- Academic Alliance Genetics, Radboud University Medical Center, Nijmegen, and Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Frans P M Cremers
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
- Academic Alliance Genetics, Radboud University Medical Center, Nijmegen, and Maastricht University Medical Center+, Maastricht, The Netherlands
| | - David J Keegan
- Mater Clinical Ophthalmic Genetics Unit, The Mater Misericordiae University Hospital, Dublin 7, Ireland
| | - Paul F Kenna
- The School of Genetics and Microbiology, Trinity College Dublin, Dublin 2, Ireland
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin 2, Ireland
| | - G Jane Farrar
- The School of Genetics and Microbiology, Trinity College Dublin, Dublin 2, Ireland
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Mahroo OA, Duignan E. Photoreceptors in health and monogenic disease: from half a billion years ago to the future. J Physiol 2022; 600:4583-4584. [PMID: 36083438 DOI: 10.1113/jp283652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Omar A Mahroo
- Institute of Ophthalmology, University College London, Bath Street, London, UK.,Retinal and Genetics Services, Moorfields Eye Hospital, 162 City Road, London, UK.,Section of Ophthalmology, King's College London, St Thomas' Hospital Campus, Westminster Bridge Road, London, UK.,Physiology, Development and Neuroscience, University of Cambridge, Downing Street, Cambridge, UK
| | - Emma Duignan
- Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin, Ireland
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Bredin P, Murphy C, O'Dwyer R, Keogh R, Doolan A, Duignan E, Jones A, Santos M, Egan K, Murphy A, Naidoo J, Morris P, Hennessy B, Grogan L, Breathnach O. 1637P Unintended consequences for an integrated oncology ecosystem from COVID adaptations. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Stephenson KAJ, Zhu J, Wynne N, Dockery A, Cairns RM, Duignan E, Whelan L, Malone CP, Dempsey H, Collins K, Routledge S, Pandey R, Crossan E, Turner J, O'Byrne JJ, Brady L, Silvestri G, Kenna PF, Farrar GJ, Keegan DJ. Target 5000: a standardized all-Ireland pathway for the diagnosis and management of inherited retinal degenerations. Orphanet J Rare Dis 2021; 16:200. [PMID: 33952326 PMCID: PMC8097252 DOI: 10.1186/s13023-021-01841-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 04/23/2021] [Indexed: 02/02/2023] Open
Abstract
Introduction Inherited retinal degenerations (IRD) are rare genetic disorders with > 300 known genetic loci, manifesting variably progressive visual dysfunction. IRDs were historically underserved due to lack of effective interventions. Many novel therapies will require accurate diagnosis (phenotype and genotype), thus an efficient and effective pathway for assessment and management is required.
Methods Using surveys of existing practice patterns and advice from international experts, an all-Ireland IRD service (Target 5000) was designed. Detailed phenotyping was followed by next generation genetic sequencing in both a research and accredited laboratory. Unresolved pedigrees underwent further studies (whole gene/whole exome/whole genome sequencing). Novel variants were interrogated for pathogenicity (cascade screening, in silico analysis, functional studies). A multidisciplinary team (MDT; ophthalmologists, physicians, geneticists, genetic counsellors) reconciled phenotype with genotype. A bespoke care plan was created for each patient comprising supports, existing interventions, and novel therapies/clinical trials. Results and discussion Prior to Target 5000, a significant cohort of patients were not engaged with healthcare/support services due to lack of effective interventions. Pathogenic or likely pathogenic variants in IRD-associated genes were detected in 62.3%, with 11.6% having variants of unknown significance. The genotyping arm of Target 5000 allowed a 42.73% cost saving over independent testing, plus the value of MDT expertise/processing. Partial funding has transferred from charitable sources to government resources. Conclusion Target 5000 demonstrates efficacious and efficient clinical/genetic diagnosis, while discovering novel IRD-implicated genes/variants and investigating mechanisms of disease and avenues of intervention. This model could be used to develop similar IRD programmes in small/medium-sized nations. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-01841-1.
