Department of Ophthalmology, Siriraj Hospital Mahidol University, Bangkok, Thailand.
Jpn J Ophthalmol. 2010 Jan;54(1):89-93. doi: 10.1007/s10384-009-0748-6. Epub 2010 Feb 12.
To identify genetic mutations of the XLRS1 gene and to describe the ocular phenotypes in two unrelated Thai patients with X-linked juvenile retinoschisis.
Ophthalmic examination, including best-corrected visual acuity and fundus examination and photography, was performed in all participants. Electroretinography (ERG) and optical coherence tomography were performed when possible. All six exons of the XLRS1 gene were amplified, and mutation screening was determined by denaturing high-performance liquid chromatography and DNA sequencing.
Two point mutations were identified, a novel missense mutation c.378A > G (p.D126G) in exon 5 and a reported mutation c.637C > T (p.R213W) in exon 6. The first proband with the p.D126G mutation developed vitreous hemorrhage in both eyes at age 7 months. Foveal and peripheral schisis with several inner layer holes were detected in both eyes. The second proband with the p.R213W mutation developed slightly blurred vision at age 10 years. Fundus examination showed numerous fine white dots at the macula without foveal or peripheral schisis. Electronegative ERG results were documented in both probands.
A novel p.D126G mutation appeared to be associated with a severe phenotype with vitreous hemorrhage developing in infancy. Both intra- and interfamilial clinical variabilities were recognized in our patients.
鉴定 XLRS1 基因突变,并描述 2 例泰国非相关 X 连锁青年性视网膜劈裂症患者的眼部表型。
对所有参与者进行眼科检查,包括最佳矫正视力和眼底检查及照相。当可能时进行视网膜电图(ERG)和光学相干断层扫描。扩增 XLRS1 基因的所有 6 个外显子,通过变性高效液相色谱法和 DNA 测序确定突变筛查。
鉴定出 2 个点突变,第 5 外显子的新型错义突变 c.378A > G(p.D126G)和第 6 外显子的报道突变 c.637C > T(p.R213W)。第 1 位先证者携带 p.D126G 突变,7 个月时双眼发生玻璃体出血。双眼均检测到中心凹和周边劈裂,并伴有多个内层孔。第 2 位先证者携带 p.R213W 突变,10 岁时视力稍有模糊。眼底检查显示黄斑区有许多细小的白色斑点,无中心凹或周边劈裂。两位先证者的 ERG 结果均为阴性。
一种新型的 p.D126G 突变似乎与一种严重的表型相关,该表型在婴儿期发生玻璃体出血。我们的患者中存在着明显的个体内和家族内临床变异性。