Congenital glaucoma

先天性青光眼
  • 文章类型: Journal Article
    目的:确定患者报告的结局指标(PROMs),已经用于患有青光眼的儿童和青少年,并评估其方法学质量。
    结论:儿童青光眼在生命的所有阶段都会损害视力和生活质量。因此,PROM需要涵盖许多不同的年龄组和主题。各种仪器已被用于评估儿童青光眼患者的患者报告结果,然而,尚不清楚哪种PROM具有最高的方法学质量,并且最符合儿童青光眼患者的需求.
    方法:搜索MEDLINE(PubMed),科克伦图书馆,WebofScienceandPsycINFO(EBSCO)。我们用英语收录了同行评审的过去十年的全文文章,德语或西班牙语在青光眼儿童中报告了PROM。确定的PROM的研究选择和方法学质量评估由两名独立的审阅者使用七点检查表进行。内容被映射到世界卫生组织国际功能分类,残疾与健康。系统评价在PROSPERO(IDCRD42022353936)中进行了前瞻性注册。
    结果:检索到的搜索策略符合3295项。筛选了2901项研究,使用十种不同的工具确定了11篇相关文章。仪器解决了功能视觉能力(FVA),视觉相关生活质量(VRQoL),健康相关QoL(HRQoL),生活满意度(LS)。六种仪器适用于儿童。七份问卷获得的正面评分最高(5/7)。这些仪器都没有考虑到儿童青光眼患者在发育过程中的观点。
    结论:本系统综述提供了用于儿童青光眼队列的特定视力和通用健康PRO仪器的描述性目录。缺乏专门为儿童青光眼开发的仪器,这可能会导致缺少重要因素,例如用滴眼液进行永久性治疗,重复的手术和疾病的遗传性,在调查青光眼儿童的生活质量时。
    OBJECTIVE: To identify patient-reported outcome measures (PROMs) that have been used in children and adolescents with glaucoma and to evaluate their methodologic quality.
    CONCLUSIONS: Childhood glaucoma impairs vision and quality of life (QoL) throughout all stages of life. Thus, a PROM needs to cover many different age groups and topics. Various instruments have been used to evaluate patient-reported outcomes (PROs) in patients with childhood glaucoma, however, it is unclear which PROM has the highest methodologic quality and complies best with the needs of patients with childhood glaucoma.
    METHODS: A systematic literature review was performed searching MEDLINE (PubMed), the Cochrane Library, Web of Science, and PsycINFO (EBSCO). We included peer-reviewed full-text articles of the past 10 years in English, German, or Spanish language that reported PROMs in children with glaucoma. The study selection and methodologic quality assessment of the identified PROMs was performed by 2 independent reviewers using a 7-point checklist. The content was mapped onto the World Health Organization International Classification of Functioning, Disability and Health. The systematic review was prospectively registered in PROSPERO (ID CRD42022353936).
    RESULTS: The search strategy retrieved 3295 matches. A total of 2901 studies were screened, and 11 relevant articles were identified using 10 different instruments. The instruments addressed functional visual ability, vision-related QoL, health-related QoL, and life satisfaction. Six instruments were applicable for the use in children. Seven of the questionnaires received the highest number of positive ratings (5/7). None of the instruments considered the views of patients with childhood glaucoma during their development.
    CONCLUSIONS: This systematic review provides a descriptive catalog of vision-specific and generic health PRO instruments that have been used in childhood glaucoma cohorts. An instrument specifically developed for childhood glaucoma is lacking which might result in missing important factors, such as permanent treatment with eye drops, repeated surgeries, and heritability of the disease, when investigating the QoL in children with glaucoma.
