RESUMO
Age-related macular degeneration is a multifactorial disease that can lead to vision impairment in older individuals. Although the etiology of age-related macular degeneration remains unknown, risk factors include age, ethnicity, smoking, hypertension, obesity, and genetic factors. Two main loci have been identified through genome-wide association studies, on chromosomes 1 and 10. Among the variants located at the 10q26 region, rs11200638, located at the HTRA1 gene promoter, has been associated with age-related macular degeneration in several populations and is considered the main polymorphism. We conducted a replication case-control study to analyze the frequency and participation of rs11200638 in the etiology of age-related macular degeneration in a sample of patients and controls from the State of São Paulo, Brazil, through polymerase chain reaction and enzymatic digestion. The frequency of the A allele was 57.60% in patients with age-related macular degeneration and 36.45% in controls (p value < 1e-07), representing a 2.369-fold higher risk factor for the disease. Both the AA and AG genotypes were observed more frequently in the age-related macular degeneration group compared to the control group (p = 1.21e-07 and 0.0357, respectively). No statistically significant results were observed after stratification in dry versus wet types or advanced versus non-advanced forms. To our knowledge, this is the first time the association between rs11200638 and overall age-related macular degeneration has been reported in South America.
Assuntos
Atrofia Geográfica/genética , Serina Peptidase 1 de Requerimento de Alta Temperatura A/genética , Polimorfismo de Nucleotídeo Único , Degeneração Macular Exsudativa/genética , Idoso , Brasil/epidemiologia , Estudos de Casos e Controles , Cromossomos Humanos Par 10/genética , Feminino , Frequência do Gene , Estudos de Associação Genética , Atrofia Geográfica/etnologia , Humanos , Masculino , Reação em Cadeia da Polimerase , Degeneração Macular Exsudativa/etnologiaRESUMO
BACKGROUND: An association between LOC387715/ARMS2 (rs10490924) gene polymorphism and AMD has been reported. The aim of this study was to evaluate whether this polymorphism is associated with AMD in a Brazilian cohort. MATERIALS AND METHODS: In total, 126 unrelated AMD patients (mean age 74.17 ± 7.64) were compared with 86 healthy controls (mean age 71.82 ± 7.12). Study subjects were classified according to the International ARM Epidemiological Study Group definition for early and late-stage AMD. LOC387715/ARMS2 rs10490924 polymorphism was evaluated through polymerase chain reaction and direct sequencing. RESULTS: The T allele frequency was significantly higher in AMD patients than in controls (39.6% compared to 20.3%). The odds ratio (OR) for AMD was 2.05 (95% CI 1.13-3.71) for heterozygotes (TG) and 8.32 (95% CI 2.30-45.99) for homozygotes (TT). CONCLUSIONS: These results suggest that there is a contribution of the rs10490924 SNP of the LOC387715/ARMS2 gene to AMD susceptibility in this sample of the Brazilian population.
Assuntos
Atrofia Geográfica/genética , Polimorfismo de Nucleotídeo Único , Proteínas/genética , Degeneração Macular Exsudativa/genética , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Feminino , Predisposição Genética para Doença , Genótipo , Atrofia Geográfica/epidemiologia , Humanos , Masculino , Reação em Cadeia da Polimerase , Fatores de Risco , Análise de Sequência de DNA , Degeneração Macular Exsudativa/epidemiologiaRESUMO
Wyburn-Mason is a rare vascular disorder, comprised of arteriovenous malformations (AVMs) of the midbrain and retina. It can cause visual symptoms depending on its localization and extension. Vitreous and intraretinal hemorrhage and neovascular glaucoma have been previously described. A case of rhegmatogenous retinal detachment in a patient with Wyburn-Mason syndrome is described. A 27 year-old woman previously diagnosed with Wyburn-Mason syndrome, sought attendance with sudden low vision in right eye 3 months before. She presented moderate vitreous hemorrhage and retinal detachment with a superior tear. She underwent a successful posterior vitrectomy with implantation of silicone oil, with reattachment of the retina. Rhegmatogenous retinal detachment in a patient with Wyburn-Mason syndrome has been not previously described in the literature. Vitrectomy in this case present challenges related to intraoperatory bleeding risk, to a posterior pole tear among AVMs and the difficulty of obtaining free retina for photocoagulation.
Assuntos
Malformações Arteriovenosas Intracranianas/complicações , Artéria Retiniana/anormalidades , Descolamento Retiniano/etiologia , Descolamento Retiniano/cirurgia , Veia Retiniana/anormalidades , Adulto , Feminino , Humanos , Descolamento Retiniano/diagnóstico , Óleos de Silicone/uso terapêutico , Síndrome , VitrectomiaRESUMO
Wyburn-Mason is a rare vascular disorder, comprised of arteriovenous malformations (AVMs) of the midbrain and retina. It can cause visual symptoms depending on its localization and extension. Vitreous and intraretinal hemorrhage and neovascular glaucoma have been previously described. A case of rhegmatogenous retinal detachment in a patient with Wyburn-Mason syndrome is described. A 27 year-old woman previously diagnosed with Wyburn-Mason syndrome, sought attendance with sudden low vision in right eye 3 months before. She presented moderate vitreous hemorrhage and retinal detachment with a superior tear. She underwent a successful posterior vitrectomy with implantation of silicone oil, with reattachment of the retina. Rhegmatogenous retinal detachment in a patient with Wyburn-Mason syndrome has been not previously described in the literature. Vitrectomy in this case present challenges related to intraoperatory bleeding risk, to a posterior pole tear among AVMs and the difficulty of obtaining free retina for photocoagulation.
A síndrome de Wyburn-Mason é uma desordem vascular rara, caracterizada por malformações arteriovenosas (MAV) do mesencéfalo e retina. Pode causar sintomas visuais por sua localização e extensão. Hemorragia vítrea, intrarretiniana e glaucoma neovascular já foram descritos. Descreve-se um caso de descolamento regmatogênico de retina em uma paciente com síndrome de Wyburn-Mason. Uma paciente feminina de 27 anos com diagnóstico prévio de síndrome de Wyburn-Mason procurou atendimento com queixa de baixa acuidade visual súbita no olho direito há três meses. Apresentava hemorragia vítrea moderada e descolamento de retina com rotura superior. Foi submetida a vitrectomia posterior com implante intravítreo de óleo de silicone, com reaplicação da retina. Descolamento regmatogênico de retina em paciente com síndrome de Wyburn-Mason não havia sido previamente descrito na literatura. A vitrectomia nesse caso apresentou dificuldades relacionadas ao risco de sangramento intraoperatório, à presença de rotura no polo posterior entre as MAVs e à dificuldade de obtenção de retina livre para fotocoagulação.