两个X连锁遗传先天性特发性眼球震颤家系FRMD7基因突变的研究

目的　研究两个Ｘ连锁遗传先天性特发性眼球震颤（ｃｏｎｇｅｎｉｔａｌｉｄｉｏｐａｔｈｉｃｎｙｓｔａｇ-ｍｕｓ,ＣＩＮ）家系的致病基因突变。方法　在获取知情同意后,对两个家系进行病史采集及临床检查以确定其遗传表型;通过系谱分析,确定遗传模式;筛选致病基因进行直接测序,分析发现致病突变。结果　两个家系均为Ｘ连锁遗传,其中ＣＩＮ-０１家系所有患者均携带错义突变ｃ．６８５Ｃ＞Ｔ,位于ＦＲＭＤ７基因外显子８上,该突变可导致ＦＲＭＤ７编码的精氨酸被半胱氨酸替换（ｐ．Ｒ２２９Ｃ）;ＣＩＮ-０２家系所有患者及携带者均携带错义突变ｃ．８８７Ｇ＞Ｃ,位于ＦＲＭＤ７基因外显子９上,该突变使ＦＲＭＤ７蛋白第２９６位的甘氨酸被替换为精氨酸（ｐ．Ｇ２９６Ｒ）。结论　ＦＲＭＤ７基因ｃ．６８５Ｃ＞Ｔ及ｃ．８８７Ｇ＞Ｃ分别是引起ＣＩＮ-０１家系及ＣＩＮ-０２家系致病的主要原因。     

一个后极性白内障家系致病基因的筛查与鉴定

目的　对中国一个具有常染色体显性遗传特点的后极性白内障家系进行致病基因的筛查。方法　分别采集家系成员外周静脉血,提取基因组ＤＮＡ,根据临床表型选取６个候选基因（ＣＲＹＡＡ、ＣＲＹＡＢ、ＰＩＴＸ３、ＣＨＭＰ４Ｂ、ＭＩＰ、ＣＲＹＧＤ）设计引物,通过ＰＣＲ扩增ＤＮＡ片段,琼脂糖凝胶电泳分离ＤＮＡ片段,直接测序法寻找致病基因及突变位点。结果　该家系符合常染色体显性遗传家系特征,先证者表型为后极性白内障,通过候选基因外显子直接测序,发现家系内患者ＣＲＹＧＤ基因第２个外显子第１２７位碱基有１个Ｔ→Ｃ的点突变,此突变导致蛋白第４３位的色氨酸被精氨酸取代（Ｗ４３Ｒ）。结论　ＣＲＹＧＤ基因ｃ．Ｔ１２７Ｃ（ｐ．Ｗ４３Ｒ）突变是该后极性白内障家系的致病原因。     

常染色体显性遗传眼球震颤家系的临床表型及致病基因的研究

目的　研究１个中国人常染色体显性遗传性眼球震颤家系的临床特点,并通过候选基因直接测序的方法对该家系的致病基因及发病机制进行研究。方法　选择１个先天性眼球震颤家系,对家系所有成员进行全身检查及视力、眼位、眼球运动、眼球震颤中间带、验光等眼科的相关检查后,从家系中每一代各选１例患者（包括先证者）及正常人,进行候选基因ＦＲＭＤ７、ＧＰＲ１４３与ＰＡＸ６基因的外显子测序。结果　家系患者的眼球震颤为水平冲动型,并且具有中间带。除了先证者有部分眼组织缺损及小眼球等异常外,其余患者的眼前节均未见明显发育异常。家系患者ＰＡＸ６基因第７外显子的第３８２碱基发生了杂合突变（ｃ．Ｃ３８２Ｔ）,从而引起了氨基酸的改变（ｐ．Ｒ１２８Ｃ）,该突变可能影响了ＰＡＸ６蛋白与其调控的下游基因的调控序列的结合,进而导致ＰＡＸ６基因功能异常,影响眼部发育。结论　该常染色体显性遗传性眼球震颤家系的致病基因为ＰＡＸ６基因。     

