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一种新的神经纤维瘤病 1 型和双侧视神经萎缩而无视神经胶质瘤的终止增益变异。

A novel stop-gain variant in neurofibromatosis type 1 and bilateral optic atrophy without optic gliomas.

机构信息

Department of Ophthalmology, Katsushika Medical Center, The Jikei University School of Medicine, Tokyo, Japan.

Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan.

出版信息

Ophthalmic Genet. 2024 Apr;45(2):186-192. doi: 10.1080/13816810.2023.2245464. Epub 2023 Aug 21.

Abstract

BACKGROUND

Neurofibromatosis type 1 (NF1) is a multisystem disorder that primarily affects the skin and peripheral nervous system and is caused by chromosomal abnormalities and mostly truncating variants in the gene. Ocular complications such as Lisch nodules and optic pathway gliomas (OPGs) can occur in NF1 patients. Herein, we report a novel variant in an NF1 patient with bilateral optic atrophy.

METHODS

Ophthalmological examinations and genetic analyses were performed using targeted next-generation sequencing (NGS).

RESULTS

A 14-year-old girl diagnosed with NF1 visited our hospital with decreased visual acuity (VA). The patient had no family history of NF1 or visual impairment. Brain and orbital magnetic resonance imaging revealed no remarkable findings. Ophthalmoscopy revealed temporal pallor of the optic discs, which was confirmed by optical coherence tomography findings of significant thinning of the circumpapillary retinal nerve fiber layer in both eyes. At 23 years of age, the decimal-corrected VA had deteriorated to 0.2 in the right eye and 0.1 in the left eye. Additionally, the targeted NGS panel revealed a novel heterozygous stop-gain variant (p.Tyr628Ter) in the gene; however, no pathogenic variants in or the mitochondrial DNA were identified.

CONCLUSIONS

A patient with NF1 without OPGs developed bilateral optic atrophy and carried a novel stop-gain variant of . Although the relationship between variants and bilateral optic atrophy remains unclear, further investigations are required.

摘要

背景

神经纤维瘤病 1 型(NF1)是一种多系统疾病,主要影响皮肤和周围神经系统,由染色体异常和基因中的大多数截短变异引起。NF1 患者可能出现眼部并发症,如神经纤维瘤性节结和视神经通路胶质瘤(OPGs)。在此,我们报告了一例 NF1 伴双侧视神经萎缩患者的新型变异。

方法

采用靶向下一代测序(NGS)进行眼科检查和基因分析。

结果

一名 14 岁女孩因视力下降(VA)就诊,被诊断为 NF1。该患者无 NF1 或视力损害家族史。颅脑和眼眶磁共振成像未见明显异常。眼底检查发现视盘颞侧苍白,光学相干断层扫描发现双眼环周视网膜神经纤维层显著变薄,证实了这一发现。23 岁时,右眼和左眼的十进制校正视力分别恶化至 0.2 和 0.1。此外,靶向 NGS 面板显示基因中存在一种新型杂合性终止获得变异(p.Tyr628Ter);然而,未发现 或线粒体 DNA 中的致病性变异。

结论

一名无 OPGs 的 NF1 患者出现双侧视神经萎缩,并携带 基因的新型终止获得变异。尽管 变异与双侧视神经萎缩之间的关系尚不清楚,但仍需要进一步研究。

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