Optic Atrophy

视神经萎缩
  • 文章类型: Journal Article
    Singleton-Merten综合征(SMS)是一种罕见的免疫遗传障碍,影响多个系统,以牙齿发育不良为特征,主动脉钙化,青光眼,骨骼异常,牛皮癣。青光眼,古典和非典型短信的一个关键特征,在其由DDX58突变引起的分子机制方面仍然知之甚少。这项研究提出了一种新的DDX58变体(c.1649A>C[p。Asp550Ala])在一个患有儿童青光眼的家庭中。功能分析显示DDX58变体引起IFN刺激的基因表达和高IFN-β-I型IFN的增加。由于小梁网(TM)负责控制眼内压(IOP),我们检测IFN-β对TM细胞的影响。我们的研究首次证明IFN-β通过激活自噬显着降低TM细胞的活力和功能。此外,前房注射IFN-β显著增加小鼠眼压水平,可以通过自噬抑制剂氯喹治疗来减毒。揭示IFN-β诱导TM细胞自噬的具体机制,我们在IFN-β处理和DDX58p.Asp550AlaTM细胞中进行了微阵列分析。表明RSAD2是IFN-β诱导的自噬所必需的。通过siRNA敲除RSAD2显著降低IFN-β诱导的自噬通量。我们的研究结果表明,DDX58突变导致IFN-β的过度产生,通过调节TM细胞中的RSAD2自噬来提高IOP。
    Singleton-Merten syndrome (SMS) is a rare immunogenetic disorder affecting multiple systems, characterized by dental dysplasia, aortic calcification, glaucoma, skeletal abnormalities, and psoriasis. Glaucoma, a key feature of both classical and atypical SMS, remains poorly understood in terms of its molecular mechanism caused by DDX58 mutation. This study presented a novel DDX58 variant (c.1649A>C [p.Asp550Ala]) in a family with childhood glaucoma. Functional analysis showed that DDX58 variant caused an increase in IFN-stimulated gene expression and high IFN-β-based type-I IFN. As the trabecular meshwork (TM) is responsible for controlling intraocular pressure (IOP), we examine the effect of IFN-β on TM cells. Our study is the first to demonstrate that IFN-β significantly reduced TM cell viability and function by activating autophagy. In addition, anterior chamber injection of IFN-β remarkably increased IOP level in mice, which can be attenuated by treatments with autophagy inhibitor chloroquine. To uncover the specific mechanism underlying IFN-β-induced autophagy in TM cells, we performed microarray analysis in IFN-β-treated and DDX58 p.Asp550Ala TM cells. It showed that RSAD2 is necessary for IFN-β-induced autophagy. Knockdown of RSAD2 by siRNA significantly decreased autophagy flux induced by IFN-β. Our findings suggest that DDX58 mutation leads to the overproduction of IFN-β, which elevates IOP by modulating autophagy through RSAD2 in TM cells.
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  • 文章类型: Journal Article
    本研究旨在评估成人非人灵长类动物(NHPs)中与自发性高度近视相关的眼部特征。
    总共有537只眼的277只猕猴,平均年龄为18.53±3.01岁(范围=5-26岁),在受控环境中长大,包括在内。我们测量了眼部参数,包括球面当量(SE),轴向长度(AXL),和眼压。以黄斑和椎间盘为中心的45度眼底图像评估了眼底细分和乳头旁萎缩(PPA)。此外,光学相干断层扫描(OCT)用于测量视网膜神经纤维层(RNFL)的厚度。
    平均SE为-1.58±3.71屈光度(D)。平均AXL为18.76±0.86mm。高度近视患病率为17.7%。随着近视加重,AXL升高(r=-0.498,P<0.001)。与非高度近视相比,高度近视的眼睛有更大的AXL(P<0.001),更少的RNFL厚度(P=0.004),PPA发生率较高(P<0.001),眼底细分等级升高(P<0.001)。进行二元逻辑回归,其中显示PPA(比值比[OR]=4.924,95%置信区间[CI]=2.375-10.207,P<0.001)和更高的眼底细分等级(OR=1.865,95%CI=1.474-2.361,P<0.001)是高度近视的独立风险特征。
    在NHPs中,较高等级的眼底细分和PPA是高度近视的重要生物标志物.
