Hirashima S, Ohba N
Department of Ophthalmology, Kagoshima University, Faculty of Medicine, Japan.
Ophthalmic Paediatr Genet. 1988 Mar;9(1):29-36. doi: 10.3109/13816818809031478.
A pedigree of Leber's congenital amaurosis compatible with autosomal recessive trait is reported. Two male infants from consanguineous parents had remarkable visual loss within the first year of life, with sluggish pupillary responses, poor fixations, minimal eyeground changes and absent electroretinograms on presentations at the ages of four or 14 months. Follow-up studies revealed definite progressions of eyeground abnormalities consisting of attenuated retinal arterioles, pepper- and salt-like appearance with numerous yellowish-white punctate lesions in the midperiphery, and pale optic nerves. Fluorescein angiographic study performed on one case showed multiple hyperfluorescent spots over the posterior and midperipheral eyegrounds suggesting alterations of the retinal pigment epithelium. These functional and morphological abnormalities of the retina were similar in the two siblings. Cycloplegic refractions revealed slight myopic or mixed astigmatism, but no marked hyperopia. The patients had normal physical and mental developments with no obvious systemic complications.
本文报告了一个符合常染色体隐性遗传特征的莱伯先天性黑蒙家系。来自近亲父母的两名男婴在出生后第一年内出现明显视力丧失,在4个月或14个月大时就诊时,瞳孔反应迟缓、注视不良、眼底变化轻微且视网膜电图消失。随访研究显示眼底异常有明确进展,包括视网膜动脉变细、中周部呈椒盐样外观并有许多黄白色点状病变,以及视神经苍白。对其中一例进行的荧光素血管造影研究显示,后极部和中周部眼底有多个高荧光点,提示视网膜色素上皮改变。这两名同胞的视网膜功能和形态异常相似。睫状肌麻痹验光显示有轻度近视或混合散光,但无明显远视。患者身体和智力发育正常,无明显全身并发症。