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1.
Zhonghua Yan Ke Za Zhi ; 60(4): 343-351, 2024 Apr 11.
Artigo em Chinês | MEDLINE | ID: mdl-38583058

RESUMO

Objective: The aim of this paper is to compare the refractive correction effects of rigid gas permeable contact lenses (RGPCL) and spectacle correction in children with aphakia after congenital cataract surgery. Methods: This was a prospective non-randomized controlled trial. Children with aphakic eyes after congenital cataract surgery, who underwent vision correction in the Strabismus and Pediatric Ophthalmology Clinic of Beijing Tongren Hospital affiliated with Capital Medical University from April 2012 to November 2019, were continuously collected. Those who voluntarily chose to wear RGPCL for refractive correction were included in the experimental group. Patients with monocular disease were in trial group 1, and patients with binocular disease were in trial group 2. Patients who chose to wear frame glasses for refractive correction were included in the control group. Patients with monocular disease were in control group 1, and patients with binocular disease were in control group 2. Regional origin, medical history, and family information were collected at the first diagnosis. During the follow-up, adverse reactions occurring during the process of wearing glasses were recorded. The Teller acuity card was used for visual examination to obtain the best-corrected visual acuity and convert it into the logarithm of the minimum resolution angle. The degree of nystagmus was determined according to the amplitude and frequency of nystagmus. Treatment cost, treatment compliance, and the reasons for adopting or not adopting RGPCL were analyzed through a questionnaire completed by the parents of children with RGPCL. Results: A total of 203 children (344 eyes) who underwent congenital cataract surgery were included, including 124 males (210 eyes) and 79 females (134 eyes). The age range was 3 to 36 months. There were 28 cases in the experimental group, including 19 cases in trial group 1 and 9 cases in trial group 2. There were 175 cases in the control group, including 43 cases in control group 1 and 132 cases in control group 2. Except for 6 months of age, the visual acuity of the experimental group was better than that of the control group, and the differences were statistically significant (P<0.05). The visual acuity of children in trial group 1 was better than that of children in control group 1 at the same age. Among them, at 12 months of age [1.54 (1.27, 1.97), 1.84 (0.97, 2.12)], 18 months of age [1.27 (0.97, 1.84), 1.84 (0.97, 2.12)], 24 months of age [1.54 (1.27, 1.84), 1.84 (0.97, 2.12)], and 30 months old [0.97 (0.66, 1.27), 1.54 (0.66, 2.12)], the difference was statistically significant (P<0.001). The visual acuity of children in trial group 2 was better than that in control group 2 at the same age. Among them, at 18 months old [1.27 (0.97, 1.54), 1.27 (0.66, 2.12)], 24 months old [0.97 (0.66, 1.27), 1.27 (0.66, 2.12)], and 30 months old [1.27 (0.66, 2.12)], the difference was statistically significant (P<0.05). The remission rate of nystagmus in the experimental group was 8/9 (8 cases), the remission rate of nystagmus in the control group was 34.40% (32 cases), and the exacerbation rate was 29.03% (27 cases). The average annual cost of the experimental group was 25 125 yuan, and that of the control group was 2 511 yuan. Conclusions: RGPCL is a well-tolerated, safe, and effective treatment for infants and young children. The visual acuity and degree of nystagmus were significantly improved in children who wore RGPCL for aphakia refractive correction after congenital cataract surgery compared with spectacle correction.


Assuntos
Afacia , Extração de Catarata , Catarata , Lentes de Contato , Nistagmo Patológico , Oftalmologia , Masculino , Lactente , Feminino , Humanos , Criança , Pré-Escolar , Óculos , Estudos Prospectivos , Catarata/terapia , Catarata/congênito
2.
J Gastrointest Surg ; 28(2): 108-114, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38445931