错配PCR—限制性片段长度多态性分析检测HBV前C区终止密码变异株技术的 …

采用错配聚合酶链反应（ｍｐＰＣＲ）对ＨＢＶ前Ｃ区基因进行扩增，对ＰＣＲ产物进行限制片段长度多态性分析（ＲＦＬＰ），鉴定前Ｃ区第８３位核苷酸点突变。并对ＰＣＲ产物进行核苷酸序列３分析以鉴定其特异性。通过对不同含量ＨＢＶ ＤＮＡ的阳性血清检测结果显示本法可检出１０＾５ｃｏｐｉｅｓ／ｍｌ的ＨＢＶＤＡＮ，预测结果证实ＰＣＲ产物８为ＨＢＶ前Ｃ区特异性序列，与ＲＦＬＰ分析结果相符。采用ｍｐＰＣＲ－ＲＦＬＰ对７     

组织激肽释放酶在糖尿病视网膜病变患者血清中的变化及其调节血管新生机制

目的　检测组织激肽释放酶（ｔｉｓｓｕｅｋａｌｌｉｋｒｅｉｎ,ＴＫＬＫ）、血管内皮细胞生长因子（ｖａｓｃｕｌａｒｅｎｄｏｔｈｅｌｉａｌｇｒｏｗｔｈｆａｃｔｏｒ,ＶＥＧＦ）和可溶性细胞间黏附分子-１（ｓｏｌｕｂｌｅｉｎｔｒａｃｅｌｌｕｌａｒａｄｈｅｎｓｉｏｎｍｏｌｅｃｕｌ-１,ｓＩＣＡＭ-１）在糖尿病视网膜病变（ｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ,ＤＲ）患者血清中的变化,观察ＴＫＬＫ在低氧条件下对人视网膜微血管内皮细胞（ｈｕｍａｎｒｅｔｉｎａｌｍｉｃｒｏｖａｓｃｕｌａｒｅｎｄｏｔｈｅｌｉａｌｃｅｌｌｓ,ＨＲＭＥＣｓ）中ＶＥＧＦ和ＩＣＡＭ-１表达的影响。方法　收集２型糖尿病患者６０例,按照ＤＲ分期标准将患者分为糖尿病无ＤＲ组（ＤＭ组）、非增生性ＤＲ组（ＮＰＤＲ组）和增生性ＤＲ组（ＰＤＲ组）,收集同期在本院体检的志愿者作为对照组,每组２０例。ＥＬＩＳＡ法检测血清中ＴＫＬＫ、ＶＥＧＦ和ｓＩＣＡＭ-１的水平。体外ＨＲＭＥＣｓ分别进行常氧和低氧培养,不同浓度重组ＴＫＬＫ处理后,检测细胞增殖、凋亡以及ＶＥＧＦ和ＩＣＡＭ-１的表达。结果　ＤＭ、ＮＰＤＲ和ＰＤＲ组患者血清中ＴＫＬＫ、ＶＥＧＦ和ｓＩＣＡＭ-１水平明显高于对照组,４组总体差异有统计学意义（Ｆ＝２８．８０５,Ｐ＝０．００２;Ｆ＝３２．０４１,Ｐ＝０．００２;Ｆ＝２６．１６９,Ｐ＝０．００１）;ＰＤＲ患者血清中ＴＫＬＫ、ＶＥＧＦ和ｓＩＣＡＭ-１水平显著高于ＤＭ和ＮＰＤＲ组（均为Ｐ＜０．００１）。ＴＫＬＫ与ＶＥＧＦ（ｒ＝０．６２３,Ｐ＜０．０１）和ｓＩＣＡＭ-１水平（ｒ＝０．５９８,Ｐ＜０．０１）均呈正相关。１０μｇ?ｍＬ－１ｒｈＴＫＬＫ可显著抑制低氧诱导的ＨＲＭＥＣｓ增殖以及ＶＥＧＦ和ＩＣＡＭ-１的表达,并可促进细胞凋亡（Ｐ＜０．０５）。结论　ＴＫＬＫ通过与ＶＥＧＦ和ＩＣＡＭ-１相互作用而影响ＤＲ的进展。     

