Catarata congénita en un paciente con aneuploidía cromosómica 47, XYY / Cataract in a patient with 47, XYY sex chromosome aneuploidy

CASO CLÍNICO: Paciente masculino de 16 años de edad con antecedente de miopía alta y catarata congénita unilateral, talla alta, dismorfias faciales, hiperlaxitud de falanges y alteraciones de la conducta. La madre tenía antecedente de 3 pérdidas gestacionales. Se realizó cariotipo en sangre periférica reportando 47,XYY. Discusión: Los pacientes con aneuploidía 47,XYY tienen mayor riesgo de malformaciones congénitas, las alteraciones oftalmológicas no son frecuentes. La evaluación de pacientes con talla alta y alteraciones de la conducta debe incluir cariotipo como parte del abordaje diagnóstico

CASE REPORT: The case concerns a 16 year-old boy with a history of high myopia and unilateral congenital cataract, tall stature for age, facial dysmorphism, hypermobile metacarpal-phalangeal joints, as well as behavioural problems. The mother had a history of recurrent pregnancy loss. Chromosomal analysis of the peripheral blood lymphocytes reported 47,XYY. DISCUSSION: Patients with sex chromosome aneuploidy 47,XYY have higher risk of congenital malformations, although ophthalmological anomalies are unusual. Evaluation of patients with tall stature and behavioural problems should include a chromosomal analysis in order to determine the aetiology

Cataract in a patient with 47,XYY sex chromosome aneuploidy. / Catarata congénita en un paciente con aneuploidía cromosómica 47,XYY.

CASE REPORT: The case concerns a 16 year-old boy with a history of high myopia and unilateral congenital cataract, tall stature for age, facial dysmorphism, hypermobile metacarpal-phalangeal joints, as well as behavioural problems. The mother had a history of recurrent pregnancy loss. Chromosomal analysis of the peripheral blood lymphocytes reported 47,XYY. DISCUSSION: Patients with sex chromosome aneuploidy 47,XYY have higher risk of congenital malformations, although ophthalmological anomalies are unusual. Evaluation of patients with tall stature and behavioural problems should include a chromosomal analysis in order to determine the aetiology.

Vitreorretinopatía exudativa familiar, reporte de un caso asintomático con herencia autosómica dominante, detectado mediante análisis molecular de FZD4 / Familial exudative vitreoretinopathy: A report of an asymptomatic case with autosomal dominant inheritance detected using FZD4 molecular analysis

OBJETIVO: Reportar un caso familiar de vitreorretinopatía exudativa familiar (VREF), con herencia autosómica dominante, identificado por el análisis molecular de FZD4. CASO CLÍNICO: El caso índice tiene 13 años y consulta por baja visión. Al examen de fondo de ojo se demuestran zonas periféricas avasculares y tracción macular, diagnosticándose VREF. El análisis molecular de FZD4 demuestra una mutación patológica en el paciente y en su madre asintomática. DISCUSIÓN: El presente caso familiar fue identificado mediante el análisis molecular de FZD4, y demuestra la importancia de explorar a los familiares de primer grado en los casos esporádicos de VREF

OBJECTIVE: To report a familial case of Familial Exudative Vitreoretinopathy (FEVR) with an autosomal dominant inheritance pattern identified with the molecular analysis of FZD4. CASE REPORT: The proband is a 13 year-old boy who consulted for low vision. Fundus examination revealed a peripheral avascular zone and macular dragging, consistent with FEVR. Molecular analysis demonstrated a mutation of FZD4 in DNA from both the patient and his asymptomatic mother. DISCUSSION: This familial case was identified with the molecular analysis of FZD4 and shows the importance to explore first degree relatives in a sporadic FEVR case

Familial exudative vitreoretinopathy: A report of an asymptomatic case with autosomal dominant inheritance detected using FZD4 molecular analysis. / Vitreorretinopatía exudativa familiar, reporte de un caso asintomático con herencia autosómica dominante, detectado mediante análisis molecular de FZD4.