    BACKGROUND: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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  • 文章类型: Systematic Review
    目的:眼部疾病的基因检测选择不断增加,包括视神经萎缩,眼前节发育不全,白内障,角膜营养不良,眼球震颤,和青光眼。基因面板的内容和覆盖范围可能有所不同,正如我们和其他人对遗传性视网膜疾病(IRD)的评估。
    目的:描述遗传性眼病表型的基因小组检测方案及其差异。这篇评论对于做出诊断决策很重要。
    方法:获得许可,认证遗传咨询师(RP)使用ConcertGenetics和搜索词视神经萎缩,角膜营养不良,白内障,青光眼,眼前节发育不全,小眼症/无眼症,和眼球震颤,以确定由CLIA认证的商业基因检测实验室执行的可用检测选项。其他合著者就用于感兴趣的适应症的遗传小组进行了调查。然后,除了自己的网站外,还使用ConcertGenetics对眼科小组进行了比较。
    结果:包括并总结了来自每个临床类别的小组。这种比较突出了小组之间的差异和相似性,以便临床医生可以做出明智的决定。
    结论:获得基因检测的机会正在增加。基因检测的诊断率正在增加。每个面板都不同,所以表型或表征临床特征可能有助于预测特定的基因型,以及关于基因型的预测试假设,应该塑造面板的选择。
    The options for genetic testing continue to grow for ocular conditions, including optic atrophy, anterior segment dysgenesis, cataracts, corneal dystrophy, nystagmus, and glaucoma. Gene panels can vary in content and coverage, as we and others have evaluated in inherited retinal disease (IRD).
    To describe gene panel testing options for inherited eye disease phenotypes and their differences. This review is important for making diagnostic decisions.
    A licensed, certified genetic counselor (RP) used Concert Genetics and the search terms optic atrophy, corneal dystrophy, cataract, glaucoma, anterior segment dysgenesis, microphthalmia/anophthalmia, and nystagmus to identify available testing options performed by CLIA-certified commercial genetic testing laboratories. Other co-authors were surveyed with respect to genetic panels used for the indications of interest. Ophthalmic panels were then compared using Concert Genetics in addition to their own websites.
    Panels from each clinical category were included and summarized. This comparison highlighted the differences and similarities between panels so that clinicians can make informed decisions.
    Access to genetic testing is increasing. The diagnostic yield of genetic testing is increasing. Each panel is different, so phenotyping or characterizing clinical characteristics that may help predict a specific genotype, as well as pre-test hypotheses regarding a genotype, should shape the choice of panels.
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  • 文章类型: Journal Article
    青光眼是指一组异质性疾病,其特征在于视网膜神经节细胞的进行性丧失和相关的视野丧失。这种疾病的早发性和成人发作形式都具有很强的遗传成分。这里,我们总结了已知的各种形式的青光眼的遗传关联,以及这些基因在疾病发病机制中可能的功能作用。我们还讨论了将遗传知识转化为临床实践的努力,包括基于基因的疾病诊断和风险分层测试以及基于基因的治疗。
    Glaucoma refers to a heterogenous group of disorders characterised by progressive loss of retinal ganglion cells and associated visual field loss. Both early-onset and adult-onset forms of the disease have a strong genetic component. Here, we summarise the known genetic associations for various forms of glaucoma and the possible functional roles for these genes in disease pathogenesis. We also discuss efforts to translate genetic knowledge into clinical practice, including gene-based tests for disease diagnosis and risk-stratification as well as gene-based therapies.
