Megalocornea

巨角膜
  • 文章类型: Case Reports
    原发性先天性青光眼是潜在的致盲疾病,其特征是眼内压升高和视盘拔罐。它通常是双边的,通常在生命的第一年表现出来。可以发生自发性停滞的原发性先天性青光眼,但这是非常罕见的。
    一名来自北舍瓦的32岁男性患者到眼科就诊,MenelikII医院视力恶化。经检查,他有水平直径为14毫米的大角膜,增加轴向长度,双眼有微弱的角膜基质混浊和Haab纹。前房角敞开。他的眼压,双眼视神经头外观和视野均正常。他右眼患有半脱位致密性白内障。
    原发性先天性青光眼无视神经病变可能会有后遗症。建议定期随访自发性先天性青光眼和人工晶状体巩膜固定。
    UNASSIGNED: Primary congenital glaucoma is potentially blinding condition characterized by elevated intraocular pressure and optic disc cupping. It is typically bilateral and usually manifest in the first year of life. Spontaneously arrested primary congenital glaucoma can occur, but it is very rare.
    UNASSIGNED: A 32-year-old male patient from North Shewa presented to the department of ophthalmology, Menelik II Hospital with deterioration of vision. On examination he had large corneas with horizontal diameter of 14 mm, increased axial length, faint corneal stromal opacity and Haab\'s striae of both eyes. Anterior chamber angles were wide open. His intraocular pressure, optic nerve head appearance and visual field in both eyes were normal. He had subluxated dense cataract of the right eye.
    UNASSIGNED: Late presentation with sequelae of primary congenital glaucoma without optic neuropathy is possible. Regular follow-up of spontaneously arrested congenital glaucoma and scleral fixation of intraocular lens is recommended.
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  • 文章类型: Case Reports
    Neonatal diabetes with congenital hypothyroidism (NDH) syndrome is a rare condition caused by homozygous or compound heterozygous mutations in the GLI-similar 3 coding gene GLIS3. Almost 20 patients have been reported to date, with significant phenotypic variability.
    We describe a boy with a homozygous deletion (exons 5-9) in the GLIS3 gene, who presents novel clinical aspects not reported previously. In addition to neonatal diabetes, congenital hypothyroidism and other known multi-organ manifestations such as cholestasis and renal cysts, he suffered from hyporegenerative anemia during the first four months of life and presents megalocornea in the absence of elevated intraocular pressure. Compensation of partial exocrine pancreatic insufficiency and deficiencies in antioxidative vitamins seemed to have exerted marked beneficial impact on several disease symptoms including cholestasis and TSH resistance, although a causal relation is difficult to prove. Considering reports on persistent fetal hemoglobin detected in a few children with GLIS3 mutations, the transient anemia seen in our patient may represent a further symptom associated with either the GLIS3 defect itself or, secondarily, micronutrient deficiency related to exocrine pancreatic deficiency or cholestasis.
    Our report expands the phenotypic spectrum of patients with GLIS3 mutations and adds important information on the clinical course, highlighting the possible beneficial effects of pancreatic enzyme and antioxidative vitamin substitutions on characteristic NDH syndrome manifestations such as TSH resistance and cholestasis. We recommend to carefully screen infants with GLIS3 mutations for subtle biochemical signs of partial exocrine pancreatic deficiency or to discuss exploratory administration of pancreatic enzymes and antioxidative vitamins, even in case of good weight gain and fecal elastase concentrations in the low-to-normal range.
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  • 文章类型: Case Reports
    The article presents a clinical case of bilateral cataract surgery on megalocornea eyes of a 20-year-old male. The Haigis formula has demonstrated the greatest potential accuracy for IOL calculation in such eyes, while the use of other formulas was associated with a higher risk of significant hyperopic refractive error. An unusually high level of pseudoaccommodation was obtained in both eyes.
    В статье представлен клинический случай двусторонней хирургии катаракты на глазах с мегалокорнеа у молодого человека 20 лет. Выявлено, что наибольшей потенциальной точностью для расчета оптической силы интраокулярной линзы при мегалокорнеа обладает формула Haigis. При расчете по другим формулам велик риск значительной рефракционной ошибки в сторону гиперметропии. На обоих артифакичных глазах получен необычно высокий уровень псевдоаккомодации.
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  • 文章类型: Case Reports
    The neonate has a horizontal diameter of the cornea, usually up to 10mm with growth up to 2mm in the first 2 years of life. We report a case of megalocornea, a rare, recessive, X-linked disorder in a 3-month-old child, seeking to review what the medical literature brings information about the condition, as well as diagnostic and follow-up parameters, of its main differential diagnoses.
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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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