Bremond-Gignac Dominique
Service d'ophtalmologie, hôpital Necker Enfants-malades, AP-HP, centre de maladies rares OPHTARA, université Paris-Descartes, université Sorbonne-Paris-Cité, Paris, France. Unité CNRS FR3636, université Paris-Descartes, université Sorbonne-Paris-Cité, Paris, France. Coordonnateur du Centre OPHTARA maladies rares en Ophtalmologie, Centre Européen ERN EYE. Présidente du CMS Geniris et Aniridia Europe.
Rev Prat. 2019 Jan;69(1):67-70.
Congenital aniridia in children. Congenital aniridia is a genetic rare disease that affects the entire eyeball (pan-ocular disease). The disease is characterized by partial or complete absence of iris. Clinical signs in children are essentially photophobia and nystagmus. The prevalence was reported range from 1:40,000 births to 1:100,000 but may be underestimated. It can also be associated with other systemic disorders then constituting a syndromic aniridia. These different syndromes are to be detected rapidly at risk of nephroblastoma in WAGR syndrome (Wilms' tumor, aniridia, genitourinary anomalies, mental retardation) or cerebellar ataxia in Gillespie syndrome. The diagnosis is mostly performed in infants. Congenital aniridia combines several types of ocular disorders, such as aniridia, foveal hypoplasia, glaucoma, cataract, and progressive corneal opacification. Preventive therapies should be instituted and all ocular aspects of the disease should be treated. This disease often leads to major visual impairment or even long-term blindness and requires UV protection optical correction. Clinical research is active with corneal stem cells and gene therapy.
儿童先天性无虹膜症。先天性无虹膜症是一种影响整个眼球的罕见遗传性疾病(全眼球疾病)。该疾病的特征是虹膜部分或完全缺失。儿童的临床症状主要是畏光和眼球震颤。据报道,其发病率在每40000例出生婴儿中有1例至每100000例出生婴儿中有1例之间,但可能被低估。它还可能与其他全身性疾病相关,进而构成综合征性无虹膜症。在WAGR综合征(威尔姆斯瘤、无虹膜症、泌尿生殖系统异常、智力迟钝)中存在肾母细胞瘤风险,或在吉莱斯皮综合征中存在小脑共济失调风险时,需要快速检测出这些不同的综合征。诊断大多在婴儿期进行。先天性无虹膜症合并多种眼部疾病,如无虹膜症、黄斑发育不全、青光眼、白内障和进行性角膜混浊。应采取预防性治疗措施,并对该疾病的所有眼部问题进行治疗。这种疾病常常导致严重的视力损害甚至长期失明,需要紫外线防护和光学矫正。关于角膜干细胞和基因治疗的临床研究正在积极开展。