Retinal Dysplasia

视网膜发育不良
  • 文章类型: Case Reports
    背景:小头症伴或不伴脉络膜视网膜病变,淋巴水肿,或智力低下是一种罕见的常染色体显性遗传疾病,由KIF11突变引起,破坏EG5蛋白功能,由于其在视网膜感光纤毛中的表达,影响视网膜和淋巴结构的发育和维持。MCLMR的主要眼部发现是脉络膜视网膜病变。额外的功能可以包括小眼症,闭角型青光眼,持续性增生性原发性玻璃体,白内障,假性结肠瘤,持续性玻璃样动脉,和近视或远视散光。脉络膜视网膜病变的外观为白色至粉红色,圆形,没有血管的非升高的萎缩性区域类似于艾卡迪综合征的腔隙。由于缺乏对病变的系统描述和显着的表型变异性,每个案件都需要一份详细的报告。
    方法:一名在妊娠晚期发现小头畸形的儿童,由于视觉上无意义的白内障,开始在眼科随访。不久之后,她出现了眼球震颤和交叉固定的大角度交替内斜视。她的眼底最初显示出苍白的视盘和色素变化,此后发展视网膜腔隙和视网膜褶皱。她的鉴别诊断伴随着眼底的动态变化,其中包括先天性感染,Leber先天性黑蒙和艾卡迪综合征。在19个月大的时候,遗传检测确定了杂合突变(c.1159C>T,p.Arg387*)在KIF11基因中。患者在2岁时因持续性内斜视接受了双侧内侧直肌收缩手术,有显著的改进。屈光度显示双眼远视散光(0.25-2.50×180OD和0.75-2.00×170OS)。她仍然需要每天2小时的右眼修补。
    结论:该病例报告通过展示独特的视网膜特征组合,扩展了MCLMR的表型谱,为Aicardy综合征的鉴别诊断提供了新的思路。我们的发现强调了与MCLMR相关的显着表型变异性,尤其是眼部受累。这强调了详细的临床评估和全面报告病例的重要性,以提高我们对疾病谱和基因型-表型相关性的理解。
    BACKGROUND: Microcephaly with or without chorioretinopathy, lymphedema, or mental retardation is a rare autosomal dominant disease caused by mutations in KIF11 which disrupt EG5 protein function, impacting the development and maintenance of retinal and lymphatic structures due to its expression in the retinal photoreceptor cilia. The primary ocular finding in MCLMR is chorioretinopathy. Additional features can include microphthalmia, angle-closure glaucoma, persistent hyperplastic primary vitreous, cataract, pseudo-coloboma, persistent hyaloid artery, and myopic or hypermetropic astigmatism. The appearance of the chorioretinal lesions as white to pinkish, round, non-elevated atrophic areas devoid of blood vessels resembles the lacunae in Aicardy syndrome. Due to the lack of systematic description of the lesions and significant phenotypical variability, there is an impending need for a detailed report of each case.
    METHODS: A child with microcephaly detected in the third trimester of gestation began her following in the ophthalmology department due to a non-visually significant cataract. Shortly after, she developed nystagmus and large-angle alternating esotropia with cross-fixation. Her fundus initially showed a pallid optic disc and pigmentary changes, developing thereafter retinal lacunae and a retinal fold. Her differential diagnosis accompanied the dynamic changes in her fundus, which included congenital infections, Leber´s Congenital Amaurosis and Aicardy syndrome. At 19 months old, genetic testing identified a heterozygous mutation (c.1159 C > T, p.Arg387*) in the KIF11 gene. The patient underwent bilateral medial rectus muscle recession surgery at 2 years old for persistent esotropia, with significant improvement. Refraction revealed a hyperopic astigmatism in both eyes (+ 0.25 -2.50 × 180 OD and + 0.75 -2.00 × 170 OS). She continues to require right eye patching for 2 hours daily.
    CONCLUSIONS: This case report expands the phenotypic spectrum of MCLMR by demonstrating a unique combination of retinal features which sheds new light on differential diagnosis from Aicardy syndrome. Our findings emphasize the significant phenotypic variability associated with MCLMR, particularly regarding ocular involvement. This underscores the importance of detailed clinical evaluation and comprehensive reporting of cases to improve our understanding of the disease spectrum and genotype-phenotype correlations.
