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伴有蛇形视网膜沉积物的视锥-视杆营养不良。

Cone-rod dystrophy with serpentine-like retinal deposits.

作者信息

Kellner U

机构信息

Department of Ophthalmology, Universitäts-Klinikum Benjamin Franklin, Freie Universität Berlin, Germany.

出版信息

Arch Ophthalmol. 1998 Oct;116(10):1307-13. doi: 10.1001/archopht.116.10.1307.

Abstract

OBJECTIVE

To describe the clinical and electrophysiologic findings in a novel retinal dystrophy.

METHODS

Ophthalmologic and electrophysiologic examinations were performed in 3 affected members of 1 family: a 10-year-old girl, her 30-year-old mother, and her 59-year-old maternal grandfather. Electro-oculography (EOG) and electroretinography (ERG) were performed according to the standards of the International Society for Clinical Electrophysiology of Vision.

RESULTS

In all 3 family members, gray, serpentine-like deposits were seen at the level of the retinal pigment epithelium (RPE). These were most distinct in the child, less prominent in her mother, and barely visible in the grandfather. Visual acuity was 20/25 OU in the child and 20/200 OU in both adults. Visual field testing showed normal outer limits and small paracentral scotomas in both adults. Electroretinographic recording revealed slightly reduced amplitudes in the 10-year-old girl, cone dysfunction in her mother, and cone-rod dysfunction in the grandfather. Multifocal ERG responses were reduced but recordable in the mother. The EOG light peak amplitude was normal in both females and borderline in the grandfather. The light peak was delayed in all 3 patients.

CONCLUSIONS

Similar deposits at the level of the RPE have not been described in other inherited retinal dystrophies. This family appears to have a novel form of cone-rod dystrophy with deposits at the level of the RPE and probable autosomal dominant inheritance.

摘要

目的

描述一种新型视网膜营养不良的临床和电生理表现。

方法

对一个家族中的3名患病成员进行了眼科和电生理检查:一名10岁女孩、她30岁的母亲以及她59岁的外祖父。根据国际临床视觉电生理学会的标准进行了眼电图(EOG)和视网膜电图(ERG)检查。

结果

在所有3名家族成员中,视网膜色素上皮(RPE)层可见灰色、蛇形样沉积物。这些沉积物在儿童中最为明显,在其母亲中不太突出,而在外祖父中几乎不可见。儿童的双眼视力为20/25,两名成年人的双眼视力均为20/200。视野检查显示两名成年人的外周界限正常,中央旁小暗点。视网膜电图记录显示,10岁女孩的振幅略有降低,其母亲存在视锥细胞功能障碍,外祖父存在视锥-视杆细胞功能障碍。母亲的多焦ERG反应降低但仍可记录。两名女性的EOG光峰振幅正常,外祖父的则处于临界值。所有3名患者的光峰均延迟。

结论

其他遗传性视网膜营养不良中尚未描述过RPE层类似的沉积物。这个家族似乎患有一种新型的视锥-视杆细胞营养不良,其RPE层有沉积物,可能为常染色体显性遗传。

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