OBJECTIVE: To report a familial case of Familial Exudative Vitreoretinopathy (FEVR) with an autosomal dominant inheritance pattern identified with the molecular analysis of FZD4. CASE REPORT: The proband is a 13 year-old boy who consulted for low vision. Fundus examination revealed a peripheral avascular zone and macular dragging, consistent with FEVR. Molecular analysis demonstrated a mutation of FZD4 in DNA from both the patient and his asymptomatic mother. DISCUSSION: This familial case was identified with the molecular analysis of FZD4 and shows the importance to explore first degree relatives in a sporadic FEVR case.

Macular optical coherence tomography findings and GPR143 mutations in patients with ocular albinism.

The aim of this study was to describe macular findings using spectral-domain optical coherence tomography (SD-OCT) in patients with ocular albinism (OA) and their carrier mothers, and to identify the frequency of GPR143 gene mutations in these patients. The study included five patients with a clinical diagnosis of OA. SD-OCT of the macular area was performed in both patients and their mothers. The anatomical characteristics of the macula and retinal pigment epithelium (RPE), patterns of autofluorescence and infrared imaging were analyzed. Polymerase chain reaction amplification of the complete coding sequence of GPR 143 was performed and subsequently analyzed by direct sequencing in patients and their possible carrier mothers. SD-OCT images revealed the presence of inner retinal layers in the fovea, an abnormal disposition of the Henle layer and a lack of thickening in the perifoveal area. We found increased thickness in the RPE to the outer segment and in the outer segment to the outer nuclear layer that is associated with increased visual acuity. Autofluorescence images revealed an absence of normal hipoautofluorescence in the fovea. No changes were observed in the images of their carrier mothers. Mutation screening and sequence analysis of the GPR 143 gene revealed a novel pathological mutation in two patients. Abnormalities in the macula were observed in all patients. SD-OCT is a useful tool for the assessment of patients with OA. No changes were observed in the SD-OCT of carrier mothers. Only two patients had the GPR143 gene mutation.

Mutational screening of CHX10, GDF6, OTX2, RAX and SOX2 genes in 50 unrelated microphthalmia-anophthalmia-coloboma (MAC) spectrum cases.

BACKGROUND/AIMS: Microphthalmia-anophthalmia-coloboma (MAC) are congenital eye malformations causing a significant percentage of visually impairments in children. Although these anomalies can arise from prenatal exposure to teratogens, mutations in well-defined genes originate potentially heritable forms of MAC. Mutations in genes such as CHX10, GDF6, RAX, SOX2 and OTX2, among others, have been recognised in dominant or recessive MAC. SOX2 and OTX2 are the two most commonly mutated genes in monogenic MAC. However, as more numerous samples of MAC subjects would be analysed, a better estimation of the actual involvement of specific MAC-genes could be made. Here, a comprehensive mutational analysis of the CHX10, GDF6, RAX, SOX2 and OTX2 genes was performed in 50 MAC subjects. METHODS: PCR amplification and direct automated DNA sequencing of all five genes in 50 unrelated subjects. RESULTS: Eight mutations (16% prevalence) were recognised, including four GDF6 mutations (one novel), two novel RAX mutations, one novel OTX2 mutation and one SOX2 mutation. Anophthalmia and nanophthalmia, not previously associated with GDF6 mutations, were observed in two subjects carrying defects in this gene, expanding the spectrum of GDF6-linked ocular anomalies. CONCLUSION: Our study underscores the importance of genotyping large groups of patients from distinct ethnic origins for improving the estimation of the global involvement of particular MAC-causing genes.

Two different PABPN1 expanded alleles in a Mexican population with oculopharyngeal muscular dystrophy arising from independent founder effects.

