Dalvin Lauren A, Pulido Jose S, Marmorstein Alan D
a Department of Ophthalmology , Mayo Clinic , Rochester , Minnesota , USA.
b Department of Molecular Medicine , Mayo Clinic , Rochester , Minnesota , USA.
Ophthalmic Genet. 2017 Mar-Apr;38(2):143-147. doi: 10.1080/13816810.2016.1175645. Epub 2016 Apr 27.
Vitelliform dystrophies are a group of macular degenerative diseases characterized by round yellow lesions in the macula. While often idiopathic, vitelliform dystrophies include inherited maculopathies such as Best disease and some cases of pattern dystrophy. The prevalence of vitelliform dystrophies in the United States has not been reported. This study examined the prevalence of vitelliform dystrophies in Olmsted County, Minnesota.
The Rochester Epidemiology Project database was used to identify all cases of vitelliform or pattern dystrophy in Olmsted County from 1 January 2000-31 December 2014.
Overall, 27 patients had true vitelliform lesions, indicating a prevalence of 1 in 5500. Of these, two had genetically confirmed Best disease, and an additional five to seven carried a diagnosis of Best disease, which chart reviews confirmed as probable cases; 18-20 patients had adult-onset vitelliform macular dystrophy. The prevalence of Best disease was 1 in 16,500 to 1 in 21,000. Adult-onset vitelliform macular dystrophy was found in 1 in 7400 to 1 in 8200.
Vitelliform dystrophies affect 1 in 5500 individuals in Olmsted County. While the values in this study provide good estimates for the prevalence of Best disease versus adult-onset vitelliform macular dystrophy, the results are limited by dependence on diagnoses made by other ophthalmologists and underutilization of genetic testing. Thus, these diseases should be thought of as at least as prevalent as reported here. As therapies for Best disease and other macular degenerative diseases are quickly becoming a reality, genetic testing should be employed as the gold standard for diagnosis of these diseases.
卵黄样营养不良是一组以黄斑区圆形黄色病变为特征的黄斑变性疾病。虽然通常为特发性,但卵黄样营养不良包括遗传性黄斑病变,如Best病和一些图案状营养不良病例。美国卵黄样营养不良的患病率尚未见报道。本研究调查了明尼苏达州奥尔姆斯特德县卵黄样营养不良的患病率。
利用罗切斯特流行病学项目数据库,确定2000年1月1日至2014年12月31日期间奥尔姆斯特德县所有卵黄样或图案状营养不良病例。
总体而言,27例患者有真正的卵黄样病变,患病率为1/5500。其中,2例经基因确诊为Best病,另外5至7例诊断为Best病,病历审查确认为可能病例;18 - 20例患者患有成人型卵黄样黄斑营养不良。Best病的患病率为1/16500至1/21000。成人型卵黄样黄斑营养不良的患病率为1/7400至1/8200。
卵黄样营养不良影响奥尔姆斯特德县1/5500的个体。虽然本研究中的数据为Best病与成人型卵黄样黄斑营养不良的患病率提供了较好的估计,但结果受限于依赖其他眼科医生做出的诊断以及基因检测利用不足。因此,这些疾病的实际患病率应至少与本研究报道的一样高。由于针对Best病和其他黄斑变性疾病的治疗方法正迅速成为现实,基因检测应作为诊断这些疾病的金标准。