RESUMO

BACKGROUND: Occult cystobiliary fistula (CBF) is a common complication of hepatic hydatid cyst (HHC). It is often the cause of high morbidity of conservative treatment of HHC. This study aimed to determine the predictive factors of occult CBF to establish the indications for the investigation and treatment of these CBFs. METHODS: This was a prospective study that included all operated HHCs over a 3-year period. HHCs complicated with large CBFs were not included in the study. Systematic cholecystectomy and methylene blue test for all cysts were performed. RESULTS: A total of 46 patients operated on with 113 cysts were included in this study. The median cyst size was 6.7 cm (IQR, 1-38). A total of 114 CBFs were detected in 51 cysts (45.1%). The postoperative course was simple in 95.0% of cases. The specific morbidity rate was 2.7%. In a bivariate study, absence of mass and abdominal pain on palpation, hemoglobin level >11.55 g/dL, negative hydatid serology, cyst size, absence of calcifications, vascular compression, existence of a single cyst, and localization at segment VIII were predictive factors of occult CBF. At the end of the multivariate study, cyst size was determined to be the only predictive factor for occult CBF. A threshold of 3 cm was used. CONCLUSION: Cyst size is a major predictive factor for occult CBF.


Assuntos
Catarata/congênito , Cistos , Equinococose Hepática , Fístula , Distúrbios do Metabolismo do Ferro/congênito , Humanos , Tratamento Conservador , Estudos Prospectivos , Equinococose Hepática/complicações , Equinococose Hepática/cirurgia
4.
Exp Eye Res ; 241: 109818, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38422787

RESUMO

Down syndrome (DS) is the most common chromosomal disorder in humans. DS is associated with increased prevalence of several ocular sequelae, including characteristic blue-dot cerulean cataract. DS is accompanied by age-dependent accumulation of Alzheimer's disease (AD) amyloid-ß (Aß) peptides and amyloid pathology in the brain and comorbid early-onset Aß amyloidopathy and colocalizing cataracts in the lens. Quasi-elastic light scattering (QLS) is an established optical technique that noninvasively measures changes in protein size distributions in the human lens in vivo. In this cross-sectional study, lenticular QLS correlation time was decreased in adolescent subjects with DS compared to age-matched control subjects. Clinical QLS was consistent with alterations in relative particle hydrodynamic radius in lenses of adolescents with DS. These correlative results suggest that noninvasive QLS can be used to evaluate molecular changes in the lenses of individuals with DS.


Assuntos
Doença de Alzheimer , Catarata/congênito , Síndrome de Down , Cristalino , Humanos , Adolescente , Síndrome de Down/complicações , Síndrome de Down/patologia , Estudos Transversais , Doença de Alzheimer/metabolismo , Cristalino/metabolismo , Peptídeos beta-Amiloides/metabolismo
6.
J Oral Biosci ; 66(1): 225-231, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38244688

RESUMO

OBJECTIVES: Oculo-facio-cardio-dental (OFCD) syndrome is a rare X-linked genetic disorder caused by mutations in the BCL6 co-repressor (BCOR) and is mainly characterized by radiculomegaly (elongated dental roots). All BCOR mutations reported to date have been associated with premature termination codons, indicating that nonsense-mediated mRNA decay (NMD) might play a vital role in the pathogenesis of OFCD syndrome. However, the molecular mechanisms underlying NMD remain unclear. In this study, we investigated the involvement of up-frameshift protein 1 (UPF1), which plays a central role in NMD, in the hyperactive root formation caused by BCOR mutations. METHODS: Periodontal ligament cells, isolated from a Japanese woman with a c.3668delC frameshift mutation in BCOR, and primary human periodontal ligament fibroblasts (HPdLFs) were used for an RNA immunoprecipitation assay to confirm the binding of UPF1 to mutated BCOR. Additionally, the effects of UPF1 on the BCOR transcription levels and corresponding gene expression were determined by performing relative quantitative real-time polymerase chain reactions. RESULTS: RNA immunoprecipitation revealed that UPF1 binds to exon 9 of mutated BCOR. Additionally, UPF1 knockdown via siRNA upregulated the transcription of BCOR, whereas overexpression of wild-type and mutated BCOR with the same frameshift mutation in HPdLFs altered bone morphogenetic protein 2 (BMP2) expression. CONCLUSIONS: Our findings indicate that BCOR mutations regulate the transcription of BCOR via UPF1, which may in turn regulate the expression of BMP2. NMD, caused by a c.3668delC mutation, potentially leads to an OFCD syndrome phenotype, including elongated dental roots.


