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Lopriore P, Vista M, Maritato P, Caldarazzo Ienco E, Bassani L, Natale G, Tessa A, Santorelli FM, Orsucci D. Deep neurological phenotyping in oculo-dento-digital syndrome. Neurol Sci 2024; 45:2853-2857. [PMID: 38253744 DOI: 10.1007/s10072-024-07331-z] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 01/11/2024] [Indexed: 01/24/2024]
Abstract
OBJECTIVES Oculodentodigital dysplasia (ODDD) is a rare autosomal dominant congenital malformation syndrome characterized by high penetrance and great phenotypic heterogeneity. Neurological manifestations are thought to occur in about one third of cases, but systematic studies are not available. We performed deep neurological phenotyping of 10 patients in one ODDD pedigree. METHODS Retrospective case series. We analyzed in depth the neurological phenotype of a three-generation family segregating the heterozygous c.416 T > C, p.(Ile139Thr) in GJA1. Clinical and neuroradiological features were retrospectively evaluated. Brain MRI and visual evoked potentials were performed in 8 and 6 cases, respectively. RESULTS Central nervous system manifestations occurred in 5 patients, the most common being isolated ataxia either in isolation or combined with spasticity. Furthermore, sphincteric disturbances (neurogenic bladder and fecal incontinence) were recognized as the first manifestation in most of the patients. Subclinical electrophysiological alteration of the optic pathway occurred in all the examined patients. Neuroimaging was significant for supratentorial hypomyelination pattern and hyperintense superior cerebellar peduncle in all examined patients. CONCLUSION The neurological involvement in ODDD carriers is often missed but peculiar clinical and radiological patterns can be recognized. Deep neurological phenotyping is needed to help untangle ODDD syndrome complexity and find genotype-phenotype correlations.
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Affiliation(s)
- P Lopriore
- Unit of Neurology, San Luca Hospital, Lucca, Italy
- Neurological Institute, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Vista
- Unit of Neurology, San Luca Hospital, Lucca, Italy
| | - P Maritato
- Unit of Neurology, San Luca Hospital, Lucca, Italy
| | | | - L Bassani
- Unit of Radiology, San Luca Hospital, Lucca, Italy
| | - G Natale
- Molecular Medicine, IRCCS Stella Maris Foundation, Pisa, Italy
| | - A Tessa
- Molecular Medicine, IRCCS Stella Maris Foundation, Pisa, Italy
| | - F M Santorelli
- Molecular Medicine, IRCCS Stella Maris Foundation, Pisa, Italy
| | - D Orsucci
- Unit of Neurology, San Luca Hospital, Lucca, Italy.
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Freitas LF, Miranda EC, Amaro AP, Narvaez EDO, Duarte ML. Tuberomammillary Fusion and Moya-Moya Vasculopathy Associated with PHACE Syndrome. Neuropediatrics 2024; 55:213-214. [PMID: 37716357 DOI: 10.1055/a-2177-0358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/18/2023]
Affiliation(s)
- Leonardo Furtado Freitas
- Division of Neuroradiology, Department of Radiology, McGill University, Montreal, Quebec, Canada
| | | | - Aline Pimentel Amaro
- Departamento de Neurorradiologia, Rede Mater Dei de Saúde, Belo Horizonte, Minas Gerais, Brazil
| | | | - Márcio Luís Duarte
- Radiology Department, Universidade de Ribeirão Preto, Guarujá, São Paulo, Brazil
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Cronemberger S, Albuquerque ALB, Silva ACSE, Zanini JLSS, da Silva AHG, Barbosa LF, da Cunha Rubião F, de Lima FL, Casimiro RF, Martins MP, Diniz-Filho A, Bastos-Rodrigues L, Friedman E, De Marco L. Bilateral Peters' anomaly, aniridia and Wilms tumour (WAGR syndrome) in monozygotic twins. Acta Paediatr 2024; 113:1420-1425. [PMID: 38363039 DOI: 10.1111/apa.17160] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/31/2024] [Accepted: 02/08/2024] [Indexed: 02/17/2024]
Abstract
AIM This study reports the bilateral association of Peters' anomaly and congenital aniridia in monozygotic twins subsequently diagnosed with Wilms tumour (WAGR syndrome). METHODS Two monozygotic female twins were referred at age 2 months with bilateral corneal opacity. A diagnosis of Peters' anomaly associated to aniridia was made in both eyes of both twins. Physical examination and ultrasonography were carried out at 12 months of age to explore the possibility of WAGR-related anomalies, specifically Wilms tumour. DNA were isolated and subjected to whole exome sequencing. RESULTS Peters' anomaly associated to aniridia in both eyes as well as bilateral Wilms tumour in both children were diagnosed. Exome analyses showed a large heterozygous deletion encompassing 6 648 473 bp in chromosome 11p13, using Integrative Genomics Viewer and AnnotSV software. CONCLUSION WAGR syndrome is a rare contiguous gene deletion syndrome with a greater risk of developing Wilms tumour associated with Peters' anomaly and congenital aniridia. However, co-occurrence of both anomalies was rarely reported in twins, and never in both eyes of monozygotic twins. Here, we report the bilateral association of Peters' anomaly and congenital aniridia in monozygotic twins with WAGR syndrome.
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Affiliation(s)
| | - Anna L B Albuquerque
- Department of Surgery, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | | | - Luciana F Barbosa
- Hospital São Geraldo, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Felipe L de Lima
- Hospital São Geraldo, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Alberto Diniz-Filho
- Hospital São Geraldo, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Eitan Friedman
- The Preventive Personalized Medicine Center, Assuta Medical Center and the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Luiz De Marco
- Department of Surgery, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Cervera-Taulet E, Montero-Hernández J, Monferrer Adsuara C, Pulido JS. The contribution of indocyanine green angiography in a case of unilateral retinal pigment epithelium dysgenesis. Eur J Ophthalmol 2024; 34:NP46-NP52. [PMID: 37649336 DOI: 10.1177/11206721231199337] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
PURPOSE To further enhance understanding of the expanded clinical spectrum of unilateral retinal pigment epithelium dysgenesis (URPED) via numerous imaging modalities including novel markers of highly detailed indocyanine green angiography (ICGA) features. METHODS Retrospective, observational, case report. RESULTS URPED in this patient is expressed as a solitary, flat and pigmented lesion in the posterior pole with RPE hyperplasia and atrophic changes. An epiretinal membrane (ERM) causing fine, tortuous retinal vessels and retinal folds was observed. Green and blue excitation light fundus autofluorescence showed a biphasic appearance with hypoautofluorescent rounded lesions and a reticular configuration of normal RPE. Fundus fluorescein angiography revealed diffuse hypofluorescence and hyperfluorescent wisps of leakage in late-phases. Early-phase of ICGA evidenced diffuse hypocianescence and a delineated hypercianescent scalloped margin appeared in the late-phase, together with focal hypocianescent spots. SD-OCT demonstrated irregularity of the RPE with fibrosis and hyperplastic changes combined with atrophic areas. Flat RPE detachments intermingled with healthy-appearing RPE were also observed together with thinning of the outer retina. ERM with thickening and disorganization involving the whole retina was present. Optical coherence tomography angiography (14 × 14 mm) revealed an oval shape foveal avascular zone and vascular anomalies such as tortuosity and looping. CONCLUSION URPED is an extremely rare clinical entity with only a few cases reported. In this case the almost pathognomonic differential features of URPED were best appreciated with ICGA imaging. To our knowledge, this is the first reported case of URPED with these abnormal findings on ICGA meaning it could be part of the spectrum of the disease.
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Affiliation(s)
| | | | | | - Jose S Pulido
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, PA, USA
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Untaroiu A, Reis LM, Higgins BP, Walesa A, Zacharias S, Nikezic D, Costakos DM, Carroll J, Semina EV. In Vivo Assessment of Retinal Phenotypes in Axenfeld-Rieger Syndrome. Invest Ophthalmol Vis Sci 2024; 65:20. [PMID: 38587439 PMCID: PMC11005067 DOI: 10.1167/iovs.65.4.20] [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: 01/05/2024] [Accepted: 03/22/2024] [Indexed: 04/09/2024] Open
Abstract
Purpose Axenfeld-Rieger syndrome (ARS) is characterized by ocular anomalies including posterior embryotoxon, iridocorneal adhesions, corectopia/iris hypoplasia, and developmental glaucoma. Although anterior segment defects and glaucoma contribute to decreased visual acuity, the role of potential posterior segment abnormalities has not been explored. We used high-resolution retinal imaging to test the hypothesis that individuals with ARS have posterior segment pathology. Methods Three individuals with FOXC1-ARS and 10 with PITX2-ARS completed slit-lamp and fundus photography, optical coherence tomography (OCT), OCT angiography, and adaptive optics scanning light ophthalmoscopy (AOSLO). Quantitative metrics were compared to previously published values for individuals with normal vision. Results All individuals demonstrated typical anterior segment phenotypes. Average ganglion cell and inner plexiform layer thickness was lower in PITX2-ARS, consistent with the glaucoma history in this group. A novel phenotype of foveal hypoplasia was noted in 40% of individuals with PITX2-ARS (but none with FOXC1-ARS). Moreover, the depth and volume of the foveal pit were significantly lower in PITX2-ARS compared to normal controls, even excluding individuals with foveal hypoplasia. Analysis of known foveal hypoplasia genes failed to identify an alternative explanation. Foveal cone density was decreased in one individual with foveal hypoplasia and normal in six without foveal hypoplasia. Two individuals (one from each group) demonstrated non-foveal retinal irregularities with regions of photoreceptor anomalies on OCT and AOSLO. Conclusions These findings implicate PITX2 in the development of the posterior segment, particularly the fovea, in humans. The identified posterior segment phenotypes may contribute to visual acuity deficits in individuals with PITX2-ARS.
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Affiliation(s)
- Ana Untaroiu
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Linda M. Reis
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Brian P. Higgins
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Ashleigh Walesa
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Serena Zacharias
- School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Danica Nikezic
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Deborah M. Costakos
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Joseph Carroll
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Elena V. Semina
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Department of Pediatrics and Children's Research Institute, Medical College of Wisconsin and Childrens Wisconsin, Milwaukee, Wisconsin, United States
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Di Nora A, Pizzo F, Testaì M, Gulizia C, Pavone P. Beard neonatal hemangioma: report of a PHACE syndrome. Acta Neurol Belg 2024; 124:727-728. [PMID: 38104298 DOI: 10.1007/s13760-023-02450-4] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/27/2023] [Indexed: 12/19/2023]
Affiliation(s)
- Alessandra Di Nora
- Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123, Catania, Italy.
| | - Francesco Pizzo
- Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Martina Testaì
- Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Carmela Gulizia
- Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - Piero Pavone
- Unit of Rare Diseases of the Nervous System in Childhood, Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, AOU "Policlinico", PO "G. Rodolico", Via S. Sofia, 87, 95128, Catania, Italy
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Sweis Dahleh D, Jiménez Gañán E, Serra Castanera A. Posterior embryotoxon as the initial ophthalmological sign of Axenfeld-Rieger syndrome. Arch Soc Esp Oftalmol (Engl Ed) 2024; 99:87. [PMID: 38006999 DOI: 10.1016/j.oftale.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 10/20/2023] [Indexed: 11/27/2023]
Affiliation(s)
- D Sweis Dahleh
- Departamento de Oftalmología, Hospital San Joan de Déu, Barcelona, Spain.
| | - E Jiménez Gañán
- Departamento de Oftalmología, Hospital San Joan de Déu, Barcelona, Spain
| | - A Serra Castanera
- Departamento de Oftalmología, Hospital San Joan de Déu, Barcelona, Spain
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Arturo C, Maurizio F, Grazia PM, Loredana A, Alessandro A, Roberta F. OCT-angiography in optic disk pit after inverted ILM flap: A case report. Eur J Ophthalmol 2024; 34:NP127-NP132. [PMID: 37264599 DOI: 10.1177/11206721231177894] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND To describe OCT-angiography features in a case of an optic disk pit (ODP) which underwent a pars plana vitrectomy with inverted ILM flap for macular detachment. CASE PRESENTATION A 12 years old child with an ODP responsible for a macular detachment underwent 23G vitrectomy in the subacute phase of the disease with an inverted ILM flap used as a plug over the lateral dehiscence of the pit. Among the various retinal imaging examinations performed in the post-operative period, the OCT-angiography showed very interesting features characterized by a capillary drop-out in correspondence of the superficial and deep capillary plexus, a fine texture of the choroid capillary layer and star-shaped folds in correspondence of both the outer retina and the choroid capillary layer. OCT-A performed 24 months after surgery showed a normalization of the macular perfusion which correlated with a full recovery of the visual acuity of the young child. CONCLUSIONS OCT-A is an useful tool to monitor the subretinal fluid reabsorption after ILM inverted flap surgery for ODP-maculopathy and correlates with visual function. OCT-A may be useful in the follow-up of this rare condition as well as its response to therapeutic strategies.