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  • 文章类型: Case Reports
    Frank-terHaar综合征(FTHS)是一种罕见的常染色体隐性遗传综合征,是由SH3PXD2B基因突变引起的,该基因突变参与了在细胞外基质重塑和细胞迁移中的作用。FTHS的特点是面部畸形,巨角膜,不恒定的青光眼,可变发育延迟,骨骼和心脏异常。迄今为止,文献中报道了40例患者的临床诊断为FTHS,只有20名患者发现了突变。我们对这20例报告的患者进行了回顾,并描述了非近亲父母所生的患者,宫内发育迟缓,低张力,先天性青光眼,尾端阑尾,脊柱侧弯,Camptodactyly,室间隔缺损,薄的call体和颅面特征提示FTHS。临床演变导致Buthemos恶化,面部特征粗化和呼吸衰竭导致4,5个月时死亡。通过鉴定先前已知的纯合突变c.969delG来确认诊断,P.(Arg324Glyfs*19)在SH3PXD2B。这是FTHS中具有致死性呼吸损伤的非常严重表型的首次描述。由于文献中描述的患者很少,3例携带c.969delG突变的患者中有2例具有良好的临床病程,需要更多的病例来更好地表征表型并了解该综合征的自然史.此外,我们假设podosome功能的改变可能导致细胞外基质降解的减少和后者在细胞外空间的积累,这可能解释了面部特征的粗化和严重的难治性青光眼。
    Frank-ter Haar syndrome (FTHS) is a rare autosomal recessive syndrome resulting from mutations in the SH3PXD2B gene involved in the formation of podosomes and invadopodia which have a role in extracellular matrix remodelling and cell migration. FTHS is characterized by facial dysmorphism, megalocornea, inconstant glaucoma, variable developmental delay, skeletal and cardiac anomalies. To date, 40 patients have been reported in the literature with a clinical diagnosis of FTHS, only 20 patients having identified mutations. We present a review of these 20 reported patients and describe a patient born to non-consanguineous parents, with intrauterine growth retardation, hypotonia, congenital glaucoma, caudal appendix, scoliosis, camptodactyly, ventricular septal defect, thin corpus callosum and craniofacial features suggestive of FTHS. Clinical evolution resulted in buphthalmos worsening, coarsening of the facial features and respiratory failure leading to death at 4,5 months. Diagnosis was confirmed by the identification of a previously known homozygous mutation c.969delG, p.(Arg324Glyfs*19) in SH3PXD2B. This is the first description of very severe phenotype with lethal respiratory impairment in FTHS. Since very few patients are described in the literature, and 2 out of the 3 patients carrying the c.969delG mutation had a favourable clinical course, more cases are needed to better characterize the phenotype and understand the natural history of this syndrome. Furthermore, we hypothesize that the alteration of podosomes function could lead to a reduction of the extracellular matrix degradation and accumulation of the latter in the extracellular space, which might explain the coarsening of the facial features and the severe refractory glaucoma.
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  • 文章类型: Journal Article
    寨卡病毒(ZIKV)在世界各地逐渐流行。自1947年发现以来,已经发生了许多影响许多不同人群的疫情。目前,在拉丁美洲和美利坚合众国,ZIKV的威胁持续存在。ZIKV主要由埃及伊蚊传播,并引起发热等非特异性症状,肌痛,和普遍的弱点。除了这些症状,已经注意到ZIKV能够引起成人的相关疾病,特别是在孕妇以及通过垂直传播的新生儿中。这些表现包括小头畸形,间脑,脑室肿大,视神经病变,先天性青光眼,关节痛,斑丘疹,和心血管异常,如心房颤动。重要的是要了解ZIKV出现的特定一组相关条件的原因。本文旨在详细确定ZIKV在成人和新生儿中的表现,并试图了解每种表现背后的病理生理学。
    The Zika Virus (ZIKV) has been slowly becoming an epidemic in different parts of the world. Since its discovery in 1947, there have been numerous outbreaks affecting many different populations. Currently, there is an ongoing threat of ZIKV in Latin America and the United States of America. ZIKV is mainly spread by the Aedes aegypti mosquito and causes non-specific symptoms such as fever, myalgia, and generalized weakness. In addition to these symptoms, it has been noted the ZIKV is capable of causing associated conditions in adults, particularly in pregnant women as well as in newborns via vertical transmission. These manifestations include microcephaly, lissencephaly, ventriculomegaly, optic neuropathy, and congenital glaucoma, arthralgia, maculopapular rash, and cardiovascular anomalies such as atrial fibrillation. It is important to understand the reason for this specific set of associated conditions that emerge with ZIKV. This paper aims to identify the manifestations of ZIKV in adults and neonates in detail and attempts to understand the pathophysiology behind each one.
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