伴发闭角型青光眼视网膜色素变性遗传家系的表型分析和基因检测

Genotype-phenotype analysis in a family with retinitis pigmentosa and concomitant angleclosure glaucoma

  • 摘要: 目的 分析一个伴发闭角型青光眼的常染色体显性遗传视网膜色素变性家系的临床表型并筛选可疑致病基因。 方法 对2016年9月于本院就诊的视网膜色素变性家系内的6例成员(5例患者,1例正常人)行眼科检查,绘制家系图谱,结合目标区域捕获高通量测序和家系内Sanger测序筛选可疑致病基因位点。 结果 此家系的5例患者均有夜盲和视野缺损,存在不同程度视力下降,视网膜呈青灰色骨细胞样改变,2例患者伴发闭角型青光眼,2例患者存在房角狭窄,初步认为发病与RHO基因c.541G> Ap.Glu181Lys突变有关。 结论 视网膜色素变性伴发青光眼患者较易漏诊,通过分析临床资料及目标区域捕获高通量测序技术可明确诊断并确定致病基因突变。

     

    Abstract: Objective To analyze the clinical phenotype of a family with autosomal dominant retinitis pigmentosa and concomitant angle-closure glaucoma, and screen for the suspicious causative genes. Methods Six members in a family (5 patients with retinitis pigmentosa and 1 normal subject) admitted to our hospital were recruited in this study in September 2016. Detailed ophthalmologic examinations were performed in all subjects, including uncorrected visual acuity, best corrected visual acuity, ultrasound biomicroscopy of the anterior ocular segment, applanation tonometry, fundus examination, spectral-domain optical coherence tomography (SD-OCT), and electroretinogram (ERG). Clinical data about five cases were analyzed with drawing a pedigree figure. The suspected mutations were confirmed by target region capture, high throughput sequencing and Sanger sequencing. Results Five patients of this family had night blindness, decreased visual acuity and visual field defect. Two cases had angle closure glaucoma, and another two cases had narrow angle. Mutation c.541G> A p.Glu181Lys in RHO was identified in these patients. Conclusion Glaucomain retinitis pigmentosa patients may go unnoticed. In this study, we have identified the diagnosis and suspected mutations by analyzing phenotypic characteristics and using target region capture and high throughput sequencing technology.

     

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