Becker M, Rohrschneider K, Tilgen W, Weber B H, Völcker H E
Universitäts-Augenklinik, Heidelberg.
Ophthalmologe. 1998 Apr;95(4):233-40. doi: 10.1007/s003470050268.
Our knowledge about the pathogenesis of hereditary macular diseases is still very circumscript. For genetic determination, a knowledge of the coincidence of eye symptoms and other defined common symptoms is helpful. The purpose of this paper was to present two sisters of a family of consanguineous parents with the combination of hypotrichosis of the head and macular dystrophy in the context of a tricho-ocular malformation of an ectodermal dysplasia. A review of the recent literature is included.
Two 13- and 17-year-old sisters presented at our hospital with reduced visual acuity because of symmetrical central changes of the retinal pigment epithelium and chorioatrophic scars according to macular dystrophy combined with hypotrichosis capitis. We performed fundus perimetry and histological examinations of the hair.
The 13-year-old patient exhibited central changes of the retinal pigment epithelium leading to a relative central scotoma for Goldmann 1/4 during fundus perimetry in both eyes (visual acuity 0.125 and 0.4). We found central chorioatrophic scars, followed by absolute central scotomas, with unstable fixation in the upper retinal hemisphere in her 17-year-old sister with reduced visual acuity (0.16 and 0.2).
There are few descriptions of the association of macular dystrophy and hypotrichosis. The combination of hypotrichosis and macular dystrophy could make genetical analysis easier. Mutational analysis of the TIMP-3 gene that has previously been associated with Sorsby fundus dystrophy did not reveal any disease-causing mutations in our patients.
我们对遗传性黄斑疾病发病机制的了解仍然非常有限。对于基因测定而言,了解眼部症状与其他明确的常见症状的相关性会有所帮助。本文旨在介绍一对近亲结婚父母所生的姐妹,她们患有头部毛发稀少症和黄斑营养不良,并伴有外胚层发育异常的毛发 - 眼部畸形。本文还包括对近期文献的综述。
两名分别为13岁和17岁的姐妹因视网膜色素上皮的对称性中央改变以及脉络膜萎缩性瘢痕而导致视力下降,前来我院就诊,这些症状符合黄斑营养不良并伴有头部毛发稀少症。我们进行了眼底视野检查和毛发组织学检查。
13岁患者在眼底视野检查中双眼均出现视网膜色素上皮的中央改变,导致Goldmann 1/4相对中央暗点(视力分别为0.125和0.4)。我们在其17岁视力下降的姐妹(视力分别为0.16和0.2)中发现了中央脉络膜萎缩性瘢痕,随后出现绝对中央暗点,且视网膜上半部分的注视不稳定。
关于黄斑营养不良与毛发稀少症关联的描述很少。毛发稀少症和黄斑营养不良的组合可能会使基因分析更容易。先前与Sorsby眼底营养不良相关的TIMP - 3基因的突变分析在我们的患者中未发现任何致病突变。