    该研究表明,在有条件的房间中饲养的成人NHP具有与人类相似的患病率和高度一致的眼底变化,这加强了在高度近视研究中利用猕猴作为动物模型的基础。
    UNASSIGNED: This study aimed to evaluate the ocular characteristics associated with spontaneously high myopia in adult nonhuman primates (NHPs).
    UNASSIGNED: A total of 537 eyes of 277 macaques with an average age of 18.53 ± 3.01 years (range = 5-26 years), raised in a controlled environment, were included. We measured ocular parameters, including spherical equivalent (SE), axial length (AXL), and intraocular pressure. The 45-degree fundus images centered on the macula and the disc assessed the fundus tessellation and parapapillary atrophy (PPA). Additionally, optical coherence tomography (OCT) was used to measure the thickness of the retinal nerve fiber layer (RNFL).
    UNASSIGNED: The mean SE was -1.58 ± 3.71 diopters (D). The mean AXL was 18.76 ± 0.86 mm. The prevalence rate of high myopia was 17.7%. As myopia aggravated, the AXL increased (r = -0.498, P < 0.001). Compared with non-high myopia, highly myopic eyes had a greater AXL (P < 0.001), less RNFL thickness (P = 0.004), a higher incidence of PPA (P < 0.001), and elevated grades of fundus tessellation (P < 0.001). The binary logistic regression was performed, which showed PPA (odds ratio [OR] = 4.924, 95% confidence interval [CI] = 2.375-10.207, P < 0.001) and higher grades of fundus tessellation (OR = 1.865, 95% CI = 1.474-2.361, P < 0.001) were independent risk characteristics for high myopia.
    UNASSIGNED: In NHPs, a higher grade of fundus tessellation and PPA were significant biomarkers of high myopia.
    UNASSIGNED: The study demonstrates adult NHPs raised in conditioned rooms have a similar prevalence and highly consistent fundus changes with human beings, which strengthens the foundation for utilizing macaques as an animal model in high myopic studies.
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  • 文章类型: Observational Study
    目的:探讨原发性闭角型疑似病例(PACS)患者β-乳头旁萎缩(β-PPA)的特点。
    方法:总共,215和259眼PACS和非PACS(NPACS),分别,参加了这次观察,横断面研究。使用立体眼底和光学相干断层扫描图像来表征β-PPA;前者还用于测量主要的β-PPA参数。使用单变量和多元逻辑回归分析来确定与β-PPA的存在和与β-PPA参数相关的因素。
    结果:PACS组和NPACS组的β-PPA发生率分别为48.80%和44.40%,分别,组间无显著差异。与NPACS组相比,PACS组的β-PPA面积明显增大(p=0.005),但在调整年龄和轴向长度后,两组之间的角度范围和最大径向长度没有差异(分别为p=0.110和0.657)。β-PPA的存在与年龄(OR1.057,95%CI1.028至1.088,p<0.001)和较大的椎间盘面积(OR1.716,95%CI1.170至2.517,p=0.006)有关。较大的β-PPA面积与年龄较大有关(p=0.014),更大的垂直杯盘比(p=0.028),较大的椎间盘面积(p<0.001)和PACS诊断(p=0.035)。
    结论:48.80%的PACS患者有β-PPA,略大于NPACS。PACS中β-PPA面积较大,而角度范围和最大径向长度在组间没有差异。
    OBJECTIVE: To investigate the characteristics of beta parapapillary atrophy (β-PPA) in patients with primary angle-closure suspect (PACS).
    METHODS: In total, 215 and 259 eyes with PACS and non-PACS (NPACS), respectively, were enrolled in this observational, cross-sectional study. Stereoscopic fundus and optical coherence tomography images were used to characterise β-PPA; the former was also used to measure the major β-PPA parameters. Univariate and multiple logistic regression analyses were used to identify the factors correlated with the presence of β-PPA and with β-PPA parameters.
