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相关 Cone-Rod 营养不良:临床特征、影像学发现和基因检测结果——病例报告。

-Related Cone-Rod Dystrophy: Clinical Characteristics, Imaging Findings, and Genetic Test Results-A Case Report.

机构信息

Department of Ophthalmology, Kornel Gibiński University Clinical Center, Medical University of Silesia, 40-514 Katowice, Poland.

Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-514 Katowice, Poland.

出版信息

Medicina (Kaunas). 2023 Feb 17;59(2):399. doi: 10.3390/medicina59020399.

Abstract

Cone-rod dystrophies (CRDs) are a heterogeneous group of inherited retinal diseases (IRDs) characterized by cone photoreceptor loss, that is followed by subsequent rod photoreceptor impairment. A 49-year-old man complaining of diminution of vision in both eyes (OU) was referred to our outpatient clinic. He reported visual loss for 5 years, but it was most progressive during the last few months. The best-corrected visual acuity (BCVA) at presentation was 0.4 in the right eye (RE) and 1.0 in the left eye (LE). Fundus fluorescein angiography (FFA) revealed granular hyperfluorescence in the macula and concomitant areas of capillary atrophy. Flash full-field electroretinography (ffERG) showed lowering of a and b waves as well as prolonged peak time in light-adapted conditions. However, outcomes of dark-adapted ERGs were within normal limits. Based on the constellation of clinical, angiographic, and electrophysiological tests findings, a diagnosis of IRD was suspected. Genetic testing showed a homozygous, pathogenic c.783G>A mutation in the cadherin-related family member 1 () gene, which confirmed CRD type 15 (CRD15). We demonstrate the clinical characteristics, retinal imaging outcomes, and genetic test results of a patient with CRD15. Our case contributes to expanding our knowledge of the clinical involvement of the pathogenic mutation c.783G>A in variants.

摘要

Cone-rod 营养不良症 (CRD) 是一组异质性遗传性视网膜疾病 (IRDs),其特征为视锥细胞丧失,随后视杆细胞受损。一名 49 岁男性因双眼视力下降(OU)到我院门诊就诊。他报告说视力下降已有 5 年,但最近几个月视力下降最为明显。就诊时最佳矫正视力(BCVA)右眼为 0.4,左眼为 1.0。眼底荧光素血管造影(FFA)显示黄斑区和伴随的毛细血管萎缩区颗粒状强荧光。闪光全视野视网膜电图(ffERG)显示在明适应条件下 a 波和 b 波降低以及峰时延长。然而,暗适应视网膜电图的结果在正常范围内。根据临床、血管造影和电生理检查结果的综合情况,怀疑为 IRD。基因检测显示 cadherin-related family member 1 () 基因中存在纯合、致病性 c.783G>A 突变,这证实了 CRD15 型(CRD15)。我们展示了一名 CRD15 患者的临床特征、视网膜成像结果和基因检测结果。我们的病例有助于扩大对致病性突变 c.783G>A 在 变异体中的临床影响的认识。

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