Assuntos
Catarata/congênito , Mutação da Fase de Leitura , Defeitos dos Septos Cardíacos , Microftalmia , Degradação do RNAm Mediada por Códon sem Sentido , Feminino , Humanos , Mutação da Fase de Leitura/genética , Degradação do RNAm Mediada por Códon sem Sentido/genética , Proteínas Repressoras/genética , Proteínas Repressoras/metabolismo , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo , Códon sem Sentido/genética , Transativadores/genética , Transativadores/metabolismo , RNA Helicases/genética , RNA Helicases/metabolismo
8.
Exp Eye Res ; 238: 109746, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-38056551

RESUMO

Heterozygous mutation of PAX6 in humans leads to congenital aniridia (OMIM 106210) which is typified by congenital iris and foveal defects, and later onset glaucoma, aniridic keratopathy, and cataract. Mice heterozygous for Pax6 mutations phenocopy many aspects of aniridia including the iris defects, keratopathy and cataract, although Pax6 mutant mice have small lenses, a phenotype which is not typically reported in human aniridia, perhaps due to difficulties in measuring lens diameter during typical ophthalmic examinations as the lens periphery is shielded by the iris. In order to overcome this, records of patients diagnosed with congenital aniridia between April 2015 and May 2021 at the Necker-Enfants Malades Hospital, and genetically confirmed with a disease-causing PAX6 variant, were retrospectively reviewed for those with normal axial length whose iris defects allowed visualization of the lens margins and corneal diameter to allow calculation of a lens/corneal diameter ratio. This value was compared with values obtained from a cohort of patients with Sjödell grade IV oculocutaneous albinism type 1 (OCA1; OMIM 203100) which allowed visualization of the lens periphery via iris transillumination. This analysis revealed that patients with congenital aniridia had a significantly lower lens/corneal ratio when compared to those with albinism, suggesting that humans haploinsufficient for PAX6, like mice, rats, frogs, and zebrafish, exhibit reductions in lens size.


Assuntos
Aniridia , Catarata , Doenças da Córnea , Humanos , Camundongos , Ratos , Animais , Fator de Transcrição PAX6/genética , Fatores de Transcrição Box Pareados/genética , Estudos Retrospectivos , Peixe-Zebra , Aniridia/genética , Aniridia/diagnóstico , Mutação , Catarata/genética , Catarata/congênito , Proteínas de Homeodomínio/genética , Proteínas do Olho/genética
9.
Br J Ophthalmol ; 108(3): 476-483, 2024 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-36828619

RESUMO

AIMS: To report the incidence and associated risk factors for developing suspected and definitive glaucoma after bilateral congenital cataract (CC) removal with a 5-year follow-up. METHODS: Secondary analysis of a prospective longitudinal cohort study. Bilateral CC patients who had undergone cataract surgery between January 2011 and December 2014 at Zhongshan Ophthalmic Centre were recruited. Suspected glaucoma was defined as persistent ocular hypertension requiring medical treatment. Definitive glaucoma was defined as accompanied by the progression of glaucomatous clinical features. According to postoperative lens status in 5 years follow-up: 130 eyes in the aphakia group; 219 in the primary intraocular lens (IOL) implantation group and 337 in the secondary IOL implantation group. The Kaplan-Meier survival and Cox regression analyses were used to explore the cumulative incidence and risk factors for suspected and definitive glaucoma. RESULTS: Three hundred fifty-one children (686 eyes) with bilateral CCs were enrolled in the study. The mean age at surgery was 1.82±2.08 years, and the mean follow-up duration was 6.26±0.97 years. Suspected and definitive glaucoma developed at a mean time of 2.84±1.75 years (range 0.02-7.33 years) postoperatively. The cumulative incidence of suspected and definitive glaucoma was 9.97% (35 of 351 patients), including 6.12% (42 eyes) for definitive glaucoma and 2.48% (17 eyes) for suspected glaucoma. Microcornea (HR 4.103, p<0.0001), CC family history (HR 3.285, p=0.001) and initial anterior vitrectomy (HR 2.365 p=0.036) were risk factors for suspected and definitive glaucoma. Gender, age at surgery, intraocular surgery frequency, length of follow-up and frequency of neodymium-doped yttrium aluminumaluminium garnet laser were non-statistically significant. Primary IOL implantation was a protective factor (HR 0.378, p=0.007). CONCLUSIONS: Identifying suspected and definitive glaucoma after bilateral CC surgery can lower the risk of secondary blindness in children. Patients with related risk factors need to pay more attention and thus reach early intervention and treatment during clinical practice. Primary IOL implantation may be a potential protective factor, need more clinical trials to be verified. TRIAL REGISTRATION NUMBER: NCT04342052.


