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Xiang F, Zhang Y, Zhang Q, Pan X, Feng H, Zhang M, Li C, Ji Q, Li Z, Li S. Characteristics of beta parapapillary atrophy in primary angle-closure suspect. BMJ Open Ophthalmol 2024; 9:e001529. [PMID: 38626931 PMCID: PMC11029359 DOI: 10.1136/bmjophth-2023-001529] [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: 10/09/2023] [Accepted: 04/03/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE To investigate the characteristics of beta parapapillary atrophy (β-PPA) in patients with primary angle-closure suspect (PACS). METHODS AND ANALYSIS In total, 215 and 259 eyes with PACS and non-PACS (NPACS), respectively, were enrolled in this observational, cross-sectional study. Stereoscopic fundus and optical coherence tomography images were used to characterise β-PPA; the former was also used to measure the major β-PPA parameters. Univariate and multiple logistic regression analyses were used to identify the factors correlated with the presence of β-PPA and with β-PPA parameters. RESULTS The β-PPA occurrence rates were 48.80% and 44.40% in the PACS and NPACS groups, respectively, with no significant difference between groups. Compared with that in the NPACS group, the β-PPA area was significantly larger (p=0.005) in the PACS group, but the angular extent and maximum radial length did not differ between groups (p=0.110 and 0.657, respectively) after adjusting for age and axial length. The presence of β-PPA was associated with older age (OR 1.057, 95% CI 1.028 to 1.088, p<0.001) and larger disc area (OR 1.716, 95% CI 1.170 to 2.517, p=0.006). A larger β-PPA area was associated with older age (p=0.014), greater vertical cup-to-disc ratio (p=0.028), larger disc area (p<0.001) and PACS diagnosis (p=0.035). CONCLUSION 48.80% of participants with PACS had β-PPA, which is slightly larger than NPACS. The area of β-PPA was larger in PACS, while the angular extent and maximum radial length did not differ between groups.
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Affiliation(s)
- Fei Xiang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ye Zhang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Qing Zhang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Ophthalmology, Beijing, China
| | - Xiaohua Pan
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Hui Feng
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Meijuan Zhang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Caixia Li
- School of Clinical Medicine, Dali University, Yunnan, China
| | - Qianqian Ji
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zhi Li
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Shuning Li
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Labella Álvarez F, Mosleh R, Bouthour W, Saindane AM, Bruce BB, Dattilo M, Newman NJ, Biousse V. Optic Nerve MRI T2-Hyperintensity: A Nonspecific Marker of Optic Nerve Damage. J Neuroophthalmol 2024; 44:22-29. [PMID: 38251954 DOI: 10.1097/wno.0000000000002017] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
BACKGROUND MRI abnormalities are common in optic neuropathies, especially on dedicated orbital imaging. In acute optic neuritis, optic nerve T2-hyperintensity associated with optic nerve contrast enhancement is the typical imaging finding. In chronic optic neuropathies, optic nerve T2-hyperintensity and atrophy are regularly seen. Isolated optic nerve T2-hyperintensity is often erroneously presumed to reflect optic neuritis, frequently prompting unnecessary investigations and neuro-ophthalmology consultations. Our goal was to determine the significance of optic nerve/chiasm T2-hyperintensity and/or atrophy on MRI. METHODS Retrospective study of consecutive patients who underwent brain/orbital MRI with/without contrast at our institution between July 1, 2019, and June 6, 2022. Patients with optic nerve/chiasm T2-hyperintensity and/or atrophy were included. Medical records were reviewed to determine the etiology of the T2-hyperintensity and/or atrophy. RESULTS Four hundred seventy-seven patients (698 eyes) were included [mean age 52 years (SD ±18 years); 57% women]. Of the 364 of 698 eyes with optic nerve/chiasm T2-hyperintensity without atrophy, the causes were compressive (104), inflammatory (103), multifactorial (49), glaucoma (21), normal (19), and other (68); of the 219 of 698 eyes with optic nerve/chiasm T2-hyperintensity and atrophy, the causes were compressive (57), multifactorial (40), inflammatory (38), glaucoma (33), normal (7), and other (44); of the 115 of 698 eyes with optic nerve/chiasm atrophy without T2-hyperintensity, the causes were glaucoma (34), multifactorial (21), inflammatory (13), compressive (11), normal (10), and other (26). Thirty-six eyes with optic nerve/chiasm T2-hyperintensity or atrophy did not have evidence of optic neuropathy or retinopathy on ophthalmologic examination, and 17 eyes had clinical evidence of severe retinopathy without primary optic neuropathy. CONCLUSIONS Optic nerve T2-hyperintensity or atrophy can be found with any cause of optic neuropathy and with severe chronic retinopathy. These MRI findings should not automatically prompt optic neuritis diagnosis, workup, and treatment, and caution is advised regarding their use in the diagnostic criteria for multiple sclerosis. Cases of incidentally found MRI optic nerve T2-hyperintensity and/or atrophy without a known underlying optic neuropathy or severe retinopathy are rare. Such patients should receive an ophthalmologic examination before further investigations.
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Affiliation(s)
- Fernando Labella Álvarez
- Departments of Ophthalmology (FLÁ, RM, WB, BBB, MD, NJN, VB), Radiology and Imaging Sciences (AMS), Neurological Surgery (AMS, NJN), and Neurology (BBB, NJN, VB), Emory University School of Medicine, Atlanta, Georgia; Sheba Medical Center (RM), Goldschleger Eye Institute, Tel Hashomer, Israel; and Department of Epidemiology (BBB), Rollins School of Public Health, Emory University, Atlanta, Georgia
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Chen F, Chen C, Zhang Y, Jiang L, Huang Z, Chen FK. Bilateral optic atrophy in Wilson disease: A case report and literature review. Clin Res Hepatol Gastroenterol 2024; 48:102299. [PMID: 38365087 DOI: 10.1016/j.clinre.2024.102299] [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: 07/11/2023] [Revised: 01/14/2024] [Accepted: 01/29/2024] [Indexed: 02/18/2024]
Abstract
Wilson disease (WD) is an autosomal recessive disorder of copper metabolism. The clinical manifestations of WD are complex and variable, with Kayser-Fleischer ring (K-F ring) and the sunflower cataract being the most common ocular findings. Visual impairment is rare in patients with WD. We report the case of a 17-year-old female with bilateral optic atrophy associated with WD and summarize the clinical features of previously reported cases of optic neuropathy in WD, Clinicians should be aware that WD is a rare cause of optic neuropathy and that optic neuropathy in patients with WD may need to be recognized and screened.
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Affiliation(s)
- Fei Chen
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, No 1, Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China; Department of Ophthalmology, Tengzhou Central People's Hospital, No.181 Xingtan Road, Tengzhou City, Shandong Province, 277500, China
| | - Chunli Chen
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, No 1, Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Yang Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, No 1, Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China; Beijing Institute of Ophthalmology, Beijing, China
| | - Libin Jiang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, No 1, Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China.
| | - Zhiqin Huang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, No 1, Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA, Australia; Lions Eye Institute, Nedlands, WA, Australia; Department of Ophthalmology, Royal Perth Hospital, Perth, WA, Australia; Department of Ophthalmology, Perth Children's Hospital, Nedlands, WA, Australia
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Zehavi Y, Saada A, Jabaly-Habib H, Dessau M, Shaag A, Elpeleg O, Spiegel R. A novel de novo heterozygous pathogenic variant in the SDHA gene results in childhood onset bilateral optic atrophy and cognitive impairment. Metab Brain Dis 2021; 36:581-588. [PMID: 33471299 DOI: 10.1007/s11011-021-00671-1] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 01/08/2021] [Indexed: 10/24/2022]
Abstract
Isolated defects in the mitochondrial respiratory chain complex II (CII; succinate-ubiquinone oxidoreductase) are extremely rare and mainly result from bi-allelic mutations in one of the nuclear encoded subunits: SDHA, SDHB and SDHD, which comprise CII and the assembly CII factor SDHAF1. We report an adolescent female who presented with global developmental delay, intellectual disability and childhood onset progressive bilateral optic atrophy. Whole exome sequencing of the patient and her unaffected parents identified the novel heterozygous de novo variant c.1984C > T [NM_004168.4] in the SDHA gene. Biochemical assessment of CII in the patient's derived fibroblasts and lymphocytes displayed considerably decreased CII residual activity compared with normal controls, when normalized to the integral mitochondrial enzyme citrate synthase. Protein modeling of the consequent p.Arg662Cys variant [NP-004159.2] suggested that this substitution will compromise the structural integrity of the FAD-binding protein at the C-terminus that will ultimately impair the FAD binding to SDHA, thus decreasing the entire CII activity. Our study emphasizes the role of certain heterozygous SDHA mutations in a distinct clinical phenotype dominated by optic atrophy and neurological impairment. This is the second mutation that has been reported to cause this phenotype. Furthermore, it adds developmental delay and cognitive disability to the expanding spectrum of the disorder. We propose to add SDHA to next generation sequencing gene panels of optic atrophy.
