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突出的视盘在遗传性视网膜病变中呈现。

Prominent Optic Disc Featured in Inherited Retinopathy.

作者信息

Todorova M G, Bojinova R I, Valmaggia C, Schorderet D F

机构信息

Department of Ophthalmology, University of Basel, Switzerland (Chairman: Prof. Hendrik Scholl).

University of Montreal - 495 Prince Arthur West, Montreal, Canada.

出版信息

Klin Monbl Augenheilkd. 2017 Apr;234(4):577-583. doi: 10.1055/s-0042-121335. Epub 2017 Feb 1.

Abstract

We investigated the relationship between prominent optic disc (POD) and inherited retinal dystrophy (IRD). A cross-sectional consecutive study was performed in 10 children and 11 adults of 7 non-related families. We performed clinical phenotyping, including a detailed examination, fundus autofluorescence, and colour fundus and OCT imaging. Genetic testing was subsequently performed for all family members presenting retinal pathology. In 4 members of a 3-generation family, hyperfluorescent deposits on the surface of POD were related to a p.(L224M) heterozygous mutation in . In the second family, one member presented deposits located on the surface on hyperaemic OD and a compound p.(R141H);(A195V) mutation in . In the third family, POD was observed in father and child with early onset cone-rod dystrophy and a novel autosomal recessive p.(W31*) homozygous mutation in . In the fourth family, POD with "mulberry-like" deposits and attenuated vessels were observed in a 7-year old girl, with a mutation in , and with early onset rod-cone dystrophy, associated with hearing loss. In the fifth family, blurry OD with tortuous vessels was observed in 4 consanguineous female carriers and a hemizygous boy with a p.(R200H) mutation in the X-linked retinoschisis . In the sixth family, a mother and her son were both affected with POD and attenuated peripapillary vessels, and presented with a p.(Y836C) heterozygous mutation in , thus confirming autosomal dominant RP. In the seventh family, in 3 family members with POD, compound p.(L541P;A1038 V);(G1961E) mutations in confirmed the diagnosis of Stargardt disease. A variety of OD findings are found in a genetically heterogeneous group of IRDs. In the presence of POD, an inherited progressive photoreceptor disease should be ruled out.

摘要

我们研究了明显视盘(POD)与遗传性视网膜营养不良(IRD)之间的关系。对7个无亲缘关系家庭的10名儿童和11名成人进行了一项横断面连续性研究。我们进行了临床表型分析,包括详细检查、眼底自发荧光、彩色眼底和光学相干断层扫描(OCT)成像。随后对所有出现视网膜病变的家庭成员进行了基因检测。在一个三代家庭的4名成员中,POD表面的高荧光沉积物与某基因的p.(L224M)杂合突变有关。在第二个家庭中,一名成员在充血的视盘表面有沉积物,且某基因存在复合p.(R141H);(A195V)突变。在第三个家庭中,父亲和孩子患有早发性锥杆营养不良,观察到POD,且某基因存在新的常染色体隐性p.(W31*)纯合突变。在第四个家庭中,一名7岁女孩观察到有“桑椹样”沉积物和血管变细的POD,某基因有突变,患有早发性杆锥营养不良,并伴有听力损失。在第五个家庭中,4名近亲女性携带者和1名半合子男孩观察到视盘模糊且血管迂曲,X连锁视网膜劈裂症某基因有p.(R200H)突变。在第六个家庭中,一位母亲和她的儿子均患有POD和视乳头周围血管变细,某基因有p.(Y836C)杂合突变,从而确诊为常染色体显性视网膜色素变性(RP)。在第七个家庭中,3名有POD的家庭成员某基因存在复合p.(L541P;A1038 V);(G1961E)突变,确诊为Stargardt病。在基因异质性的IRD群体中发现了多种视盘表现。在存在POD的情况下,应排除遗传性进行性光感受器疾病。

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