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多学科方法治疗双感官障碍的遗传病因。

Multidisciplinary approach to inherited causes of dual sensory impairment.

机构信息

Department of Ophthalmology, Miguel Servet University Hospital, 1-3 Isabel la Católica Street, 50009, Zaragoza, Spain.

Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragón), Zaragoza, Spain.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2024 Mar;262(3):701-715. doi: 10.1007/s00417-023-06153-7. Epub 2023 Jun 21.

Abstract

PURPOSE

This article presents a review of the main causes of inherited dual sensory impairment (DSI) with an emphasis on the multidisciplinary approach.

METHODS

A narrative review of English literature published before January 2023 was conducted using PubMed, Medline, and Scopus databases. The different causes of inherited DSI are discussed from a multidisciplinary perspective.

RESULTS

There are a wide range of dual sensory impairment (DSI), commonly referred to as blindness and deafness. While Usher syndrome is the most frequent genetic cause, other genetic syndromes such as Alport syndrome or Stickler syndrome can also lead to DSI. Various retinal phenotypes, including pigmentary retinopathy as seen in Usher syndrome, vitreoretinopathy as in Stickler syndrome, and macular dystrophy as in Alport syndrome, along with type of hearing loss (sensorineural or conductive) and additional systemic symptoms can aid in diagnostic suspicion. A thorough ophthalmologic and otorhinolaryngologic examination can help guide diagnosis, which can then be confirmed with genetic studies, crucial for determining prognosis. Effective hearing rehabilitation measures, such as hearing implants, and visual rehabilitation measures, such as low vision optical devices, are crucial for maintaining social interaction and proper development in these patients.

CONCLUSIONS

While Usher syndrome is the primary cause of inherited dual sensory impairment (DSI), other genetic syndromes can also lead to this condition. A proper diagnostic approach based on retinal phenotypes and types of hearing loss can aid in ruling out alternative causes. Multidisciplinary approaches can assist in reaching a definitive diagnosis, which has significant prognostic implications.

摘要

目的

本文综述了遗传性双感觉障碍(DSI)的主要病因,并强调了多学科方法。

方法

通过使用 PubMed、Medline 和 Scopus 数据库,对 2023 年 1 月前发表的英文文献进行了叙述性综述。从多学科的角度讨论了遗传性 DSI 的不同病因。

结果

双感觉障碍(DSI)的范围很广,通常指失明和耳聋。虽然 Usher 综合征是最常见的遗传病因,但其他遗传综合征,如 Alport 综合征或 Stickler 综合征,也可导致 DSI。各种视网膜表型,包括 Usher 综合征中所见的色素性视网膜炎、Stickler 综合征中的玻璃体视网膜病变以及 Alport 综合征中的黄斑营养不良,以及听力损失类型(感音神经性或传导性)和其他全身症状有助于诊断怀疑。全面的眼科和耳鼻喉科检查有助于指导诊断,然后通过基因研究确认诊断,这对于确定预后至关重要。有效的听力康复措施,如听力植入,以及视觉康复措施,如低视力光学设备,对于维持这些患者的社交互动和正常发育至关重要。

结论

虽然 Usher 综合征是遗传性双感觉障碍(DSI)的主要原因,但其他遗传综合征也可导致这种情况。基于视网膜表型和听力损失类型的适当诊断方法可以帮助排除其他病因。多学科方法有助于明确诊断,这具有重要的预后意义。

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