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Affiliation(s)
- Carta Arturo
- Ophthalmology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | | | - Pertile Maria Grazia
- Department of Ophthalmology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Appezzati Loredana
- Department of Ophthalmology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Alfano Alessandro
- Department of Ophthalmology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
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Patra S, Goyal G, Lone YA, Gupta G. Novel variant CPLANE 1: c.5051C>A (p.Ser1684Ter) in an Indian neonate with Joubert syndrome. BMJ Case Rep 2023; 16:e255561. [PMID: 37258045 PMCID: PMC10255207 DOI: 10.1136/bcr-2023-255561] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Joubert syndrome (JS) is a rare ciliopathy that presents with the triad of hypotonia, developmental delay and molar tooth sign (MTS) in brain MRI. Next-generation sequencing has identified about 35 genes which are known to cause JS of which CPLANE 1 mutation is found in 8%-10% of cases. We report a case of JS in an Indian neonate who presented with hypotonia, dysmorphic facies, polydactyly, syndactyly and occipital encephalocele. MRI of the brain revealed MTS, and compound heterozygous mutations in CPLANE 1 gene were detected by clinical exome sequencing, one of them a novel variant CPLANE 1: c.5051C>A (p.Ser1684Ter) in exon 26, which was inherited from the parents.
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Affiliation(s)
- Saikat Patra
- Neonatology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Garima Goyal
- Neonatology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Yasir Ahmad Lone
- Paediatric Surgery, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Girish Gupta
- Neonatology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
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Kaur S, Vyas S, Singh AK, Sukhija J. Utility of Anterior Segment Optical Coherence Tomography in Muscle Aplasia. J Pediatr Ophthalmol Strabismus 2022; 59:e20-e22. [PMID: 35343825 DOI: 10.3928/01913913-20211206-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Congenital absence of the extraocular muscles is a relatively rare entity that is diagnosed by magnetic resonance imaging and is usually associated with craniofacial syndromes, microcornea, microphthalmos, and coloboma. The authors describe anterior segment optical coherence tomography as a quick and valuable modality in this setting before subjecting the patient to magnetic resonance imaging or computed tomography. [J Pediatr Ophthalmol Strabismus. 2022;59(2):e20-e22.].
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Jiang S, Turco B, Choudhry N. VASCULAR PERFUSION DENSITY MAPPING USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY COMPARING NORMAL AND OPTIC DISK PIT EYES. Retin Cases Brief Rep 2022; 16:126-132. [PMID: 31688795 DOI: 10.1097/icb.0000000000000908] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE Optic disk pits (ODPs) are typically detected incidentally as small, gray, unilateral, oval-shaped excavation in the temporal optic disk on routine fundus examination. In this cross-sectional retrospective case series, we report optical coherence tomography angiography findings in patients with unilateral ODPs and describe changes in vessel perfusion associated with ODP. METHODS A total of eight eyes (four with ODP and four normal contralateral) were included in this study. Patients were excluded if any other optic disk abnormalities were present. Spectral-domain optical coherence tomography angiography (AngioVue; Optovue, Fremont, CA) imaging was conducted to map the vascularization of three layers in the optic nerve over a 4.5-mm × 4.5-mm region. The radial peripapillary capillaries, the nerve head capillaries, and the choriocapillaris were automatically segmented based on the OCT system software, and the capillary perfusion density (CPD) was quantified for each layer. Kruskal-Wallis one-way analysis of variance was used to compare CPD in normal and ODP eyes of four patients with monocular ODP. RESULTS Overall, CPD was lower in eyes with ODP compared with the contralateral normal eye in the radial peripapillary capillary (0.4521 ± 0.08 vs. 0.5505 ± 0.03, P = 0.08) and nerve head capillary layers (0.5461 ± 0.08 vs. 0.5989 ± 0.01, P = 0.08). Significantly lower CPD values were associated with ODP eyes in the radial peripapillary capillary layer within the disk (P = 0.04), inferior nasal (P = 0.04), and temporal (P = 0.02) regions and in the nerve head vessel layer within the disk region (P = 0.04). Significantly higher CPD values were associated with ODP eyes in the choriocapillaris layer within the nasal (P = 0.02), superior temporal (P = 0.02), and inferior temporal (P = 0.02) regions. Visual acuity was also decreased in ODP eyes at 0.4 ± 0.3 logarithm of the minimum angle of resolution units (20/50) compared with normal eyes at 0.1 ± 0.1 logarithm of the minimum angle of resolution units (20/25) (P = 0.12). CONCLUSION This study demonstrated that the presence of an ODP is associated with decreased vascular density in some regions of the optic disk and reduced visual acuity.
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Affiliation(s)
- Shangjun Jiang
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Bryen Turco
- Wayne State University School of Medicine, Detroit, Michigan
| | - Netan Choudhry
- Vitreous Retina Macula Specialists of Toronto, Etobicoke, Ontario, Canada; and
- Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ontario, Canada
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Affiliation(s)
- Jihane Habi
- Department of Radiology, Faculty of Medicine, Mohammed VI University of Health Sciences, Cheikh Khalifa International University Hospital, Casablanca, Morocco
- Corresponding author: Jihane Habi, Department of Radiology, Faculty of Medicine, Mohammed VI University of Health Sciences, Cheikh Khalifa International University Hospital, Casablanca, Morocco.
| | - Mohamed Mahi
- Department of Radiology, Faculty of Medicine, Mohammed VI University of Health Sciences, Cheikh Khalifa International University Hospital, Casablanca, Morocco
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Mahalingam K, Singh A, Gupta V, Gupta S. Hyperproliferative embryotoxon simulating double cornea. BMJ Case Rep 2021; 14:e246960. [PMID: 34937757 PMCID: PMC8704954 DOI: 10.1136/bcr-2021-246960] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2021] [Indexed: 11/04/2022] Open
Abstract
Posterior embryotoxon, an anteriorly displaced Schwalbe's line, is the most common feature of Axenfeld Rieger syndrome. We report a case of Axenfeld anomaly with unusual corneal manifestation, that is, a fairly symmetric, hyperproliferated posterior embryotoxon mimicking double cornea as well as a double pupil.
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Affiliation(s)
- Karthikeyan Mahalingam
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Abhishek Singh
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Viney Gupta
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Shikha Gupta
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India
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14
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Krajden Haratz K, Oliveira Szejnfeld P, Govindaswamy M, Leibovitz Z, Gindes L, Severino M, Rossi A, Paladini D, Garcia Rodriguez R, Ben-Sira L, Borkowski Tillman T, Gupta R, Lotem G, Raz N, Hamamoto TENK, Kidron D, Arad A, Birnbaum R, Brussilov M, Pomar L, Vial Y, Leventer RJ, McGillivray G, Fink M, Krzeszowski W, Fernandes Moron A, Lev D, Tamarkin M, Shalev J, Har Toov J, Lerman-Sagie T, Malinger G. Prenatal diagnosis of rhombencephalosynapsis: neuroimaging features and severity of vermian anomaly. Ultrasound Obstet Gynecol 2021; 58:864-874. [PMID: 33942916 DOI: 10.1002/uog.23660] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/24/2021] [Accepted: 04/16/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To describe the prenatal neuroimaging spectrum of rhombencephalosynapsis (RES) and criteria for its classification according to the severity of vermian anomaly. METHODS In this multicenter retrospective study of fetuses with RES between 2002 and 2020, the medical records and brain ultrasound and magnetic resonance images were evaluated comprehensively to determine the severity of the vermian anomaly and the presence of associated brain findings. RES was classified, according to the pattern of vermian agenesis and the extent of the fusion of the hemispheres, as complete RES (complete absence of the vermis) or partial RES (further classified according to the part of the vermis that was missing and, consequently, the region of hemispheric fusion, as anterior, posterior, severe or mixed RES). Findings were compared between cases with complete and those with partial RES. RESULTS Included in the study were 62 fetuses with a gestational age ranging between 12 and 37 weeks. Most had complete absence of the vermis (complete RES, 77.4% of cases), a 'round-shaped' cerebellum on axial views (72.6%) and a transverse cerebellar diameter (TCD) < 3rd centile (87.1%). Among the 22.6% of cases with partial RES, 6.5% were classified as severe partial, 6.5% as partial anterior, 8.1% as partial mixed and 1.6% as partial posterior. Half of these cases presented with normal or nearly normal cerebellar morphology and 28.5% had a TCD within the normal limits. Infratentorially, the fourth ventricle was abnormal in 88.7% of cases overall, and anomalies of the midbrain and pons were frequent (93.5% and 77.4%, respectively). Ventriculomegaly was observed in 80.6% of all cases, being more severe in cases with complete RES than in those with partial RES, with high rates of parenchymal and septal disruption. CONCLUSIONS This study provides prenatal neuroimaging criteria for the diagnosis and classification of RES, and identification of related features, using ultrasound and magnetic resonance imaging. According to our findings, a diagnosis of RES should be considered in fetuses with a small TCD (severe cerebellar hypoplasia) and/or a round-shaped cerebellum on axial views, during the second or third trimester, especially when associated with ventriculomegaly. Partial RES is more common than previously thought, but presents an extreme diagnostic challenge, especially in cases with normal or nearly-normal cerebellar morphobiometric features. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- K Krajden Haratz
- Fetal Neurology Multidisciplinary Group, Division of Ultrasound in Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - P Oliveira Szejnfeld
- Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, Brazil
- DDI UNIFESP, São Paulo, Brazil
- Fundação Instituto de Pesquisa e Estudo de Diagnostico por Imagem, São Paulo, Brazil
| | - M Govindaswamy
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Z Leibovitz
- Ultrasound in Obstetrics and Gynecology Unit, Bnai-Zion Medical Center, Haifa, Israel
- Technion Faculty of Medicine, Haifa, Israel
- Fetal Neurology Clinic, Ultrasound in Obstetrics and Gynecology Unit, Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel
| | - L Gindes
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Fetal Neurology Clinic, Ultrasound in Obstetrics and Gynecology Unit, Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel
| | - M Severino
- Neuroradiology Unit, IRCCS Istituto Giannini Gaslini, Genoa, Italy
| | - A Rossi
- Neuroradiology Unit, IRCCS Istituto Giannini Gaslini, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - D Paladini
- Fetal Medicine Unit, IRCCS Istituto G. Gaslini, Genoa, Italy
| | - R Garcia Rodriguez
- Complejo Hospitalario Insular Materno Infantil de Canarias, Las Palmas de Gran Canaria, Spain
| | - L Ben-Sira
- Fetal Neurology Multidisciplinary Group, Division of Ultrasound in Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Radiology Unit, Department of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - T Borkowski Tillman
- Fetal Neurology Multidisciplinary Group, Division of Ultrasound in Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - R Gupta
- Sunehri Devi Hospital, Sonepat India, Indraprastha Apollo Hospital, New Delhi, India
| | - G Lotem
- Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel
| | - N Raz
- Technion Faculty of Medicine, Haifa, Israel
- Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hedera, Israel
| | - T E N K Hamamoto
- Departamento de Obstetrícia da Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil
| | - D Kidron