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Affiliation(s)
- Kirk A J Stephenson
- Mater Clinical Ophthalmic Genetics Unit, Mater Misericordiae University Hospital, Dublin, Ireland.
| | - Julia Zhu
- Mater Clinical Ophthalmic Genetics Unit, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Niamh Wynne
- The Research Foundation, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Adrian Dockery
- Ocular Genetics Unit, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Rebecca M Cairns
- Belfast Health and Social Care Trust Hospitals, Belfast, Northern Ireland
| | - Emma Duignan
- The Research Foundation, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Laura Whelan
- Ocular Genetics Unit, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Conor P Malone
- The Research Foundation, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Hilary Dempsey
- The Research Foundation, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Karen Collins
- The Research Foundation, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Shana Routledge
- Mater Clinical Ophthalmic Genetics Unit, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Rajiv Pandey
- Mater Clinical Ophthalmic Genetics Unit, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Elaine Crossan
- Mater Clinical Ophthalmic Genetics Unit, Mater Misericordiae University Hospital, Dublin, Ireland.,National Council for the Blind of Ireland, Whitworth Road, Dublin 9, Ireland
| | - Jacqueline Turner
- Mater Clinical Ophthalmic Genetics Unit, Mater Misericordiae University Hospital, Dublin, Ireland
| | - James J O'Byrne
- Mater Clinical Ophthalmic Genetics Unit, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Laura Brady
- Fighting Blindness Ireland, Ely Place, Dublin 2, Ireland
| | - Giuliana Silvestri
- Belfast Health and Social Care Trust Hospitals, Belfast, Northern Ireland
| | - Paul F Kenna
- The Research Foundation, Royal Victoria Eye and Ear Hospital, Dublin, Ireland.,Ocular Genetics Unit, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - G Jane Farrar
- Ocular Genetics Unit, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - David J Keegan
- Mater Clinical Ophthalmic Genetics Unit, Mater Misericordiae University Hospital, Dublin, Ireland
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Duignan E, O'Day R, Moloney T, Rahman W, Damato B. A Case Series of "Solitary Idiopathic Choroiditis" and Proposal of a Nomenclature Change to "Idiopathic Scleroma". Ocul Oncol Pathol 2021; 7:48-53. [PMID: 33796517 PMCID: PMC7989809 DOI: 10.1159/000509942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/06/2020] [Indexed: 11/19/2022] Open
Abstract
Objective To define the characteristics of solitary idiopathic choroiditis (SIC) in a consecutive series of patients and propose a nomenclature change to idiopathic scleroma. Materials and Methods Electronic patient records were retrospectively interrogated to identify all patients diagnosed with SIC between 2002 and 2019 in a tertiary referral ophthalmic hospital in the United Kingdom. Results Thirty-four eyes of 34 patients were found to have SIC. The mean age at diagnosis was 48 years (range 24-78) and 23 patients (68%) were female. All lesions were located posterior to the equator, most frequently in the inferotemporal quadrant (13 eyes, 38%). The lesions had a mean largest basal diameter of 1.2 ± 0.4 disc diameters (range 0.5-2) and their distance to the optic disc had a mean of 1.2 ± 0.9 disc diameters (range 0-3.3). All lesions were intrascleral on enhanced depth imaging optical coherence tomography, demonstrating a hypo-reflective zone within the sclera, with an underlying hyper-reflective zone in some cases. No lesion enlarged or developed features consistent with active inflammation after a median follow-up time of 0.9 years (range 0-16.8). Discussion/Conclusion Optical coherence tomography shows SIC to be an intrascleral lesion. Furthermore, we found no evidence of any inflammatory component. A nomenclature change to idiopathic scleroma is appropriate to prevent unnecessary investigation.
