Lim Hyun Taek, Kim Dae Hee, Kim Hyuna
aDepartment of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea bDepartment of Ophthalmology, Kim's Eye Hospital, College of Medicine, Konyang University, Nonsan, Korea.
Curr Opin Ophthalmol. 2017 Sep;28(5):436-447. doi: 10.1097/ICU.0000000000000405.
Aniridia is a rare and panocular disorder affecting most of the ocular structures which may have significant impact on vision. The purpose of this review is to describe the clinical features, genetics, and therapeutic options for this disease and to provide an update of current knowledge and latest research findings.
Aside from the ocular features, a variety of associated systemic abnormalities, including hormonal, metabolic, gastrointestinal, genitourinary, and neurologic pathologies have been reported in children with aniridia. Although mutations in PAX6 are a major cause of aniridia, genetic defects in nearby genes, such as TRIM44 or ELP4, have also been reported to cause aniridia. Recent improvement in genetic testing technique will help more rapid and precise diagnosis for aniridia. A promising therapeutic approach called nonsense suppression therapy has been introduced and successfully used in an animal model.
Aniridia is a challenging disease. The progressive nature of this condition and its potential complications require continuous and life-long ophthalmologic care. Genetic diagnosis for aniridia is important for establishing definitive molecular characterization as well as identifying individuals at high risk for Wilms tumor. Recent advancement in understanding the genetic pathogenesis of this disease offers promise for the approaches to treatment.
无虹膜症是一种罕见的全眼球疾病,会影响大部分眼部结构,可能对视力产生重大影响。本综述的目的是描述该疾病的临床特征、遗传学及治疗选择,并提供当前知识和最新研究结果的更新。
除了眼部特征外,已有报道称患有无虹膜症的儿童存在多种相关的全身异常,包括激素、代谢、胃肠道、泌尿生殖系统和神经病理学方面的异常。虽然PAX6基因突变是无虹膜症的主要原因,但也有报道称附近基因如TRIM44或ELP4的遗传缺陷也会导致无虹膜症。基因检测技术的最新进展将有助于更快速、准确地诊断无虹膜症。一种名为无义抑制疗法的有前景的治疗方法已被引入并成功应用于动物模型。
无虹膜症是一种具有挑战性的疾病。这种疾病的进行性本质及其潜在并发症需要持续的终身眼科护理。无虹膜症的基因诊断对于确定明确的分子特征以及识别患威尔姆斯瘤高风险个体很重要。最近在理解该疾病的遗传发病机制方面的进展为治疗方法带来了希望。