Assuntos
Extração de Catarata , Catarata , Glaucoma , Hipertensão Ocular , Criança , Humanos , Lactente , Incidência , Seguimentos , Estudos Longitudinais , Estudos Prospectivos , Acuidade Visual , Complicações Pós-Operatórias , Catarata/complicações , Catarata/epidemiologia , Catarata/congênito , Extração de Catarata/efeitos adversos , Glaucoma/diagnóstico , Glaucoma/epidemiologia , Glaucoma/etiologia , Hipertensão Ocular/cirurgia , Fatores de Risco
10.
Rev. bras. oftalmol ; 83: e0011, 2024. tab
Artigo em Português | LILACS | ID: biblio-1535606

RESUMO

RESUMO Objetivo: O objetivo deste estudo foi revisar os aspectos clínicos e patológicos da catarata congênita secundária às infecções por sífilis, toxoplasmose, rubéola, citomegalovírus e herpes simples. Métodos: Trata-se de uma revisão de literatura, na qual foram incluídos artigos de periódicos indexados às bases de dados PubMed®, Cochrane, Lilacs, Embase e SciELO de 2010 a 2023. Resultados: Foram encontrados 45 artigos, e, após seleção, restaram 9 artigos. Além disso, foram adicionados artigos para enriquecer a discussão. A infecção por sífilis está relacionada a alterações corneanas. O citomegalovírus e a toxoplasmose estão relacionados com a coriorretinite e/ou microftalmia. A rubéola é responsável por causar catarata, glaucoma, microftalmia e retinite em sal e pimenta. Conclusão: Foram abordadas as principais etiologias infecciosas e seu quadro clínico na CC. O melhor tratamento para CC é cirúrgico associado a acompanhamento clínico, mas a prevenção é a maneira mais eficaz de combater a CC de etiologia infecciosa. O diagnóstico precoce e o tratamento efetivo previnem alterações e sequelas visuais irreversíveis. Nesse contexto, mostram-se importantes as ações de políticas públicas para o melhor desfecho clínico e melhor qualidade de vida.


ABSTRACT Objective: To review the clinical and pathological aspects of CC secondary to infections by syphilis, toxoplasmosis, rubella, cytomegalovirus, herpes simplex. Methods: This is a literature review. Articles from journals indexed to PubMed, COCHRANE, LILACS, EMBASE and SCIELO from 2010 to 2023 were included. Results: A total of 45 articles were found, which, after selection, remained in 9 articles. Some articles were included to enrich the discussion in this topic. The infection caused by syphilis is related to corneal changes. Cytomegalovirus and Toxoplasmosis due to chorioretinitis and/or microphthalmia. Rubella is responsible for causing cataracts, glaucoma, microphthalmia, and salt and pepper retinitis. Conclusion: The main infectious etiologies and their clinical status in CC were addressed. The best treatment for CC is surgery associated with clinical follow-up, but prevention is the most effective way to combat CC of infectious etiology. Early diagnosis and effective treatment prevent irreversible visual changes and sequelae. In this context, public policy actions are important for the best clinical outcome and better quality of life.