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Affiliation(s)
- Yoav Zehavi
- Pediatric Department B' Emek Medical Center, 1834111, Afula, Israel
- Rappaport School of Medicine Technion, Haifa, Israel
| | - Ann Saada
- Faculty of Medicine, Hebrew University, Jerusalem, Israel
- Department of Human Genetics, Hadassah Medical Center, Jerusalem, Israel
| | | | - Moshe Dessau
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Avraham Shaag
- Department of Human Genetics, Hadassah Medical Center, Jerusalem, Israel
| | - Orly Elpeleg
- Faculty of Medicine, Hebrew University, Jerusalem, Israel
- Department of Human Genetics, Hadassah Medical Center, Jerusalem, Israel
| | - Ronen Spiegel
- Pediatric Department B' Emek Medical Center, 1834111, Afula, Israel.
- Rappaport School of Medicine Technion, Haifa, Israel.
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Abstract
A 33-year-old Japanese woman was referred for hoarseness. She had been diagnosed with Charcot-Marie-Tooth disease at age 3 and bilateral optic atrophy at age 15. Laryngoscopy revealed left vocal fold palsy. These findings suggested Charcot-Marie-Tooth disease type 2; the diagnosis was confirmed by a mitofusin 2 mutation analysis. Her symptoms remained stable for almost 10 years. Although vocal fold palsy and optic atrophy have been previously reported in patients with mitofusin 2 mutations, detailed clinical information and clinical course have never been documented. These data might contribute to the elucidation of the pathological conditions associated with mitofusin 2 mutations.
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Affiliation(s)
- Kazuki Kanemaru
- Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Japan
| | - Go Ogawa
- Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Japan
| | - Hitoshi Mochizuki
- Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Japan
| | - Masamitsu Nakazato
- Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Japan
| | - Kazutake Shiomi
- Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Japan
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Begum N, Choudhury IR, Sheuly AH, Nahar L, Quadir MM, Nag D. Clinical Profile of Low Vision Patients Attending in Low Vision Clinic in a Tertiary Care Hospital. Mymensingh Med J 2019; 28:399-404. [PMID: 31086157] [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: 06/09/2023]
Abstract
The purpose of the study was to determine the disease profile of patients attending the low vision clinic of a tertiary eye care hospital at National Institute of Ophthalmology & Hospital (NIO&H), Dhaka, Bangladesh July 2016 to June 2017. Low vision and blindness are major causes of morbidity and an economic burden on the individual, family and the country. Low vision service has emerged as a major challenge faced by the developing countries .so prompt diagnosis; early treatment and early use of low vision devices can improve the quality of life. It was a prospective observational study conducted in low vision clinic at a tertiary care hospital in Bangladesh for one year. A total 419 patient, aged 6-60 years among them 267(63.7%) were male and 152(36.3%) were female. The leading causes of low vision in patient attending the low vision clinic were Retinitis pigmentosa (31.3%) macular dystrophy/stargards diseases & maculopathy (20.3%) and myopia with macular degeneration (14.8%). The percentage of visual impaired (6/18-6/60) were 38.3%, severely visual impaired (<6/60-3/60) were 24.4% & (<3/60) 37.3%. Almost all the patient was prescribed spectacles and Telescope for distant vision, Hand held magnifier and video magnifier were prescribed for near vision. Vision improved with low vision devices (6/18 or better) in 49.5%, (6/18-6/60) in 47.3%, (<6/60-3/60) in 2.8%, (<3/60) in 0.3% patient. Vision with low vision devices were significantly changes (p=0.001). The present study shows that hereditary ocular anomalies (Retinitis pigmentosa, macular dystrophy, myopic degeneration) and amblyopia were more common causes of low vision in this part of world.
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Affiliation(s)
- N Begum
- Dr Nazneen Begum, Senior Consultant, National Institute of Ophthalmology, Dhaka, Bangladesh; E-mail: nazneenbegum1467@ gmail.com
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Affiliation(s)
- J D Gass
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Florida
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Assoum M, Philippe C, Isidor B, Perrin L, Makrythanasis P, Sondheimer N, Paris C, Douglas J, Lesca G, Antonarakis S, Hamamy H, Jouan T, Duffourd Y, Auvin S, Saunier A, Begtrup A, Nowak C, Chatron N, Ville D, Mireskandari K, Milani P, Jonveaux P, Lemeur G, Milh M, Amamoto M, Kato M, Nakashima M, Miyake N, Matsumoto N, Masri A, Thauvin-Robinet C, Rivière JB, Faivre L, Thevenon J. Autosomal-Recessive Mutations in AP3B2, Adaptor-Related Protein Complex 3 Beta 2 Subunit, Cause an Early-Onset Epileptic Encephalopathy with Optic Atrophy. Am J Hum Genet 2016; 99:1368-1376. [PMID: 27889060 DOI: 10.1016/j.ajhg.2016.10.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [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: 07/21/2016] [Revised: 10/14/2016] [Accepted: 10/14/2016] [Indexed: 11/30/2022] Open
Abstract
Early-onset epileptic encephalopathy (EOEE) represents a heterogeneous group of severe disorders characterized by seizures, interictal epileptiform activity with a disorganized electroencephalography background, developmental regression or retardation, and onset before 1 year of age. Among a cohort of 57 individuals with epileptic encephalopathy, we ascertained two unrelated affected individuals with EOEE associated with developmental impairment and autosomal-recessive variants in AP3B2 by means of whole-exome sequencing. The targeted sequencing of AP3B2 in 86 unrelated individuals with EOEE led to the identification of an additional family. We gathered five additional families with eight affected individuals through the Matchmaker Exchange initiative by matching autosomal-recessive mutations in AP3B2. Reverse phenotyping of 12 affected individuals from eight families revealed a homogeneous EOEE phenotype characterized by severe developmental delay, poor visual contact with optic atrophy, and postnatal microcephaly. No spasticity, albinism, or hematological symptoms were reported. AP3B2 encodes the neuron-specific subunit of the AP-3 complex. Autosomal-recessive variations of AP3B1, the ubiquitous isoform, cause Hermansky-Pudlak syndrome type 2. The only isoform for the δ subunit of the AP-3 complex is encoded by AP3D1. Autosomal-recessive mutations in AP3D1 cause a severe disorder cumulating the symptoms of the AP3B1 and AP3B2 defects.
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Affiliation(s)
- Mirna Assoum
- Equipe d'Accueil 4271, Génétique des Anomalies du Développement, Université de Bourgogne, 21079 Dijon, France
| | - Christophe Philippe
- Laboratoire de Génétique Médicale, INSERM U954 (Nutrition-Genetics-Environmental Risk Exposure), Centre Hospitalier Universaire Hôpitaux de Brabois, 54511 Vandoeuvre les Nancy, France
| | - Bertrand Isidor
- Service de Génétique Médicale, Centre Hospitalier Universaire de Nantes, 44093 Nantes, France; INSERM UMR_S957, 44093 Nantes, France
| | - Laurence Perrin
- Département de Génétique, Centre Hospitalier Universaire Paris - Hôpital Robert Debré, Assistance Publique - Hôpitaux de Paris, 75019 Paris, France
| | - Periklis Makrythanasis
- Department of Genetic Medicine and Development, University of Geneva, Rue Michel-Servet 1, 1211 Geneva 4, Switzerland; Service of Genetic Medicine, University Hospitals of Geneva, 1211 Geneva 4, Switzerland
| | - Neal Sondheimer
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada
| | - Caroline Paris
- Centre Hospitalier Régional Universitaire, Hôpital Jean Minjoz, 25030 Besançon, France
| | - Jessica Douglas
- Boston Children's Hospital, Feingold Center, Boston, MA 02115, USA
| | - Gaetan Lesca
- Department of Medical Genetics, Groupement Hospitalier Est, Hospices Civils de Lyon, 69677 Bron, France; Université de Lyon, 69100 Villeurbanne, France; Centre Nationnal de la Recherche Scientifique UMR 5292, INSERM U1028, Centre de Recherche en Neurosciences de Lyon, bâtiment l'Institut Multidisciplinaire de Biochimie des Lipides, 69621 Villeurbanne, France
| | - Stylianos Antonarakis
- Department of Genetic Medicine and Development, University of Geneva, Rue Michel-Servet 1, 1211 Geneva 4, Switzerland; Service of Genetic Medicine, University Hospitals of Geneva, 1211 Geneva 4, Switzerland; Institute of Genetics and Genomics of Geneva, University of Geneva, 1211 Geneva 4, Switzerland
| | - Hanan Hamamy
- Department of Genetic Medicine and Development, University of Geneva, Rue Michel-Servet 1, 1211 Geneva 4, Switzerland
| | - Thibaud Jouan
- Equipe d'Accueil 4271, Génétique des Anomalies du Développement, Université de Bourgogne, 21079 Dijon, France
| | - Yannis Duffourd
- Equipe d'Accueil 4271, Génétique des Anomalies du Développement, Université de Bourgogne, 21079 Dijon, France; Fédération Hospitalo-Universitaire Médecine Translationnelle et Anomalies du Développement, Centre Hospitalier Universitaire Dijon, 21079 Dijon, France
| | - Stéphane Auvin
- INSERM 1141, Service de Neurologie Pédiatrique, Hôpital Robert Debré, 75019 Paris, France
| | - Aline Saunier
- Laboratoire de Génétique Médicale, INSERM U954 (Nutrition-Genetics-Environmental Risk Exposure), Centre Hospitalier Universaire Hôpitaux de Brabois, 54511 Vandoeuvre les Nancy, France
| | - Amber Begtrup
- GeneDx, 207 Perry Parkway, Gaithersburg, MD 20877, USA
| | - Catherine Nowak
- Boston Children's Hospital, Feingold Center, Boston, MA 02115, USA
| | - Nicolas Chatron
- Department of Medical Genetics, Groupement Hospitalier Est, Hospices Civils de Lyon, 69677 Bron, France; Université de Lyon, 69100 Villeurbanne, France; Centre Nationnal de la Recherche Scientifique UMR 5292, INSERM U1028, Centre de Recherche en Neurosciences de Lyon, bâtiment l'Institut Multidisciplinaire de Biochimie des Lipides, 69621 Villeurbanne, France
| | - Dorothée Ville
- Department of Pediatric Neurology, Groupement Hospitalier Est, Hospices Civils de Lyon, 69677 Bron, France
