Tsai Andrew S H, Chan R V Paul, Blair Michael P, Shapiro Michael J
Singapore National Eye Centre, DUKE-NUS Medical School, Singapore.
Department of Ophthalmology & Visual Sciences, University of Illinois at Chicago, Illinois Eye and Ear Infirmary, Chicago, IL, USA.
J Vitreoretin Dis. 2024 Apr 15;8(4):457-461. doi: 10.1177/24741264241246864. eCollection 2024 Jul-Aug.
To describe a patient with familial exudative vitreoretinopathy (FEVR) and the treatment course. A case was evaluated. A 3-year-old boy presented with severe onset of FEVR, with a subhyaloid hemorrhage in 1 eye and tractional retinal detachment (TRD) in the fellow eye. Aggressive treatment with retinal photocoagulation and repeated injections of intravitreal bevacizumab resulted in stability of the retinal disease. Lens-sparing vitrectomy was performed for the TRD. The treatment effect was durable, and the patient retained useful vision in the better eye at 19 years of age. A subsequent genetic analysis showed 2 novel heterozygous missense mutations in and . The presence of 2 novel mutations associated with severe FEVR identified in our patient is in agreement with in vitro studies showing that a more severe reduction in Norrin/β-catenin signal activity occurs with the combination of 2 mutations.
描述一名患有家族性渗出性玻璃体视网膜病变(FEVR)的患者及其治疗过程。对一例病例进行了评估。一名3岁男孩表现为FEVR严重发病,一只眼睛有玻璃膜下出血,另一只眼睛有牵拉性视网膜脱离(TRD)。积极进行视网膜光凝治疗并反复玻璃体内注射贝伐单抗,使视网膜疾病得以稳定。对TRD进行了保留晶状体的玻璃体切除术。治疗效果持久,患者19岁时较好的一只眼睛仍保留有用视力。随后的基因分析显示在[基因名称1]和[基因名称2]中有2个新的杂合错义突变。在我们的患者中鉴定出与严重FEVR相关的2个新突变,这与体外研究结果一致,即2种突变组合会导致Norrin/β-连环蛋白信号活性更严重降低。