BACKGROUND: Oculopharyngeal muscular dystrophy (OPMD) is a late onset hereditary myopathy of autosomal dominant transmission characterised by ptosis, dysphagia and limb weakness. The disease is caused by short heterozygous expansions of a (GCN)(10) triplet located in the first exon of the PABPN1 gene at chromosome 14q11.1. Most affected individuals from North America and Europe carry a mutant (GCN)(13) allele. Although evidence for a founder mutation effect has been shown in several populations with OPMD, analysis of large groups of patients from different ethnic backgrounds will help to identify the relative contribution of each allele to the disease and a possible genotype-phenotype correlation. METHODS: 22 unrelated patients with OPMD from Mexico, a previously uncharacterised population, were clinically and molecularly analysed. Detailed ophthalmological and clinical examinations were performed in each proband and molecular analysis of the PABPN1 gene was carried out by PCR amplification and allele-specific cloning/sequencing. Two single nucleotide polymorphisms (SNPs) linked to PABPN1 were determined in each individual and in a number of affected first-degree relatives. RESULTS: 15 subjects (68%) carried a mutant (GCN)(15) or (GCG)(11)(GCA)(3)(GCG) PABPN1 allele; the remaining 7 (32%) exhibited an abnormal (GCN)(13) or (GCG)(9)(GCA)(3)(GCG) allele. Analysis of two SNPs linked to PABPN1 strongly suggests that both expanded alleles originate from two independent founder effects. In addition, in this particular population the (GCN)(15) allele was associated with an earlier onset of the disease (mean 46.5 years) compared with the (GCN)(13) allele (mean 54.7 years). CONCLUSION: The results of this study suggest that OPMD in the Mexican population is mostly due to (GCG)(11) or (GCG)(9) PABPN1 expanded alleles arising from two independent founder effect mutations. These findings add to the definition of the genetic features of the disease and to the establishment of a probable genotype-phenotype correlation.

[Familiar case of granular dystrophy and oculocutaneous albinism]. / Asociación de albinismo oculocutáneo y distrofia granular en una familia.

CLINICAL CASE: A 35-year-old female patient with blurred vision since childhood, for which no treatment had been given, presented with poor visual acuity. She had white skin and fair yellow hair. There were several well circumscribed deposits in the central and anterior corneal stroma, and iris transillumination and foveal hypoplasia were evident. The clinical diagnosis was oculo-cutaneous albinism and granular corneal dystrophy. We found oculo-cutaneous albinism in two brothers and granular dystrophy in three brothers, the mother and a son. DISCUSSION: Corneal dystrophy is an autosomal dominant disorder inherited independently of oculocutaneous albinism, which is inherited as an autosomal recessive condition. This is the first case report of granular dystrophy concurrent with oculocutaneous albinism.

Asociación de albinismo oculocutáneo y distrofia granular en una familia / Familiar case of granular dystrophy and oculocutaneous albinism

Caso clínico: Paciente femenino de 35 años deedad con mala agudeza visual desde la infancia. Ala exploración se encontró baja agudeza visual, nistagmo,hipopigmentación de piel y cabello amarillento,córnea con depósitos blanquecinos en estromacentral y anterior, transiluminación de iris ehipoplasia foveal. Se diagnosticaron albinismo oculocutáneoy distrofia corneal granular. Se encontróalbinismo oculocutáneo en dos hermanos y distrofiagranular en tres hermanos, la madre y el hijo.Discusión: La distrofia corneal granular se transmitegenéticamente siguiendo un patrón autosómicodominante e independiente del albinismo oculocutáneo.Este es el primer caso publicado de presentaciónconcomitante de ambas entidades

Clinical case: A 35-year-old female patient with ;;blurred vision since childhood, for which no treatment ;;had been given, presented with poor visual ;;acuity. She had white skin and fair yellow hair. There ;;were several well circumscribed deposits in the ;;central and anterior corneal stroma, and iris transillumination ;;and foveal hypoplasia were evident. ;;The clinical diagnosis was oculo-cutaneous albinism ;;and granular corneal dystrophy. We found oculo- ;;cutaneous albinism in two brothers and granular ;;dystrophy in three brothers, the mother and a son. ;;Discussion: Corneal dystrophy is an autosomal ;;dominant disorder inherited independently of oculocutaneous ;;albinism, which is inherited as an autosomal ;;recessive condition. This is the first case ;;report of granular dystrophy concurrent with oculocutaneous ;;albinism