| | - Kamiar Mireskandari
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada
| | - Paolo Milani
- Service de Physiologie Clinique et Explorations Fonctionnelles, Hôpital Lariboisière, Assistance Publique - Hôpitaux de Paris, 75475 Paris, France
| | - Philippe Jonveaux
- Laboratoire de Génétique Médicale, INSERM U954 (Nutrition-Genetics-Environmental Risk Exposure), Centre Hospitalier Universaire Hôpitaux de Brabois, 54511 Vandoeuvre les Nancy, France
| | - Guylène Lemeur
- Service d'Ophtalmologie, Centre Hospitalo-Universitaire de Nantes, 44093 Nantes, France
| | - Mathieu Milh
- Service de Neurologie Pédiatrique, Hôpital de la Timone, Assistance Publique des Hôpitaux de Marseille, 13005 Marseille, France; INSERM UMR_S910, Aix-Marseille Université, 13005 Marseille, France
| | - Masano Amamoto
- Pediatrics Emergency Center, Kitakyushu Municipal Yahata Hospitals, Kitakyushu 803-8501, Japan
| | - Mitsuhiro Kato
- Department of Pediatrics, Showa University School of Medicine, Tokyo 142-8555, Japan
| | - Mitsuko Nakashima
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan
| | - Noriko Miyake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan
| | - Amira Masri
- Department of Paediatrics, Faculty of Medicine, Jordan University, Amman 11942, Jordan
| | - Christel Thauvin-Robinet
- Equipe d'Accueil 4271, Génétique des Anomalies du Développement, Université de Bourgogne, 21079 Dijon, France; INSERM 1141, Service de Neurologie Pédiatrique, Hôpital Robert Debré, 75019 Paris, France; Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Interrégion Est, Centre Hospitalier Universitaire Dijon, 21079 Dijon, France
| | - Jean-Baptiste Rivière
- Equipe d'Accueil 4271, Génétique des Anomalies du Développement, Université de Bourgogne, 21079 Dijon, France; INSERM 1141, Service de Neurologie Pédiatrique, Hôpital Robert Debré, 75019 Paris, France
| | - Laurence Faivre
- Equipe d'Accueil 4271, Génétique des Anomalies du Développement, Université de Bourgogne, 21079 Dijon, France; INSERM 1141, Service de Neurologie Pédiatrique, Hôpital Robert Debré, 75019 Paris, France; Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Interrégion Est, Centre Hospitalier Universitaire Dijon, 21079 Dijon, France
| | - Julien Thevenon
- Equipe d'Accueil 4271, Génétique des Anomalies du Développement, Université de Bourgogne, 21079 Dijon, France; INSERM 1141, Service de Neurologie Pédiatrique, Hôpital Robert Debré, 75019 Paris, France; Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'Interrégion Est, Centre Hospitalier Universitaire Dijon, 21079 Dijon, France.
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Bai XL, Xu X, Lu M, He JN, Xu X, Du X, Zhang B, He XG, Lu LN, Zhu JF, Zou HD, Zhao JL. [A cross-sectional study of moderate or severe visual impairment and blindness in residents with type 2 diabetes living in Xinjing Town, Shanghai]. Zhonghua Yan Ke Za Zhi 2016; 52:825-830. [PMID: 27852398 DOI: 10.3760/cma.j.issn.0412-4081.2016.11.005] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Objective: To investigate the prevalence, underlying causes and risk factors of moderate or severe visual impairment and blindness in a population with type 2 diabetes in Xinjing Town, Shanghai, China. Methods: A cross-sectional survey among local Han adult residents, who were previously diagnosed as type 2 diabetes, was conducted between October 2014 and January 2015. The survey was preceded by a pilot study; operational methods were refined and quality assurance evaluation was carried out. The best corrected visual acuity was recorded and classified following the modified World Health Organization grading system. Assigned ophthalmic doctors assured the leading causes of every blind or visually impaired eye. Binary logistic regression analysis was used to determine the related factors of blindness and moderate or severe visual impairment. Results: A total of 2 216 type 2 diabetic residents were enrolled, and 166 eyes (3.7%, 166/4 432) were blind. Cataract was the leading cause of blindness (39.8%); macular degeneration (18.0%) and eyeball atrophy (11.4%) were the second and third leading causes of blindness, respectively. Moderate or severe visual impairment was found in 376 eyes (8.5%, 376/4 432), and the most frequent cause was cataract (65.7%), followed by diabetic retinopathy (9.8%) and macular degeneration (9.4% ). Older age, female gender, earlier onset diabetes and a lower spherical equivalent in the better eye were associated with best corrected visual acuity<20/63 in the better eye. Conclusion: The prevalences of moderate or severe visual impairment and blindness in our population with type 2 diabetes were high. (Chin J Ophthalmol, 2016, 52: 825-830).
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Affiliation(s)
- X L Bai
- Shanghai Xinjing County Community Health Center, Shanghai 200335, China
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Vasyuta VA. [STUDY EFFECT OF ASSOSIATED PATHOLOGY ON THE DEVELOPMENT OF OPTIC NERVE ATROPHY]. Lik Sprava 2015:109-112. [PMID: 27491161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Studied effect of assosiated pathology on the development of optic nerve atrophy (ONA). The basis of population study was comparison some factors in the groups with ONA and without ONA (analysis case-control) and evaluation of relative risk. Analysis showed that the risk of development of ONA increased in coronary heart disease, hypertension, diabetes, atherosclerosis. A functional-organizational model of care for patients with ONA was proposed.
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Weisfeld-Adams JD, McCourt EA, Diaz GA, Oliver SC. Ocular disease in the cobalamin C defect: a review of the literature and a suggested framework for clinical surveillance. Mol Genet Metab 2015; 114:537-46. [PMID: 25742969 DOI: 10.1016/j.ymgme.2015.01.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [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: 12/07/2014] [Revised: 01/28/2015] [Accepted: 01/28/2015] [Indexed: 01/23/2023]
Abstract
The association between combined methylmalonic acidemia and homocystinuria of cblC type (cobalamin C defect, cblC) and ocular disease is now well recognized, and is a significant component of morbidity and disability associated with the condition. In this review, through collation of historically reported cases of early- and late-onset cblC and previously unreported cases, we have attempted to characterize the epidemiology, clinical features, and pathomechanisms of individual ocular features of cblC. These data suggest that maculopathy and nystagmus with abnormal vision are extremely common and affect the majority of children with early-onset cblC, usually before school age; strabismus and optic atrophy are also seen at relatively high frequency. The timing of progression of macular disease may coincide with a critical period of postnatal foveal development. Maculopathy and retinal disease may be subclinical and show only partial correlation with the extent of visual deficits, and visual deterioration may be relentlessly progressive in spite of aggressive treatment of biochemical abnormalities. In later-onset forms of the disease, visual loss and ocular complications appear to be infrequent. Finally, we discuss investigational strategies in diagnosing and characterizing eye disease in individuals with cblC, explore possible therapeutic avenues that may attenuate progression and severity of eye disease, and propose a clinical surveillance guideline for monitoring progression of ocular disease in children and adults with cblC.
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Affiliation(s)
- James D Weisfeld-Adams
- Children's Hospital Colorado, Aurora, CO, USA; Division of Clinical Genetics and Metabolism, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Emily A McCourt
- Children's Hospital Colorado, Aurora, CO, USA; Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
| | - George A Diaz
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Scott C Oliver
- Children's Hospital Colorado, Aurora, CO, USA; Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
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Cheng CY, Wu JC, Tsai JW, Nian FS, Wu PC, Kao LS, Fann MJ, Tsai SJ, Liou YJ, Tai CY, Hong CJ. ENU mutagenesis identifies mice modeling Warburg Micro Syndrome with sensory axon degeneration caused by a deletion in Rab18. Exp Neurol 2015; 267:143-51. [PMID: 25779931 DOI: 10.1016/j.expneurol.2015.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 12/21/2014] [Accepted: 03/05/2015] [Indexed: 11/18/2022]
Abstract
Mutations in the gene of RAB18, a member of Ras superfamily of small G-proteins, cause Warburg Micro Syndrome (WARBM) which is characterized by defective neurodevelopmental and ophthalmological phenotypes. Despite loss of Rab18 had been reported to induce disruption of the endoplasmic reticulum structure and neuronal cytoskeleton organization, parts of the pathogenic mechanism caused by RAB18 mutation remain unclear. From the N-ethyl-N-nitrosourea (ENU)-induced mutagenesis library, we identified a mouse line whose Rab18 was knocked out. This Rab18(-/-) mouse exhibited stomping gait, smaller testis and eyes, mimicking several features of WARBM. Rab18(-/-) mice were obviously less sensitive to pain and touch than WT mice. Histological examinations on Rab18(-/-) mice revealed progressive axonal degeneration in the optic nerves, dorsal column of the spinal cord and sensory roots of the spinal nerves while the motor roots were spared. All the behavioral and pathological changes that resulted from abnormalities in the sensory axons were prevented by introducing an extra copy of Rab18 transgene in Rab18(-/-) mice. Our results reveal that sensory axonal degeneration is the primary cause of stomping gait and progressive weakness of the hind limbs in Rab18(-/-) mice, and optic nerve degeneration should be the major pathology of progressive optic atrophy in children with WARBM. Our results indicate that the sensory nervous system is more vulnerable to Rab18 deficiency and WARBM is not only a neurodevelopmental but also neurodegenerative disease.