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Pathology, Meir Medical Center, Kfar Saba, Israel
| | - A Arad
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Pathology, Bnai Zion Medical Center, Haifa, Israel
| | - R Birnbaum
- Fetal Neurology Multidisciplinary Group, Division of Ultrasound in Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M Brussilov
- Fetal Neurology Multidisciplinary Group, Division of Ultrasound in Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - L Pomar
- Ultrasound and Fetal Medicine Unit, Department Woman-Mother-Child, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
| | - Y Vial
- Ultrasound and Fetal Medicine Unit, Department Woman-Mother-Child, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
| | - R J Leventer
- Department of Neurology, The Royal Children's Hospital, Murdoch Children's Research Institute and University of Melbourne Department of Pediatrics, Melbourne, Australia
| | - G McGillivray
- Royal Women's Hospital, Mercy Hospital for Women and Murdoch Children's Research Institute, Melbourne, Australia
| | - M Fink
- Department of Medical Imaging, The Royal Children's Hospital and Perinatal Unit, The Mercy Hospital for Women, Melbourne, Australia
| | | | - A Fernandes Moron
- Departamento de Obstetrícia da Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil
| | - D Lev
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Fetal Neurology Clinic, Ultrasound in Obstetrics and Gynecology Unit, Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel
- Institute of Genetics, Wolfson Medical Center, Holon, Israel
| | - M Tamarkin
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Fetal Neurology Clinic, Ultrasound in Obstetrics and Gynecology Unit, Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel
| | - J Shalev
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Fetal Neurology Clinic, Ultrasound in Obstetrics and Gynecology Unit, Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel
- Institute of Genetics, Wolfson Medical Center, Holon, Israel
| | - J Har Toov
- Fetal Neurology Multidisciplinary Group, Division of Ultrasound in Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - T Lerman-Sagie
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Fetal Neurology Clinic, Ultrasound in Obstetrics and Gynecology Unit, Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel
- Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel
| | - G Malinger
- Fetal Neurology Multidisciplinary Group, Division of Ultrasound in Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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15
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Fieß A, Wagner FM, Urschitz MS, Nagler M, Stoffelns B, Wild PS, Münzel T, Beutel ME, Lackner KJ, Pfeiffer N, Schuster AK. Association of Birth Weight With Foveolar Thickness in Adulthood: Results From a Population-Based Study. Invest Ophthalmol Vis Sci 2021; 62:9. [PMID: 34757404 PMCID: PMC8590182 DOI: 10.1167/iovs.62.14.9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 10/04/2021] [Indexed: 12/23/2022] Open
Abstract
Purpose Low birth weight (BW) is associated with alterations of foveal shape development in childhood-leading to an increased retinal thickness of the fovea. The aim of the present study was to assess whether BW has a long-term effect on foveal retinal thickness (RT) and is still present in adulthood. Methods In the German population-based Gutenberg Health Study (GHS), participants were examined with spectral-domain optical coherence tomography. The association between self-reported BW and RT in the foveolar and perifoveal locations was assessed. Multivariable linear regression analyses with adjustment for potential confounders and grading of foveal hypoplasia were performed. Results Overall, RT measurements and self-reported BW were available for 2,539 participants (1300 female, mean age 54.5 ± 9.7 years). The absolute foveolar RT was 239.6 ± 25.8 µm, 232.2 ± 20.1 µm and 234.8 ± 21.0 µm, respectively, in the low (<2500 g), normal (2500-4000 g) and high (>4000 g) BW groups (P < 0.001). After adjustment for confounders, an association was observed between lower BW and increased foveolar thickness (B = -0.35 [95% confidence interval {CI}: -0.49; -0.20] µm/100 g; P < 0.001), whereas only a weak association with RT was observed with the nasal (P = 0.010), temporal (P = 0.011), and inferior (P = 0.021) quadrants in the 1 mm distance, with no association in the 2 mm distance to the fovea. Foveal hypoplasia grade 1 was more frequent in the low BW group (6.8%) compared to the normal (0.9%) and high BW group (1.2%). Conclusions This study provides evidence of an association between lower BW and increased foveolar thickness and foveal hypoplasia, indicating that prenatal growth may affect macular morphology, which in turn may persist until adulthood and predispose to retinal disease later in life.
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Affiliation(s)
- Achim Fieß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Felix M. Wagner
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael S. Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Markus Nagler
- Preventive Cardiology and Preventive Medicine/Department of Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Bernhard Stoffelns
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Philipp S. Wild
- Preventive Cardiology and Preventive Medicine/Department of Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology–Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Karl J. Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K. Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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16
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Sakurai Y, Watanabe T, Abe Y, Nawa T, Uchida T, Aoi H, Mizuguchi T, Matsumoto N, Haginoya K. Head titubation and irritability as early symptoms of Joubert syndrome with a homozygous NPHP1 variant. Brain Dev 2021; 43:863-866. [PMID: 34090716 DOI: 10.1016/j.braindev.2021.04.011] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/22/2021] [Accepted: 04/29/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Joubert syndrome is an autosomal recessive or X-linked genetic disease with a cerebellar vermis defect or hypoplasia, hypotonia, ocular dyskinesia, and mental retardation. In neonates, respiratory problems such as apnea and tachypnea are notable. CASE REPORT We report a patient Joubert syndrome with a homozygous NPHP1 variant, who had head titubation with irritability, including exaggerated jitteriness and a marked Morrow reflex appeared soon after birth without neonatal respiratory problems. These symptoms decreased gradually and disappeared until 1 year. CONCLUSION Irritability with head titubation may be an early clinical clue for the clinician to suspect Joubert syndrome.
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Affiliation(s)
- Yoshie Sakurai
- Department of Neonatology, Miyagi Children's Hospital, Japan.
| | | | - Yuki Abe
- Department of Neonatology, Miyagi Children's Hospital, Japan
| | - Tatsuro Nawa
- Department of Neonatology, Miyagi Children's Hospital, Japan
| | | | - Hiromi Aoi
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Takeshi Mizuguchi
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kazuhiro Haginoya
- Department of Pediatric Neurology, Miyagi Children's Hospital, Japan
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17
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Mamlouk MD, Vossough A, Caschera L, Maheshwari M, Hess CP. Arterial Spin-Labeling Perfusion for PHACE Syndrome. AJNR Am J Neuroradiol 2021; 42:173-177. [PMID: 33214180 DOI: 10.3174/ajnr.a6871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/19/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND PURPOSE Arterial stroke is a rare-but-reported complication in patients with posterior fossa brain malformations, hemangiomas, arterial anomalies, coarctation of the aorta and cardiac defects, and eye abnormalities (PHACE) syndrome. Currently, stroke risk is inferred by the severity of arterial anomalies identified on MRA, though no evidenced-based data exist. The purpose of our study was to determine whether arterial spin-labeling MR imaging perfusion can detect alterations in CBF in patients with PHACE syndrome. MATERIALS AND METHODS Records were reviewed from 3 institutions for all patients with PHACE syndrome who underwent arterial spin-labeling from 2000 to 2019. CBF was qualitatively investigated with arterial spin-labeling to determine whether there was decreased or normal perfusion. Arterial anomalies were characterized on MRA imaging, and parenchymal brain findings were evaluated on conventional MR imaging sequences. RESULTS Forty-one patients with PHACE syndrome had arterial spin-labeling imaging. There were 30 females and 11 males (age range, 7 days to 15 years). Of the 41 patients, 10 (24%) had decreased CBF signal corresponding to a major arterial territory. Ten of 10 patients had decreased CBF signal in the anterior circulation, 2/10 had decreased anterior and posterior circulation CBF signal, 2/10 had decreased bilateral anterior circulation CBF signal, and 1/10 had globally decreased CBF signal. Forty of 41 (97.5%) patients had at least 1 arteriopathy, and in those with decreased CBF signal, the arteriopathy corresponded to the CBF signal alteration in 10/10 patients. CONCLUSIONS Arterial spin-labeling can potentially characterize hemodynamic changes in patients with PHACE syndrome.
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Affiliation(s)
- M D Mamlouk
- From the Department of Radiology (M.D.M.), The Permanente Medical Group, Kaiser Permanente Medical Center, Santa Clara, Santa Clara, California
- Department of Radiology and Biomedical Imaging (M.D.M., C.P.H.), University of California, San Francisco, San Francisco, California
| | - A Vossough
- Department of Radiology (A.V., L.C.), Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - L Caschera
- Department of Radiology (A.V., L.C.), Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Radiology (L.C.), La Fondazione Institute for Research, Hospitalization and Health Care Ca' Granda Ospedale Maggiore di Milano Policlinico, Milan, Italy
| | - M Maheshwari
- Department of Radiology (M.M.), Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee, Wisconsin
| | - C P Hess
- Department of Radiology and Biomedical Imaging (M.D.M., C.P.H.), University of California, San Francisco, San Francisco, California
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18
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Epting D, Senaratne LDS, Ott E, Holmgren A, Sumathipala D, Larsen SM, Wallmeier J, Bracht D, Frikstad KM, Crowley S, Sikiric A, Barøy T, Käsmann‐Kellner B, Decker E, Decker C, Bachmann N, Patzke S, Phelps IG, Katsanis N, Giles R, Schmidts M, Zucknick M, Lienkamp SS, Omran H, Davis EE, Doherty D, Strømme P, Frengen E, Bergmann C, Misceo D. Loss of CBY1 results in a ciliopathy characterized by features of Joubert syndrome. Hum Mutat 2020; 41:2179-2194. [PMID: 33131181 PMCID: PMC7756669 DOI: 10.1002/humu.24127] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 08/31/2020] [Accepted: 10/04/2020] [Indexed: 12/17/2022]
Abstract
Ciliopathies are clinically and genetically heterogeneous diseases. We studied three patients from two independent families presenting with features of Joubert syndrome: abnormal breathing pattern during infancy, developmental delay/intellectual disability, cerebellar ataxia, molar tooth sign on magnetic resonance imaging scans, and polydactyly. We identified biallelic loss-of-function (LOF) variants in CBY1, segregating with the clinical features of Joubert syndrome in the families. CBY1 localizes to the distal end of the mother centriole, contributing to the formation and function of cilia. In accordance with the clinical and mutational findings in the affected individuals, we demonstrated that depletion of Cby1 in zebrafish causes ciliopathy-related phenotypes. Levels of CBY1 transcript were found reduced in the patients compared with controls, suggesting degradation of the mutated transcript through nonsense-mediated messenger RNA decay. Accordingly, we could detect CBY1 protein in fibroblasts from controls, but not from patients by immunofluorescence. Furthermore, we observed reduced ability to ciliate, increased ciliary length, and reduced levels of the ciliary proteins AHI1 and ARL13B in patient fibroblasts. Our data show that CBY1 LOF-variants cause a ciliopathy with features of Joubert syndrome.