珊瑚状先天性白内障一家系致病基因筛查与鉴定

目的：对一个珊瑚状先天性白内障家系进行致病基因的筛查。方法：采集家系中2例患者和1例正常对照者的外周静脉血,提取基因组DNA。选择与珊瑚状白内障相关的候选基因GJA3、GJA8、CRYGC及CRYGD设计引物,进行聚合酶链反应（ PCR）扩增候选基因,并对扩增片段进行Sanger测序。结果：该家系疾病表型为珊瑚状白内障,呈常染色体显性遗传。通过对扩增产物测序,发现家系内患者CRYGD第2个外显子第70位有1个C＞A碱基的杂合突变（ c．70C＞A）,正常对照未见该点突变。结论：CRYGD基因的错义突变c．70C＞A是该珊瑚状白内障家系的致病原因。     

紫外光A/核黄素角膜交联后兔角膜基质内基质金属蛋白酶-1含量的变化

目的　检测紫外光Ａ／核黄素角膜交联（ｕｌｔｒａｖｉｏｌｅｔＡ／ｒｉｂｏｆｌａｖｉｎｃｏｒｎｅａｌｃｒｏｓｓ-ｌｉｎｋ-ｉｎｇ,ＵＶＡＲＣＸＬ）后兔角膜基质内基质金属蛋白酶（ｍａｔｒｉｘｍｅｔａｌｌｏｐｒｏｔｅｉｎａｓｅ,ＭＭＰ）-１的短期含量变化。方法　１５只新西兰白兔,随机分为３组,每组５只,Ａ组为空白对照组,Ｂ组为角膜交联后３ｄ,Ｃ组为角膜交联后７ｄ。Ｂ、Ｃ两组行ＵＶＡＲＣＸＬ。各组取角膜后去除角膜上皮和内皮细胞,应用ＥＬＩＳＡ法检测角膜基质内ＭＭＰ-１的含量。结果　Ａ组角膜基质内ＭＭＰ-１／总蛋白含量为（０．１４０±０．０３６）×１０－６,Ｂ组为（０．２４２±０．０５９）×１０－６,Ｃ组为（０．３７２±０．０６１）×１０－６,３组之间差异有统计学意义（Ｆ＝２４．０５１,Ｐ＝０．０００）。ＵＶＡＲＣＸＬ后３ｄ,兔角膜基质内ＭＭＰ-１含量显著升高,与Ａ组相比差异有统计学意义（Ｐ＜０．０５）,术后７ｄ其含量进一步升高,与Ｂ组相比差异有统计学意义（Ｐ＜０．０１）。结论　ＵＶＡＲＣＸＬ后７ｄ内,兔角膜基质内ＭＭＰ-１含量持续增加,推测ＭＭＰ-１可能对ＵＶＡＲＣＸＬ后的角膜基质重塑起一定作用。     

斑状角膜营养不良近亲结婚的家系中新的CHST6突变研究

目的　了解斑状角膜营养不良近亲婚配家系遗传结构特征,探讨斑状角膜营养不良临床表现、与ＣＨＳＴ６基因突变的关系以及基因突变的类型。方法　该斑状角膜营养不良的家系所有成员都经过详细病史询问、严格的眼科检查,留存外眼像。患者术中切除的病变角膜标本行组织病理学检查,采用标准方法行ＨＥ染色,采集７名成员外周血各５ｍＬ,提取ＲＮＡ,逆转录生成ｃＤＮＡ,对其产物测序,ＣＨＳＴ６测序结果与正常人群进行比对。结果　基因测序结果显示Ⅱ１和Ⅱ４的基因型为隐性纯合子。组织病理学检查发现先证者角膜基质中有大量的淀粉样物质沉积。斑状角膜营养不良家系中２例患者在两条等位ＣＨＳＴ６基因上存在相同的点突变（１０７２Ｔ＞Ｃ）,余表型正常且与先证者有血缘关系的人员均是该突变基因的携带者。结论　２例患者的两条等位ＣＨＳＴ６基因上存在相同点突变（１０７２Ｔ＞Ｃ）,基因型为隐性纯合子。     

