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[两名Stickler综合征患者兄弟姐妹的玻璃体视网膜改变。两个家族的研究]

[Vitreoretinal changes in siblings of two patients with Stickler syndrome. Study of two families].

作者信息

Langmann A, Langmann G, Kainer U, Faulborn J

机构信息

Universitäts-Augenklinik Graz.

出版信息

Ophthalmologe. 1993 Oct;90(5):506-9.

PMID:8219641
Abstract

In 1965 Stickler described a pedigree combining ocular, facial, palatal and skeletal changes. The ocular findings comprise vitreoretinal changes, tears, retinal detachment, myopia and subcapsular cataract. We investigated eight siblings in two families with Stickler syndrome, two of them with a retinal detachment. In two members we observed subcapsular cataract, in four members an optically empty vitreous containing sparse transvitreal strands and sheets of condensed vitreous behind the lens; in the eyes of four emmetropic members with normal visual function large oral bays and large dental processes were found which extended much more posterior to the equator with localized depigmentation, erosions and small tears in the affected area. Similar changes could be observed in the second eye of one patient with a retinal detachment due to a giant tear. The changes of the peripheral retinal pigment epithelium in addition to the affected vitreoretinal base and vitreoretinal adhesions are responsible for the development of erosions, small tears, or even giant tears. Minimal changes as observed in the second eye of our patients with retinal detachment, or in the fundus of other family members, seem to be precursors of retinal detachment. Changes in the second eye of retinal detachment or in the retina of "unaffected" family members without retinal detachment or other associated symptoms of Stickler syndrome should be evaluated regularly and, if necessary, treated by laser, cryotherapy or even an encircling procedure.

摘要

1965年,斯蒂克勒描述了一个合并眼部、面部、腭部和骨骼改变的家系。眼部表现包括玻璃体视网膜改变、裂孔、视网膜脱离、近视和后囊下白内障。我们对两个患有斯蒂克勒综合征家庭的八名兄弟姐妹进行了研究,其中两人患有视网膜脱离。我们观察到两名成员有后囊下白内障,四名成员的玻璃体呈光学透明状,含有稀疏的经玻璃体条索和晶状体后方的浓缩玻璃体片;在四名视力正常的正视眼成员眼中,发现大的口腔间隙和大的牙突,其向赤道后方延伸得更远,受累区域有局部色素脱失、糜烂和小裂孔。在一名因巨大裂孔导致视网膜脱离的患者的另一只眼中也观察到了类似变化。除了受累的玻璃体视网膜基部和玻璃体视网膜粘连外,周边视网膜色素上皮的变化是糜烂、小裂孔甚至巨大裂孔形成的原因。在我们患有视网膜脱离的患者的另一只眼中,或在其他家庭成员的眼底观察到的微小变化,似乎是视网膜脱离的先兆。对于视网膜脱离患者的另一只眼,或没有视网膜脱离或斯蒂克勒综合征其他相关症状的“未受影响”家庭成员的视网膜变化,应定期进行评估,必要时采用激光、冷冻疗法甚至环扎手术进行治疗。

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