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Affiliation(s)
- Emma Duignan
- Ophthalmology Department, Moorfields Eye Hospital, London, United Kingdom
| | - Roderick O'Day
- Ophthalmology Department, Moorfields Eye Hospital, London, United Kingdom
| | - Thomas Moloney
- Ophthalmology Department, Moorfields Eye Hospital, London, United Kingdom
| | - Waheeda Rahman
- Ophthalmology Department, Moorfields Eye Hospital, London, United Kingdom
| | - Bertil Damato
- Ophthalmology Department, Moorfields Eye Hospital, London, United Kingdom.,Nuffield Laboratory of Ophthalmology, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
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McHale C, Briggs R, Fitzhenry D, O'Neill D, Coughlan T, Collins R, Connolly A, Austin N, Freeman J, Duignan E, Mooney C, Kennelly S. 272PERCEPTIONS OF SAFE FUNCTIONING WITHIN THE CONTEXT OF PEOPLE ATTENDING A MULTIDISCIPLINARY MEMORY ASSESSMENT SERVICE. Age Ageing 2016. [DOI: 10.1093/ageing/afw159.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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McHale C, Briggs R, Fitzhenry D, O'Neill D, Coughlan T, Collins R, Doherty J, Connolly A, Austin N, Freeman J, Tobin F, Duignan E, Mooney C, Lawson S. 271DRIVING PREVALENCE AMONGST PEOPLE ATTENDING A MULTIDISCIPLINARY MEMORY ASSESSMENT SERVICE. Age Ageing 2016. [DOI: 10.1093/ageing/afw159.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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8
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Carrigan M, Duignan E, Malone CPG, Stephenson K, Saad T, McDermott C, Green A, Keegan D, Humphries P, Kenna PF, Farrar GJ. Panel-Based Population Next-Generation Sequencing for Inherited Retinal Degenerations. Sci Rep 2016; 6:33248. [PMID: 27624628 PMCID: PMC5021935 DOI: 10.1038/srep33248] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 08/23/2016] [Indexed: 12/15/2022] Open
Abstract
Inherited retinopathies affect approximately two and a half million people globally, yet the majority of affected patients lack clear genetic diagnoses given the diverse range of genes and mutations implicated in these conditions. We present results from a next-generation sequencing study of a large inherited retinal disease patient population, with the goal of providing clear and actionable genetic diagnoses. Targeted sequencing was performed on 539 individuals from 309 inherited retinal disease pedigrees. Causative mutations were identified in the majority (57%, 176/309) of pedigrees. We report the association of many previously unreported variants with retinal disease, as well as new disease phenotypes associated with known genes, including the first association of the SLC24A1 gene with retinitis pigmentosa. Population statistics reporting the genes most commonly implicated in retinal disease in the cohort are presented, as are some diagnostic conundrums that can arise during such studies. Inherited retinal diseases represent an exemplar group of disorders for the application of panel-based next-generation sequencing as an effective tool for detection of causative mutations.
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Affiliation(s)
- Matthew Carrigan
- School of Genetics and Microbiology, Trinity College Dublin, Dublin, Ireland
| | - Emma Duignan
- Research Foundation, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Conor P G Malone
- Research Foundation, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | | | - Tahira Saad
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - Ciara McDermott
- School of Genetics and Microbiology, Trinity College Dublin, Dublin, Ireland
| | - Andrew Green
- Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
| | - David Keegan
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - Peter Humphries
- School of Genetics and Microbiology, Trinity College Dublin, Dublin, Ireland
| | - Paul F Kenna
- School of Genetics and Microbiology, Trinity College Dublin, Dublin, Ireland.,Research Foundation, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - G Jane Farrar
- School of Genetics and Microbiology, Trinity College Dublin, Dublin, Ireland
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Carrigan M, Duignan E, Humphries P, Palfi A, Kenna PF, Farrar GJ. A novel homozygous truncating GNAT1 mutation implicated in retinal degeneration. Br J Ophthalmol 2015; 100:495-500. [PMID: 26472407 PMCID: PMC4826887 DOI: 10.1136/bjophthalmol-2015-306939] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 08/01/2015] [Indexed: 11/30/2022]
Abstract
Background The GNAT1 gene encodes the α subunit of the rod transducin protein, a key element in the rod phototransduction cascade. Variants in GNAT1 have been implicated in stationary night-blindness in the past, but unlike other proteins in the same pathway, it has not previously been implicated in retinitis pigmentosa. Methods A panel of 182 retinopathy-associated genes was sequenced to locate disease-causing mutations in patients with inherited retinopathies. Results Sequencing revealed a novel homozygous truncating mutation in the GNAT1 gene in a patient with significant pigmentary disturbance and constriction of visual fields, a presentation consistent with retinitis pigmentosa. This is the first report of a patient homozygous for a complete loss-of-function GNAT1 mutation. The clinical data from this patient provide definitive evidence of retinitis pigmentosa with late onset in addition to the lifelong night-blindness that would be expected from a lack of transducin function. Conclusion These data suggest that some truncating GNAT1 variants can indeed cause a recessive, mild, late-onset retinal degeneration in human beings rather than just stationary night-blindness as reported previously, with notable similarities to the phenotype of the Gnat1 knockout mouse.