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Affiliation(s)
- Chih-Ya Cheng
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jaw-Ching Wu
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine and Cancer Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jin-Wu Tsai
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Brain Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Fang-Shin Nian
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Pei-Chun Wu
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Life Sciences and Institute of Genome Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Lung-Sen Kao
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Life Sciences and Institute of Genome Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Ming-Ji Fann
- Brain Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Life Sciences and Institute of Genome Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ying-Jay Liou
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chin-Yin Tai
- Institute of Molecular Biology, Academia Sinica, Nankang, Taipei, Taiwan
| | - Chen-Jee Hong
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
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Abstract
PURPOSE To examine size and frequency of parapapillary atrophy (beta zone) in patients with intrasellar or perisellar tumours and a glaucoma-like appearance of the intrapapillary optic disc region. METHODS Thirty-four Chinese subjects with intrasellar or perisellar tumours and a glaucoma-like appearance of the intrapapillary optic disc region and 129 age-matched subjects randomly selected from the population-based Beijing Eye Study were enrolled. Beta zone was measured on fundus photographs. Size and location of the tumours were assessed on neuroradiological images. RESULTS Beta zone was significantly more common (79 ± 7% versus 46 ± 4%; p = 0.001), and it was significantly larger in the tumour group than in the control group (circumferential extent: 135 ± 99 versus 57 ± 72; p < 0.001; relative area: 1856 ± 1923 versus 759 ± 1390; p = 0.002). The width of the intracerebral tumours was significantly associated with the circumferential extent of beta zone (r = 0.36, p = 0.039) and with the area of beta zone (r = 0.37, p = 0.032). Tumour width, height and depth were significantly (p = 0.001; p = 0.012; and p < 0.001, respectively) larger in the group of patients with beta zone than in the subgroup of patients without beta zone of parapapillary atrophy. CONCLUSIONS Patients with large intrasellar or perisellar tumours and a glaucoma-like appearance of the intrapapillary region as compared with a population-based control group had a significantly larger and more frequently occurring beta zone of parapapillary atrophy. It suggests that large parasellar or suprasellar tumours can be associated with typical glaucomatous abnormalities in the parapapillary and intrapapillary region of the optic nerve head. It may give hints for the pathogenesis of glaucomatous optic neuropathy.
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Affiliation(s)
- Ya X Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, China
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Azizzadeh M, Rezaei M, Hashemi N. Incontinentia pigmenti: a newborn with characteristic skin lesions and bilateral optic atrophy: case report and review of literature. Acta Med Iran 2013; 51:805-810. [PMID: 24390952] [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] [Received: 12/21/2013] [Accepted: 12/21/2013] [Indexed: 06/03/2023] Open
Abstract
Incontinentia Pigmenti (IP) is a rare X-linked dominant disorder with skin, eye, central nervous system (CNS) and tooth abnormalities. According to the reported cases, it is estimated that there have been nearly 900-1200 affected individuals. In this article, the literature is reviewed and a case of IP with characteristic skin lesions and optic atrophy is presented.
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Affiliation(s)
- Maryam Azizzadeh
- Department of Dermatology, Semnan University of Medical Sciences, Semnan, Iran.
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Schaaf CP, Blazo M, Lewis RA, Tonini RE, Takei H, Wang J, Wong LJ, Scaglia F. Early-onset severe neuromuscular phenotype associated with compound heterozygosity for OPA1 mutations. Mol Genet Metab 2011; 103:383-7. [PMID: 21636302 DOI: 10.1016/j.ymgme.2011.04.018] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [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: 03/29/2011] [Revised: 04/29/2011] [Accepted: 04/30/2011] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Pathogenic mutations in the OPA1 gene are the most common identifiable cause of autosomal dominant optic atrophy (DOA), which is characterized by selective retinal ganglion cell loss, a distinctive pattern of temporal pallor of the optic nerve and a typical color vision deficit, with variable effects on visual acuity. Haploinsufficiency has been suggested as the major pathogenic mechanism for DOA. Here we present two siblings with severe ataxia, hypotonia, gastrointestinal dysmotility, dysphagia, and severe, early-onset optic atrophy who were found to be compound heterozygotes for two pathogenic OPA1 mutations. This example expands the clinical phenotype of OPA1-associated disorders and provides additional evidence for semi-dominant inheritance. METHODS AND RESULTS Molecular analysis of the OPA1 gene in this family by Sanger sequencing revealed compound heterozygosity for two mutations in trans configuration, a p.I382 M missense mutation and a p.V903GfsX3 frameshift deletion in both affected siblings. Electron microscopy of a skeletal muscle biopsy of the older sibling revealed dense osmiophilic bodies within the mitochondria. Mitochondrial DNA (mtDNA) content was within normal limits, and electron transport chain analysis showed no deficiencies of the mitochondrial respiratory chain enzymes. Multiple mtDNA deletions were not found. CONCLUSION Compound heterozygosity of pathogenic OPA1 mutations may cause severe neuromuscular phenotypes in addition to early-onset optic atrophy. While a role for OPA1 in mtDNA maintenance has been discussed, compound biallelic pathogenic OPA1 mutations in our patients did not result in altered mtDNA copy number, mtDNA deletions, or deficiencies of the electron transport chain, despite the severe clinical phenotype.
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Affiliation(s)
- Christian P Schaaf
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
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Abstract
The purpose of our study was to evaluate the characteristics and the changes of low vision patients over ten years in Korea, and to establish useful data for planning low vision services, active care and rehabilitation. We conducted a retrospective study of 681 low vision patients who visited two low vision clinics in Seoul from 1995 to 2008. Age and sex distribution, cause of low vision, type of prescribed low vision aids, and changes of the characteristics were reviewed. In result, male were more than female. The age group between 11 and 20-yr-old (18.1%) was the largest age group. Optic atrophy (28.3%) was main causes of low vision. However, elderly low vision patients is increasing and macular degeneration is becoming a leading cause of low vision (P<0.05). One thousand five low vision aids (LVAs) were prescribed for 681 patients (1.46+/-0.62 aids for each patient). Near LVAs were prescribed more than distance LVAs. In most patients, the use of LVAs improved both near and distance visual function. This study is the first survey of a large number of low vision patients over a ten year period in Korea. On the base of this study, the planning of low vision services and more active rehabilitation for low vision patients, especially elderly patients, need in Korea.
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Affiliation(s)
- Jae Hoon Kim
- Department of Ophthalmology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Kwang Sic Joo
- Department of Ophthalmology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Nam Ju Moon
- Department of Ophthalmology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
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Ikesugi K, Tsukitome H, Yagi T, Yamaguchi T, Tamei I, Sasoh M, Uji Y. [Causes of visual impairment in Mie Prefecture during a 5-year period]. Nippon Ganka Gakkai Zasshi 2010; 114:505-511. [PMID: 20593655] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
PURPOSE The purpose of this study was to determine the causes of visual impairment in Mie prefecture during a five-year period. SUBJECTS AND METHODS The study was conducted between April 2004 and March 2009 in Mie Prefecture. 1,322 visually impaired people as defined by the Act on Welfare of Physically Disabled Persons were enrolled. We reviewed age, sex, causes of visual impairment, degree of disability and medical conditions according to their physical disability certificate. RESULTS The four major causes of visual impairment were glaucoma (20.3%), diabetic retinopathy (18.9%), retinitis pigmentosa (12.2%), and macular degeneration (9.1%), followed by chorioretinal degeneration, stroke or brain tumor, optic atrophy, and cataract. The average ages of the four major causes were glaucoma (77.1 years), diabetic retinopathy (65.1 years), retinitis pigmentosa (62.5 years) and macular degeneration (77.7 years). CONCLUSIONS The most common cause of visual impairment in Mie prefecture was glaucoma. The four major causes in Mie prefecture were the same as the results of the nation-wide investigation reported in 2006.
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Affiliation(s)
- Kengo Ikesugi
- Department of Ophthalmology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-shi 514-8507, Japan.