Assuntos
Humanos , Complicações Infecciosas na Gravidez , Rubéola (Sarampo Alemão)/complicações , Catarata/congênito , Catarata/etiologia , Sífilis/complicações , Toxoplasmose/complicações , Citomegalovirus , Herpes Zoster/complicações
11.
Am J Med Genet A ; 194(5): e63504, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38153133

RESUMO

Congenital cataracts are the leading cause of irreversible visual disability in children, and genetic factors play an important role in their development. In this study, targeted exome sequencing revealed a novel single-base deletional mutation of MIP (c.301delG; p.Ala101Profs*16) segregated with congenital punctate cataract in a Chinese family. The hydrophobic properties, and secondary and tertiary structures for truncated MIP were predicted to affect the function of protein by bioinformatics analysis. When MIP-WT and MIP-Ala101fs expression constructs were singly transfected into HeLa cells, it was found that the mRNA level showed no significant difference, while the protein level of the mutant was remarkably reduced compared to that of the wild-type MIP. Immunofluorescence images showed that the MIP-WT was principally localized to the plasma membrane, whereas the MIP-Ala101fs protein was aberrantly trapped in the cytoplasm. Furthermore, the cell-to-cell adhesion capability and the cell-to-cell communication property were both significantly reduced for MIP-Ala101fs compared to the MIP-WT (all *p < 0.05). This is the first report of the c.301delG mutation in the MIP gene associated with autosomal dominant congenital cataracts. We propose that the cataract is caused by the decreased protein expression and reduced cell-to-cell adhesion by the mutant MIP. The impaired trafficking or instability of the mutant protein, as well as compromised intercellular communication is probably a concurrent result of the mutation. The results expand the genetic and phenotypic spectra of MIP and help to better understand the molecular basis of congenital cataracts.


Assuntos
Catarata , Proteínas do Olho , Criança , Humanos , Catarata/genética , Catarata/congênito , Adesão Celular/genética , China , Proteínas do Olho/genética , Células HeLa , Mutação
12.
Int J Mol Sci ; 24(23)2023 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-38068917

RESUMO

Congenital cataract (CC), the most prevalent cause of childhood blindness and amblyopia, necessitates prompt and precise genetic diagnosis. The objective of this study is to identify the underlying genetic cause in a Swiss patient with isolated CC. Whole exome sequencing (WES) and copy number variation (CNV) analysis were conducted for variant identification in a patient born with a total binocular CC without a family history of CC. Sanger Sequencing was used to confirm the variant and segregation analysis was used to screen the non-affected parents. The first de novo missense mutation at c.391T>C was identified in exon 3 of CRYGC on chromosome 2 causing the substitution of a highly conserved Tryptophan to an Arginine located at p.Trp131Arg. Previous studies exhibit significant changes in the tertiary structure of the crystallin family in the following variant locus, making CRYGC prone to aggregation aggravated by photodamage resulting in cataract. The variant can be classified as pathogenic according to the American College of Medical Genetics and Genomics (ACMG) criteria (PP3 + PM1 + PM2 + PS2; scoring 10 points). The identification of this novel variant expands the existing knowledge on the range of variants found in the CRYGC gene and contributes to a better comprehension of cataract heterogeneity.


Assuntos
Catarata , gama-Cristalinas , Humanos , Triptofano/genética , gama-Cristalinas/química , Variações do Número de Cópias de DNA , Linhagem , Mutação , Catarata/genética , Catarata/congênito , Mutação de Sentido Incorreto
13.
J Binocul Vis Ocul Motil ; 73(4): 109-114, 2023 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-37931117

RESUMO

Unilateral congenital cataracts present multiple barriers in the development of vision and stereoacuity despite the improved visual optics that early surgery, contact lenses and intraocular lenses (IOL) have provided. With better understanding of the latent period (the timeframe in which the abnormal event has no long-term effect on visual development in the deprived eye) and the critical periods (the age range during which developing brains can be altered in a profound and permanent way by abnormal experience) for stereoacuity and amblyopia we can focus our treatment methods to not only improve vision but also develop binocularity. Fifty years ago, it was believed that it was almost impossible for an eye with a unilateral congenital cataract to achieve good visual acuity. Twenty-five years ago, we believed that it was almost impossible for an eye with a unilateral cataract to achieve stereoacuity. It is time to expand our belief that the best that we can do with the eye in unilateral congenital cataract is to create a spare.


