Chaker N, Mghaieth F, Baccouri R, Merdassi A, Turki F, El Matri L
Service d'Ophtalmologie B, Institut Hedi Rais, Tunis, Tunisia.
J Fr Ophtalmol. 2007 Jan;30(1):39-43. doi: 10.1016/s0181-5512(07)89548-9.
Bietti's crystalline corneoretinal dystrophy is a tapetoretinal degeneration, characterized by the presence of refringent crystals in the corneal limbus and the retina with sclerosis of choroidal vessels. We report the clinical and angiographic features of an 8-year-old girl affected with Bietti's crystalline dystrophy.
This 8-year-old girl was a sporadic case, born of consanguineous parents. She was referred to our hospital for intermittent strabismus. Her visual acuity was 4/10 at the right eye and 3/10 at the left eye. Biomicroscopy revealed very fine crystals in the limbal area bilaterally. Mydriatic funduscopic examination showed bilateral macular pigment mottling and depigmentation, numerous tiny refractile yellow dots scattered throughout the posterior pole and the mid-periphery associated with diffuse retinal pigment epithelial atrophy and pigment accumulation. Fluorescein angiography revealed retinal pigmentary epithelium alterations. Indocyanine green (Infracyanin) angiography showed areas of choroidal atrophy. The electroretinogram noted a reduction in the number of both types of photoreceptors.
Ophthalmological lesions normally occur between 20 and 30 years of age. The particularity of our case report is the manifestation of the disease at an earlier age (8 years). The progression is characterized by a centrifuge expansion of lesions.
比埃蒂结晶性角膜视网膜营养不良是一种视网膜色素变性,其特征是角膜缘和视网膜出现折光性晶体,并伴有脉络膜血管硬化。我们报告了一名患有比埃蒂结晶性营养不良的8岁女孩的临床和血管造影特征。
这名8岁女孩为散发病例,父母为近亲结婚。她因间歇性斜视被转诊至我院。其右眼视力为4/10,左眼视力为3/10。生物显微镜检查发现双侧角膜缘区域有非常细小的晶体。散瞳眼底检查显示双侧黄斑色素斑驳和色素脱失,无数微小的可折射黄色小点散在分布于后极部和中周边部,伴有弥漫性视网膜色素上皮萎缩和色素沉着。荧光素血管造影显示视网膜色素上皮改变。吲哚菁绿血管造影显示脉络膜萎缩区域。视网膜电图显示两种类型的光感受器数量减少。
眼科病变通常发生在20至30岁之间。我们病例报告的特殊性在于该疾病在较早年龄(8岁)出现。其进展特征为病变呈离心性扩展。