关键词: ABCA4 COL11A1 COL11A2 Stargardt disease Stickler’s syndrome inherited eye disorders

Mesh : ATP-Binding Cassette Transporters / genetics Adolescent Aged Arthritis / complications genetics pathology Collagen Type XI / genetics Connective Tissue Diseases / complications genetics pathology Eye Diseases, Hereditary / complications genetics pathology Female Hearing Loss, Sensorineural / complications genetics pathology Humans Macular Degeneration / complications congenital genetics pathology Male Mutation Prognosis Retinal Detachment / complications genetics pathology Stargardt Disease

来  源:   DOI:10.1080/13816810.2018.1498530

Abstract:
Inherited eye disorders are genetically determined conditions that are present from birth and usually manifest early, although some may develop later in life. Despite their low incidence, they are a common etiology of pediatric blindness. The occurrence of more than one such disease in a patient is very rare.
Case series of two unrelated patients with simultaneous Stargardt disease (STGD1) as well as Stickler\'s Syndrome (SS), both genetically confirmed.
Patient 1: 13-year-old girl was referred for unexplained bilateral decreased vision for 6 months. She had a clinical diagnosis of SS, same as her mother. Her visual acuity was 20/200 with high myopia in both eyes. Her fundus showed foveal/perifoveal atrophy, retinal pigment epithelium (RPE) changes and beaded vitreous. Goldman visual fields (GVF) revealed enlarged blind spots with central depression. A macular dystrophy was suspected. Genetic testing revealed SS, COL11A1 gene mutation; and STGD1, ABCA4 gene mutation. Patient 2: 67-year-old female with a history of hearing loss, cleft palate, strabismus and myopia, same as her daughter and granddaughters. Her visual acuity was 20/400 and 20/250 with high myopia in both eyes. Her fundus showed macular pigment clumping and RPE atrophy with no vitreous abnormality. GVF revealed a relative central scotoma with generalized constriction. Genetic testing revealed SS, COL11A2 gene mutation; and STGD1, ABCA4 gene mutation.
If a patient\'s signs/symptoms cannot be explained by the working/known diagnosis, additional work up should be pursued for concomitant diseases. SS and STGD1 are commonly diagnosed inherited eye disorders and can coexist in one patient on rare occasions.
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