    RESULTS: The β-PPA occurrence rates were 48.80% and 44.40% in the PACS and NPACS groups, respectively, with no significant difference between groups. Compared with that in the NPACS group, the β-PPA area was significantly larger (p=0.005) in the PACS group, but the angular extent and maximum radial length did not differ between groups (p=0.110 and 0.657, respectively) after adjusting for age and axial length. The presence of β-PPA was associated with older age (OR 1.057, 95% CI 1.028 to 1.088, p<0.001) and larger disc area (OR 1.716, 95% CI 1.170 to 2.517, p=0.006). A larger β-PPA area was associated with older age (p=0.014), greater vertical cup-to-disc ratio (p=0.028), larger disc area (p<0.001) and PACS diagnosis (p=0.035).
    CONCLUSIONS: 48.80% of participants with PACS had β-PPA, which is slightly larger than NPACS. The area of β-PPA was larger in PACS, while the angular extent and maximum radial length did not differ between groups.
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  • 文章类型: Journal Article
    背景:Wolfram样综合征(WFLS)是一种常染色体显性遗传性疾病,其特征是WFS1基因中的单个杂合致病变异。其临床表现与常染色体隐性Wolfram综合征相似。
    方法:我们报告了一例10岁男孩和他的家人最初出现听力障碍(HI)的病例,其次是视神经萎缩.基因检测显示存在WFS1变体(chr4-6302385exon8NM_006005.3:c.2590G>A,p.Glu864Lys)。
    结论:Wolfram样综合征,一种罕见的神经退行性遗传疾病,表现为耳聋,视神经萎缩,和糖尿病。目前还没有明确的治疗方法。早期鉴定WFS1基因中的变异体对遗传咨询是有益的。
    BACKGROUND: Wolfram-like syndrome (WFLS) is an autosomal dominant inherited disease characterized by a single heterozygous pathogenic variant in the WFS1 gene. Its clinical presentation is similar to autosomal recessive Wolfram syndrome.
    METHODS: We reported a case of a 10-year-old boy and his family members who initially experienced hearing impairment (HI), followed by optic atrophy. Genetic testing revealed the presence of a WFS1 variant (chr4-6302385 exon8 NM_006005.3: c.2590G > A, p. Glu864Lys).
    CONCLUSIONS: Wolfram-like syndrome, a rare neurodegenerative genetic disorder, manifested as deafness, optic atrophy, and diabetes mellitus. There hasn\'t been a definite treatment yet. Early identification of the variant in the WFS1 gene is beneficial for genetic counseling.
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  • 文章类型: Review
    Wilson病(WD)是铜代谢的常染色体隐性遗传疾病。WD的临床表现复杂多变,Kayser-Fleischer环(K-F环)和向日葵白内障是最常见的眼部发现。视力障碍在WD患者中很少见。我们报告了一名17岁女性,患有与WD相关的双侧视神经萎缩,并总结了先前报道的WD视神经病变病例的临床特征。临床医生应该意识到WD是视神经病变的罕见原因,并且可能需要认识和筛查WD患者的视神经病变。
    Wilson disease (WD) is an autosomal recessive disorder of copper metabolism. The clinical manifestations of WD are complex and variable, with Kayser-Fleischer ring (K-F ring) and the sunflower cataract being the most common ocular findings. Visual impairment is rare in patients with WD. We report the case of a 17-year-old female with bilateral optic atrophy associated with WD and summarize the clinical features of previously reported cases of optic neuropathy in WD, Clinicians should be aware that WD is a rare cause of optic neuropathy and that optic neuropathy in patients with WD may need to be recognized and screened.
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  • 文章类型: Case Reports
    CAPOS syndrome is an autosomal dominant neurological disorder caused by mutations in the ATP1A3 gene. Initial symptoms, often fever-induced, include recurrent acute ataxic encephalopathy in childhood, featuring cerebellar ataxia, optic atrophy, areflflexia, sensorineural hearing loss, and in some cases, pes cavus. This report details a case of CAPOS syndrome resulting from a maternal ATP1A3 gene mutation. Both the child and her mother exhibited symptoms post-febrile induction,including severe sensorineural hearing loss in both ears, ataxia, areflexia, and decreased vision. Additionally, the patient\'s mother presented with pes cavus. Genetic testing revealed a c. 2452G>A(Glu818Lys) heterozygous mutation in theATP1A3 gene in the patient . This article aims to enhance clinicians\' understanding of CAPOS syndrome, emphasizing the case\'s clinical characteristics, diagnostic process, treatment, and its correlation with genotypeic findings.