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Affiliation(s)
- Daniel Epting
- Department of Medicine IV, Faculty of MedicineMedical Center‐University of FreiburgFreiburgGermany
| | | | - Elisabeth Ott
- Department of Medicine IV, Faculty of MedicineMedical Center‐University of FreiburgFreiburgGermany
| | - Asbjørn Holmgren
- Department of Medical GeneticsOslo University Hospital, University of OsloOsloNorway
| | - Dulika Sumathipala
- Department of Medical GeneticsOslo University Hospital, University of OsloOsloNorway
| | - Selma M. Larsen
- Division of Pediatric and Adolescent MedicineOslo University Hospital, University of OsloOsloNorway
| | - Julia Wallmeier
- Klinik für Kinder‐ und JugendmedizinUniversitätsklinikum MünsterMünsterGermany
| | - Diana Bracht
- Klinik für Kinder‐ und JugendmedizinUniversitätsklinikum MünsterMünsterGermany
| | - Kari‐Anne M. Frikstad
- Department of Radiation Biology, Division of Cancer Medicine, Surgery and Transplantation, Institute for Cancer ResearchOslo University Hospitals–Norwegian Radium HospitalOsloNorway
| | - Suzanne Crowley
- Division of Pediatric and Adolescent MedicineOslo University Hospital, University of OsloOsloNorway
| | - Alma Sikiric
- Department of NeurohabilitationOslo University HospitalOsloNorway
| | - Tuva Barøy
- Department of Medical GeneticsOslo University Hospital, University of OsloOsloNorway
| | - Barbara Käsmann‐Kellner
- Section of Pediatric Ophthalmology and Low Vision, Department of OphthalmologyUniversity of SaarlandHomburgGermany
| | - Eva Decker
- Medizinische Genetik MainzLimbach GeneticsMainzGermany
| | | | | | - Sebastian Patzke
- Department of Radiation Biology, Division of Cancer Medicine, Surgery and Transplantation, Institute for Cancer ResearchOslo University Hospitals–Norwegian Radium HospitalOsloNorway
| | - Ian G. Phelps
- Department of Pediatrics, Seattle Children's Research InstituteUniversity of WashingtonSeattleWashingtonUSA
| | - Nicholas Katsanis
- Center for Human Disease ModelingDuke University Medical CenterDurhamNorth CarolinaUSA
| | - Rachel Giles
- Department of Nephrology and HypertensionUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Miriam Schmidts
- International Radboud Institute for Molecular Life SciencesRadboud University NijmegenNijmegenThe Netherlands
| | - Manuela Zucknick
- Oslo Centre for Biostatistics and Epidemiology, Institute for Basic Medical SciencesUniversity of OsloOsloNorway
| | | | - Heymut Omran
- Klinik für Kinder‐ und JugendmedizinUniversitätsklinikum MünsterMünsterGermany
| | - Erica E. Davis
- Center for Human Disease ModelingDuke University Medical CenterDurhamNorth CarolinaUSA
| | - Dan Doherty
- Department of Pediatrics, Seattle Children's Research InstituteUniversity of WashingtonSeattleWashingtonUSA
| | - Petter Strømme
- Division of Pediatric and Adolescent MedicineOslo University Hospital, University of OsloOsloNorway
| | - Eirik Frengen
- Department of Medical GeneticsOslo University Hospital, University of OsloOsloNorway
| | - Carsten Bergmann
- Department of Medicine IV, Faculty of MedicineMedical Center‐University of FreiburgFreiburgGermany
- Medizinische Genetik MainzLimbach GeneticsMainzGermany
| | - Doriana Misceo
- Department of Medical GeneticsOslo University Hospital, University of OsloOsloNorway
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20
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Kuht HJ, Han J, Maconachie GDE, Park SE, Lee ST, McLean R, Sheth V, Hisaund M, Dawar B, Sylvius N, Mahmood U, Proudlock FA, Gottlob I, Lim HT, Thomas MG. SLC38A8 mutations result in arrested retinal development with loss of cone photoreceptor specialization. Hum Mol Genet 2020; 29:2989-3002. [PMID: 32744312 PMCID: PMC7645707 DOI: 10.1093/hmg/ddaa166] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 01/09/2023] Open
Abstract
Foveal hypoplasia, optic nerve decussation defects and anterior segment dysgenesis is an autosomal recessive disorder arising from SLC38A8 mutations. SLC38A8 is a putative glutamine transporter with strong expression within the photoreceptor layer in the retina. Previous studies have been limited due to lack of quantitative data on retinal development and nystagmus characteristics. In this multi-centre study, a custom-targeted next generation sequencing (NGS) gene panel was used to identify SLC38A8 mutations from a cohort of 511 nystagmus patients. We report 16 novel SLC38A8 mutations. The sixth transmembrane domain is most frequently disrupted by missense SLC38A8 mutations. Ninety percent of our cases were initially misdiagnosed as PAX6-related phenotype or ocular albinism prior to NGS. We characterized the retinal development in vivo in patients with SLC38A8 mutations using high-resolution optical coherence tomography. All patients had severe grades of arrested retinal development with lack of a foveal pit and no cone photoreceptor outer segment lengthening. Loss of foveal specialization features such as outer segment lengthening implies reduced foveal cone density, which contributes to reduced visual acuity. Unlike other disorders (such as albinism or PAX6 mutations) which exhibit a spectrum of foveal hypoplasia, SLC38A8 mutations have arrest of retinal development at an earlier stage resulting in a more under-developed retina and severe phenotype.
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Affiliation(s)
- Helen J Kuht
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester – RKCSB, PO Box 65, Leicester LE2 7LX, UK
| | - Jinu Han
- Institute of Vision Research, Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
| | - Gail D E Maconachie
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester – RKCSB, PO Box 65, Leicester LE2 7LX, UK
- Academic Unit of Ophthalmology and Orthoptics, University of Sheffield, Sheffield S10 2RX, UK
| | - Sung Eun Park
- Institute of Vision Research, Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
| | - Seung-Tae Lee
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
| | - Rebecca McLean
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester – RKCSB, PO Box 65, Leicester LE2 7LX, UK
| | - Viral Sheth
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester – RKCSB, PO Box 65, Leicester LE2 7LX, UK
| | - Michael Hisaund
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester – RKCSB, PO Box 65, Leicester LE2 7LX, UK
| | - Basu Dawar
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester – RKCSB, PO Box 65, Leicester LE2 7LX, UK
| | - Nicolas Sylvius
- Department of Genetics and Genome Biology, University of Leicester, Leicester LE1 7RH, UK
| | - Usman Mahmood
- Department of Ophthalmology, Hull and East Yorkshire Hospitals NHS Trust, Hull HU3 2JZ, UK
| | - Frank A Proudlock
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester – RKCSB, PO Box 65, Leicester LE2 7LX, UK
| | - Irene Gottlob
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester – RKCSB, PO Box 65, Leicester LE2 7LX, UK
| | - Hyun Taek Lim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Mervyn G Thomas
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester – RKCSB, PO Box 65, Leicester LE2 7LX, UK
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Bothra N, Krishnamurthy G, Ali MJ. Congenital canaliculops with punctal agenesis: is there a possibility to establish patency? Orbit 2020; 39:383-386. [PMID: 31755330 DOI: 10.1080/01676830.2019.1691609] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 11/07/2019] [Indexed: 06/10/2023]
Abstract
Canaliculops is a non-inflammatory dilatation of the canaliculus which can be secondary to trauma, punctal agenesis, herpetic infections or chronic drug use. This condition can affect either canaliculi and has shown female preponderance. Treatment described so far has consisted of cyst marsupialization with no literature on the post-operative epiphora in these cases. We describe two cases of canaliculops with punctal agenesis where we have tried to establish lacrimal patency.
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Affiliation(s)
- Nandini Bothra
- Govindram Seksaria Institute of Dacryology, L.V.Prasad Eye Institute , Hyderabad, India
| | - Gayatri Krishnamurthy
- Govindram Seksaria Institute of Dacryology, L.V.Prasad Eye Institute , Hyderabad, India
| | - Mohammad Javed Ali
- Govindram Seksaria Institute of Dacryology, L.V.Prasad Eye Institute , Hyderabad, India
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22
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Toto L, Evangelista F, Viggiano P, Erroi E, D'Onofrio G, Libertini D, Porreca A, D'Aloisio R, Mariacristina P, Di Antonio L, Di Nicola M, Mastropasqua R. Changes in Ocular Blood Flow after Ranibizumab Intravitreal Injection for Diabetic Macular Edema Measured Using Laser Speckle Flowgraphy. Biomed Res Int 2020; 2020:9496242. [PMID: 32104710 PMCID: PMC7035512 DOI: 10.1155/2020/9496242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/16/2019] [Accepted: 12/18/2019] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the effects of intravitreal ranibizumab (IVR) treatment on the blood flow of the optic nerve head (ONH) and of retinal vessels of the peripapillary region of eyes with diabetic macular edema (DME) assessed using laser speckle flowgraphy (LSFG). METHODS Forty eyes of 30 patients treated with IVR for DME were included in this prospective clinical study. Mean blur rate (MBR) and relative flow volume (RFV) of the ONH and of a superior retinal artery and an inferior retinal vein of the peripapillary region were measured using LSFG at baseline, 2 weeks (T1), and 1 month (T2) after IVR injection. In addition, best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were measured in all cases. RESULTS The BCVA improved and CRT decreased significantly during the follow-up period (p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p < 0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA. CONCLUSION IVR injection leads to a reduction of ocular blood flow both in the ONH and in the retinal peripapillary vessels associated with peripapillary vessel constriction. The reduction of CRT and related improvement of vision may be related to the changes in ocular blood flow.
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Affiliation(s)
- Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Federica Evangelista
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Pasquale Viggiano
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Emanuele Erroi
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Giada D'Onofrio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Daniele Libertini
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Annamaria Porreca
- Department of Economic Studies, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Rossella D'Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | | | - Luca Di Antonio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Italy
| | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University “G. d'Annunzio” Chieti-Pescara, Chieti 66100, Via dei Vestini 31, Italy
| | - Rodolfo Mastropasqua
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
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Shen W, Dai M, Su Y, Zhang Q, Li H. Hallermann-Streiff syndrome with uncommon ocular features, ultrasound biomicroscopy and optical coherence tomography findings: A case report. Medicine (Baltimore) 2019; 98:e18272. [PMID: 31804366 PMCID: PMC6919421 DOI: 10.1097/md.0000000000018272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Hallermann-Streiff syndrome (HSS) is a rare congenital disorder characterized by craniofacial malformations, sparse hair, degenerative skin changes, eye abnormalities, dental defects, and proportionate short stature. PATIENT CONCERNS A 24-year-old Chinese male patient presented to the ophthalmologist because of his sore eye and blurred vision. DIAGNOSES The final diagnosis of presented case is HSS having the main features of the syndrome, however, associated with uncommon ocular features, ultrasound biomicroscopy (UBM) and optical coherence tomography (OCT)changes, including aphakia, glaucoma, long eye axes, cilliary abnormalities, and chorioretinal atrophy. INTERVENTIONS Antiglaucomatous medical therapy failed to reduce the pressure in the right eye and a cyclocryotherapy was carried out. The antiglaucoma eye drops was continued in the left eye. OUTCOMES The intraocular pressure has been reduced to the normal range, but the vision has not improved. LESSONS In the diagnosis of HSS, we should not ignore the extraordinary information especially uncommon ophthalmic features, UBM and OCT changes. We highlight the necessity of a multidisciplinary approach for accurate diagnosis and appropriate management.