Assuntos
Ambliopia , Extração de Catarata , Catarata , Lentes Intraoculares , Humanos , Criança , Ambliopia/terapia , Implante de Lente Intraocular , Catarata/congênito
14.
J Binocul Vis Ocul Motil ; 73(4): 104-108, 2023 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-37931120

RESUMO

Congenital cataracts account for a significant proportion of blindness in children worldwide. They affect approximately 12-136 per 100,000 births worldwide. A genetic etiology is present in a large proportion of patients and can lead to isolated cataracts or those in the context of genetic multisystem disorders. We present two examples of genetically determined childhood cataracts and briefly review the work-up of such patients. Mutations in numerous genes have been identified that cause congenital cataracts, such as those encoding for crystallins, connexins and aquaporins, as well as some developmental regulatory proteins. Identifying the genetic or molecular etiology of congenital cataract is essential for identifying and better understanding the pathways leading to this disease, and for providing individualized genetic counseling and guiding treatment for possible associated systemic problems.


Assuntos
Catarata , Cristalinas , Criança , Humanos , Catarata/congênito , Catarata/genética , Testes Genéticos , Fatores de Transcrição/genética , Mutação , Cristalinas/genética
15.
J Binocul Vis Ocul Motil ; 73(4): 83-92, 2023 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-37931121

RESUMO

Childhood cataract is a complex condition requiring longitudinal care, including early diagnosis, timely referral to a specialist, early surgical intervention, and dedicated postoperative care. Adherence to refractive correction and amblyopia therapy are critical for visual rehabilitation, even months to years after the cataract is removed. We review the impact of the social determinants of health on each step in the visual rehabilitation pathway for children with congenital and infantile cataracts. Children from socioeconomically marginalized backgrounds are more likely to experience delays in access to care and utilization of surgical services. They are also less likely to adhere to amblyopia therapy, with corresponding decrements in visual outcomes. Additional sociocultural factors, including parental stress, self-efficacy, and health literacy, pose barriers for these children. Standardizing clinical roles, improving health communication, managing parental stress, and implementing systemic policy changes may alleviate socioeconomic disparities in outcomes for children with cataracts.


Assuntos
Ambliopia , Extração de Catarata , Catarata , Criança , Humanos , Estados Unidos , Ambliopia/terapia , Implante de Lente Intraocular , Catarata/congênito , Catarata/diagnóstico , Catarata/terapia , Acuidade Visual
16.
Turk J Ophthalmol ; 53(5): 267-274, 2023 10 19.
Artigo em Inglês | MEDLINE | ID: mdl-37867431