    摘要: CAPOS综合征是由ATP1A3基因引起的常染色体显性遗传的神经系统疾病,现报告1例母源性ATP1A3基因变异所致CAPOS综合征的病例,本例患儿及其母亲均表现为发热后诱发,双耳重度以上的神经性耳聋、共济失调、腱反射消失、视力下降,母亲高足弓。经全外显子测序及线粒体基因检测证实为ATP1A3c.2452G>A(Glu818Lys)杂合变异致病。本文通过阐述病例的临床特点、诊疗经过及其与基因型的相关性,提高临床医师对CAPOS综合征的认识。.
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  • 文章类型: Case Reports
    Different from classical autosomal recessive Wolfram syndrome, Wolfram-like syndrome is an autosomal dominant disorder caused by a heterozygous mutation in the WFS1 gene. In this case, a 7-year-old male child presented to the eye clinic due to vision loss that could not be corrected, discovered during a routine examination. The child had experienced hearing impairment since early childhood, leading to cochlear implantation. Ophthalmic examination revealed optic disc atrophy in both eyes. Optical coherence tomography imaging demonstrated a distinctive thickening of the outer plexiform layer with abnormal layering, characteristic of a single mutation in the WFS1 gene. Subsequent genetic testing identified a de novo heterozygous missense mutation c.2051C>T (p.A684V) in the WFS1 gene, which ultimately led to the diagnosis of Wolfram-like syndrome.
    与经典的常染色体隐性Wolfram综合征不同,Wolfram-like综合征是一种由WFS1基因单个杂合变异引起的常染色体显性疾病。本例7岁男性儿童因体检时发现视力无法矫正来眼科就诊。患儿自幼听力差,行人工耳蜗植入术。眼科检查发现双眼视神经萎缩,其中相干光层析成像术(OCT)可见WFS1基因单一变异所特有的双眼外网状层增厚且结构异常分层。进一步行基因检测,患者WFS1基因单个杂合错义变异c.2051C>T(p.A684V),父母均未携带该变异,最终诊断为Wolfram-like综合征。.
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  • 文章类型: Case Reports
    MECR相关神经系统疾病,也称为线粒体烯酰辅酶A还原酶蛋白相关神经变性(MEPAN)或儿童期伴有视神经萎缩和基底神经节异常的肌张力障碍(MIM:#617282),是一种常染色体隐性遗传性疾病,其特征是进行性儿童期发作的运动障碍和视神经萎缩。这里我们报道一个19岁的男性,呈现渐进的视觉失败,眼球震颤,和右眼眶疼痛,童年时期没有运动史或眼病.他的视力下降始于18岁,而眼球震颤在七个月后出现。全外显子组测序(WES)分析揭示了一个纯合的轮回变异(NM_016011.5:c.772C>T,p.Arg258Trp)在MECR中。这些发现表明MECR相关神经系统疾病的表型异质性,因此,更多相关病例筛查,将有助于描绘MECR基因的基因型-表型相关性。
    MECR-related neurologic disorder, also known as mitochondrial enoyl CoA reductase protein-associated neurodegeneration (MEPAN) or dystonia with optic atrophy and basal ganglia abnormalities in childhood (MIM: #617282), is an autosomal recessive inherited disease characterized by a progressive childhood-onset movement disorder and optic atrophy. Here we report a 19-year-old male, presented with progressive visual failure, nystagmus, and right orbital pain, with no history of movement or eye disorder in his childhood. His visual decline started at age 18 years, whereas nystagmus emerged seven months later. Analysis of whole-exome sequencing (WES) revealed a homozygous recurrent variant (NM_016011.5:c.772C > T, p.Arg258Trp) in MECR. These findings suggest phenotypic heterogeneity in MECR-related neurologic disorder, thus, more relevant case screening, will help to delineate the genotype-phenotype correlation of the MECR gene.
