Coco-Martin Rosa M, Diego-Alonso Miguel, Orduz-Montaña W Andres, Sanabria M Rosa, Sanchez-Tocino Hortensia
Instituto Universitario de Oftalmobiología Aplicada (IOBA), University of Valladolid, Valladolid, Spain.
Red Temática de Investigación Cooperativa en Salud de Oftalmologia (Oftared), Instituto de Salud Carlos III, Madrid, Spain.
Clin Ophthalmol. 2021 Mar 9;15:1075-1084. doi: 10.2147/OPTH.S293381. eCollection 2021.
To analyze the distribution of inherited retinal diseases (IRDs), describe the clinical characteristics of patients, and determine the percentages of patients with genetic diagnosis in the Castilla y Leon region of Spain.
All patients with an IRD seen in the two major referral units of Castilla y Leon during a 20-year period were included. The ages at symptom onset, diagnosis, and the last visit; sex; family history; history of consanguinity; type of inheritance; status of the fundus and electroretinogram findings; lens and macular status, visual acuity; and visual field data were recorded. Patients were divided into those with retinitis pigmentosa (RP) and all others. Gene mutations were gathered when available.
Four hundred eighty-eight patients with IRDs were studied: 216 (44.26%) with RP of which 34 (15.74%) had syndromic diseases, and 272 had other conditions being 161 (59,19%) macular dystrophies. The mean delay in diagnosis was 6-16.2 years respectively. For the RP group the mean age at the last visit was 47.96±17,26; mean age of cataract surgery was 48.30 ± 12.01 years; and the foveal area was preserved in 74 (35.07%) patients, atrophic in 101 (47.87%), and edematous in 36 (17.06%). A genetic study had been performed in 58 (26.85%) of patients with RP and 71 (26,1%) of the rest, being indeterminate in 17 (29.31%) out of RP group and 20 (28.16%) out of the others.
Clinical characteristics are comparable to other published series. There is a significant delay in diagnosis. The number of patients with IRDs and available genetic diagnosis, thus being possible candidates for undergoing personalized treatments including gene therapy in our region is low and must be improved.
分析遗传性视网膜疾病(IRDs)的分布情况,描述患者的临床特征,并确定西班牙卡斯蒂利亚-莱昂地区基因诊断患者的比例。
纳入在卡斯蒂利亚-莱昂地区两个主要转诊单位20年间诊治的所有IRD患者。记录症状出现、诊断及最后一次就诊的年龄;性别;家族史;近亲结婚史;遗传类型;眼底和视网膜电图检查结果;晶状体和黄斑状态、视力;以及视野数据。患者分为视网膜色素变性(RP)患者和其他患者。如有可用信息,收集基因突变情况。
共研究了488例IRD患者:216例(44.26%)为RP患者,其中34例(15.74%)患有综合征性疾病,272例患有其他疾病,其中161例(59.19%)为黄斑营养不良。诊断的平均延迟时间分别为6至16.2年。RP组最后一次就诊的平均年龄为47.96±17.26岁;白内障手术的平均年龄为48.30±12.01岁;74例(35.07%)患者的黄斑区得以保留,101例(47.87%)萎缩,36例(17.06%)水肿。58例(26.85%)RP患者和71例(26.1%)其他患者进行了基因研究,RP组中有17例(29.31%)结果不确定,其他患者中有20例(28.16%)结果不确定。
临床特征与其他已发表的系列研究相当。诊断存在显著延迟。在我们地区,IRD患者及可进行基因诊断(因此可能成为包括基因治疗在内的个性化治疗候选者)的患者数量较少,必须加以改善。