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  • 文章类型: Journal Article
    目的:本研究旨在描述法国猫群中假定的遗传性或假定的品种相关眼病的流行病学和临床表现。
    方法:回顾了2013年9月至2017年8月的医疗记录,以确定猫患有至少一种遗传性或品种相关的眼部疾病。猫与并发,或历史,排除眼部或全身感染性疾病.信号,记录病史和临床表现.
    结果:在研究期间提交给我们机构的1161只猫中,129例被诊断为至少一种推测的遗传性或推测的品种相关眼病(11.1%,95%置信区间[CI]9.3-12.9)。五种眼部异常的患病率>1%:内翻,角膜隔离症,持久的瞳孔膜,白内障和视网膜发育不良。内翻的患病率为2.2%(95%CI1.3-3.0),与波斯人(P=0.03),缅因州Coons(P<0.01)和雄性猫(P<0.01)被过度代表。角膜隔离症的患病率为2.4%(95%CI1.5-3.3),波斯人(P<0.01)和异国情调的短毛线(P=0.02)被过度代表。持续的瞳孔膜和白内障的患病率相同,为2.3%(95%CI1.5-3.2),没有特定的性别或品种明显过多的代表。视网膜发育不良的患病率为1.6%(95%CI0.8-2.3),波斯猫的患病率过高(P=0.04)。前段发育不全的患病率较低(0.9%,95%CI0.4-1.5),所有受影响的猫都是家养的短跑,因此该品种的代表过多(P=0.04)。
    结论:在法国的猫中,假定的遗传性或品种相关的眼部疾病占所有眼部疾病的11.1%。白内障,角膜隔离症,持久的瞳孔膜,最常见的病症是内翻和视网膜发育不良。统计品种的过度代表性被观察到,角膜隔离和视网膜发育不良。我们建议对猫科动物进行更系统的筛选。
    This study aimed to describe the epidemiology and clinical presentation of presumed hereditary or presumed breed-related ocular diseases in a population of cats in France.
    Medical records from between September 2013 and August 2017 were reviewed to identify cats with at least one presumed hereditary or breed-related ocular disease. Cats with concurrent, or a history of, ocular or systemic infectious diseases were excluded. Signalment, history and clinical findings were recorded.
    Of the 1161 cats that presented to our institution during the study period, 129 were diagnosed with at least one presumed hereditary or presumed breed-related ocular disease (11.1%, 95% confidence interval [CI] 9.3-12.9). Five ocular abnormalities had a prevalence of >1%: entropion, corneal sequestration, persistent pupillary membrane, cataract and retinal dysplasia. The prevalence of entropion was 2.2% (95% CI 1.3-3.0), with Persians (P = 0.03), Maine Coons (P <0.01) and male cats (P <0.01) being over-represented. The prevalence of corneal sequestration was 2.4% (95% CI 1.5-3.3), with Persians (P <0.01) and Exotic Shorthairs (P = 0.02) being over-represented. Persistent pupillary membranes and cataracts had the same prevalence of 2.3% (95% CI 1.5-3.2), with no particular sex or breed significantly over-represented. Retinal dysplasia had a prevalence of 1.6% (95% CI 0.8-2.3) and Persian cats were over-represented (P = 0.04). Anterior segment dysgenesis had a low prevalence (0.9%, 95% CI 0.4-1.5), with all affected cats being domestic shorthairs and this breed therefore was over-represented (P = 0.04).
    In a French population of cats, presumed hereditary or breed-related ocular diseases accounted for 11.1% of all ocular diseases. Cataracts, corneal sequestration, persistent pupillary membrane, entropion and retinal dysplasia were the most common conditions. Statistical breed over-representation was observed for entropion, corneal sequestration and retinal dysplasia. We recommend that more systematic screening of feline species is conducted.
