Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA.
Ophthalmic Genet. 2020 Feb;41(1):63-68. doi: 10.1080/13816810.2020.1723118. Epub 2020 Feb 10.
: Neonatal retinal folds and/or vitreoretinal traction can be signs of isolated ocular or syndromic disorders. Etiologies include retinopathy of prematurity, perinatal infections or inherited vitreoretinal disorders such as familial exudative vitreoretinopathy (FEVR) or Norrie disease. We present the clinical and genetic findings of a two-month-old infant with microcephaly, mild motor developmental delay, and FEVR, who required urgent surgical interventions.: The patient underwent an initial examination under anesthesia (EUA) with fluorescein angiography (FA) and subsequent medical and surgical treatments. Genetic testing was undertaken to identify the etiology.: Examination at 2 months of age demonstrated microcephaly with a head circumference smaller than the 1st percentile. Family history was negative for microcephaly or retinal disease. Anterior segment eye exam was normal OU. There were bilateral macular folds involving the fovea and extending from the disc to the temporal periphery. FA demonstrated bilateral incomplete vascularization of the retina most notable nasally. Indirect laser was applied to ischemic retina OU. Scleral buckling procedures were performed OU as well as a vitrectomy in the left eye. Follow-up examinations demonstrated the stable appearance of the folds and attached retinas OU. Genetic testing identified a novel dominant heterozygous c.2046_2047del [p.Phe683Glnfs*9] mutation in , predicted to result in a frameshift causing a truncated protein.: mutations are an uncommon cause of FEVR with microcephaly.
: 新生儿视网膜褶皱和/或玻璃体视网膜牵引可能是孤立性眼部或综合征性疾病的征象。病因包括早产儿视网膜病变、围产期感染或遗传性玻璃体视网膜疾病,如家族性渗出性玻璃体视网膜病变(FEVR)或 Norrie 病。我们报告了一例两个月大婴儿的临床和遗传学发现,该婴儿有小头畸形、轻度运动发育迟缓以及 FEVR,需要紧急手术干预。
: 患者接受了全身麻醉下的初步检查(EUA),包括荧光素血管造影(FA)以及随后的药物和手术治疗。进行了基因检测以确定病因。
: 2 个月大时的检查显示小头畸形,头围小于第 1 百分位。家族史中无小头畸形或视网膜疾病。眼前节眼部检查双眼正常。双眼黄斑区均有涉及黄斑区并从视盘延伸至颞侧周边的褶皱。FA 显示视网膜双侧血管化不完全,最明显的是鼻侧。双眼间接激光治疗缺血性视网膜。双眼均行巩膜扣带术以及左眼玻璃体切除术。随访检查显示双眼褶皱和附着的视网膜稳定。基因检测发现了一个新的杂合子 c.2046_2047del [p.Phe683Glnfs*9] 突变,位于 中,预测会导致移码,产生截短蛋白。
: 突变是伴有小头畸形的 FEVR 的一个不常见病因。