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土耳其一个家系中 KCNV2 相关的 cone dystrophy 与超正常值的 rod 视网膜电图和 MFRP 相关的眼病共存。

Coexistence of KCNV2 associated cone dystrophy with supernormal rod electroretinogram and MFRP related oculopathy in a Turkish family.

机构信息

Department of Ophthalmology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna A-1090, Austria.

出版信息

Br J Ophthalmol. 2013 Feb;97(2):169-73. doi: 10.1136/bjophthalmol-2012-302355. Epub 2012 Nov 10.

Abstract

BACKGROUND AND AIM

To describe the clinical and genetic characteristics of a mother and her son presenting with two distinct and rare forms of retinal degeneration.

METHODS

Investigations in both patients comprised spectral domain optical coherence tomography (SD-OCT), fundus autofluorescence imaging, non-contact biometry, ultrasonography, electroretinography (ERG) and analysis of the mutational status of the KCNV2 and MFRP genes in genomic DNA.

RESULTS

The clinical course and typical ERG pattern indicated a 'cone dystrophy with supernormal rod electroretinogram' in the proband, and SD-OCT demonstrated a subfoveal optical gap with loss of the inner segment/outer segment junction line. The proband was homozygous for a c.782C>A (p.Ala261Asp) mutation in KCNV2. Her son's axial length was shortened with refractive errors of +16.75 dioptres in the right and +14.0 dioptres in the left eye; ERG evidenced a rod-cone dystrophy, OCT showed central macular thickening with cystoid changes and ultrasonography revealed optic disc drusen. MFRP analysis disclosed a 1 bp deletion (c.498delC) that predicts a truncated protein.

CONCLUSIONS

Two distinct ocular phenotypes with pathogenic mutations in two different genes segregated in this family. The coexistence of two independent autosomal recessive disorders should be considered even when dealing with diseases that bear low carrier frequencies in the general population.

摘要

背景与目的

描述一位母亲和她的儿子所患的两种不同且罕见的视网膜变性疾病的临床和遗传特征。

方法

对两名患者的检查包括频域光学相干断层扫描(SD-OCT)、眼底自发荧光成像、非接触式生物测量、超声检查、视网膜电图(ERG)以及 KCNV2 和 MFRP 基因突变在基因组 DNA 中的分析。

结果

临床过程和典型的 ERG 模式表明先证者患有“具有超正常杆状细胞视网膜电图的 cones 变性”,SD-OCT 显示了一个位于黄斑下的光学间隙,内节/外节连接线缺失。先证者为 KCNV2 基因的 c.782C>A(p.Ala261Asp)纯合突变。她儿子的眼轴长度缩短,右眼近视 16.75 屈光度,左眼近视 14.0 屈光度;ERG 显示 rod-cone 变性,OCT 显示中央黄斑增厚伴有囊样改变,超声检查显示视盘玻璃疣。MFRP 分析显示存在 1 bp 缺失(c.498delC),预测会导致截短蛋白。

结论

这个家系中两种不同的眼部表型与两种不同基因的致病性突变相关。即使在处理一般人群中携带频率较低的疾病时,也应考虑两种独立的常染色体隐性疾病的共存。

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