Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Advanced Eye Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Indian J Ophthalmol. 2023 Mar;71(3):935-940. doi: 10.4103/ijo.IJO_1177_22.
Hereditary causes are an important etiological category of childhood blindness. This study reports the real-world experience of a developing ocular genetic service.
The study was carried out from Jan 2020 to Dec 2021 jointly by the Pediatric Genetic Clinic and the Department of Ophthalmology of a tertiary care hospital in North-West India. Children presenting to the genetic clinic with congenital or late-onset ocular disorder(s) and any individual (irrespective of age) suffering from an ophthalmic disorder and referred by an ophthalmologist for genetic counseling for himself/herself and/or his/her family member(s) were included. Genetic testing (exome sequencing/panel-based sequencing/chromosomal microarray) was outsourced to third-party laboratories with the cost of the test being borne by the patient.
Exactly 8.6% of the registered patients in the genetic clinic had ocular disorders. Maximum number of patients belonged to the category of anterior segment dysgenesis, followed by microphthalmia anophthalmia coloboma spectrum, lens disorders, and inherited retinal disorders in decreasing numbers. The ratio of syndromic ocular to isolated ocular disorders seen was 1.8:1. Genetic testing was accepted by 55.5% of families. The genetic testing was clinically useful for ~35% of the tested cohort, with the opportunity for prenatal diagnosis being the most useful application of genetic testing.
Syndromic ocular disorders are seen at a higher frequency compared to isolated ocular disorders in a genetic clinic. Opportunity for prenatal diagnosis is the most useful application of genetic testing in ocular disorders.
遗传原因是儿童失明的一个重要病因类别。本研究报告了一个正在发展的眼科遗传服务的真实世界经验。
该研究于 2020 年 1 月至 2021 年 12 月在印度西北部一家三级保健医院的儿科遗传诊所和眼科共同进行。患有先天性或迟发性眼部疾病并就诊于遗传诊所的儿童,以及任何患有眼部疾病并由眼科医生转介进行遗传咨询的个人(无论年龄大小),均被纳入研究。遗传测试(外显子组测序/基于面板的测序/染色体微阵列)外包给第三方实验室,测试费用由患者承担。
遗传诊所登记患者中恰好有 8.6%存在眼部疾病。属于前节发育不良类别的患者最多,其次是小眼症/无眼症/脉络膜裂畸形综合征、晶状体疾病和遗传性视网膜疾病,数量逐渐减少。综合征性眼部疾病与孤立性眼部疾病的比例为 1.8:1。有 55.5%的家庭接受了基因检测。约 35%的受试患者的基因检测具有临床意义,产前诊断的机会是基因检测最有用的应用。
在遗传诊所中,综合征性眼部疾病比孤立性眼部疾病更为常见。产前诊断的机会是眼部疾病基因检测最有用的应用。