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  • 文章类型: Journal Article
    视网膜色素上皮(RPE)的液体和溶质转运蛋白是外部血液-视网膜屏障的核心组成部分。表征这些转运蛋白及其在视网膜稳态中的作用可以提供对眼功能和疾病的见解。这里,我们描述了tvrm77小鼠的RPE缺陷,在中央视网膜中表现出色素减退的斑块。tvrm77小鼠的作图和核苷酸测序揭示了碳酸氢钠协同转运蛋白基因Slc4a5中的5'剪接供体序列被破坏。相对于对照,tvrm77RPE中Slc4a5的表达减少了19.7倍,并检测到选择性剪接变体。SLC4A5定位于培养的人RPE细胞的高尔基体以及顶膜和基底膜。眼底成像,光学相干层析成像,显微镜,tvrm77小鼠的视网膜电图(ERG)显示视网膜脱离,与新生血管病变相对应的色素沉着斑块,和视网膜褶皱。随着年龄的增长,分离恶化,外核层厚度减小。ERGa-和b-波反应振幅最初是正常的,但在老年小鼠中下降。直流ERG快速振荡和光峰在所有年龄段的振幅都有所降低,而其他RPE相关反应未受影响。这些结果将新的Slc4a5突变与视网膜下液积聚和改变的光诱发RPE电生理反应联系起来,这表明SLC4A5在外血-视网膜屏障上发挥作用。
    Fluid and solute transporters of the retinal pigment epithelium (RPE) are core components of the outer blood-retinal barrier. Characterizing these transporters and their role in retinal homeostasis may provide insights into ocular function and disease. Here, we describe RPE defects in tvrm77 mice, which exhibit hypopigmented patches in the central retina. Mapping and nucleotide sequencing of tvrm77 mice revealed a disrupted 5\' splice donor sequence in Slc4a5, a sodium bicarbonate cotransporter gene. Slc4a5 expression was reduced 19.7-fold in tvrm77 RPE relative to controls, and alternative splice variants were detected. SLC4A5 was localized to the Golgi apparatus of cultured human RPE cells and in apical and basal membranes. Fundus imaging, optical coherence tomography, microscopy, and electroretinography (ERG) of tvrm77 mice revealed retinal detachment, hypopigmented patches corresponding to neovascular lesions, and retinal folds. Detachment worsened and outer nuclear layer thickness decreased with age. ERG a- and b-wave response amplitudes were initially normal but declined in older mice. The direct current ERG fast oscillation and light peak were reduced in amplitude at all ages, whereas other RPE-associated responses were unaffected. These results link a new Slc4a5 mutation to subretinal fluid accumulation and altered light-evoked RPE electrophysiological responses, suggesting that SLC4A5 functions at the outer blood-retinal barrier.
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  • 文章类型: Case Reports
    背景:为了描述临床,诊断成像,以及两匹视障密切相关马的组织病理学发现,并确定可能的原因。
    方法:两匹热血马,有一个共同的大坝和陛下,被送到列日眼科进行视力受损的调查。收集的信息包括身体和眼科检查结果,眼超声结果,视网膜电图,磁共振成像(MRI),和组织病理学。眼科检查,眼部超声和MRI显示左眼完全视网膜脱离(RD),两匹马的双眼均出现玻璃体分离。视网膜电图显示两只右眼的反应正常,但左眼的视网膜反应完全丧失。组织病理学检查显示左眼多灶性视网膜发育不良。
    结论:在这两匹马中,RD可能是由玻璃体和视网膜的先天性后段异常引起的。高度怀疑玻璃体视网膜病变,并且在这些密切相关的兄弟姐妹中可能是遗传性的。
    BACKGROUND: To describe the clinical, diagnostic imaging, and histopathological findings of two visually impaired closely related horses and to identify a possible cause.
    METHODS: Two warmblood horses, with a common dam and sire, were presented to the ophthalmology department of Liège for investigation of impaired vision. Information collected included physical and ophthalmic examination findings, results of ocular ultrasound, electroretinogram, magnetic resonance imaging (MRI), and histopathology. Ophthalmic examination, ocular ultrasound and MRI revealed a complete retinal detachment (RD) in the left eye and vitreous synaeresis in both eyes of both horses. Electroretinograms showed a normal response in both right eyes but a total loss of the retinal response in their left eyes. Histopathologic examination revealed multifocal retinal dysplasia in both left eyes.
