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眼牙指发育不全:新的眼部发现及一种新的连接蛋白43突变

Oculodentodigital dysplasia: new ocular findings and a novel connexin 43 mutation.

作者信息

Gabriel Luis A Rassi, Sachdeva Reecha, Marcotty Andreas, Rockwood Edward J, Traboulsi Elias I

机构信息

Cole Eye Institute, Cleveland Clinic, Cleveland, OH 44195, USA.

出版信息

Arch Ophthalmol. 2011 Jun;129(6):781-4. doi: 10.1001/archophthalmol.2011.113.

DOI:10.1001/archophthalmol.2011.113
PMID:21670345
Abstract

OBJECTIVES

To describe new ocular findings associated with oculodentodigital dysplasia (ODDD) and a novel mutation in the connexin 43 transmembrane domain.

DESIGN

Oculodentodigital dysplasia is a rare autosomal dominant disease characterized by multiple systemic abnormalities, most commonly of the ocular, nasal, dental, and limb structures. Herein, we studied 2 patients with ODDD. We describe their clinical findings and 2 ocular abnormalities not previously emphasized or reported.

RESULTS

Optic nerve and retinal dysplasia was observed in both patients, and ciliary body cysts were observed in 1 patient. Both patients carried isolated in-frame deletion and missense mutations of the GJA1 gene on chromosome 6.

CONCLUSIONS

Optic nerve and retinal dysplasia had not been emphasized as ocular manifestations of ODDD. Ciliary body cysts have not previously been reported in association with ODDD.

CLINICAL RELEVANCE

Our findings support the potential significance of connexin 43 in the retina, optic nerve, and ciliary body. Retinal and optic nerve dysplasia may be more common than previously appreciated and may be associated with reduced vision. In addition, the ciliary body cysts observed in 1 patient may be secondary to weakened cellular adhesions between ciliary body pigmented and nonpigmented epithelium associated with the in-frame deletion identified in the affected patient. The presence of these cysts may exacerbate glaucoma or complicate its management.

摘要

目的

描述与眼牙指发育异常(ODDD)相关的新的眼部表现以及连接蛋白43跨膜结构域中的一种新突变。

设计

眼牙指发育异常是一种罕见的常染色体显性疾病,其特征为多种全身异常,最常见于眼部、鼻部、牙齿和肢体结构。在此,我们研究了2例ODDD患者。我们描述了他们的临床发现以及2种此前未被重点强调或报道过的眼部异常。

结果

两名患者均观察到视神经和视网膜发育异常,1例患者观察到睫状体囊肿。两名患者均携带6号染色体上GJA1基因的孤立框内缺失和错义突变。

结论

视神经和视网膜发育异常此前未被强调为ODDD的眼部表现。此前未报道过睫状体囊肿与ODDD相关。

临床意义

我们的发现支持连接蛋白43在视网膜、视神经和睫状体中的潜在重要性。视网膜和视神经发育异常可能比之前认为的更常见,并且可能与视力下降有关。此外,在1例患者中观察到的睫状体囊肿可能继发于受影响患者中发现的框内缺失所导致的睫状体色素上皮和非色素上皮之间细胞黏附减弱。这些囊肿的存在可能会加重青光眼或使其治疗复杂化。

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