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Abstract
OBJECTIVE To describe the population registered as blind in Israel and estimate the prevalence and incidence of blindness, by age, sex and the causes of blindness. METHODS Israel has maintained a Registry for the Blind since 1987. Patients are identified by ophthalmologists and registered if they have a visual acuity of < or = 0.05 (20/400) or a visual field of < 20 degrees radius in their better eye. The Registry consists of all eligible citizens living in Israel at the time of registration. This report includes prevalence data on 18,891 persons enrolled in the Registry from 1987-1999 and still alive and living in Israel in 1999, and incidence data on 2,511 persons newly registered in 1999. Data were collected on visual acuity and visual field loss, cause of blindness, and patient demographics. RESULTS In 1999, the estimated prevalence rate of blindness nationwide was 0.31% and the estimated incidence rate was 0.037%. The major causes of blindness in the complete Registry were age related macular degeneration (AMD) and glaucoma (14%), followed by diabetic retinopathy (11%), cataract and myopic maculopathy (10%), and optic atrophy (8.4%). The leading causes of newly diagnosed blindness were age-related macular degeneration (AMD) (20%), glaucoma (14%), diabetic retinopathy (12%), myopic maculopathy (11%), and optic atrophy and cataract (10%). CONCLUSIONS Israel has one of the few nationwide blindness registries in the world. The prevalence and incidence of blindness in Israel appear to be comparable to other western countries. Comparisons are difficult because of different definitions of blindness, age distributions, and the uniqueness of the Israeli Registry.
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Affiliation(s)
- Marilyn D Farber
- Michaelson Institute for Visual Rehabilitation, Department of Ophthalmology, Hadassah University Hospital, Jerusalem, Israel.
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19
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Russell BG, Jensen H, Kjaer I. Ocular findings and sphenoid bone morphology in tuberous sclerosis. Acta Ophthalmol Scand Suppl 2009:36-9. [PMID: 8741115 DOI: 10.1111/j.1600-0420.1996.tb00382.x] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The aim of the study was to focus on the correlation between the ocular findings and the morphology of the sphenoid bone supporting the optic nerve in patients with tuberous sclerosis. Ten patients participated in the investigation. The sphenoid bone morphology was analyzed from existing radiographs of the cranium. The results were compared to the individual ophthalmologic diagnosis. Changes in the midline osseous structure, the sella turcica and optic sulcus seem to be correlated with the severity of the ocular findings.
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Affiliation(s)
- B G Russell
- Copenhagen County Dental Clinic for Handicapped, Gentofte, Denmark
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20
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Ring K, Møller PM. A preliminary report on the denervation hypersensitivity of the pupil. Acta Ophthalmol 2009; 173:54-6. [PMID: 3002103 DOI: 10.1111/j.1755-3768.1985.tb06839.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Warburg M. Why are the blind and severely visually impaired children with mental retardation much more retarded than the sighted children? Acta Ophthalmol Suppl 2009; 157:72-81. [PMID: 6305101 DOI: 10.1111/j.1755-3768.1983.tb03935.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Five per cent of mentally retarded children in Denmark have a visual acuity below 6/60 as compared to 0.02% in the normal child population. Profound mental retardation was more prevalent among the visually impaired than among the sighted patients. An analysis was performed concerning the correlation between the degree of retardation and the severity of visual impairment, chronological age, number of complicating signs, and degree of motor impairment. The degree of mental retardation was also compared with the aetiology of visual impairment. Severe motor impairments was closely correlated with profound mental retardation.
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Abstract
AIMS Diabetic retinopathy has long been regarded as the commonest preventable cause of blindness in the working age population. The aim was to determine if consistent annual screening for treatable retinopathy decreased the incidence of new blindness. METHODS We collated the causes of blindness for a 5-year period between 2001 and 2005 for the 16- to 64-year age group in a district that had operated systematic retinal screening in diabetes since 1986. RESULTS Diabetic retinopathy was found to be the second commonest cause of blindness, with optic atrophy being the commonest cause in Newcastle District. This differs from national data showing diabetic retinopathy to be the commonest cause. Diabetic retinopathy was also the second commonest cause of partial sightedness registrations, with stroke being the commonest cause. Overall, stroke disease accounted for 16.2% and diabetic retinopathy for 15.4% of registrations. The annual incidence of blindness was 0.22 per 1000 with diabetes and of partial sightedness 0.43 per 1000 with diabetes. CONCLUSIONS In a district that has operated retinal screening since 1986, diabetic retinopathy was not the commonest cause of blindness in the working age population, consistent with an effect of systematic annual screening.
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Affiliation(s)
- C S Arun
- Diabetes Centre, Royal Victoria Infirmary, Newcastle University, Newcastle upon Tyne NE4 6BE, UK
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Kamenskikh TG, Galanzha VA, Raĭgorodskiĭ IM, Kolbenev IO, Dubinina IA, Tishkova AS. [Physiotherapeutic correction of visual functions in rehabilitation of patients after phacoemulsification of cataract with concomitant ophthalmopathology]. Vopr Kurortol Fizioter Lech Fiz Kult 2009:31-34. [PMID: 19284117] [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: 05/27/2023]
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Ho G, Walter JH, Christodoulou J. Costeff optic atrophy syndrome: new clinical case and novel molecular findings. J Inherit Metab Dis 2008; 31 Suppl 2:S419-23. [PMID: 18985435 DOI: 10.1007/s10545-008-0981-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [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: 06/25/2008] [Revised: 09/22/2008] [Accepted: 09/24/2008] [Indexed: 11/30/2022]
Abstract
3-Methylglutaconic aciduria (MGA) encompasses a heterogeneous group of disorders, often coinciding with elevated levels of urinary 3-methylglutaric acid. Type I MGA is a disorder of leucine metabolism, while the biological basis for the MGA is unclear for the other types (MGA types II-V). MGA type III (Costeff optic atrophy syndrome, autosomal recessive optic atrophy-3 or optic atrophy plus syndrome, OMIM 258501) is distinguished by early bilateral optic atrophy, later-onset spasticity, extrapyramidal dysfunction, ataxia, and occasional cognitive deficits. It is caused by homozygous mutations in the optic atrophy 3 gene (OPA3). We present a case of a patient with MGA who has infantile-onset optic atrophy, ataxia, extrapyramidal movements and spasticity, but with normal intellect. Sequencing of the patient's DNA revealed a homozygous nonsense mutation c.415C>T (p.Q139X) in exon 2 of transcript 2 of the OPA3 gene, as well as a common silent polymorphism c.231T>C in the same exon. This is the first nonsense mutation found in OPA3. The molecular findings in OPA3 are also reviewed, including mutations in OPA3 that result in autosomal dominant optic atrophy and cataract (ADOAC). The recessive mode of inheritance of MGA type III as a result of the p.Q139X mutation is supported by the carrier status of the unaffected father.
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Affiliation(s)
- G Ho
- Genetic Metabolic Disorders Research Unit, Children's Hospital at Westmead, Sydney, Australia
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Xu L, Wang Y, Yang H, Jonas JB. Differences in parapapillary atrophy between glaucomatous and normal eyes: the Beijing Eye Study. Am J Ophthalmol 2007; 144:541-6. [PMID: 17651676 DOI: 10.1016/j.ajo.2007.05.038] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [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: 02/13/2007] [Revised: 05/21/2007] [Accepted: 05/24/2007] [Indexed: 11/21/2022]
Abstract
PURPOSE To determine in a population-based study whether parapapillary atrophy is associated with glaucoma. DESIGN Population-based cross-sectional study. METHODS The Beijing Eye Study included 4,439 of 5,324 subjects invited to participate (response rate, 83.4%). Mean age was 56.2 +/- 10.6 years (range, 40 to 101 years). Color optic disk photographs (30 degrees) were examined morphometrically. Parapapillary atrophy was divided into alpha and beta zones. Glaucomatous optic nerve atrophy was defined by a glaucomatous optic nerve head appearance. RESULTS After excluding highly myopic eyes, data from 4,003 (90.2%) subjects entered the statistical analysis. Glaucomatous optic nerve damage was detected in 93 (2.3%) subjects. The beta zone of parapapillary atrophy as a whole and measured separately in four disk sectors was significantly larger and occurred significantly more frequently in the glaucomatous group than in the nonglaucomatous group (beta zone total area, 1.21 +/- 1.92 mm2 vs 0.32 +/- 0.99 mm2; P < .001). In multiple regression analysis, area of beta zone was significantly associated with age (P < .001), myopic refractive error (P < .001), and presence of glaucomatous optic nerve damage (P < .001), with no significant difference between chronic open-angle glaucoma (n = 72) and chronic angle-closure glaucoma (n = 21; beta zone area, 1.20 +/- 0.39 mm2 vs 1.19 +/- 0.46 mm2; P = .69). CONCLUSIONS In a population-based setting, the beta zone of parapapillary atrophy is significantly larger and occurs more frequently in glaucomatous eyes than in normal eyes of Chinese adults, with no marked difference between chronic open-angle glaucoma and primary angle-closure glaucoma.
