关键词: Bietti corneoretinal dystrophy Bietti crystalline dystrophy CYP4V2 choroideremia corneal crystals

Mesh : Adult Corneal Diseases / physiopathology Corneal Dystrophies, Hereditary / genetics pathology Corneal Opacity / physiopathology Crystallization Cytochrome P450 Family 4 / genetics Female Homozygote Humans Male Mutation Pedigree Prognosis Retinal Diseases / genetics pathology

来  源:   DOI:10.1080/13816810.2019.1678176   PDF(Sci-hub)

Abstract:
Background: Bietti crystalline corneoretinal dystrophy (BCD) (OMIM 210370) is a rare autosomal recessive retinal dystrophy typically characterized by multiple intraretinal crystals over the posterior pole of the retina. Degeneration of the retina and sclerosis of the choroidal vessels results in progressive night blindness and central visual field loss.Methods: Detailed ophthalmic and genetic testing of the patient and his father were performed.Results: We report on a 41-year-old male patient with advanced chorioretinal dystrophy at the posterior pole extending into the peripheral retina. His sister and his father were similarly affected with nyctalopia and decreased visual acuity, although his father had a milder phenotype of a typical macular dystrophy. On close slit-lamp examination, however, both patient and his father had multiple yellow-white crystals in the peripheral cornea. Corneal findings and consanguinity of the patient\'s parents lead to suspicion of BCD. Molecular genetic results of the patient and his father showed homozygous for CYP4V2, c. 197T>G p.(Met66Arg) confirming the diagnosis of BCD.Conclusions: The patient\'s pedigree shows pseudodominant inheritance due to consanguineous parents. However, careful examination of the corneal findings strengthened the clinical suspicion of BCD, facilitating the molecular genetic confirmation of this autosomal recessive disease.
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