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[德国遗传性视网膜疾病患者的诊断与管理:对大学和非大学眼科部门及专科诊所的全国性调查结果]

[Diagnostics and management of patients with inherited retinal diseases in Germany : Results of a nationwide survey of university and non-university eye departments and specialized practices].

作者信息

Künzel Sandrine H, Mahren Elias, Morr Mitjan, Holz Frank G, Lorenz Birgit

机构信息

Klinik für Augenheilkunde, Universitätsklinikum Bonn, Ernst-Abbe Str. 2, 53127, Bonn, Deutschland.

Sektion für Medizinische Psychologie, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Bonn, Bonn, Deutschland.

出版信息

Ophthalmologie. 2023 Nov;120(11):1127-1137. doi: 10.1007/s00347-023-01902-9. Epub 2023 Aug 15.

DOI:10.1007/s00347-023-01902-9
PMID:37582888
Abstract

BACKGROUND

Inherited retinal diseases (IRDs) refer to a heterogeneous group of rare disorders that potentially lead to blindness. Emerging therapeutic options have led to a growing interest in IRDs; however, there are insufficient systematic studies on IRDs in Germany characterizing the demographics and management in clinical practice.

OBJECTIVE

To characterize the care for IRD patients in Germany, to assess the applied diagnostics, the use of databases and the implementation of education in ophthalmic genetics.

METHODS

The anonymous online survey (SoSci Survey GmbH) was sent to all German ophthalmology departments listed on the website of the German Ophthalmological Society and to three practices focusing on IRDs.

RESULTS

The overall response rate was 44.8%. Almost all institutions (93.6%) reported seeing IRD patients, but university and non-university hospitals differed in the number of patients. Databases are used in 60% of universities but only in 5.9% of non-university hospitals. Regarding the number of patients with genetic diagnostics, 53% of the non-university and 12% of the university sites reported that 20% at most of their patients had received a molecular genetic diagnosis. The results of the IRD practices are comparable with the university hospitals. Patients with biallelic RPE65 mutations-associated IRD, potential candidates for treatment with voretigene neparvovec (Luxturna®), were followed in 9/25 participating university departments.

CONCLUSION

This survey highlights the deficits in the management of IRD patients. In particular, we found a clear difference between university and non-university hospitals in the rate of patients with known molecular genetic results. Improvements should be initiated in the latter, especially because of existing and emerging therapeutic options.

摘要

背景

遗传性视网膜疾病(IRD)是一组异质性罕见疾病,可能导致失明。新出现的治疗选择引发了人们对IRD的兴趣日益浓厚;然而,德国对IRD缺乏系统研究,无法描述其在临床实践中的人口统计学特征和管理情况。

目的

描述德国IRD患者的护理情况,评估应用的诊断方法、数据库的使用情况以及眼科遗传学教育的实施情况。

方法

通过在线匿名调查(SoSci Survey GmbH),将问卷发送给德国眼科学会网站上列出的所有德国眼科科室以及三家专注于IRD的诊所。

结果

总体回复率为44.8%。几乎所有机构(93.6%)都报告接待过IRD患者,但大学医院和非大学医院的患者数量有所不同。60%的大学医院使用数据库,而非大学医院只有5.9%使用。关于接受基因诊断的患者数量,53%的非大学医院和12%的大学医院表示,其患者中最多只有20%接受了分子基因诊断。专注于IRD的诊所的结果与大学医院相当。25家参与调查的大学科室中有9家跟踪观察了双等位基因RPE65突变相关IRD患者,这些患者是voretigene neparvovec(Luxturna®)治疗的潜在候选者。

结论

本次调查凸显了IRD患者管理方面的不足。特别是,我们发现大学医院和非大学医院在已知分子基因检测结果的患者比例上存在明显差异。尤其是考虑到现有的和新出现的治疗选择,应在后者中采取改进措施。

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本文引用的文献

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Ophthalmic Res. 2023;66(1):727-748. doi: 10.1159/000529777. Epub 2023 Mar 6.
2
Therapy with voretigene neparvovec. How to measure success?伏瑞替戈尼静脉输注治疗。如何衡量疗效?
Prog Retin Eye Res. 2023 Jan;92:101115. doi: 10.1016/j.preteyeres.2022.101115. Epub 2022 Sep 10.
3
Challenges, facilitators and barriers to the adoption and use of a web-based national IRD registry: lessons learned from the IRD-PT registry.
采用和使用基于网络的全国 IRD 登记处所面临的挑战、促进因素和障碍:IRD-PT 登记处的经验教训。
Orphanet J Rare Dis. 2022 Aug 26;17(1):323. doi: 10.1186/s13023-022-02489-1.
4
Gene-Based Therapeutics for Inherited Retinal Diseases.用于遗传性视网膜疾病的基因疗法
Front Genet. 2022 Jan 7;12:794805. doi: 10.3389/fgene.2021.794805. eCollection 2021.
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Gene therapy in retinal diseases: A review.基因治疗在视网膜疾病中的应用:综述。
Indian J Ophthalmol. 2021 Sep;69(9):2257-2265. doi: 10.4103/ijo.IJO_3117_20.
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