Clínica Alemana de Santiago- Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile.
Departamento de oftalmología, Hospital de niños Roberto del Río, Santiago, Chile.
Ophthalmic Genet. 2020 Feb;41(1):36-40. doi: 10.1080/13816810.2020.1734944. Epub 2020 Mar 6.
: Inherited ocular conditions are a frequent cause of blindness. Gene therapy has encouraged the development of genetic testing, currently able to detect up to 80% of mutations in contrast to the 5% sensitivity achieved a few decades ago.: One hundred sixty-three patients with suspected genetic ocular disorders who were referred to a single clinician between August 2014 and August 2019 underwent a thorough ophthalmologic examination. Those diagnosed with congenital cataract, retinoblastoma, anterior segment dysgenesis, autoimmune retinal disease, posterior microphthalmia, or cobalamin C deficiency were excluded, along with patients who opted against genetic testing. Included probands were classified into a diagnostic clinical category and offered genetic testing. Blood samples were sent to foreign accredited diagnostic laboratories, followed by clinical interpretation of the results.: Of the 163 patients referred, 104 were enrolled in the study. Median age at disease onset was 2 years (range, 0 to 43 years). A molecular diagnosis was established at a median age of 10 years (range, 0.4 to 50 years). Disease-causing genotypes were identified in 82 of the probands, indicating a mutation detection rate of 78.8%. Mutations were identified in 38 genes, being the most commonly affected (23% of mutations), followed by (13% of mutations). Whole-exome sequencing was performed in 6 patients, resulting in a definite diagnosis in 3 (50%).: Molecular testing for inherited ocular conditions is feasible in developing countries by sending samples to certified foreign laboratories, with a mutation detection rate comparable to published values in developed countries. Further studies to identify more disease-causing genes may improve the overall sensitivity.
遗传性眼部疾病是导致失明的常见原因。基因治疗促进了基因检测的发展,目前能够检测到 80%的突变,而几十年前的检测灵敏度仅为 5%。
2014 年 8 月至 2019 年 8 月期间,一名临床医生对 163 名疑似遗传性眼部疾病患者进行了全面的眼科检查。患有先天性白内障、视网膜母细胞瘤、眼前段发育不良、自身免疫性视网膜疾病、小眼后段和钴胺素 C 缺乏症的患者,以及拒绝基因检测的患者被排除在外。纳入的先证者被分为诊断临床类别,并提供基因检测。将血液样本送到国外认可的诊断实验室,然后对结果进行临床解读。
在被转诊的 163 名患者中,有 104 名纳入了研究。疾病发病的中位年龄为 2 岁(范围:0 至 43 岁)。中位年龄为 10 岁(范围:0.4 至 50 岁)时确定了分子诊断。在 82 名先证者中确定了致病变异型,提示突变检出率为 78.8%。在 38 个基因中发现了突变,其中 (23%的突变)最为常见,其次是 (13%的突变)。对 6 名患者进行了全外显子组测序,其中 3 名(50%)患者获得了明确诊断。
通过将样本送到认证的国外实验室,发展中国家可以进行遗传性眼部疾病的分子检测,其突变检出率可与发达国家的已发表值相媲美。进一步研究以确定更多的致病基因可能会提高整体灵敏度。