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Leber 先天性黑矇和早发性儿童期发病的视网膜色素变性患者的视力。

Visual acuity in patients with Leber's congenital amaurosis and early childhood-onset retinitis pigmentosa.

机构信息

Department of Ophthalmology, University of Illinois at Chicago, Chicago, Illinois, USA.

出版信息

Ophthalmology. 2010 Jun;117(6):1190-8. doi: 10.1016/j.ophtha.2009.09.056. Epub 2010 Jan 15.

Abstract

PURPOSE

To correlate visual acuity of patients with Leber's congenital amaurosis (LCA) and early childhood-onset retinitis pigmentosa (RP) with mutations in underlying LCA genes.

DESIGN

Multicentered retrospective observational study.

PARTICIPANTS

After exclusion of 28 subjects, 169 patients with the diagnosis of LCA and 27 patients with early childhood-onset RP were included in the study because the underlying mutations in AIPL1, GUCY2D, RDH12, RPE65, CRX, CRB1, RPGRIP1, CEP290, LCA5, and TULP1 genes could be identified in this cohort of patients.

METHODS

We collected data on best-corrected visual acuity as recorded at the time of the patient's most recent visit to one of the participating ophthalmology departments. The median and range of visual acuities for each genetic subtype were calculated separately for the LCA and early childhood-onset RP groups.

MAIN OUTCOME MEASURES

The range and median best-corrected visual acuities for each genetic subtype and age-related mean visual acuities for each genetic subtype.

RESULTS

A wide variation in visual acuity was observed in patients with LCA and RPE65, RDH12, and CRB1 mutations, whereas AIPL1, GUCY2D, CRX, and RPGRIP1 gene mutations were associated with severely decreased visual acuities beginning within the first year of life. It was also noted that patients with either an RPE65 or CRB1 mutation have progressive visual loss with advancing age. Onset of visual symptoms after infancy was associated with a relatively better visual prognosis.

CONCLUSIONS

The data obtained from this study will help clinicians provide counseling on visual prognosis to patients with known mutations in LCA genes and be of value in future studies aimed at the treatment of LCA and early childhood-onset RP.

摘要

目的

将莱伯先天性黑蒙(LCA)和早发性儿童期视网膜色素变性(RP)患者的视力与潜在的 LCA 基因的突变相关联。

设计

多中心回顾性观察性研究。

参与者

在排除 28 名受试者后,共有 169 名患有 LCA 诊断的患者和 27 名患有早发性儿童期 RP 的患者被纳入本研究,因为在这组患者中可以鉴定出 AIPL1、GUCY2D、RDH12、RPE65、CRX、CRB1、RPGRIP1、CEP290、LCA5 和 TULP1 基因的潜在突变。

方法

我们收集了每位患者最近一次到参与的眼科部门就诊时记录的最佳矫正视力数据。分别计算了 LCA 和早发性儿童期 RP 组中每个遗传亚型的视力中位数和范围。

主要观察指标

每个遗传亚型的最佳矫正视力范围和中位数以及每个遗传亚型的年龄相关平均视力。

结果

在患有 LCA 和 RPE65、RDH12 和 CRB1 基因突变的患者中观察到视力的广泛变化,而 AIPL1、GUCY2D、CRX 和 RPGRIP1 基因突变与出生后第一年开始的严重视力下降有关。还注意到,具有 RPE65 或 CRB1 突变的患者随着年龄的增长视力逐渐丧失。婴儿期后出现视觉症状与相对较好的视觉预后相关。

结论

从这项研究中获得的数据将帮助临床医生为已知 LCA 基因突变的患者提供视觉预后咨询,并对旨在治疗 LCA 和早发性儿童期 RP 的未来研究具有价值。

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