Chertkof Julia, Hufnagel Robert B, Blain Delphine, Gropman Andrea L, Brooks Brian P
Ophthalmic Genetics & Visual Function Branch, National Eye Institute, National Institutes of Health , Bethesda, Maryland, USA.
Department of Neurology, Children's National Medical Center , Washington, District of Columbia, USA.
Ophthalmic Genet. 2020 Oct;41(5):497-500. doi: 10.1080/13816810.2020.1799416. Epub 2020 Aug 13.
Kearns-Sayre Syndrome (KSS) is characterized by pigmentary retinopathy, external ophthalmoplegia and heart block. We report on a now 24-year-old male with clinical retinoschisis and molecularly confirmed KSS.
Physical and complete ophthalmic examination, molecular diagnosis.
Over nine years of follow-up, the subject manifested progressive signs and symptoms of KSS, including external ophthalmoplegia/strabismus, ptosis, pigmentary retinopathy, corneal edema, Type I diabetes mellitus, gut dysmotility, sensorineural deafness and heart block. At age 21 he was incidentally found to have retinoschisis on optical coherence tomography that remained stable over three years follow-up. Sequencing of the gene revealed no pathogenic variants, effectively ruling out co-existing X-linked retinoschisis.
These findings suggest retinoschisis may be a rare manifestation of KSS. A trial of a carbonic anhydrase inhibitor was frustrated by coexisting corneal edema associated with the condition.
卡恩斯-塞尔综合征(KSS)的特征为色素性视网膜病变、眼外肌麻痹和心脏传导阻滞。我们报告一名现年24岁的男性,患有临床诊断的视网膜劈裂症且经分子检测确诊为KSS。
体格检查及全面眼科检查、分子诊断。
经过九年的随访,该患者表现出KSS的进行性体征和症状,包括眼外肌麻痹/斜视、上睑下垂、色素性视网膜病变、角膜水肿、I型糖尿病、肠道动力障碍、感音神经性耳聋和心脏传导阻滞。在21岁时,他经光学相干断层扫描偶然发现患有视网膜劈裂症,在三年的随访中病情保持稳定。该基因测序未发现致病变异,有效排除了并存的X连锁视网膜劈裂症。
这些发现提示视网膜劈裂症可能是KSS的一种罕见表现。由于该疾病并存角膜水肿,使用碳酸酐酶抑制剂的试验受阻。