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鸟氨酸氨基转移酶缺乏症伴中心性凹劈裂:病例报告。

Foveoschisis associated with gyrate atrophy in ornithine aminotransferase deficiency: A case report.

机构信息

Ersin Arslan Research and Education Hospital, Gaziantep, Turkey.

Ersin Arslan Research and Education Hospital, Gaziantep, Turkey.

出版信息

Photodiagnosis Photodyn Ther. 2023 Jun;42:103618. doi: 10.1016/j.pdpdt.2023.103618. Epub 2023 May 19.

DOI:10.1016/j.pdpdt.2023.103618
PMID:37209764
Abstract

Ornithine aminotransferase (OAT) deficiency is an autosomal recessive disease characterized by elevated serum ornithine levels caused by mutations in genes encoding for ornithine aminotransferase, a vitamin B6-dependent mitochondrial matrix enzyme. Gyrate atrophy (GA) is characteristic findings in OAT that characterized by sharply demarcated circular, pigmentary, brain-like areas of chorioretinal atrophy in the peripheral retina. This case report presents rare assosiation between OAT and GA and describes the characteristic imaging findings of this unique, not fully understood clinical entity. The coexistence of GA and foveoschisis is extremely rare in OAT deficiency. We report a case of foveoschisis in a patient with OAT, and we will discuss the possible mechanisms that lead to it. A 24-year-old male patient presented with complaints of decreased vision and nictalopia for 1 year. The patient, who was diagnosed with oat 6 years ago, had typical gyrate atrophy in his Fundus floresein angiography and foveoschisis in his Optical coherence tomography. He was diagnosed with gyrate atrophy and foveoschisis. GA caused by OAT deficiency may present with macular involvement in the form of foveoschisis causing central visual impairment. Ophthalmologists should not ignore detailed fundus examination in children and young patients with visual impairment and should be aware of possible systemic diseases.

摘要

鸟氨酸氨基转移酶(OAT)缺乏症是一种常染色体隐性疾病,其特征是血清中鸟氨酸水平升高,这是由于编码鸟氨酸氨基转移酶的基因突变所致,鸟氨酸氨基转移酶是一种维生素 B6 依赖性线粒体基质酶。鸟氨酸氨基转移酶缺乏症的特征性眼部表现为脑回样脉络膜视网膜萎缩,是 Gyrate 萎缩(GA)的特征性表现,其特征是在外周视网膜出现界限分明的圆形、色素性、脑回样脉络膜视网膜萎缩区。本病例报告介绍了 OAT 和 GA 之间罕见的关联,并描述了这种独特、尚未完全了解的临床实体的特征性影像学表现。GA 和黄斑劈裂在 OAT 缺乏症中同时存在极为罕见。我们报告了一例 OAT 患者黄斑劈裂的病例,并将讨论导致其发生的可能机制。一名 24 岁男性患者因视力下降和夜间视力丧失 1 年来就诊。该患者 6 年前被诊断为 oat,眼底荧光血管造影显示典型的脑回样萎缩,光学相干断层扫描显示黄斑劈裂。他被诊断为脑回样萎缩和黄斑劈裂。OAT 缺乏引起的 GA 可能以黄斑受累的形式表现为黄斑劈裂,导致中心视力损害。眼科医生不应忽视视力下降的儿童和年轻患者的详细眼底检查,并应意识到可能存在全身性疾病。

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