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  • 文章类型: Case Reports
    背景:NR2F1致病变异与Bosch-Boonstra-Schaaf视神经萎缩综合征(BBSOAS)相关。最近的研究表明,BBSOAS患者不仅有视力障碍,还可能有发育迟缓,低张力,胼胝体薄和癫痫发作。然而,很少有BBSOAS发生和婴儿癫痫性痉挛综合征(IESS)的报道。
    方法:这里,我们报告了3例涉及由从头NR2F1致病变异引起的IESS和BBSOAS儿童的病例,并总结了基因型,临床特征,诊断和治疗。
    结果:所有三个孩子都经历了癫痫性痉挛和整体发育迟缓,脑磁共振成像(MRI)提示异常(call体变薄或脑外间隙变宽),其中两名儿童表现出异常的视觉诱发电位。
    结论:我们的研究结果表明,新的错义NR2F1致病变异可能导致具有异常视觉诱发电位的IESS。因此,临床医生应了解Bosch-Boonstra-Schaaf视神经萎缩综合征,并定期监测眼底,在随访期间视神经是必要的。
    BACKGROUND: NR2F1 pathogenetic variants are associated with the Bosch-Boonstra-Schaaf optic atrophy syndrome (BBSOAS). Recent studies indicate that BBSOAS patients not only have visual impairments but may also have developmental delays, hypotonia, thin corpus callosum and epileptic seizures. However, reports of BBSOAS occurrence along with infantile epileptic spasm syndrome (IESS) are rare.
    METHODS: Here, we report three cases involving children with IESS and BBSOAS caused by de novo NR2F1 pathogenetic variants and summarize the genotype, clinical characteristics, diagnosis and treatment of them.
    RESULTS: All three children experienced epileptic spasms and global developmental delays, with brain Magnetic Resonance Imaging (MRI) suggesting abnormalities (thinning of the corpus callosum or widened extracerebral spaces) and two of the children exhibiting abnormal visual evoked potentials.
    CONCLUSIONS: Our findings indicate that new missense NR2F1 pathogenetic variants may lead to IESS with abnormal visual evoked potentials. Thus, clinicians should be aware of the Bosch-Boonstra-Schaaf optic atrophy syndrome and regular monitoring of the fundus, and the optic nerve is necessary during follow-up.
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  • 文章类型: Journal Article
    背景:Wolfram综合征(WS)是一种罕见的常染色体隐性遗传多系统神经退行性疾病,其特征是非自身免疫性胰岛素依赖型糖尿病,视神经萎缩,感觉神经性耳聋,以糖尿病为主要特征。由于临床表型异质性,误诊率高。然而,早期准确诊断和综合管理是提高生活质量和延长寿命的关键。
    结果:来自7个WS家系的11名患者,具有10个突变位点(c.1314_1317delCTTT,c.C529T,c.C529A,c.G2105A,c.C1885T,c.1859_1860del,c.G2020A,c.C529A,c.G2105A,包括WFS1基因中的c.G1393C)。我们进行了进一步的专家部门分析,以明确诊断并分析基因与表型之间的相关性。
    结论:这些患者的基因型与其表型密切相关。分析患者的临床资料,为该病的诊断和临床管理提供依据。
    BACKGROUND: Wolfram syndrome (WS) is a rare autosomal recessive multisystem neurodegenerative disease characterized by non-autoimmune insulin-dependent diabetes mellitus, optic atrophy, sensorineural deafness, and diabetes as the main features. Owing to clinical phenotypic heterogeneity, the misdiagnosis rate is high. However, early accurate diagnosis and comprehensive management are key to improving quality of life and prolonging life.
    RESULTS: Eleven patients from seven WS pedigrees with 10 mutation sites (c.1314_1317delCTTT, c.C529T, c.C529A, c.G2105A, c.C1885T, c.1859_1860del, c.G2020A, c.C529A, c.G2105A, and c.G1393C) in the WFS1 gene were included. We conducted further expert department analysis to clarify the diagnosis and analyze the correlation between genes and phenotypes.
    CONCLUSIONS: The genotypes of these patients were closely associated with their phenotypes. The clinical data of the patients were analyzed to provide a basis for the diagnosis and clinical management of the disease.
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