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Affiliation(s)
- Liang Xu
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital University of Medical Science, Beijing, China
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Abstract
Brain-damaged patients with lesion or dysfunction involving the parietal cortex may show a variety of neuropsychological impairments involving spatial cognition. The more frequent and disabling deficit is the syndrome of unilateral spatial neglect that, in a nutshell, consists in a bias of spatial representation and attention ipsilateral to of extrapersonal, personal (ie, the body) space, or both, toward the side of the hemispheric lesion. The deficit is more frequent and severe after damage to the right hemisphere, involving particularly the posterior-inferior parietal cortex at the temporo-parietal junction. Damage to these posterior parietal regions may also impair visuospatial short-term memory, which may be associated with and worsen spatial neglect. The neural network supporting spatial representation, attention and short-term memory is, however, more extensive, including the right premotor cortex. Also disorders of drawing and building objects (traditionally termed constructional apraxia) are a frequent indicator of posterior parietal damage in the left and in the right hemispheres. Other less frequent deficits, which, however, have a relevant localizing value, include optic ataxia (namely, the defective reaching of visual objects, in the absence of elementary visuo-motor impairments), which is typically brought about by damage to the superior parietal lobule. Optic ataxia, together with deficits of visual attention, of estimating distances and depth, and with apraxia of gaze, constitutes the severely disabling Balint-Holmes' syndrome, which is typically associated with bilateral posterior parietal and occipital damage. Finally, lesions of the posterior parietal lobule (angular gyrus) in the left hemisphere may bring about a tetrad of symptoms (left-right disorientation, acalculia, finger agnosia, and agraphia) termed Gerstmann's syndrome, that also exists in a developmental form.
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Affiliation(s)
- Giuseppe Vallar
- Department of Psychology, University of Milano-Bicocca, Milan, Italy.
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Seroczyńska M, Grałek M, Kanigowska K. [Analysis of the changes in the causes of blindness and significant vision loss among children and young adults born between 1974 and 2004]. Med Wieku Rozwoj 2007; 11:193-216. [PMID: 17965470] [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] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
INTRODUCTION Visual impairment develops serious medical, psychological, social and economical problems. Thus, of most importance is improvement in prophylaxis, early diagnosis and treatment. THE AIM of this paper is to define the reasons of blindness and significant loss of vision in children and youths in Poland, and changes in them among children and youths under the age of 24, born between 1974-2004, with classification by age. SUBJECT AND METHOD Included in the study were the records of 2,518 children and youths under the age of 24, associates of the Polski Zwiazek Niewidomych (PZN, Polish Association of the Blind); these were analyzed for the prevalence of each cause of vision loss. There were two groups. The first group were files of 1,504 students and pupils in the institutions for blind and visually impaired children, and the archives of PZN, describing the members who joined it between year 1974 and 1998. The second, comparative group, was based on files of 1,014 children and students, who joined PZN between year 1999 and 2004. Each group was also analysed within different age groups. RESULTS The most important causes of visual impairment are: optic nerve atrophy, retinopathy of prematurity (ROP), high myopia, congenital cataract and retinal degradations. Changes in them between 1998-2004 introduce a percentage growth of optic nerve atrophy from 21.66% to 25.41% and decrement in vision degrading stages of ROP from 14.14% to 10.71%, in development disorders from 8.09% to 7.10%. There is an alarming growth in congenital toxoplasmosis percentage, from 1.06% to 2.39%, and of congenital cataract, from 3.02% to 4.47%. High myopia among the visually impaired remains at the same level. There is a big growth in the percentage of heavy (bilateral) injuries, which cause significant vision loss. Less often, the cause of serious vision damage are uveitis, secondary glaucoma and toxocariasis. CONCLUSIONS The study conducted between 1998-2004 revealed changes in the causes of blindness and significantly vision loss in children and youths under the age of 24, as compared to a similar study conducted between 1974-1998. There is constant increase of the optic nerve atrophy as a cause of vision loss, and decrease among vision impairments caused by vision damaging stages of ROP. Cataract and congenital abnormalities are more frequent among youngest children. Cortical blindness, formerly rarely diagnosed, is becoming a significant factor. The results of our study, describing the changes in blindness and significant vision loss factors, should provide a proper rationale for developing a strategy for control of visual impairment in children and youths.
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Kepa B, Hautz W, Seroczyńska M, Adach K. [Optic nerve atrophy--the main cause of visual impairment in children and young adults]. Med Wieku Rozwoj 2007; 11:217-220. [PMID: 17965471] [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] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Blindness and visual disability are a very significant problem all over the world. Inflammation, metabolic disorders, tumours, hereditary optic neuropathies may all lead to visual impairment. The main cause of visual impairment and disability in children and young adults is optic nerve atrophy. THE AIM of the paper is the presentation of clinical features and treatment of nerve atrophy in children. Patients with optic nerve disorders should receive effective refraction and amblyopia treatment.
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Affiliation(s)
- Beata Kepa
- Klinika Okulistyki, Instytut Pomnik-Centrum Zdrowia Dziecka, Al. Dzieci Polskich 20, 04-730 Warszawa
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Morava E, Bongers EMHF, Kress W, Sie L, Rodenburg R, Heuvel LVD, Brunner HG. Encephalomyopathy and optic atrophy with tall stature and mitochondrial dysfunction: a new syndrome. Clin Dysmorphol 2007; 16:131-134. [PMID: 17351361 DOI: 10.1097/mcd.0b013e328014715e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Eva Morava
- Departments of Pediatrics Human Genetics Child Neurology, Nijmegen Centre for Mitochondrial Disorders, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands Department of Human Genetics, University Biocenter Am Hubland, Wurzburg, Germany
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Abstract
Wolfram syndrome (WFS) is a rare diffuse neurodegenerative disorder characterized by diabetes insipidus, diabetes mellitus, optic atrophy, deafness, and a wide variety of central nervous system abnormalities. Insulin-dependent diabetes mellitus with optic nerve atrophy is sufficient criteria for the diagnosis. WFS is a devastating disease for the patients and their families. This study emphasizes the need for careful evaluation of cases having insulin-dependent diabetes mellitus and optic atrophy.
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Affiliation(s)
- Seyhmus Ari
- Department of Opthalmology, Diyarbakir State Hospital, Diyarbakir, Turkey.
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Affiliation(s)
- Neroli Porter
- Department of Clinical Genetics, Churchill Hospital, Churchill Drive, Oxford, England
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Ruiter EM, Siers MH, van den Elzen C, van Engelen BG, Smeitink JAM, Rodenburg RJ, Hol FA. The mitochondrial 13513G > A mutation is most frequent in Leigh syndrome combined with reduced complex I activity, optic atrophy and/or Wolff-Parkinson-White. Eur J Hum Genet 2006; 15:155-61. [PMID: 17106447 DOI: 10.1038/sj.ejhg.5201735] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [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: 11/09/2022] Open
Abstract
The m.13513G > A transition in the mitochondrial gene encoding the ND5 subunit of respiratory chain complex I, can cause mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) and has been reported to be a frequent cause of Leigh syndrome (LS). We determined the frequency of the mutation in a cohort of 123 patients with reduced complex I activity in muscle (n = 113) or fibroblast (n = 10) tissue. We describe a Pyrosequencing assay for rapid detection and quantification of the m.13513G > A mutation. Two patients with the mutation were identified; both had LS, optical atrophy and a Wolff-Parkinson-White Syndrome (WPWS)-like cardiac conduction defect. The clinical presentation of the m.13513G > A mutation is discussed. We conclude that the m.13513G > A mutation seems not as frequent as previously suggested and is most likely to be present in patients with Leigh (-like) syndrome combined with a complex I deficiency, optic atrophy and/ or WPWS. In addition, we confirmed that the adjacent m.13514A > G mutation is a rare cause of LS or MELAS since no cases with this transition were found.
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Affiliation(s)
- E Mariken Ruiter
- Radboud University Nijmegen Medical Centre, Department of Human Genetics, Nijmegen, The Netherlands.
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Nakanishi Y, Nakamura M, Tatsumi Y, Nagai-Kusuhara A, Negi A. Quantification of retinal nerve fiber layer thickness reduction associated with a relative afferent pupillary defect. Graefes Arch Clin Exp Ophthalmol 2006; 244:1480-4. [PMID: 16628417 DOI: 10.1007/s00417-006-0327-1] [Citation(s) in RCA: 8] [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] [Subscribe] [Scholar Register] [Received: 09/07/2005] [Revised: 02/17/2006] [Accepted: 03/05/2006] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND A relative afferent pupillary defect (RAPD) is known to develop only when more than 25% of retinal ganglion cells are ablated in monkeys' eyes. However, there was no prior study to estimate biometrically the degree of retinal nerve fiber layer (RNFL) thickness reduction leading to the development of RAPD in live human eyes. The purpose of this study was to examine the correlation between the amount of RNFL thickness reduction and the depth of a clinically detectable RAPD in patients with unilateral optic atrophy. METHODS Enrolled were 20 patients with optic atrophy of various etiologies. We quantified RAPD by performing the swinging flashlight test with log-scaled neutral density filters placed over the unaffected eye. Average RNFL thickness was measured by OCT3000 with the average RNFL thickness program. Linear regression analysis was used in assessing the relationship between RAPD and the ratio of affected to unaffected average RNFL thickness. RESULTS The mean of average RNFL thickness was 95.6+/-17.3 microm in the unaffected eyes and 50.7+/-19.3 microm in the affected eyes (P<0.001). Regression analysis between RAPD and the ratio of affected to unaffected average RNFL thickness revealed a correlation coefficient R2=0.48 (P=0.0007). The regression line intersected the y-axis at 0.77. CONCLUSIONS RAPD was not clinically detected until at least approximately 25% of the retinal nerve fibers were lost when compared with the unaffected eyes. Substantial retinal ganglion cell damage is required for the development of RAPD.