慢病毒载体介导TLR2基因干扰大鼠角膜上皮细胞和基质细胞的实验研究

目的　观察慢病毒载体（ｌｅｎｔｉｖｉｒａｌｖｅｃｔｏｒ,ＬＶ）介导ＴＬＲ２基因干扰大鼠角膜上皮细胞（ｃｏｒｎｅａｌｅｐｉｔｈｅｌｉａｌｃｅｌｌ,ＣＥＣ）和基质细胞（ｃｏｒｎｅａｌｓｔｒｏｍａｌｃｅｌｌ,ＣＳＣ）的有效性和安全性。方法　分别培养大鼠ＣＥＣ和ＣＳＣ,转染组用携带绿色荧光蛋白（ｅｎｈａｎｃｅｄｇｒｅｅｎｆｌｕｏｒｅｓｃｅｎｔｐｒｏｔｅｉｎ,ｅＧＦＰ）和ＴＬＲ２小干扰ＲＮＡ（ｓｍａｌｌｉｎｔｅｒｆｅｒｅｎｃｅＲＮＡ,ｓｉＲＮＡ）的ＬＶ转染,空白对照组加入空白培养液,阴性对照组加入不携带目的基因的ＬＶ。转染组按最佳感染复数（ｍｕｌｔｉｐｌｉｃｉｔｙｏｆｉｎｆｅｃｔｉｏｎ,ＭＯＩ）分别为１０、５０、１００、２００加入ＬＶ-ＴＬＲ２-ｓｉＲＮＡ-ｅＧＦＰ,选择ｅＧＦＰ表达最强的ＭＯＩ进行后续实验,观察细胞形态,ＣＣＫ８检测细胞增殖情况。流式细胞仪检测两种角膜细胞的转染效率,ＲＴ-ＰＣＲ检测转染后ＴＬＲ２ｍＲＮＡ的表达情况。结果　ＭＯＩ＝２００时转染ＣＥＣ和ＣＳＣ荧光表达最高,和空白对照组相比细胞形态未发生明显改变;ＣＣＫ８结果显示转染组与空白对照组、阴性对照组的ＩＯＤ值差异均无统计学意义（均为Ｐ＞０．０５）;流式细胞仪检测ＣＥＣ和ＣＳＣ转染效率分别为７７．６００％ ±１．１００％和７６．３００％ ±１．３８７％,和阴性对照组相比差异均有显著统计学意义（均为Ｐ＜０．００１）。ＲＴ-ＰＣＲ检测转染后ＣＥＣ和ＣＳＣＴＬＲ２ｍＲＮＡ相对表达量均较对照组明显下降,差异均有显著统计学意义（均为Ｐ＜０．００１）。结论　ＬＶ-ＴＬＲ２-ｓｉＲＮＡ-ｅＧＦＰ可在体外稳定有效转染ＣＥＣ和ＣＳＣ,且对细胞安全性无影响,可有效下调ＴＬＲ２ｍＲＮＡ的表达。     