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Affiliation(s)
- Wei Shen
- Department of Ophthalmology, Fourth Affiliated Hospital of Kunming Medical University (the Second People's Hospital of Yunnan Province), Yunnan Eye Institute, Key Laboratory of Yunnan Province for the Prevention and Treatment of ophthalmology, Provincial Innovation Team for Cataract and Ocular Fundus Disease, The Second People's Hospital of Yunnan Province; Expert Workstation of Yao Ke
| | - Min Dai
- Department of Ophthalmology, Fourth Affiliated Hospital of Kunming Medical University (the Second People's Hospital of Yunnan Province), Yunnan Eye Institute, Key Laboratory of Yunnan Province for the Prevention and Treatment of ophthalmology, Provincial Innovation Team for Cataract and Ocular Fundus Disease, The Second People's Hospital of Yunnan Province; Expert Workstation of Yao Ke
| | - Yunshan Su
- Department of Radiology, the Second People's Hospital of Yunnan Province
| | - Qing Zhang
- Department of Ophthalmology, Fourth Affiliated Hospital of Kunming Medical University (the Second People's Hospital of Yunnan Province), Yunnan Eye Institute, Key Laboratory of Yunnan Province for the Prevention and Treatment of ophthalmology, Provincial Innovation Team for Cataract and Ocular Fundus Disease, The Second People's Hospital of Yunnan Province; Expert Workstation of Yao Ke
| | - Hongsong Li
- School of Information Science and Engineering, Yunnan University, Kunming, China
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Chawla R, Kumar A, Mandal S. Three-Dimensional Reconstruction Imaging of Peripapillary Intrachoroidal Cavitation in a Myopic Patient. Ophthalmol Retina 2019; 3:928. [PMID: 31699309 DOI: 10.1016/j.oret.2019.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 06/21/2019] [Accepted: 06/25/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Rohan Chawla
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Atul Kumar
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Sohini Mandal
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Pace NP, Benoit V, Agius D, Grima MA, Parascandalo R, Hilbert P, Borg I. Two novel GJA1 variants in oculodentodigital dysplasia. Mol Genet Genomic Med 2019; 7:e882. [PMID: 31347275 PMCID: PMC6732303 DOI: 10.1002/mgg3.882] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/05/2019] [Accepted: 07/08/2019] [Indexed: 12/20/2022] Open
Abstract
Background Oculodentodigital dysplasia (ODDD) is a rare disorder with pleiotropic effects involving multiple body systems, caused by mutations in the gap junction protein alpha 1 (GJA1) gene. GJA1 gene encodes a polytopic connexin membrane protein, Cx43, that is a component of connexon membrane channels. Methods We describe two unrelated female probands referred for a genetic review in view of a dysmorphic clinical phenotype. Results Two novel missense mutations in GJA1 that substitute conserved amino acids in the first and second transmembrane domains (NM_000165.5: c.77T>C p.Leu26Pro and NM_000165.5:c.287T>G p.Val96Gly) were detected through targeted sequencing of GJA1. These variants were detected in the heterozygous state in the two Maltese probands and segregated with the disease phenotype. Conclusion This report further expands the mutational spectrum of ODDD.
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Affiliation(s)
- Nikolai P. Pace
- Centre for Molecular Medicine and BiobankingUniversity of MaltaMsidaMalta
| | - Valerie Benoit
- Département de Biologie MoléculaireInstitut de Pathologie et de Génétique ASBLGosseliesBelgium
| | - David Agius
- Department of OphthalmologyMater Dei HospitalMsidaMalta
| | | | | | - Pascale Hilbert
- Département de Biologie MoléculaireInstitut de Pathologie et de Génétique ASBLGosseliesBelgium
| | - Isabella Borg
- Centre for Molecular Medicine and BiobankingUniversity of MaltaMsidaMalta
- Department of Pathology, Faculty of Medicine and SurgeryUniversity of MaltaMsidaMalta
- Medical Genetics Unit, Department of PathologyMater Dei HospitalMsidaMalta
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Dubucs C, Merveille M, Kessler S, Sevely A, Chassaing N, Calvas P. Prenatal diagnosis of Norrie disease based on ultrasound findings. Ultrasound Obstet Gynecol 2019; 54:138-139. [PMID: 30125416 DOI: 10.1002/uog.20097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 07/17/2018] [Accepted: 08/08/2018] [Indexed: 06/08/2023]
Affiliation(s)
- C Dubucs
- Service de Génétique Médicale, CHU Toulouse, Toulouse, France
| | - M Merveille
- Centre d'échographie des Carmes, Toulouse, France
| | - S Kessler
- Centre d'échographie des Carmes, Toulouse, France
| | - A Sevely
- Service de Radiologie Pédiatrique, CHU Toulouse, Toulouse, France
| | - N Chassaing
- Service de Génétique Médicale, CHU Toulouse, Toulouse, France
- UDEAR, UMR 1056 Inserm - Université de Toulouse, Toulouse, France
| | - P Calvas
- Service de Génétique Médicale, CHU Toulouse, Toulouse, France
- UDEAR, UMR 1056 Inserm - Université de Toulouse, Toulouse, France
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27
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Haratz KK, Shulevitz SL, Leibovitz Z, Lev D, Shalev J, Tomarkin M, Malinger G, Lerman-Sagie T, Gindes L. Fourth ventricle index: sonographic marker for severe fetal vermian dysgenesis/agenesis. Ultrasound Obstet Gynecol 2019; 53:390-395. [PMID: 29484745 DOI: 10.1002/uog.19034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 02/10/2018] [Accepted: 02/16/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Prenatal diagnosis of midbrain-hindbrain (MB-HB) malformations relies primarily on abnormal size and shape of the cerebellum and retrocerebellar space, particularly 'open fourth ventricle' (4V), the most common indicator of MB-HB malformations. The aim of this study was to present the fourth ventricle index (4VI), and to evaluate its role as a marker for severe vermian dysgenesis/agenesis in cases without open 4V. METHODS This was a prospective cross-sectional study of patients with singleton low-risk pregnancy at 14 + 1 to 36 + 6 gestational weeks presenting between May 2016 and November 2017 for routine ultrasound examination. Axial images of the fetal 4V were obtained and the 4VI was calculated as the ratio between the laterolateral and the anteroposterior diameters. Reference ranges were constructed and retrospectively collected values from 44 fetuses with confirmed anomalies involving severe vermian dysgenesis/agenesis (Joubert syndrome and related disorders, rhombencephalosynapsis, cobblestone malformations and cerebellar hypoplasia) but without open 4V were compared with the normal values. RESULTS In total, 384 healthy fetuses were enrolled into the study, from which reference ranges were produced, and 44 cases were collected retrospectively. The 4VI in the normal fetuses was always > 1. In affected fetuses, it was always below mean -2 SD and < 1. CONCLUSIONS The 4VI is a sonographic marker for severe fetal vermian dysgenesis/agenesis in the absence of an open 4V. It may be incorporated easily into the routine brain scan; 4VI < 1 indicates a need for dedicated fetal neuroimaging for diagnosis and prenatal counseling. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- K K Haratz
- Fetal Neurology Clinic, Ultrasound in ObGyn Unit, Wolfson Medical Center, Holon, Israel
- Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Lis Maternity Hospital, Tel Aviv Medical Center, Tel Aviv, Israel
| | - S L Shulevitz
- Fetal Neurology Clinic, Ultrasound in ObGyn Unit, Wolfson Medical Center, Holon, Israel
- Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Z Leibovitz
- Fetal Neurology Clinic, Ultrasound in ObGyn Unit, Wolfson Medical Center, Holon, Israel
- Ultrasound in ObGyn Unit, Department of ObGyn, Bnai Zion Medical Center, Haifa, Israel
| | - D Lev
- Fetal Neurology Clinic, Ultrasound in ObGyn Unit, Wolfson Medical Center, Holon, Israel
- Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute of Genetics, Wolfson Medical Center, Holon, Israel
| | - J Shalev
- Fetal Neurology Clinic, Ultrasound in ObGyn Unit, Wolfson Medical Center, Holon, Israel
- Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M Tomarkin
- Fetal Neurology Clinic, Ultrasound in ObGyn Unit, Wolfson Medical Center, Holon, Israel
- Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - G Malinger
- Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Lis Maternity Hospital, Tel Aviv Medical Center, Tel Aviv, Israel
| | - T Lerman-Sagie
- Fetal Neurology Clinic, Ultrasound in ObGyn Unit, Wolfson Medical Center, Holon, Israel
- Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel
| | - L Gindes
- Fetal Neurology Clinic, Ultrasound in ObGyn Unit, Wolfson Medical Center, Holon, Israel
- Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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28
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Jernigan S, Storey A, Hammer C, Riordan C, Orbach DB, Scott RM, Smith E. Moyamoya syndrome and PHACE syndrome: clinical and radiographic characterization of the intracranial arteriopathy and response to surgical revascularization. J Neurosurg Pediatr 2019; 23:493-497. [PMID: 30717056 DOI: 10.3171/2018.10.peds18582] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 10/29/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE PHACE syndrome (PHACES) has been linked to cervical and cerebral vascular anomalies, including persistent embryonic anastomoses and progressive steno-occlusive disease. However, no prior studies have documented the long-term response of PHACES patients with moyamoya disease to surgical revascularization with pial or myosynangiosis. The authors present their experience with 8 consecutive patients with PHACES and moyamoya disease. METHODS Retrospective review of patients who underwent pial synangiosis revascularization for moyamoya disease with concurrent diagnosis of PHACES. RESULTS A total of 8 patients out of 456 surgically treated moyamoya patients had a diagnosis of PHACES. All patients were female, and their average age at the time of surgical treatment was 9.3 years (range 1.8-25.8 years). Five patients had associated basilar artery anomalies or stenosis. All patients had symptomatic narrowing of the petrous segment of the internal carotid artery with tortuous collateralization. Three patients underwent unilateral pial or myo-synangiosis and 5 underwent bilateral procedures. The average hospital length of stay was 5.0 days (range 3-7 days). There were no postoperative complications. Follow-up ranged from 8 to 160 months (average 56 months). Seven of 8 patients have had follow-up angiograms and all had Matsushima grade A or B collateralization without progression of stenosis in other locations. All patients had reduced cortical FLAIR signal on 6-month follow-up MRI and no evidence of new radiographic or clinical strokes. CONCLUSIONS Patients with moyamoya disease and PHACES had an intracranial arteriopathy characterized by ectactic anterior vasculature with concomitant basilar artery stenosis, and were all female. The patients had both radiographic and clinical responses to pial synangiosis. The surgical treatment of these patients can be challenging given facial hemangiomas located near the surgical field. Patients with unilateral disease did not have evidence of progression in other cerebral circulation during the given follow-up period.
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Affiliation(s)
| | | | | | | | - Darren B Orbach
- Departments of1Neurosurgery and
- 2Neurointerventional Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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29
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Eves D, O'Connor SJ, Boyle MA. Optic Nerve Hypoplasia and Crouzon Syndrome. J Pediatr Ophthalmol Strabismus 2018; 55:e45-e48. [PMID: 30571838 DOI: 10.3928/01913913-20181012-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 07/25/2018] [Indexed: 11/20/2022]
Abstract
Crouzon syndrome is the most common cause of syndromic craniosynostosis. The authors present a previously unreported association between Crouzon syndrome and optic nerve hypoplasia. A male infant was transferred to the center for treatment of respiratory distress. He was diagnosed as having dysmorphic features, a membranous choanal stenossi bilaterally, and bilateral optic nerve hypoplasia. Genetic testing confirmed a molecular diagnosis of Crouzon syndrome. He had a complicated course in relation to choanal stenosis management, and was discharged home at 10 weeks of age. Although uncommon in Crouzon syndrome, the association with optic nerve hypoplasia changes the initial work-up and the management of parental expectations. [J Pediatr Ophthalmol Strabismus. 2018;55:e45-e48.].
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Choi J, Yang A, Song A, Lim M, Kim J, Jang JH, Park KT, Cho S, Jin DK. Oculodentodigital Dysplasia with a Novel Mutation in GJA1 Diagnosed by Targeted Gene Panel Sequencing: A Case Report and Literature Review. Ann Clin Lab Sci 2018; 48:776-781. [PMID: 30610049] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Oculodentodigital dysplasia (ODDD; MIM #164200), a rare genetic disorder characterized by abnormal craniofacial, dental, ocular, and digital features, is caused by mutations in the gap junction alpha-1 (GJA1) gene. We report a case of a 6-year-old male who presented with dysmorphic facial features (short palpebral fissure, thin nose with hypoplastic alae nasi, and flat face), bilateral syndactyly, abnormal dentition, and proportionate short stature with growth hormone deficiency. A novel de novo heterozygous missense mutation (c.221A>C, p.H74P) in GJA1 was identified by targeted gene panel sequencing. This is the first case report of a novel ODDD-causing mutation in GJA1 confirmed by genetic analysis in Korea.