RESUMO

Objectives: To evaluate the predictive factors of complications and visual acuity outcomes in pediatric cataract patients. Materials and Methods: This retrospective, observational clinical study included 80 eyes of 50 patients treated for pediatric cataracts between 2010 and 2020. The eyes were divided into Group I (congenital cataracts, n=38) and Group II (developmental cataracts, n=42). Group II was also divided into Group IIA (aphakic, n=21) and Group IIB (pseudophakic, n=21). The effects of the age, laterality, cataract morphology, intraocular lens implantation, preoperative nystagmus/strabismus, and intraoperative anterior hyaloid rupture on complications and final best-corrected visual acuity (BCVA; logMAR) were evaluated. Results: The median (interquartile range) age and follow-up time were 28 (5-79) months and 60 (29-84) months, respectively. There was a significant difference in mean final BCVA between Group I (0.79±0.46) and Group II (0.57±0.51) (p=0.047); however, no difference was observed between Group IIA and Group IIB (p=0.541). Having congenital cataract (p=0.045), preoperative nystagmus/strabismus (p=0.042), total/mature cataract (p<0.001), and postoperative complications (p=0.07) were significantly associated with final BCVA. However, in multivariate analysis, only total/mature cataract (ß: 0.52, p<0.001) and having any complication (ß: 0.24, p=0.018) were associated with final BCVA. Congenital cataract and intraoperative anterior hyaloid rupture were the only significant risk factors of postoperative complications on univariate (p=0.027 and p=0.003, respectively) and binary logistic regression analysis (odds ratio [OR]: 2.95 [95% confidence interval: 1.07-8.15], p=0.036 and OR: 4.28 [95% confidence interval: 1.55-11.77], p=0.005, respectively). Conclusion: Total/mature cataract and the presence of any postoperative complication adversely affected the final BCVA. Having a congenital cataract and intraoperative anterior hyaloid membrane rupture increased the risk of complications.


Assuntos
Catarata , Estrabismo , Humanos , Criança , Implante de Lente Intraocular/efeitos adversos , Estudos Retrospectivos , Seguimentos , Resultado do Tratamento , Catarata/congênito , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia
17.
BMC Med Genomics ; 16(1): 241, 2023 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-37828500

RESUMO

BACKGROUND: Cranio-lenticulo-sutural dysplasia (CLSD) is a rare dysmorphic syndrome characterized by skeletal dysmorphism, late-closing fontanels, and cataracts. CLSD is caused by mutations in the SEC23A gene (OMIM# 607812) and can be inherited in either an autosomal dominant or autosomal recessive pattern. To date, only four mutations have been reported to cause CLSD. This study aims to identify the disease-causing variants in a large cohort of congenital cataract patients, to expand the genotypic and phenotypic spectrum of CLSD, and to confirm the association between SEC23A and autosomal recessive CLSD (ARCLSD). METHODS: We collected detailed medical records and performed comprehensive ocular examinations and whole-exome sequencing (WES) on 115 patients with congenital cataracts. After suspecting that a patient may have CLSD based on the sequencing results, we proceeded to conduct transmission electron microscopy (TEM) on the cultured skin fibroblasts. The clinical validity of the reported gene-disease relationships for the gene and the disease was evaluated using the ClinGen gene curation framework. RESULTS: Two novel compound heterozygous variants (c.710A > C p.Asp237Ala, c.1946T > C p.Leu649Pro) of the SEC23A gene, classified as variant of uncertain significance, were identified in the proband with skeletal, cardiac, ocular, and hearing defects. The observation of typical distended endoplasmic reticulum cisternae further supported the diagnosis of CLSD. Application of the ClinGen gene curation framework confirmed the association between SEC23A and ARCLSD. CONCLUSION: This study expands the genotypic and phenotypic spectrum of CLSD, proposes TEM as a supplemental diagnostic method, and indicates that congenital cataracts are a typical sign of ARCLSD.


Assuntos
Catarata , População do Leste Asiático , Humanos , Catarata/congênito , Catarata/diagnóstico , Catarata/genética , Retículo Endoplasmático , Família , Mutação , Linhagem , Proteínas de Transporte Vesicular/genética
18.
Cell Biochem Biophys ; 81(4): 757-763, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37667037

RESUMO

Beaded filament structural protein 1 (BFSP1) gene plays important role in the development of congenital cataract. We aimed to investigate and analyze the molecular mechanism of congenital cataract caused by D348N mutation of BFSP1 gene, and to provide evidence for the intervention of congenital cataract. BFSP1 and CP49 genes were cloned, wild type and mutant expression plasmids of BFSP1 were constructed and transfected into 293T cells. The BFSP1 wild type and mutant (D348N) gene sequence (NM_001195) were constructed into pEGFP-N1 vector by the restriction site NheI/KpnI. The effect of mutation on cell proliferation and apoptosis was analyzed. There was no significant change between the expression site of BFSP1 D348N mutation and the wild type. The expression of BFSP1 protein in wild group was higher than that in mutant group. CCK8 detection showed that the proliferation ability of 293T cells in mutant group was weaker than that in BFSP1 group. The mutation led to an increase in apoptosis. BFSP1 mutation significantly decreases the expression of BFSP1 protein, weakened the ability of cell proliferation and increased apoptosis. BFSP1 D348N mutation may be closely associated with congenital cataract and is of great significance to the investigations of the mechanism and intervention of congenital cataract.