增殖性糖尿病视网膜病变患者玻璃体中血管内皮细胞生长因子含量的检测

目的检测增殖性糖尿病视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ，ＰＤＲ）患者玻璃体中血管内皮细胞生长因子（ｖａｓｃｕｌａｒｅｎｄｏｔｈｅｌｉａｌｇｒｏｗｔｈｆａｃｔｏｒ，ＶＥＧＦ）的含量并与正常人进行对比研究，探讨ＶＥＧＦ在ＰＤＲ病理过程中的作用。方法应用酶联免疫吸附测定法（ｅｎｚｙｍｅｌｉｎｋｅｄｉｍｍｕｎｏｓｏｒｂｅｎｔａｓｓａｙ，ＥＬＩＳＡ）对７例正常人及１９例ＰＤＲ患者玻璃体中的ＶＥＧＦ进行定量分析研究。结果７例正常人玻璃体中，ＶＥＧＦ的含量为０．１８～０．６０ｎｇ／ｍｌ，平均值为０．３５ｎｇ／ｍｌ。１９例ＰＤＲ患者玻璃体中ＶＥＧＦ的含量升高，范围为０．８４～１５．６４ｎｇ／ｍｌ，平均值为５．６６ｎｇ／ｍｌ。两组比较，差异有显著性（Ｐ＜０．０５），其中男性组玻璃体中ＶＥＧＦ的含量为０．８４～１５．６４ｎｇ／ｍｌ，平均值为４．８３ｎｇ／ｍｌ；女性组为１．３４～１２．３４ｎｇ／ｍｌ，平均值为７．０８ｎｇ／ｍｌ，两组比较，差异无显著性（Ｐ＞０．０５）。结论ＰＤＲ患者玻璃体中ＶＥＧＦ的含量升高，在ＰＤＲ的病理过程中起一定作用     

Heterogeneous phenotype in a family with the FERM domain-containing 7 gene R335X mutation

Objective

Infantile nystagmus (IN) is characterized by bilateral involuntary, periodic, and predominantly ocular oscillations. In this article, we describe a mutation screen conducted on a 4-generation family in which 4 patients were affected with X-linked IN (XLIN).

Design

Experimental study.

Participants

A 4-generation Chinese Han family including 4 symptomatic members with IN and 200 normal male controls.

Methods

DNA was extracted from peripheral blood, and the FERM domain-containing 7 gene (FRMD7) was amplified on DNA samples of all the available family members. The mutation screen was conducted by performing direct DNA sequencing.

Results

A nonsense mutation (R335X) in the FRMD7 gene was identified in 4 male patients and an asymptomatic female member.

Conclusions

Although the R335X mutation in the FRMD7 gene has been previously described, the clinical features, including both disease penetrance and severity, among individuals with FRMD7 mutation in our family vary greatly. One female member with the heterozygous R335X mutation had no clinical manifestation of the disease. This incomplete penetrance suggests that random X-chromosome inactivation may play a role in the pathogenesis of IN, and that loss of functional FRMD7 may account for the development of this disorder. Our findings may be helpful in the genetic counseling of patients with nystagmus.     

FRMD7基因新突变位点导致先天性眼球震颤一家系的遗传学研究

目的探讨4.1埃兹蛋白－根蛋白－膜突蛋白结构域包含的7(FRMD7)基因新突变位点导致先天性眼球震颤(CN)一家系的遗传学特征。 方法2021年10月,收集于北京大学人民医院眼视光中心确诊CN家系四代19例的临床资料。采集家系中3例CN患者和9例眼正常者的外周血样本,检查受试者的最佳矫正视力(BCVA)、眼前节及眼底;评估眼球震颤的类型、头位、是否有中间带及眼位等。应用GenCap液相仪抓取目标基因技术,获取与眼部疾病相关的811个基因的外显子区域及其侧翼区域,对先证者进行高通量测序,筛选出致病基因和突变位点,并在家系中进行Sanger测序和共分离验证。使用Mutation Taster软件分析突变位点的基因突变类型;预测突变型蛋白质的三维结构和功能改变。 结果该家系的先证者(Ⅲ6)男性,11岁。此患者右眼BCVA 0.7,左眼BCVA 0.8。先证者表弟(Ⅲ9)男性,2岁,双眼视力检查配合度不佳。先证者祖父(Ⅰ1)男性,73岁。此患者右眼BCVA 0.3,左眼BCVA 0.4,双眼晶状体混浊。3患者均双眼正位,眼球震颤呈水平钟摆型,无中间带及代偿头位,眼底检查未见明显异常。此家系患者均为男性,呈现隔代遗传特征,符合X连锁隐性遗传。家系中12例受试者外周血基因检测结果显示,3例患者FRMD7基因第9外显子编码区发生半合子变异,Ⅱ6、Ⅱ8及Ⅲ8等3例眼正常女性者在该区域发生杂合变异,核苷酸变异c.822C>A,氨基酸变异p.Y274X,使终止密码子提前出现,造成蛋白质编码提前终止,大量氨基酸丢失。根据美国医学遗传学与基因组学学会遗传变异分类标准与指南,该变异被评定为疑似致病性变异。经Mutation Taster软件分析,结果显示突变性质为无义突变;突变型蛋白质三维结构和功能的预测显示该突变影响FRMD7蛋白结构的稳定性,可能使其功能受损。 结论FRMD7基因核苷酸变异c.822C>A(p.Y274X)为无义突变,属于新突变位点,此变异是该家系CN的可能致病原因,扩大了FRMD7基因突变频谱。     