    CONCLUSIONS: In these two horses, RD has likely been caused by the congenital posterior segment abnormalities of the vitreous and the retina. A vitreoretinopathy is highly suspected and is possibly hereditary in these closely related siblings.
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  • 文章类型: Journal Article
    Three related male English Cocker Spaniels (ECS) were reported to be congenitally blind. Examination of one of these revealed complete retinal detachment. A presumptive diagnosis of retinal dysplasia (RD) was provided and pedigree analysis was suggestive of an X-linked mode of inheritance. We sought to investigate the genetic basis of RD in this family of ECS.
    Following whole genome sequencing (WGS) of the one remaining male RD-affected ECS, two distinct investigative approaches were employed: a candidate gene approach and a whole genome approach. In the candidate gene approach, COL9A2, COL9A3, NHEJ1, RS1 and NDP genes were investigated based on their known associations with RD and retinal detachment in dogs and humans. In the whole genome approach, affected WGS was compared with 814 unaffected canids to identify candidate variants, which were filtered based on appropriate segregation and predicted pathogenic effects followed by subsequent investigation of gene function. Candidate variants were tested for appropriate segregation in the ECS family and association with disease was assessed using samples from a total of 180 ECS.
    The same variant in NDP (c.653_654insC, p.Met114Hisfs*16) that was predicted to result in 15 aberrant amino acids before a premature stop in norrin protein, was identified independently by both approaches and was shown to segregate appropriately within the ECS family. Association of this variant with X-linked RD was significant (P = 0.0056).
    For the first time, we report a variant associated with canine X-linked RD. NDP variants are already known to cause X-linked RD, along with other abnormalities, in human Norrie disease. Thus, the dog may serve as a useful large animal model for research.
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  • 文章类型: Journal Article
    Seckel综合征是一种小头原始侏儒症(MPD),其特征是生长迟缓和神经发育缺陷,包括视网膜病变的报告.复制应激反应的关键介质中的突变,相互依赖的合作伙伴ATR和ATRIP,是塞克尔综合征的已知原因之一。然而,目前尚不清楚它们的缺乏如何破坏中枢神经系统(CNS)的发育和功能。这里,我们研究了ATRIP缺乏在发育中的鼠神经视网膜的不同细胞群体中的细胞和分子后果。我们发现感光神经元中Atrip的条件性失活不会影响它们的存活或功能。相比之下,视网膜祖细胞(RPC)中的Atrip缺乏导致严重的层压缺陷,随后是继发性光感受器变性和视力丧失。此外,我们发现缺乏功能性ATRIP的RPCs表现出更高水平的复制应激和累积的内源性DNA损伤,并伴随着TRP53的稳定。值得注意的是,Trp53的失活阻止了Atrip缺陷祖细胞的凋亡,并且足以挽救视网膜发育不良,神经变性和视力丧失。一起,这些结果揭示了ATRIP介导的复制应激反应在CNS发育中的重要作用,并提示TRP53介导的祖细胞凋亡可能导致Seckel综合征和其他MPD疾病中的视网膜畸形.本文与该论文的第一作者进行了相关的第一人称访谈。
    Seckel syndrome is a type of microcephalic primordial dwarfism (MPD) that is characterized by growth retardation and neurodevelopmental defects, including reports of retinopathy. Mutations in key mediators of the replication stress response, the mutually dependent partners ATR and ATRIP, are among the known causes of Seckel syndrome. However, it remains unclear how their deficiency disrupts the development and function of the central nervous system (CNS). Here, we investigated the cellular and molecular consequences of ATRIP deficiency in different cell populations of the developing murine neural retina. We discovered that conditional inactivation of Atrip in photoreceptor neurons did not affect their survival or function. In contrast, Atrip deficiency in retinal progenitor cells (RPCs) led to severe lamination defects followed by secondary photoreceptor degeneration and loss of vision. Furthermore, we showed that RPCs lacking functional ATRIP exhibited higher levels of replicative stress and accumulated endogenous DNA damage that was accompanied by stabilization of TRP53. Notably, inactivation of Trp53 prevented apoptosis of Atrip-deficient progenitor cells and was sufficient to rescue retinal dysplasia, neurodegeneration and loss of vision. Together, these results reveal an essential role of ATRIP-mediated replication stress response in CNS development and suggest that the TRP53-mediated apoptosis of progenitor cells might contribute to retinal malformations in Seckel syndrome and other MPD disorders.This article has an associated First Person interview with the first author of the paper.