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Affiliation(s)
- Matthew Carrigan
- School of Genetics and Microbiology, Trinity College Dublin, Dublin, Ireland
| | - Emma Duignan
- Research Foundation, Royal Victoria Eye & Ear Hospital, Dublin, Ireland
| | - Pete Humphries
- School of Genetics and Microbiology, Trinity College Dublin, Dublin, Ireland
| | - Arpad Palfi
- School of Genetics and Microbiology, Trinity College Dublin, Dublin, Ireland
| | - Paul F Kenna
- School of Genetics and Microbiology, Trinity College Dublin, Dublin, Ireland Research Foundation, Royal Victoria Eye & Ear Hospital, Dublin, Ireland
| | - G Jane Farrar
- School of Genetics and Microbiology, Trinity College Dublin, Dublin, Ireland
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10
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Treacy MP, Wynne NC, Gale JL, Duignan E, Moran B, Flynn AM, Ormond P, Barry R, Khan R, Moriarty P, Cassidy L. Mohs micrographic surgery for periocular skin tumours in Ireland. Ir J Med Sci 2015; 185:779-783. [PMID: 26159430 DOI: 10.1007/s11845-015-1296-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 04/06/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To describe the shared care and outcomes of patients with periocular skin tumours who underwent Mohs micrographic surgery (MMS) performed by dermatologists, followed by oculoplastic reconstruction undertaken by ophthalmologists at two teaching and one private hospital in Ireland. RESEARCH DESIGN AND METHODS This was a retrospective chart review at the Royal Victoria Eye and Ear Hospital, St James Hospital and the Hermitage Clinic. RESULTS One hundred and twenty seven patients had periocular Mohs surgery between November 2006 and January 2013 mainly indicated for basal cell carcinoma. The mean follow-up time was 2 years and to date there have been no local recurrences. CONCLUSIONS MMS is available in Ireland and should be considered for patients with facial tumours in the ocular region.
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Affiliation(s)
- M P Treacy
- Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin, 2, Ireland, Ireland
| | - N C Wynne
- Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin, 2, Ireland, Ireland.
| | - J L Gale
- Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin, 2, Ireland, Ireland
| | - E Duignan
- Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin, 2, Ireland, Ireland
| | - B Moran
- Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin, 2, Ireland, Ireland
| | - A M Flynn
- Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin, 2, Ireland, Ireland.,St James Hospital, James Street, Dublin, 8, Ireland
| | - P Ormond
- Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin, 2, Ireland, Ireland.,St James Hospital, James Street, Dublin, 8, Ireland
| | - R Barry
- Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin, 2, Ireland, Ireland.,St James Hospital, James Street, Dublin, 8, Ireland
| | - R Khan
- Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin, 2, Ireland, Ireland
| | - P Moriarty
- Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin, 2, Ireland, Ireland
| | - L Cassidy
- Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin, 2, Ireland, Ireland
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Duignan E, Kenna P, Watson R, Fitzsimon S, Brosnahan D. Ophthalmic manifestations of vitamin A and D deficiency in two autistic teenagers: case reports and a review of the literature. Case Rep Ophthalmol 2015; 6:24-9. [PMID: 25759666 PMCID: PMC4327555 DOI: 10.1159/000373921] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We describe the cases of 2 autistic children with ophthalmic and systemic manifestations of vitamin A deficiency due to food faddism. Although vitamin A deficiency is common in the developing world, reports in developed societies are rare. Our patients presented over a 1-year period. The patients were 14 and 13 years old at the time of presentation and were both found to have marked features of vitamin A deficiency related to unusual dietary habits. Anterior segment signs of xerophthalmia were present in both patients. In addition, patient 1 showed evidence of a rod-predominant retinopathy, which resolved with vitamin A supplementation. Due to its rare occurrence, hypovitaminosis A must be highlighted and anticipated in this cohort.
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Affiliation(s)
- Emma Duignan
- Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Paul Kenna
- Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | | | | | - Donal Brosnahan
- Royal Victoria Eye and Ear Hospital, Dublin, Ireland ; Our Lady's Children's Hospital, Dublin, Ireland
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12
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Healy DG, Duignan E, Tolan M, Young VK, O’Connell B, McGovern E. Should cardiac surgery be delayed among carriers of methicillin-resistant Staphylococcus aureus to reduce methicillin-resistant Staphylococcus aureus-related morbidity by preoperative decolonisation? Eur J Cardiothorac Surg 2011; 39:68-74. [DOI: 10.1016/j.ejcts.2010.05.043] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Revised: 05/17/2010] [Accepted: 05/20/2010] [Indexed: 10/19/2022] Open
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