Pfau Kristina, Gross Oliver, Bemme Sebastian, Meyer Peter, Take Patricia, Boeckhaus Jan, Holz Frank G, Feltgen Nicolas
Universitäts-Augenklinik Bonn, Bonn, Deutschland.
Augenklinik, Universitätsspital Basel, Mittlere Str. 91, 4056, Basel, Schweiz.
Ophthalmologie. 2023 Jun;120(6):645-651. doi: 10.1007/s00347-022-01805-1. Epub 2023 Feb 8.
Alport syndrome (AS) is a rare hereditary systemic disease that results in alterations of the kidneys, inner ear, and various structures of the eye. It is caused by mutations in one of the genes encoding collagen type IV. In recent years, new and innovative imaging techniques have added characteristics of ocular alterations in AS and provided new insights, including into the pathogenesis of the disease. The aim of this paper is to provide an overview of the current knowledge of ocular changes in AS, as well as to present the Alport ocular pass.
Narrative review article.
Ocular manifestations of AS include changes in the cornea, lens, and retina. Specifically, posterior polymorphic corneal dystrophy, anterior lenticonus (pathognomonic for AS), and various retinal changes have been described, which have been further characterized in recent years by newer imaging techniques. In particular, foveal changes in AS may present as both a thickened central retina in the context of foveal hypoplasia or a staircase-like thinning of the fovea. Both lesions could provide further insights into the role of type IV collagen in ocular structures.
The AS can manifest in various structures of the eye. The staircase-like changes of the central retina in AS patients indicate the important role of collagen type IV in the homeostasis and regular function of the inner retinal layers. The often mild foveal hypoplasia may provide clues to the role of collagen type IV in retinal embryogenesis. While anterior lenticonus is pathognomonic for AS and can be treated easily by refractive lens exchange, the only option currently available for retinal alterations is close follow-up and, if necessary, treatment of systemic complications of AS.
Alport综合征(AS)是一种罕见的遗传性全身性疾病,可导致肾脏、内耳和眼部各种结构的改变。它由编码IV型胶原的基因之一发生突变引起。近年来,新型创新成像技术增加了对AS眼部改变特征的认识,并提供了新的见解,包括对该疾病发病机制的认识。本文旨在概述目前对AS眼部变化的认识,并介绍Alport眼部检查表。
叙述性综述文章。
AS的眼部表现包括角膜、晶状体和视网膜的变化。具体而言,已描述了后极性多形性角膜营养不良、前圆锥形晶状体(AS的特征性表现)和各种视网膜变化,近年来通过更新的成像技术对其进行了进一步特征描述。特别是,AS的黄斑变化可能表现为黄斑发育不全背景下中央视网膜增厚或黄斑呈阶梯状变薄。这两种病变都可以为IV型胶原在眼部结构中的作用提供进一步的见解。
AS可在眼部的各种结构中表现出来。AS患者中央视网膜的阶梯状变化表明IV型胶原在视网膜内层的稳态和正常功能中起重要作用。通常较轻的黄斑发育不全可能为IV型胶原在视网膜胚胎发生中的作用提供线索。虽然前圆锥形晶状体是AS的特征性表现,可通过屈光性晶状体置换轻松治疗,但目前对于视网膜改变唯一可用的选择是密切随访,必要时治疗AS的全身并发症。