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  • 文章类型: Comparative Study
    OBJECTIVE: To compare the scanning laser ophthalmoscopy (SLO), optical coherence tomography (OCT), and fluorescein angiography (FA) findings in retrievers with a single unilateral circular retinal plaque to those of an English springer spaniel with bilateral retinal dysplasia.
    METHODS: A retrospective record review identified three dogs with circular retinal plaques that underwent SLO and OCT; in two of the three dogs, FA was also completed. Morphologic changes, lesion measurements, and angiogram characteristics were documented. An English springer spaniel with bilateral retinal dysplasia that had undergone SLO, OCT, and FA was used for comparison.
    RESULTS: Scanning laser ophthalmoscopy of the retriever dogs revealed circular retinal plaques with a dark periphery located in the tapetal retina. OCT revealed a thickening of the nerve fiber layer corresponding to the circular pattern observed on SLO. Within the circular plaque, the retina was predominantly of normal architecture. FA revealed variable hypofluorescence of both the rim and the center of the circular lesion throughout the early angiogram phases. In the late recirculation phase, small multifocal areas of hyperfluorescence were observed. OCT of geographic retinal dysplasia in the English springer spaniel revealed disorganization of both inner and outer retinal layers, and retinal detachment.
    CONCLUSIONS: Circular plaques observed in the tapetal retina are predominantly formed by a thickening of inner retina, while retinal dysplasia has disorganization of both inner and outer retinal layers. Further etiologic research is needed, including pedigree mapping to determine whether retinal plaques are an acquired or inherited condition.
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    UNASSIGNED: To reexamine the etiology of a unique retinal pathology (linear and vermiform sub-retinal tubular structures) described among subjects with and without neurodegenerative disease in former high-incidence foci of Western Pacific amyotrophic lateral sclerosis and parkinsonism-dementia complex (ALS/PDC) in Guam (USA) and the Kii peninsula of Honshu island (Japan).
    UNASSIGNED: Analysis of published and unpublished reports of 1) ALS/PDC and the retinal and cerebellar pathology associated therewith and 2) exogenous neurotoxic factors associated with ALS/PDC and the developing retina and cerebellum.
    UNASSIGNED: ALS/PDC retinal and cerebellar pathology matches persistent retinal and cerebellar dysplasia found in laboratory animals given single in utero or postnatal systemic treatment with cycasin, the principal neurotoxic component in the seed of cycad plants traditionally used for food (Guam) or oral medicine (Kii-Japan), both of which have been linked to the human neurodegenerative disease.
    UNASSIGNED: ALS/PDC-associated retinal and cerebellar dysplasia could arise from in utero exposure to methylazoxymethanol, the genotoxic metabolite of cycasin that results from maternal ingestion of this azoxyglucoside. These results support the environmental toxic etiology of retinal and brain pathology in ALS/PDC.
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  • 文章类型: Case Reports
    BACKGROUND: Homozygous protein C (PC) deficiency is a potentially fatal disease with ocular blinding presentation or sequela.
    METHODS: A 5 month-old boy was presented for evaluation of leukocoria. He had a history of frequent bruises and PC deficiency, treated with warfarin. His intraocular pressure was normal. In the left eye leukoma with anterior segment dysgenesis, shallow anterior chamber, and cataract were observed. Fundus was not visible. B-scan revealed a closed funnel retinal detachment. His right eye had a normal anterior segment and a thin retina with anomalous retinal vascular branching at equator and peripheral retina. A fibrovascular tuft on the optic nerve head with induced traction on superior arcade was visible. Total loss of a and b wave of both were appreciated in electroretinography (ERG). Fluorescein angiography (FA) showed very severe leakage at the junction of the vascularized and non-vascularized retina and optic nerve head. Favorable outcome was achieved with lasering of avascular retina in the right eye.
    CONCLUSIONS: The potential for protein C deficiency should be assessed in all infants with leukocoria, anterior segment dysgenesis, retinal detachment and retinal dysplasia. Early diagnosis could save the child\'s life and vision.
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