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Affiliation(s)
- Jaeyoung Choi
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Aram Yang
- Department of Pediatrics, Inha University Hospital, Inha University College of Medicine, Incheon, Korea
| | - Ari Song
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Minji Lim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jinsup Kim
- Department of Pediatrics, Hanyang University Medical Center, Hanyang University School of Medicine, Seoul, Korea
| | - Ja-Hyun Jang
- Green Cross Genome, Yongin, Sunkyunkwan University School of Medicine, Seoul, Korea
| | - Ki-Tae Park
- Department of Pediatric Dentistry, Samsung Medical Center, Sunkyunkwan University School of Medicine, Seoul, Korea
| | - SungYoon Cho
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong-Kyu Jin
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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31
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Naqaish R, Sadiq N, Salam Z, Arif AS, Parvez A. Nystagmus And Beyond: A Rare Ocular Motility Disorder. J Ayub Med Coll Abbottabad 2018; 30:476-478. [PMID: 30465390] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Joubert syndrome is a rare autosomal recessive disorder predominantly involving the cerebellar vermis and brain stem. It is characterized clinically by global developmental delay, abnormal ocular movements, hypotonia, ataxia, intellectual disability and neonatal breathing abnormalities. Due to its uncommon and unconventional presentation, its diagnosis is usually delayed. Diagnosis of this atypical disease essentially relies upon the atypical finding of the "molar tooth" sign on Magnetic Resonance Imaging (MRI). We report a case of a 5-year-old boy who presented with abnormal eye movements, regression of milestones and developmental delay. MRI investigation revealed the distinctive molar tooth sign and bat wing shaped 4th ventricle. It requires high levels of clinical suspicion and holistic approach to such children who present with delayed milestones and abnormal eye movements, to reach at early detection and diagnosis of such rare pathologies.
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Affiliation(s)
| | - Naqaish Sadiq
- Ophthalmology Rawal Medical College and Rawal Institute of Health Sciences, Islamabad
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Rotter A, Samorano LP, Rivitti-Machado MC, Oliveira ZNP, Gontijo B. PHACE syndrome: clinical manifestations, diagnostic criteria, and management. An Bras Dermatol 2018; 93:405-411. [PMID: 29924216 PMCID: PMC6001075 DOI: 10.1590/abd1806-4841.20187693] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 01/07/2018] [Indexed: 11/25/2022] Open
Abstract
Infantile hemangioma can be linked to other organ malformations. In 1996, PHACE syndrome was first defined as the association of large and segmental infantile hemangioma, usually on the face, head, or cervical region, with malformations of the posterior fossa of the brain, arterial anomalies of the central nervous system, coarctation of the aorta, cardiac defects, and ocular abnormalities. Over 300 cases of PHACE syndrome have been reported, and it is cconsidered one of the most common neurocutaneous vascular disorders in childhood. Knowledge of the features and locations of lesions that imply a greater risk of systemic involvement is crucial for the diagnosis and proper management of PHACE syndrome patients. This review highlights the diagnostic criteria for PHACE syndrome, the imaging workup for extracutaneous involvement, the treatment of infantile hemangioma, and the importance of a multidisciplinary approach in the management of these patients.
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Affiliation(s)
- Anita Rotter
- Dermatology Department, Hospital das Clínicas, Faculdade de
Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Luciana Paula Samorano
- Dermatology Department, Hospital das Clínicas, Faculdade de
Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Maria Cecília Rivitti-Machado
- Dermatology Department, Hospital das Clínicas, Faculdade de
Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Zilda Najjar Prado Oliveira
- Dermatology Department, Hospital das Clínicas, Faculdade de
Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil
| | - Bernardo Gontijo
- Dermatology Unit. Hospital das Clínicas, Universidade
Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil
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Garcia-Saenz MC, Crespo Carballés MJ, Leal Gonzalez M, Martín Carbajo M. Prepapillary vascular loops. Arch Soc Esp Oftalmol (Engl Ed) 2018; 93:e32-e33. [PMID: 29150216 DOI: 10.1016/j.oftal.2017.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Accepted: 09/17/2017] [Indexed: 06/07/2023]
Affiliation(s)
- M C Garcia-Saenz
- Servicio de Oftalmología, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Alcorcón, Madrid, España.
| | - M J Crespo Carballés
- Servicio de Oftalmología, Hospital Universitario Infanta Leonor, Madrid, España; Clínica Oftalmológica Cresmar, Madrid, España
| | - M Leal Gonzalez
- Servicio de Oftalmología, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Alcorcón, Madrid, España
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Fleming LR, Doherty DA, Parisi MA, Glass IA, Bryant J, Fischer R, Turkbey B, Choyke P, Daryanani K, Vemulapalli M, Mullikin JC, Malicdan MC, Vilboux T, Sayer JA, Gahl WA, Gunay-Aygun M. Prospective Evaluation of Kidney Disease in Joubert Syndrome. Clin J Am Soc Nephrol 2017; 12:1962-1973. [PMID: 29146704 PMCID: PMC5718273 DOI: 10.2215/cjn.05660517] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [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: 05/26/2017] [Accepted: 09/18/2017] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND OBJECTIVES Joubert syndrome is a genetically heterogeneous ciliopathy associated with >30 genes. The characteristics of kidney disease and genotype-phenotype correlations have not been evaluated in a large cohort at a single center. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We evaluated 97 individuals with Joubert syndrome at the National Institutes of Health Clinical Center using abdominal ultrasonography, blood and urine chemistries, and DNA sequencing. RESULTS Patients were ages 0.6-36 years old (mean of 9.0±7.6 years old); 41 were female. Mutations were identified in 19 genes in 92 patients; two thirds of the mutations resided in six genes: TMEM67, C5orf42, CC2D2A, CEP290, AHI1, and KIAA0586. Kidney disease was detected in 30%, most commonly in association with the following genes: CEP290 (six of six), TMEM67 (11 of 22), and AHI1 (three of six). No kidney disease was identified in patients with mutations in C5orf42 (zero of 15) or KIAA0586 (zero of six). Prenatal ultrasonography of kidneys was normal in 72% of patients with kidney disease. Specific types of kidney disease included nephronophthisis (31%), an overlap phenotype of autosomal recessive polycystic kidney disease/nephronophthisis (35%), unilateral multicystic dysplastic kidney (10%), and indeterminate-type cystic kidney disease (24%). Early-onset hypertension occurred in 24% of patients with kidney disease. Age at ESRD (n=13) ranged from 6 to 24 years old (mean of 11.3±4.8 years old). CONCLUSIONS Kidney disease occurs in up to one third of patients with Joubert syndrome, most commonly in those with mutations in CEP290, TMEM67, and AHI1. Patients with mutations in C5orf42 or KIAA0586 are less likely to develop kidney disease. Prenatal ultrasonography is a poor predictor of kidney involvement in Joubert syndrome. Unilateral multicystic dysplastic kidney and autosomal recessive polycystic kidney disease-like enlarged kidneys with early-onset hypertension can be part of the Joubert syndrome kidney phenotype.
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MESH Headings
- Abnormalities, Multiple/diagnostic imaging
- Abnormalities, Multiple/genetics
- Abnormalities, Multiple/metabolism
- Adaptor Proteins, Signal Transducing/genetics
- Adaptor Proteins, Vesicular Transport
- Adolescent
- Adult
- Age of Onset
- Antigens, Neoplasm/genetics
- Cell Cycle Proteins/genetics
- Cerebellum/abnormalities
- Cerebellum/diagnostic imaging
- Cerebellum/metabolism
- Child
- Child, Preschool
- Cytoskeletal Proteins
- Eye Abnormalities/complications
- Eye Abnormalities/diagnostic imaging
- Eye Abnormalities/genetics
- Eye Abnormalities/metabolism
- Female
- Genotype
- Humans
- Infant
- Kidney Diseases, Cystic/complications
- Kidney Diseases, Cystic/congenital
- Kidney Diseases, Cystic/diagnostic imaging
- Kidney Diseases, Cystic/genetics
- Kidney Diseases, Cystic/metabolism
- Kidney Failure, Chronic/etiology
- Kidney Failure, Chronic/genetics
- Magnetic Resonance Imaging
- Male
- Membrane Proteins/genetics
- Multicystic Dysplastic Kidney/complications
- Multicystic Dysplastic Kidney/diagnostic imaging
- Multicystic Dysplastic Kidney/genetics
- Mutation
- Neoplasm Proteins/genetics
- Phenotype
- Polycystic Kidney, Autosomal Recessive/complications
- Polycystic Kidney, Autosomal Recessive/diagnostic imaging
- Polycystic Kidney, Autosomal Recessive/genetics
- Prospective Studies
- Proteins/genetics
- Retina/abnormalities
- Retina/diagnostic imaging
- Retina/metabolism
- Ultrasonography, Prenatal
- Young Adult
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Affiliation(s)
- Leah R Fleming
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
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Komiyama M. Cardio-cephalic neural crest syndrome: A novel hypothesis of vascular neurocristopathy. Interv Neuroradiol 2017; 23:572-576. [PMID: 28814167 PMCID: PMC5814071 DOI: 10.1177/1591019917726093] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 07/21/2017] [Indexed: 01/15/2023] Open
Abstract
A novel hypothesis proposes that "cardio-cephalic neural crest (NC) syndrome," i.e. cephalic NC including cardiac NC, contributes to the concurrent occurrence of vascular diseases in the cardio- and cerebrovascular regions. NC is a transient structure present in early embryogenesis. Cephalic NC provides mesenchymal cells to the vascular media in these regions. Concurrent cardio- and cerebrovascular lesions have been reported in PHACE syndrome, ACTA2 mutation syndrome, and less frequently in the spontaneous occlusion of the circle of Willis (so-called moyamoya disease). Cardiovascular lesions in these syndromes include coarctation of the aorta, persistent truncus arteriosus, patent ductus arteriosus, and coronary artery disease, and cerebrovascular lesions include agenesis and stenosis/occlusion of the internal carotid arteries, and moyamoya phenomenon. These concurrent vascular lesions both in the cardio- and cerebrovascular regions might be related to cephalic NC. This hypothesis, although not proven, may facilitate a better understanding of the above-mentioned NC-related vascular pathologies and lead to appropriate diagnostic and therapeutic approaches for clinicians and chart future direction for researchers.
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Affiliation(s)
- M Komiyama
- Department of Neuro-Intervention, Osaka City General
Hospital, Osaka, Japan
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Arrigoni F, Romaniello R, Peruzzo D, De Luca A, Parazzini C, Valente EM, Borgatti R, Triulzi F. Anterior Mesencephalic Cap Dysplasia: Novel Brain Stem Malformative Features Associated with Joubert Syndrome. AJNR Am J Neuroradiol 2017; 38:2385-2390. [PMID: 28838911 DOI: 10.3174/ajnr.a5360] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 06/30/2017] [Indexed: 11/07/2022]
Abstract
In Joubert syndrome, the "molar tooth" sign can be associated with several additional supra- and infratentorial malformations. Here we report on 3 subjects (2 siblings, 8-14 years of age) with Joubert syndrome, showing an abnormal thick bulging of the anterior profile of the mesencephalon causing a complete obliteration of the interpeduncular fossa. DTI revealed that the abnormal tissue consisted of an ectopic white matter tract with a laterolateral transverse orientation. Tractographic reconstructions support the hypothesis of impaired axonal guidance mechanisms responsible for the malformation. The 2 siblings were compound heterozygous for 2 missense variants in the TMEM67 gene, while no mutations in a panel of 120 ciliary genes were detected in the third patient. The name "anterior mesencephalic cap dysplasia," referring to the peculiar aspect of the mesencephalon on sagittal MR imaging, is proposed for this new malformative feature.
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Affiliation(s)
- F Arrigoni
- From the Neuroimaging Lab (F.A., D.P., A.D.L.)
| | - R Romaniello
- Neuropsychiatry and Neurorehabilitation Unit (R.R., R.B.), Scientific Institute Istituto Di Ricovero e Cura a Carattere Scientific Eugenio Medea, Bosisio Parini, Italy
| | - D Peruzzo
- From the Neuroimaging Lab (F.A., D.P., A.D.L.)
| | - A De Luca
- From the Neuroimaging Lab (F.A., D.P., A.D.L.)
