Werdich Xiang Q, Place Emily M, Pierce Eric A
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School , Boston, Massachusetts , USA.
Semin Ophthalmol. 2014 Sep-Nov;29(5-6):319-28. doi: 10.3109/08820538.2014.959202.
Inherited retinal degeneration (IRD) may occur in isolation or as part of a multi-systemic condition. Ocular manifestations may be the presenting symptom of a syndromic disease and can include retinitis pigmentosa, cone-rod dystrophy, or maculopathy. Alternatively, patients affected with syndromic disease may already have other systemic manifestations at the time retinal disease is diagnosed. Some of these systemic diseases can cause significant morbidity. Here, we review several of these syndromic IRDs and their underlying genetic causes. Early recognition and referral for systemic evaluation and surveillance may lead to early intervention and an improved outcome. Obtaining a molecular diagnosis can be beneficial in securing a definitive diagnosis, especially in cases with atypical presentations. A genetic diagnosis may also be informative with regard to prognosis and potential therapies. Effective management and rehabilitation for patients with syndromic retinal dystrophy requires a comprehensive genetic-based team approach involving patients, family members, ophthalmologists, primary care physicians, and geneticists.
遗传性视网膜变性(IRD)可能单独发生,也可能作为多系统疾病的一部分出现。眼部表现可能是综合征性疾病的首发症状,可包括色素性视网膜炎、锥杆营养不良或黄斑病变。或者,患有综合征性疾病的患者在视网膜疾病被诊断时可能已经有其他全身表现。其中一些全身性疾病可导致严重的发病率。在这里,我们回顾几种此类综合征性IRD及其潜在的遗传原因。早期识别并转诊进行全身评估和监测可能会带来早期干预并改善预后。获得分子诊断有助于明确诊断,特别是在表现不典型的病例中。基因诊断对于预后和潜在治疗也可能具有指导意义。对综合征性视网膜营养不良患者进行有效的管理和康复需要一种基于遗传学的综合团队方法,涉及患者、家庭成员、眼科医生、初级保健医生和遗传学家。