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Affiliation(s)
- Yoriko Nakanishi
- Department of Organs Therapeutics, Division of Ophthalmology, Kobe University Graduate School of Medicine, 650-0017, Kobe, Japan
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Nakamura M, Lin J, Ueno S, Asaoka R, Hirai T, Hotta Y, Miyake Y, Terasaki H. Novel mutations in the OPA1 gene and associated clinical features in Japanese patients with optic atrophy. Ophthalmology 2006; 113:483-488.e1. [PMID: 16513463 DOI: 10.1016/j.ophtha.2005.10.054] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [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: 05/13/2005] [Revised: 08/15/2005] [Accepted: 10/24/2005] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Autosomal dominant optic atrophy (ADOA) is characterized by symmetrical bilateral optic atrophy associated with reduced corrected visual acuity (VA), central or centrocecal scotoma, and color vision disturbances. The disease is genetically heterogeneous, and the OPA1 gene has been identified as the only causative gene. The aims of this study were to identify and report mutations in the OPA1 gene in Japanese patients with ADOA and to describe the clinical features associated with the mutations. DESIGN Molecular genetic study and observational case reports. PARTICIPANTS Nine unrelated Japanese families with optic atrophy and 8 isolated cases of optic atrophy. METHODS Genomic DNA was extracted from peripheral leukocytes, and all exons containing the open reading frame of the OPA1 gene and the flanking intron splice sites were sequenced directly. Complete ophthalmologic examinations were performed. MAIN OUTCOME MEASURES Direct sequencing of the OPA1 gene and clinical evaluations including VA, visual field, color vision, and disc appearance. RESULTS Ten different heterozygous mutations, including 6 novel mutations, were detected in the OPA1 gene. The identified mutations included 5 deletions/insertions (c.2061delA, c.2098_2103delCTTAAA, c.2538insT, c.2591insC, and c.2708_2711delTTAG), 4 nonsense mutations (c.112C>T [p.R38X], c.181C>T [p.Q61X], c.946A>T [p.R316X], and c.2713C>T [p.R905X]), and 1 missense mutation (c.1635C>A [p.S545R]). The most common mutation in Caucasians (c.2708_2711delTTAG) was found in 3 unrelated families, suggesting that it is a mutational hot spot. We detected an OPA1 mutation in 8 of 9 familial cases of optic atrophy and in 4 of 8 cases that were initially considered to be sporadic from the patients' family histories. Examinations of family members of 2 sporadic probands revealed the existence of other family members with the OPA1 mutations whose phenotype was very mild or within normal limits. This indicates that patients with ADOA sometimes seem to be sporadic because of the extensive variation in the phenotype or, alternatively, a low penetrance of ADOA. CONCLUSIONS OPA1 gene mutations are causative in most familial cases of ADOA in Japanese. Sporadic cases of optic atrophy frequently may be caused by OPA1 mutations in the Japanese population. Molecular genetic examinations are useful in determining the hereditary patterns in some cases of optic atrophy.
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Affiliation(s)
- Makoto Nakamura
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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Affiliation(s)
- Toshinobu Kubota
- Department of Ophthalmology, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan.
| | - Hiroshi Hirose
- Department of Ophthalmology, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan
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Hirata F, Tamura H, Ogura Y. Visualization of residual perfluorocarbon liquid using intravitreal triamcinolone acetonide. Ophthalmic Surg Lasers Imaging 2005; 36:169-72. [PMID: 15792323] [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] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The visualization of transparent perfluorocarbon liquid (PFCL) using triamcinolone acetonide is described. Intravitreal injection of triamcinolone acetonide enabled visualization of residual PFCL intraoperatively. In addition, it was shown that triamcinolone acetonide could visualize PFCL in an in vitro preparation of balanced salt solution. This in vitro experiment confirmed that triamcinolone acetonide also could be adsorbed by PFCL outside the vitreous. Triamcinolone acetonide was helpful to visualize transparent PFCL both in vivo and in vitro, and may be useful at the end of vitrectomy to completely remove residual PFCL from the eye.
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Affiliation(s)
- Fumisato Hirata
- Department of Ophthalmology, Nagoya City University Medical School, Nagoya, Japan
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41
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Moll A, Orawiec B, Niwald A, Grałek M. Causes of visual disability in children and young adults. Klin Oczna 2005; 107:93-5. [PMID: 16052813] [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] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
PURPOSE Blindness and visual disability is a great problem all over the world. Loss of visual acuity in children requires special attention. The aim of the study was to determine the causes of uni- and bilateral low vision in children and young adults. Patients were from our clinic and from the School for the Blind and Visually Impaired in Lodz. MATERIAL AND METHODS The study group included 271 patients aged from 3 months to 21 years, visually disabled and with uniocular reduction of visual acuity to 25% or less. RESULTS The commonest cause of low visual acuity in the group was optic nerve atrophy (22%) due to perinatal hypoxia. Other important causes were retinopathy of prematurity (17%) and congenital abnormalities of the eye globe (11%). The main causes of uniocular low vision were anisometropia and strabismus. CONCLUSIONS The main cause of visual impairment and disability in the study group from our region was optic nerve atrophy. Retinopathy of prematurity was also frequently seen in the handicapped children and was responsible for severe visual loss. Anisometropia and strabismus were predominant causes of uniocular visual deterioration, but not of visual disability.
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Affiliation(s)
- Agnieszka Moll
- Z Kliniki Okulistyki Dzieciecej Instytutu Pediatrii Uniwersytetu Medycznego w łodzi
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Khot R, Tankhiwale SR, Shinghade PU, Ravi M. Takayasu's arteritis with bilateral anterior ischaemic optic atrophy. J Assoc Physicians India 2004; 52:835. [PMID: 15909864] [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] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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Abstract
AIMS To measure axonal loss in patients with band atrophy of the optic nerve caused by optic chiasm compression using optical coherence tomography and to evaluate its ability in identifying this pattern of retinal nerve fibre layer (RNFL) loss. METHODS Twenty eyes from 16 consecutive patients with band atrophy of the optic nerve and permanent temporal hemianopia due to chiasmal compression, and 20 eyes from an age and sex matched control group of 16 healthy individuals, were studied prospectively. All patients were submitted to an ophthalmic examination including perimetry and evaluation of the RNFL using optical coherence tomography. Mean RNFL thickness around the optic disc was compared between the two groups. RESULTS The mean (SD) peripapillary RNFL thickness of eyes with band atrophy was 101.00 (9.89) microm, 62.21 (12.71) microm, 104.89 (12.60) microm, and 50.13 (16.88) microm in the superior, temporal, inferior, and nasal regions, respectively. The total RNFL mean was 79.94 (7.17) microm. In the control group, the corresponding values were 140.10 (16.06) microm, 86.50 (12.17) microm, 144.60 (15.70) microm, and 97.94 (16.02) microm. The total RNFL mean was 117.72 (9.53) microm. The measurements were significantly different between the two groups. Measurements in each of twelve 30 degrees divisions provided by the equipment also showed significantly different values between eyes with band atrophy and normal controls. CONCLUSIONS Optical coherence tomography was able to identify axonal loss in all four quadrants as well as in each of the twelve 30 degrees segments of the disc. Thus, it seems to be a promising instrument in the diagnosis and follow up of neuro-ophthalmic conditions responsible for RNFL loss, even if predominantly in the nasal and temporal areas of the optic disc.
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Affiliation(s)
- M L R Monteiro
- Division of Ophthalmology, Hospital das Clínicas, University of Sao Paulo Medical School, SP, Brazil.
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Abstract
BACKGROUND In eyes with severe organic defects the question arises if amblyopia therapy makes sense. PATIENTS AND METHODS Three children are presented in whom despite severe organic eye diseases amblyopia therapy was tried. The first child had a unilateral large macular scar secondary to retinoblastoma treatment, the second a unilateral severe optic nerve atrophy secondary to an orbital hemangioma, and the third a unilateral large optic nerve coloboma. RESULTS In the first case a reading visual acuity of 0.9 was achieved by occlusion therapy and in the second a reading visual acuity of 0.5. In the third case occlusion lead to alternation of the divergent strabismus (child too strongly retarded for reliable visual acuity measurements). CONCLUSIONS During the sensitive phase, amblyopia therapy is also indicated in eyes with severe organic defects since good visual acuities can be achieved.