Assuntos
Catarata , Proteínas do Olho , Humanos , Proteínas do Olho/genética , Proteínas do Olho/metabolismo , Catarata/genética , Catarata/congênito , Mutação , Éxons , Sequência de Bases
19.
J AAPOS ; 27(5): 253-258, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37716436

RESUMO

Unilateral congenital cataracts lead to deprivation amblyopia, which can be severe. Until the 1970s, they were believed to be always associated with poor visual outcomes. However, advances in our understanding of the plasticity of the infant brain and the development of better surgical techniques allowed good visual outcomes to be obtained in a few of these patients. The Infant Aphakia Treatment Study (IATS) was conducted to provide empirical evidence regarding the best type of optical correction to be used following surgical extraction of the cataract. Specifically, infants were randomly assigned to either be left aphakic and to wear contact lenses or an intraocular lens (IOL) was implanted and the residual refractive error was corrected with spectacles. The study found that good visual acuity and stereopsis could be achieved in some patients in both treatment groups. Early cataract surgery, consistent optical correction and part-time patching of the fellow eye are important elements needed to achieve good visual outcomes. However, excess patching of the fellow eye may interfere with the development of stereopsis. More adverse events occurred after IOL implantation, particularly visual axis opacification, compared with the infants who were left aphakic. Glaucoma-related adverse events occurred in 40% of eyes after a 10-year follow-up and were not associated with IOL implantation. Further research is needed to increase the percentage of children with unilateral congenital cataracts who achieve good visual outcomes.


Assuntos
Afacia Pós-Catarata , Extração de Catarata , Catarata , Lentes Intraoculares , Criança , Lactente , Humanos , Afacia Pós-Catarata/cirurgia , Implante de Lente Intraocular , Acuidade Visual , Seguimentos , Catarata/congênito , Complicações Pós-Operatórias
20.
Int Ophthalmol ; 43(12): 4573-4583, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37592116

RESUMO

PURPOSE: The present study aimed to identify the molecular etiology of non-syndromic congenital cataract (CC) using whole-exome sequencing (WES) analysis. METHODS: In the present study, ophthalmologic results and pedigree analysis of the families of 12 patients with non-syndromic CC were evaluated. WES analysis was conducted after DNA was isolated from peripheral blood samples obtained from the patients. RESULTS: Twelve non-syndromic probands (10 males and 2 females) with bilateral CC were included in the study. Patient age ranged between 1 and 11 months. WES analysis showed pathogenic/likely pathogenic variant in 7 (58%) of the 12 families and variant of unknown significance (VUS) in 5 (42%) of them. All the 13 different variants detected in 9 different CC-related genes were co-segregated with the disease. Autosomal dominant inheritance was found in 7 (58%) of the families and autosomal recessive inheritance was found in 5 (42%) of them. CONCLUSION: To the best of our knowledge, the present research is one of the limited numbers of studies in the Turkish population in which genetically heterogeneous non-syndromic CC was investigated using WES analysis. Novel variants that we identified in DNMBP, LSS, and WFS1 genes, which are rarely associated with the CC phenotype, have contributed to the mutation spectrum of this disease. Identifying the relevant molecular genetic etiology allows accurate genetic counseling to be provided to the families.


Assuntos
Catarata , Masculino , Feminino , Humanos , Lactente , Sequenciamento do Exoma , Mutação , Fenótipo , Catarata/genética , Catarata/congênito , Linhagem
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