Berninger T A, Jaeger W, Krastel H
Max-Planck Institute for Clinical and Physiological Research, Bad Nauheim, Federal Republic of Germany.
Br J Ophthalmol. 1991 Jan;75(1):49-52. doi: 10.1136/bjo.75.1.49.
A typical finding in dominant infantile optic atrophy (DIOA) is the variation of the phenotypic expression of the DIOA gene even within one family. It is of special interest for genetic consultation to evaluate an examination method for detecting subclinically involved patients. Seven patients of two families were examined. Three of them had the typical symptoms of DIOA: reduced visual acuity, tritan defect, temporal pallor of both optic discs, and a relative central scotoma for white test spots. In visual evoked cortical potentials (VECP) the amplitudes were reduced, and in one patient the latencies were slightly delayed and two patients considerably so. The amplitude of the negative component of the PERG was markedly reduced, while the positive component was normal. In the remaining four family members normal retinal and cortical responses were recorded under standard conditions and visual fields and colour vision (FM 100 hue) were also normal. However, static perimetry with blue test spots showed in two family members enlarged central scotomas, thus proving that they had subclinical DIOA.
在显性遗传性婴儿型视神经萎缩(DIOA)中,一个典型的发现是即使在一个家族内部,DIOA基因的表型表达也存在差异。评估一种检测亚临床受累患者的检查方法对于遗传咨询具有特殊意义。对两个家族的7名患者进行了检查。其中3人有DIOA的典型症状:视力下降、蓝黄色觉异常、双侧视盘颞侧苍白以及对白色测试点的相对中心暗点。在视觉诱发电位(VECP)中,波幅降低,1例患者潜伏期稍有延迟,2例患者延迟明显。图形视网膜电图(PERG)负向波成分的波幅明显降低,而正向波成分正常。在其余4名家族成员中,在标准条件下记录到正常的视网膜和皮质反应,视野和色觉(FM100色调)也正常。然而,用蓝色测试点进行的静态视野检查显示,两名家族成员有扩大的中心暗点,从而证明他们患有亚临床DIOA。