■隐匿性黄斑营养不良(OMD),一种由色素性视网膜炎1样蛋白1基因(RP1L1)突变引起的罕见常染色体显性疾病,其特征是在没有眼底镜检查异常的情况下失去中心视力。在因无法解释的中心性视力丧失和/或畏光而怀疑患有OMD的患者中,变化可以通过谱域光学相干断层扫描来检测。随后,诊断可以通过基因分析来确认。我们报告了一例18岁的白人男性,其可疑的OMD诊断已通过分子检测得到证实。我们对迄今为止以前报道的OMD患者的文献进行了广泛的回顾。
■PubMed搜索“RP1L1和隐匿性黄斑营养不良”显示了34篇论文。有225个人被基因证实,有症状的OMD;另外15例确诊突变,但无症状,偶然发现.
■我们的患者有10年无法解释的中心视力丧失和畏光的病史。遗传分析证实了RP1L1基因上存在p.R45W替换,OMD中最常见的病理突变。
■由于缺乏明显的眼底变化,正确识别疾病可能很困难。不完整的外显率与这种情况有关,发病年龄变化很大。讨论OMD的大部分研究来自东亚,但是这是否是由于意识和筛查方案的提高,或增加的发病率尚不清楚。更多的研究和全球意识的提高将有助于更及时和准确的诊断。
UNASSIGNED: Occult Macular Dystrophy (OMD), a rare autosomal dominant disorder caused by mutations in the retinitis pigmentosa 1-like protein 1 gene (RP1L1), is characterized by loss of central visual acuity in the absence of fundoscopic abnormalities. In patients suspected of having OMD based on unexplained central vision loss and/or
photophobia, changes may be detected with spectral-domain optical coherence tomography. Subsequently, the diagnosis can be confirmed with genetic analysis.We report a
case of an 18-year-old White male whose suspected diagnosis of OMD was confirmed by molecular testing. We conducted an extensive review of the literature of previously reported patients with OMD to date.
UNASSIGNED: A PubMed search of \"RP1L1 and Occult Macular Dystrophy\" revealed 34 papers. There were 225 individuals with genetically confirmed, symptomatic OMD; an additional 15 had a confirmed mutation but were asymptomatic and discovered incidentally.
UNASSIGNED: Our patient presented with a 10-year history of unexplained loss of central visual acuity and
photophobia. Genetic analysis confirmed the presence of a p.R45W substitution on the RP1L1 gene, the most common pathologic mutation in OMD.
UNASSIGNED: Due to the lack of appreciable fundoscopic changes, correct identification of the disease can be difficult. Incomplete penetrance has been associated with the condition, and the age of onset is highly variable. Much of the research discussing OMD has come from Eastern Asia, but whether this is due to a heightened awareness and screening protocols, or increased incidence is unclear. Additional research and increased awareness globally will help with more timely and accurate diagnoses.