- Department of Information Engineering (A.D.L.), University of Padova, Padova, Italy
| | - C Parazzini
- Department of Pediatric Radiology and Neuroradiology (C.P.), "V. Buzzi" Children's Hospital, Milan, Italy
| | - E M Valente
- Department of Molecular Medicine (E.M.V.), University of Pavia, Pavia, Italy
- Neurogenetics Unit (E.M.V.), Istituto Di Ricovero e Cura a Carattere Scientific Santa Lucia Foundation, Rome, Italy
| | - R Borgatti
- Neuropsychiatry and Neurorehabilitation Unit (R.R., R.B.), Scientific Institute Istituto Di Ricovero e Cura a Carattere Scientific Eugenio Medea, Bosisio Parini, Italy
| | - F Triulzi
- Department of Neuroradiology (F.T.), Scientific Institute Istituto Di Ricovero e Cura a Carattere Scientific Cà Granda Foundation-Ospedale Maggiore Policlinico, Milan, Italy
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Abstract
INTRODUCTION Joubert syndrome (JS) is a rare autosomal recessive inherited disease belonging to ciliopathy with the causative mutation of genes. Except for X-linked inheritance, the high recurrence rate of a family is about 25%. After birth, it may cause a series of neurological symptoms, even with retina, kidney, liver, and other organ abnormalities, which is defined as Joubert syndrome and related disorders (JSRD). Molecular genetics research contributes to disease prediction and genetic counseling. Prenatal diagnosis is rare. Magnetic resonance imaging (MRI) is usually the first-choice diagnostic modality with typical brain images characterized by the molar tooth sign. We describe a case of JS prenatally and Dandy-Walker malformation for the differential diagnosis based on ultrasonograms. We also review the etiology, imaging features, clinical symptoms, and diagnosis of JSRD. CASE PRESENTATION A 22-year-old woman was pregnant at 27 1/7 weeks' gestation with fetal cerebellar vermis hypoplasia. Fetal ultrasonography and MRI confirmed a diagnosis of JS at our center. The couple finally opted to terminate the fetus, which had a normal appearance and growth parameters. The couple also had an AHI1 gene mutation on chromosome 6. CONCLUSIONS Currently, a diagnosis of JS is commonly made after birth. Fewer cases of prenatal diagnosis by ultrasonography have been made, and they are more liable to be misdirected because of some nonspecial features that also manifest in Dandy-Walker malformation, cranio-cerebello-cardiac syndrome, and so on.
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Gennette S, Carlan SJ, Busowski J, Madruga M, McWhorter J. Congenital glaucoma detected by unilateral megalophthalmos on prenatal sonography. J Clin Ultrasound 2017; 45:499-501. [PMID: 27911017 DOI: 10.1002/jcu.22427] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 10/26/2016] [Indexed: 06/06/2023]
Abstract
A 36-week male fetus was noted to have isolated right megalophthalmos on prenatal ultrasound and was found to have buphthalmos and congenital glaucoma at birth. Detection of congenital glaucoma at birth may be occasionally possible if abnormal orbit dimensions are noted on late prenatal sonographic examination. Early neonatal intervention may improve the chances to retain vision. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:499-501, 2017.
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Affiliation(s)
- Sarah Gennette
- Department of Obstetrics and Gynecology, Orlando Healthcare, 1401 Lucerne Terrace, 2nd floor, Orlando, FL, 32806
| | - Steve J Carlan
- Department of Obstetrics and Gynecology, Orlando Healthcare, 1401 Lucerne Terrace, 2nd floor, Orlando, FL, 32806
| | - John Busowski
- Department of Obstetrics and Gynecology, Orlando Healthcare, 1401 Lucerne Terrace, 2nd floor, Orlando, FL, 32806
| | - Mario Madruga
- Department of Internal Medicine, Orlando Healthcare, 1401 Lucerne Terrace, 2nd floor, Orlando, FL, 32806
| | - Jeannie McWhorter
- Department of Obstetrics and Gynecology, Orlando Healthcare, 1401 Lucerne Terrace, 2nd floor, Orlando, FL, 32806
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39
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Wen H, Chen L, Yan K, He J. [Prenatal diagnosis of Joubert syndrome:one case report and literature review]. Zhejiang Da Xue Xue Bao Yi Xue Ban 2017; 46:274-278. [PMID: 29039169 PMCID: PMC10396837 DOI: 10.3785/j.issn.1008-9292.2017.06.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A 25-year-old nulliparity underwent prenatal ultrasonography, and the fetal cerebellar abnormality was suspected. The fetal MRI showed 'molar tooth sign' in midbrain and cerebellar vermis hypoplasia. The fetal cerebellar vermis hypoplasia was confirmed by MRI imaging and autopsy after induced abortion. The next-generation sequencing showed that the fetus had a heterozygous mutation of CC2D2A gene (c.2728C > T and c.4598T > C), which might be the cause of the disease.
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Affiliation(s)
- Hong Wen
- Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Lu Chen
- Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
| | - Kai Yan
- Department of Reproductive Genetics, Women's Hospital, Zhejiang University School of Medicine, Key Laboratory of Reproductive Genetics, Ministry of Education, Hangzhou 310006, China
| | - Jing He
- Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China.
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40
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Stephen J, Vilboux T, Mian L, Kuptanon C, Sinclair CM, Yildirimli D, Maynard DM, Bryant J, Fischer R, Vemulapalli M, Mullikin JC, Huizing M, Gahl WA, Malicdan MCV, Gunay-Aygun M. Mutations in KIAA0753 cause Joubert syndrome associated with growth hormone deficiency. Hum Genet 2017; 136:399-408. [PMID: 28220259 DOI: 10.1007/s00439-017-1765-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 02/08/2017] [Indexed: 12/28/2022]
Abstract
Joubert syndrome and related disorders (JSRD) are a heterogeneous group of ciliopathies defined based on the mid-hindbrain abnormalities that result in the characteristic "molar tooth sign" on brain imaging. The core clinical findings of JSRD are hypotonia, developmental delay, abnormal eye movements and breathing abnormalities. To date, more than 30 JSRD genes that encode proteins important for structure and/or function of cilia have been identified. Here, we present 2 siblings with Joubert syndrome associated with growth hormone deficiency. Whole exome sequencing of the family identified compound heterozygous mutations in KIAA0753, i.e., a missense mutation (p.Arg257Gly) and an intronic mutation (c.2359-1G>C). The intronic mutation alters normal splicing by activating a cryptic acceptor splice site in exon 16. The novel acceptor site skips nine nucleotides, deleting three amino acids from the protein coding frame. KIAA0753 (OFIP) is a centrosome and pericentriolar satellite protein, previously not known to cause Joubert syndrome. We present comprehensive clinical descriptions of the Joubert syndrome patients as well as the cellular phenotype of defective ciliogenesis in the patients' fibroblasts.
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Affiliation(s)
- Joshi Stephen
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Thierry Vilboux
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
- Division of Medical Genomics, Inova Translational Medicine Institute, Falls Church, VA, USA
| | - Luhe Mian
- NIH Undiagnosed Diseases Program, Common Fund, Office of the Director, National Institutes of Health, Bethesda, MD, USA
| | - Chulaluck Kuptanon
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Courtney M Sinclair
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Deniz Yildirimli
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Dawn M Maynard
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Joy Bryant
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Roxanne Fischer
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Meghana Vemulapalli
- NIH Intramural Sequencing Center (NISC), National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - James C Mullikin
- NIH Intramural Sequencing Center (NISC), National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Marjan Huizing
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - William A Gahl
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
- NIH Undiagnosed Diseases Program, Common Fund, Office of the Director, National Institutes of Health, Bethesda, MD, USA
- Office of the Clinical Director, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - May Christine V Malicdan
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.
- NIH Undiagnosed Diseases Program, Common Fund, Office of the Director, National Institutes of Health, Bethesda, MD, USA.
- Office of the Clinical Director, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.
| | - Meral Gunay-Aygun
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.
- Office of the Clinical Director, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.
- Department of Pediatrics and McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Jerber J, Zaki MS, Al-Aama JY, Rosti RO, Ben-Omran T, Dikoglu E, Silhavy JL, Caglar C, Musaev D, Albrecht B, Campbell KP, Willer T, Almuriekhi M, Çağlayan AO, Vajsar J, Bilgüvar K, Ogur G, Abou Jamra R, Günel M, Gleeson JG. Biallelic Mutations in TMTC3, Encoding a Transmembrane and TPR-Containing Protein, Lead to Cobblestone Lissencephaly. Am J Hum Genet 2016; 99:1181-1189. [PMID: 27773428 PMCID: PMC5097947 DOI: 10.1016/j.ajhg.2016.09.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [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: 07/24/2016] [Accepted: 09/13/2016] [Indexed: 12/13/2022] Open
Abstract
Cobblestone lissencephaly (COB) is a severe brain malformation in which overmigration of neurons and glial cells into the arachnoid space results in the formation of cortical dysplasia. COB occurs in a wide range of genetic disorders known as dystroglycanopathies, which are congenital muscular dystrophies associated with brain and eye anomalies and range from Walker-Warburg syndrome to Fukuyama congenital muscular dystrophy. Each of these conditions has been associated with alpha-dystroglycan defects or with mutations in genes encoding basement membrane components, which are known to interact with alpha-dystroglycan. Our screening of a cohort of 25 families with recessive forms of COB identified six families affected by biallelic mutations in TMTC3 (encoding transmembrane and tetratricopeptide repeat containing 3), a gene without obvious functional connections to alpha-dystroglycan. Most affected individuals showed brainstem and cerebellum hypoplasia, as well as ventriculomegaly. However, the minority of the affected individuals had eye defects or elevated muscle creatine phosphokinase, separating the TMTC3 COB phenotype from typical congenital muscular dystrophies. Our data suggest that loss of TMTC3 causes COB with minimal eye or muscle involvement.