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Affiliation(s)
- D Lengyel
- Augenklinik, Kantonsspital St. Gallen, Schweiz
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Medlej R, Wasson J, Baz P, Azar S, Salti I, Loiselet J, Permutt A, Halaby G. Diabetes mellitus and optic atrophy: a study of Wolfram syndrome in the Lebanese population. J Clin Endocrinol Metab 2004; 89:1656-61. [PMID: 15070927 DOI: 10.1210/jc.2002-030015] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.9] [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] [Indexed: 11/19/2022]
Abstract
Wolfram syndrome (WFS) is a rare hereditary neurodegenerative disorder also known as DIDMOAD (diabetes insipidus, diabetes mellitus, optic atrophy, and deafness). WFS seems to be a heterogeneous disease that has not yet been fully characterized in terms of clinical features and pathophysiological mechanisms because the number of patients in most series was small. In this study we describe 31 Lebanese WFS patients belonging to 17 families; this, to our knowledge, is the largest number of patients reported in one series so far. Criteria for diagnosis of WFS were the presence of insulin-dependent diabetes mellitus and optic atrophy unexplained by any other disease. Central diabetes insipidus was found in 87% of the patients, and sensorineural deafness confirmed by audiograms was present in 64.5%. Other less frequent features included neurological and psychiatric abnormalities, urodynamic abnormalities, limited joint motility, cardiovascular and gastrointestinal autonomic neuropathy, hypergonadotropic hypogonadism in males, and diabetic microvascular disease. New features, not reported in previous descriptions, such as heart malformations and anterior pituitary dysfunction, were recognized in some of the patients and participated in the morbidity and mortality of the disease. Genetic analysis revealed WFS1 gene mutations in three families (23.5%), whereas no abnormalities were detected in mitochondrial DNA. In conclusion, WFS is a devastating disease for the patients and their families. More information about WFS will lead to a better understanding of this disease and hopefully to improvement in means of its prevention and treatment.
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Affiliation(s)
- R Medlej
- Departments of Endocrinology and Metabolism, Hôtel Dieu Hospital, Beirut, Lebanon
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Abstract
PURPOSE To investigate the correlation between a disc hemorrhage and peripapillary atrophy in glaucoma patients with a unilateral disc hemorrhage. METHODS The 44 glaucoma patients (7 with primary open-angle glaucoma and 37 with normal-tension glaucoma) with a unilateral disc hemorrhage from June 1997 to November 2002 were selected randomly and included sequentially. The topographic measurements were performed using Heidelberg Retina Tomograph (HRT) within 3 months of detecting the disc hemorrhage. The zone beta parameters of the peripapillary atrophy were analyzed by the Atrophy Zone Analysis software. The intraocular pressure, refractive error, visual field parameters, and optic disc parameters were compared between both eyes. Univariate and multivariate regression analysis were performed. RESULTS The area, angular and radial extent of the zone beta, and the ratio of the zone beta area to the disc area were significantly greater in the hemorrhagic eyes than in the contralateral eyes (P < 0.001). The prevalence of peripapillary atrophy was significantly higher in the hemorrhagic eyes (84%) than in the contralateral eyes (66%) (P = 0.034, chi2 test). The rim area and the rim volume of the hemorrhagic eyes were significantly smaller than those of the contralateral eyes (P = 0.02, < 0.001, respectively). In multivariate regression analysis, the peripapillary atrophy area was the independent significant factor associated with disc hemorrhage (P = 0.03, Odds Ratio = 1.51). The refractive error, intraocular pressure, Mean Deviation (MD), and Corrected Pattern Standard Deviation (CPSD) of the visual fields in both eyes were similar. CONCLUSION The area and extent of the peripapillary atrophy was significantly greater and more prevalent in the eyes with a disc hemorrhage than in the contralateral control eyes. Peripapillary atrophy is closely associated with a disc hemorrhage in glaucoma patients irrespective of small neuroretinal rim area and volume.
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Affiliation(s)
- Jae Kyoun Ahn
- Department of Ophthalmology, Seoul National University College of Medicine, Korea
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Puska P, Harju M, Liebkind R. Peripapillary atrophy in the unilateral exfoliation syndrome. Graefes Arch Clin Exp Ophthalmol 2004; 242:301-5. [PMID: 14747950 DOI: 10.1007/s00417-003-0843-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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: 09/08/2003] [Revised: 11/27/2003] [Accepted: 11/28/2003] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To compare the areas of peripapillary atrophy between fellow eyes in patients with unilateral exfoliation syndrome. METHODS Topographic measurements for peripapillary atrophy and the optic nerve head with confocal scanning laser ophthalmoscopy, using the Heidelberg Retina Tomograph were performed on 45 nonglaucomatous patients with unilateral exfoliation syndrome. The area of peripapillary atrophy was divided into an alpha and a beta zone. The areas of alpha and beta peripapillary atrophy and their angular extents around the disc were measured. The frequency distributions of the alpha and beta areas and their largest radial extents at different positions around the disc were calculated. RESULTS An alpha area was detected in 84% of the exfoliative and 89% of the nonexfoliative fellow eyes, and a beta area in 31% and 42% of eyes, respectively. The exfoliative and the fellow nonexfoliative eyes did not differ in the sizes of the alpha (0.43+/-0.46 vs 0.33+/-0.18 mm(2), P=0.68) and beta (0.14+/-0.30 vs 0.17+/-0.34 mm(2), P=0.96) areas of peripapillary atrophy. The angular extents, the locations of the largest radial extent, and the frequency distributions of the alpha and beta peripapillary atrophy areas were similar in fellow eyes. CONCLUSION Exfoliation syndrome itself is not a risk factor for peripapillary atrophy.
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Affiliation(s)
- Päivi Puska
- Helsinki University Eye Hospital, Haartmaninkatu 4 C, PO Box 220, 00029, HYKS, Finland.
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Marszał E, Jamroz E, Paprocka J, Kluczewska E, Sokół M. Leukoencephalopathy with macrocephaly and mild clinical course. Neurol Neurochir Pol 2004; 38:S25-30. [PMID: 15045864] [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: 04/29/2023]
Abstract
The study of the magnetic resonance pattern allowed for identification and description of many genetic disorders belonging to a group of non-specific leukodystrophy e.g. leukoencephalopathy with macrocephaly and mild clinical course (van der Knaap syndrome, MLC megalencephalic leukoencephalopathy with subcortical cysts). This leukodystrophy is characterized by macrocephaly in the first year of life, initially normal development, progressive neurological dysfunction and preservation of mental abilities. The authors describe 3 new cases of vacuolating leukoencephalopathy with megalencephaly. The presented patients fulfill the clinical and neuroimaging criteria of van der Knaap syndrome.
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Affiliation(s)
- Elzbieta Marszał
- Klinika Pediatrii i Neurologii Wieku Rozwojowego, Slaska Akademia Medyczna, Katowice
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Abstract
PURPOSE To describe the demographic and clinical features, complications, treatment, and visual results in patients with childhood-onset Behçet uveitis. DESIGN Observational case series. METHODS A retrospective study was made of 36 consecutive patients with Behçet disease seen at the Uveitis Service, Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, between January 1975 and January 2002. Inclusion criteria were fulfillment of the classification criteria of the International Study Group for Behçet Disease and onset of uveitis at 16 years of age or younger. The medical records of 36 patients with childhood-onset Behçet uveitis were reviewed. The main outcome measures were sex, age at onset of uveitis, the initial symptom of Behçet disease, clinical ocular features, ocular complications, systemic treatment, complications of treatment, and final visual acuity. RESULTS Twenty-five patients were male, 11 were female. Mean age at onset of uveitis was 13.6 years. The initial symptom was oral ulcer in 63.8% of the patients. The majority of patients (83.3%) had bilateral involvement. Panuveitis was the most common form (86.2%). Retinal vasculitis and retinitis were the most common ocular findings seen in 83.3% and 68.2% of the involved eyes, respectively. Cataract, maculopathy, and optic atrophy were the most common complications seen in 46.9%, 45.4%, and 39.4% of the involved eyes, respectively. Immunosuppressive therapy was administered to 75% of the patients. Response to treatment was variable. The most common complications of systemic treatment were associated with corticosteroid therapy. Final visual acuity was worse than 0.1 in 22.7% of the involved eyes. CONCLUSIONS Childhood-onset Behçet uveitis was more common among males. Bilateral panuveitis with retinal vasculitis and retinitis was the most common form of ocular involvement, similar to the adult patient. The treatment is challenging, as the use oral corticosteroids is associated with significant complications and the response to conventional immunosuppressive therapy is variable.
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Affiliation(s)
- Ilknur Tugal-Tutkun
- Department of Ophthalmology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.
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Abstract
PURPOSE To determine the ocular and systemic anomalies associated with optic disc colobomas. PATIENTS AND METHODS The records of patients with a diagnosis of isolated optic disc coloboma and chorioretinal coloboma with optic disc involvement were retrospectively reviewed. RESULTS Fifteen patients were included in the study. Of the 30 eyes, the optic disc and choroid were involved in 18, an isolated disc coloboma was present in 5, a normal optic disc was present in 4, and the optic disc could not be identified because of extreme microphthalmia in 1. Of the optic discs outside the fundus colobomas, 1 had an abnormal shape and 1 had optic atrophy and hypoplasia. Eight patients had bilateral but asymmetric involvement of the optic nerve with the coloboma. Fourteen eyes of 9 patients were microphthalmic. Nine eyes of 6 patients had microcornea. One patient had a nonrhegmatogenous retinal detachment at the time of diagnosis. One eye had a retrobulbar cyst with microphthalmia. Eight (53%) of the patients had sensory strabismus. Two patients had unilateral cortical lens opacities. Associated systemic findings were present in 6 (40%) of the 15 patients. CONCLUSIONS Optic disc colobomas have a wide variety of presentations. Poor visual acuity was observed mostly in eyes with macular involvement and microphthalmia.
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Affiliation(s)
- A Tülin Berk
- Pediatric Ophthalmology and Strabismus Unit, Department of Ophthalmology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
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