Mantagos Iason S, Kleinman Monica E, Kieran Mark W, Gordon Leslie B
Department of Ophthalmology, Boston Children's Hospital - Harvard Medical School, Boston, Massachusetts.
Department of Anesthesia, Boston Children's Hospital - Harvard Medical School, Boston, Massachusetts.
Am J Ophthalmol. 2017 Oct;182:126-132. doi: 10.1016/j.ajo.2017.07.020. Epub 2017 Jul 27.
To establish the natural history of ophthalmic characteristics in Progeria patients and to determine incidence of ocular manifestations.
Retrospective case series of patients with Progeria who were seen between 2007 and 2016.
Setting: Tertiary-care academic center.
Fourteen patients (28 eyes) with Hutchinson-Gilford Progeria syndrome were included for statistical analysis from a total of 84 patients who have been enrolled in clinical trials for Progeria at Boston Children's Hospital. Clinical treatment trial patients who were not seen at the Department of Ophthalmology at our hospital, but for whom we had detailed clinical ophthalmologic records, were also included. This essentially represents an estimated 20% of the world's known patients with Progeria. Interventions or Observation Procedures: Complete ophthalmic examination.
Visual acuity, stereoacuity, refraction, clinical findings of slit-lamp and dilated fundus examinations.
Ophthalmic manifestations noted were hyperopia and signs of ocular surface disease owing to nocturnal lagophthalmos and exposure keratopathy. Additional ophthalmic manifestations included reduced brow hair, madarosis, and reduced accommodation. Most patients had relatively good acuity; however, advanced ophthalmic disease was associated with reduced acuity.
Children with Progeria are at risk for serious ophthalmic complications owing to ocular surface disease. Children with Progeria should have an ophthalmic evaluation at the time of diagnosis and at least yearly after that. Aggressive ocular surface lubrication is recommended, including the use of tape tarsorrhaphy at night.
确定早老症患者眼部特征的自然病程,并确定眼部表现的发生率。
2007年至2016年间对早老症患者的回顾性病例系列研究。
地点:三级医疗学术中心。
从波士顿儿童医院纳入早老症临床试验的84名患者中,选取14名(28只眼)患有哈钦森 - 吉尔福德早老症综合征的患者进行统计分析。还纳入了未在我院眼科就诊,但我们有详细临床眼科记录的临床治疗试验患者。这基本上代表了世界上已知早老症患者的约20%。干预或观察程序:全面眼科检查。
视力、立体视锐度、屈光、裂隙灯检查和散瞳眼底检查的临床结果。
观察到的眼部表现为远视以及由于夜间睑裂闭合不全和暴露性角膜病变导致的眼表疾病体征。其他眼部表现包括眉毛毛发减少、睫毛脱落和调节功能减退。大多数患者视力相对较好;然而,严重的眼部疾病与视力下降有关。
早老症患儿因眼表疾病有发生严重眼科并发症的风险。早老症患儿在诊断时应进行眼科评估,之后至少每年评估一次。建议积极进行眼表润滑,包括夜间使用胶带睑裂缝合术。