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Affiliation(s)
- Julie Jerber
- Laboratory for Pediatric Brain Disease, The Rockefeller University, New York, NY 10065, USA; Howard Hughes Medical Institute, Rady Children's Institute for Genomic Medicine, University of California, San Diego, San Diego, CA 92093, USA
| | - Maha S Zaki
- Clinical Genetics Department, Human Genetics and Genome Research Division, National Research Centre, Cairo 12311, Egypt
| | - Jumana Y Al-Aama
- Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah 21453, Saudi Arabia; Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah 21453, Saudi Arabia
| | - Rasim Ozgur Rosti
- Laboratory for Pediatric Brain Disease, The Rockefeller University, New York, NY 10065, USA; Howard Hughes Medical Institute, Rady Children's Institute for Genomic Medicine, University of California, San Diego, San Diego, CA 92093, USA
| | - Tawfeg Ben-Omran
- Clinical and Metabolic Genetics Section, Department of Pediatrics, Hamad Medical Corporation, PO Box 3050, Doha, Qatar; Weill Cornell Medical College, Qatar, Education City, PO Box 24144, Doha, Qatar
| | - Esra Dikoglu
- Laboratory for Pediatric Brain Disease, The Rockefeller University, New York, NY 10065, USA; Howard Hughes Medical Institute, Rady Children's Institute for Genomic Medicine, University of California, San Diego, San Diego, CA 92093, USA
| | - Jennifer L Silhavy
- Laboratory for Pediatric Brain Disease, The Rockefeller University, New York, NY 10065, USA; Howard Hughes Medical Institute, Rady Children's Institute for Genomic Medicine, University of California, San Diego, San Diego, CA 92093, USA
| | - Caner Caglar
- Laboratory for Pediatric Brain Disease, The Rockefeller University, New York, NY 10065, USA
| | - Damir Musaev
- Laboratory for Pediatric Brain Disease, The Rockefeller University, New York, NY 10065, USA; Howard Hughes Medical Institute, Rady Children's Institute for Genomic Medicine, University of California, San Diego, San Diego, CA 92093, USA
| | - Beate Albrecht
- Institut für Humangenetik, Universitätsklinikum Essen, Universität Duisburg-Essen, 45122 Essen, Germany
| | - Kevin P Campbell
- Howard Hughes Medical Institute, Departments of Neurology, Internal Medicine, and Molecular Physiology and Biophysics, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA 52242-1101, USA
| | - Tobias Willer
- Howard Hughes Medical Institute, Departments of Neurology, Internal Medicine, and Molecular Physiology and Biophysics, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA 52242-1101, USA
| | - Mariam Almuriekhi
- Clinical and Metabolic Genetics Section, Department of Pediatrics, Hamad Medical Corporation, PO Box 3050, Doha, Qatar; Weill Cornell Medical College, Qatar, Education City, PO Box 24144, Doha, Qatar
| | - Ahmet Okay Çağlayan
- Department of Medical Genetics, School of Medicine, Istanbul Bilim University, Istanbul 34394, Turkey
| | - Jiri Vajsar
- Division of Neurology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Kaya Bilgüvar
- Yale Program on Neurogenetics, Departments of Neurosurgery, Neurobiology, and Genetics, School of Medicine, Yale University, New Haven, CT 06510, USA
| | - Gonul Ogur
- Department of Genetics, School of Medicine, Ondokuz Mayis University, 55000 Samsun, Turkey
| | - Rami Abou Jamra
- Institute of Human Genetics, University of Leipzig Hospitals and Clinics, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany; Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Murat Günel
- Yale Program on Neurogenetics, Departments of Neurosurgery, Neurobiology, and Genetics, School of Medicine, Yale University, New Haven, CT 06510, USA
| | - Joseph G Gleeson
- Laboratory for Pediatric Brain Disease, The Rockefeller University, New York, NY 10065, USA; Howard Hughes Medical Institute, Rady Children's Institute for Genomic Medicine, University of California, San Diego, San Diego, CA 92093, USA.
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Quarello E. Enlarged intracranial translucency and molar tooth sign in the first trimester as features of Joubert syndrome and related disorders. Ultrasound Obstet Gynecol 2016; 48:532-534. [PMID: 26748614 DOI: 10.1002/uog.15856] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 12/22/2015] [Accepted: 12/30/2015] [Indexed: 06/05/2023]
Affiliation(s)
- E Quarello
- Institut de Médecine de la Reproduction, 6 rue Rocca, Marseille, France and Unité d'Échographies Obstétricales et de Diagnostic Prénatal, Hôpital Saint Joseph, Marseille, France.
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43
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Pittyanont S, Jatavan P, Suwansirikul S, Tongsong T. Prenatal features of Pena-Shokeir sequence with atypical response to acoustic stimulation. J Clin Ultrasound 2016; 44:459-462. [PMID: 27312123 DOI: 10.1002/jcu.22373] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 05/02/2016] [Indexed: 06/06/2023]
Abstract
A fetal sonographic screening examination performed at 23 weeks showed polyhydramnios, micrognathia, fixed postures of all long bones, but no movement and no breathing. The fetus showed fetal heart rate acceleration but no movement when acoustic stimulation was applied with artificial larynx. All these findings persisted on serial examinations. The neonate was stillborn at 37 weeks and a final diagnosis of Pena-Shokeir sequence was made. In addition to typical sonographic features of Pena-Shokeir sequence, fetal heart rate accelerations with no movement in response to acoustic stimulation suggests that peripheral myopathy may possibly play an important role in the pathogenesis of the disease. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:459-462, 2016.
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Affiliation(s)
- Sirida Pittyanont
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Phudit Jatavan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Songkiat Suwansirikul
- Department of Pathology, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, 50200, Thailand
| | - Theera Tongsong
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
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44
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Al-Ryalat NT, Ezzat JW, Ababneh OH, AlRyalat SAS, Al-Hadidy AM. Isolated Bilateral Lacrimal Gland Agenesis. J Pediatr Ophthalmol Strabismus 2016; 53:e35-8. [PMID: 27486892 DOI: 10.3928/01913913-20160719-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Accepted: 03/08/2016] [Indexed: 11/20/2022]
Abstract
A 5-year-old boy presented to the ophthalmology department complaining of absent tearing while crying. Slit-lamp examination showed decreased tear margin film with normal punctae. Orbit magnetic resonance imaging was done and showed bilateral absent lacrimal glands. This is the third case of isolated bilateral lacrimal gland agenesis in the literature. [J Pediatr Ophthalmol Strabismus. 2016;53:e35-e38.].
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Guha S, Hurakadli PM, Shah SV, Shah K. Surgical treatment of familial absence of the inferior rectus muscle. J AAPOS 2015; 19:289-92. [PMID: 26059678 DOI: 10.1016/j.jaapos.2015.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 02/15/2015] [Accepted: 02/17/2015] [Indexed: 11/19/2022]
Abstract
Familial inferior rectus muscle aplasia is rare. Patients with this condition require surgery to correct hypertropia and anomalous head posture. We report successful surgical outcomes in a father with bilateral and his 2 children with unilateral absent inferior rectus muscle, all 3 of whom were diagnosed preoperatively by imaging.
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Affiliation(s)
- Sujata Guha
- Department of Pediatric Ophthalmology, Sankara Nethralaya, Kolkata, India
| | - Preeti M Hurakadli
- Department of Pediatric Ophthalmology, Sankara Nethralaya, Kolkata, India.
| | - Sanil V Shah
- Department of Pediatric Ophthalmology, Sankara Nethralaya, Kolkata, India
| | - Khyati Shah
- Department of Pediatric Ophthalmology, Sankara Nethralaya, Kolkata, India
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Tabakin ER, Dean AJ, Panebianco N. An alternative explanation for abnormal globe contour. J Emerg Med 2015; 48:e77-e79. [PMID: 25497843 DOI: 10.1016/j.jemermed.2014.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 10/08/2014] [Accepted: 10/12/2014] [Indexed: 06/04/2023]
Affiliation(s)
- Erica R Tabakin
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anthony J Dean
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nova Panebianco
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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Knowlton PB, Mawn LA, Atkinson JB, Donahue SP. Strabismus resulting from an anomalous extraocular muscle in Gorlin syndrome. J AAPOS 2014; 18:495-8. [PMID: 25266843 DOI: 10.1016/j.jaapos.2014.06.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 05/30/2014] [Accepted: 06/03/2014] [Indexed: 11/18/2022]
Abstract
Strabismus associated with anomalous extraocular muscles is rare. We present a case of strabismus caused by an anomalous orbital structure that was histopathologically consistent with an accessory extraocular muscle rather than a fibrous band, in a patient with Gorlin syndrome (nevoid basal cell carcinoma syndrome), an autosomal dominant multisystem disorder related to a mutation in the patched tumor suppressor gene (PTCH). Histopathology of an anomalous orbital structure consistent with extraocular muscle has not been previously reported.
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Affiliation(s)
- Peter B Knowlton
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Louise A Mawn
- Vanderbilt Eye Institute, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - James B Atkinson
- Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Sean P Donahue
- Vanderbilt Eye Institute, Vanderbilt University School of Medicine, Nashville, Tennessee.
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Massoud M, Cagneaux M, Garel C, Varene N, Moutard ML, Billette T, Benezit A, Rougeot C, Jouannic JM, Massardier J, Gaucherand P, Desportes V, Guibaud L. Prenatal unilateral cerebellar hypoplasia in a series of 26 cases: significance and implications for prenatal diagnosis. Ultrasound Obstet Gynecol 2014; 44:447-454. [PMID: 24185815 DOI: 10.1002/uog.13217] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Revised: 09/13/2013] [Accepted: 09/16/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To define imaging patterns of unilateral cerebellar hypoplasia (UCH), discuss possible pathophysiological mechanisms and underline the etiology and prognosis associated with these lesions. METHODS In this retrospective study we reviewed the charts of 26 fetuses diagnosed between 2003 and 2011 with UCH, defined by asymmetrical cerebellar hemispheres with or without decreased transverse cerebellar diameter. The review included analysis of the anatomy of the cerebellar hemispheres, including foliation, borders and parenchymal echogenicity, and of the severity of the hypoplasia. Data from clinical and biological work-up and follow-up were obtained. RESULTS Our series could be divided into two groups according to whether imaging features changed progressively or remained constant during follow-up. In Group 1 (n = 8), the progression of imaging features, echogenic cerebellar changes and/or hyposignal in T2*-weighted MR images were highly suggestive of ischemic/hemorrhagic insult. In Group 2 (n = 18), imaging features remained constant during follow-up; UCH was associated with abnormal foliation in three proven cases of clastic lesions, a cystic lesion was noted in three cases of PHACE (posterior fossa anomalies, hemangioma, arterial anomalies, cardiac abnormalities/aortic coarctation, eye abnormalities) syndrome and, in the remaining cases, UCH remained unchanged, with no imaging pattern typical of hemorrhage. In 24 cases the infant was liveborn and follow-up was continued in 23, for a mean period of 3 years. Among these, neurological complications were identified in seven (in one of seven (at a mean of 46 months) in Group 1 and in six of 16 (at a mean of 35 months) in Group 2). The surface loss of cerebellar hemisphere was > 50% in 19/24 fetuses and the vermis was clearly normal in appearance in 19/24. Predisposing factors for fetal vascular insult were identified in eight cases: these included maternal alcohol addiction, diabetes mellitus, congenital cytomegalovirus infection and pathological placenta with thrombotic vasculopathy and infarctions. CONCLUSION UCH is defined as a focal lesion of the cerebellum that may be secondary to hemorrhage and/or ischemic insult, suggesting a clastic origin, particularly when imaging follow-up reveals changes over time. UCH may also be a clue for the prenatal diagnosis of PHACE syndrome. The amount of surface loss of cerebellar hemisphere does not correlate with poor prognosis. UCH with normal vermis is often associated with normal outcome.
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Affiliation(s)
- M Massoud
- Centre Pluridisciplinaire de Diagnostic Prénatal, Hôpital Femme Mère Enfant, Université Claude Bernard Lyon I, Lyon, France
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Nortjé CJ. Maxillo-facial radiology case 118. Oculodentodigital dysplasia. SADJ 2014; 69:76. [PMID: 24974522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Quarello E, Molho M, Garel C, Couture A, Legac MP, Moutard ML, Bault JP, Fallet-Bianco C, Guibaud L. Prenatal abnormal features of the fourth ventricle in Joubert syndrome and related disorders. Ultrasound Obstet Gynecol 2014; 43:227-232. [PMID: 23868831 DOI: 10.1002/uog.12567] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 06/27/2013] [Accepted: 07/11/2013] [Indexed: 06/02/2023]
Abstract
Joubert syndrome and related disorders (JSRD) are characterized by absence or underdevelopment of the cerebellar vermis and a malformed brainstem. This family of disorders is a member of an emerging class of diseases called ciliopathies. We describe the abnormal features of the brain, particularly the fourth ventricle, in seven fetuses affected by JSRD. In three cases abnormality of the fourth ventricle was isolated and in four cases there were associated malformations. The molar tooth sign (MTS) was always present and visible on two-dimensional ultrasound and, when performed, on three-dimensional ultrasound and magnetic resonance imaging. The fourth ventricle was always abnormal, in both axial and sagittal views, presenting pathognomonic deformities. It is important to identify JSRD, preferably prenatally or at least postnatally, due to its high risk of recurrence of about 25%. A detailed prenatal assessment of the fourth ventricle in several views may help to achieve this goal.
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Affiliation(s)
- E Quarello
- Unité d'Échographies Obstétricales, Service de Gynécologie Obstétrique, Pôle Parents Enfants, Hôpital Saint-Joseph, Marseille, France; Institut de Médecine de la Reproduction, Marseille, France
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