与多小脑回畸形和早期视网膜脱离相关的诺布罗赫综合征:两例报告。
Knobloch syndrome associated with Polymicrogyria and early onset of retinal detachment: two case reports.
作者信息
White Robert J, Wang Yao, Tang Peter, Montezuma Sandra R
机构信息
Department of Ophthalmology and Visual Neurosciences, University of Minnesota, 420 Delaware St. SE, MMC 493, Minneapolis, MN, 55455-0501, USA.
出版信息
BMC Ophthalmol. 2017 Nov 25;17(1):214. doi: 10.1186/s12886-017-0615-z.
BACKGROUND
Knobloch Syndrome (KS) is a rare congenital syndrome characterized by occipital skull defects and vitreoretinal degeneration. Retinal detachment (RD) often occurs at the end of the first decade of life or later. Aside from occipital skull defects, central nervous system abnormalities are uncommon.
CASE PRESENTATIONS
We report on two siblings with KS. The first, a seven month old male, presented with nystagmus and was found to have a serous RD and a tessellated retinal appearance. His sister had a history of multiple visual abnormalities and had a similar retinal appearance although no signs of RD, but retina staphylomas. Genetic testing performed on both siblings showed a mutation in COL18A1, diagnostic of KS. MRI of both siblings demonstrated polymicrogyria but did not show occipital defects.
CONCLUSIONS
Although several families with KS have been described previously, our case is noteworthy for several reasons. The RD observed in our first patient occurred at an early age, and we find evidence of only one patient with KS who had an RD identified at an earlier age. The findings of polymicrogyria are not characteristic of KS, and we found only a few previous reports of this association. Additionally, we review potential treatment options for this condition.
背景
诺布罗赫综合征(KS)是一种罕见的先天性综合征,其特征为枕骨颅骨缺损和玻璃体视网膜变性。视网膜脱离(RD)通常发生在生命的第一个十年末或更晚。除枕骨颅骨缺损外,中枢神经系统异常并不常见。
病例报告
我们报告了两名患有KS的兄弟姐妹。第一名是一名7个月大的男性,表现为眼球震颤,被发现患有浆液性RD和视网膜呈棋盘状外观。他的妹妹有多次视觉异常病史,视网膜外观相似,尽管没有RD迹象,但有视网膜葡萄肿。对两名兄弟姐妹进行的基因检测显示COL18A1基因突变,确诊为KS。两名兄弟姐妹的MRI均显示多小脑回,但未显示枕骨缺损。
结论
尽管此前已描述了几个患有KS的家庭,但我们的病例因几个原因而值得注意。我们的第一名患者中观察到的RD发生在早年,并且我们发现只有一名KS患者在更早年龄被确诊患有RD。多小脑回的发现并非KS的特征,我们仅发现了少数关于这种关联的先前报告。此外,我们回顾了针对这种疾病的潜在治疗选择。