眼脑肾综合征一家系的OCRL基因致病突变检测

目的 探讨眼脑肾综合征一家系的OCRL基因致病突变筛查与检测。方法 采集家系成员外周血及胎儿羊水并提取基因组DNA。在OCRL基因两侧选取微卫星标记进行连锁分析;对患者OCRL基因全部外显子进行PCR扩增和测序;对可能致病突变采用限制酶分析验证。利用连锁分析、直接测序及酶切分析,对胎儿进行产前基因检测。结果 先证者及3名肯定携带者OCRL基因存在无义突变c.2032C--→T(p.R678X);其他7名家系成员及胎儿均不携带此突变。结论 OCRL基因c.2032C→T突变是该家系出现眼脑肾综合征的原因;家系中胎儿不携带此致病突变。     

常染色体显性遗传核性白内障合并小角膜的CRYAA基因突变研究

目的 研究一个4代常染色体显性遗传先天性核性白内障伴小角膜家系的致病基因.方法 实验研究.对12例家系成员(6例患者,6例非患者)进行眼部检查并采集静脉血,提取基因组DNA.在已知的与先天性白内障伴小角膜相关致病基因附近选择微卫星标记,进行聚合酶链反应扩增-变性聚丙烯酰胺凝胶电泳,并进行基因型分析和连锁分析.对连锁区域内候选基因的外显子、外显子和内含子交界区进行测序.限制性内切酶ApaL Ⅰ法在全部家系成员和正常人群中验证突变.结果 该家系患者表型为先天性核性白内障伴小角膜;在染色体21q22.3区域的D21S1885和D21S1890两个标记,家系患者均有共享基因型,并且两点连锁分析Lod值为2.11,提示该位点与家系致病基因连锁;对此区域内候选基因CRYAA测序发现cDNA序列第34位碱基存在C＞T杂合突变(c.34C＞T),导致其编码肽链第12位精氨酸变为半胱氨酸(p.R12C).ApaL Ⅰ酶切验证家系患者均携带c.34C＞T突变,家系中及对照正常个体均不携带此突变.结论 CRYAA的p.R12C突变可能是该先天性白内障伴小角膜家系发病的遗传基础.

Abstract：

Objective To identify the gene mutation in a four-generation Chinese family with autosomal dominant congenital cataract associated with microcornea. Methods Experimental research.Twelve members in this family (including six affected and six unaffected individuals) were enrolled into this study. They underwent full ophthalmological and clinical examinations to rule out any concomitant disorders.Blood samples were collected and genomic DNA was extracted. Microsatellite markers near the reported loci,which are associated with congenital cataract and microcornea were selected and amplified from DNA samples using polymerase chain reaction. Linkage analysis was performed. The exons and exon/intron junction of candidate gene in the related chromosome were sequenced. The product of the first exon was digested by ApaL Ⅰ restriction enzyme to certify the mutation. Results The phenotype studied in this family was nuclear cataract accompanied with microcornea. At markers D21S1885 and D21S1890 near the locus 21q22. 3, the affected members had the same allele, but the unaffected did not. The Lod scores were 2. 11in both markers, indicating that this locus were linked to the congenital cataract in this family. DNA sequencing of candidate gene CRYAA showed a heterozygous mutation c. 34C ＞ T in exon 1, which led to condon 12 in peptide chain encoding arginine substituted by cysteine. ApaL Ⅰ enzyme digestion certified that all of the affected members had the same mutation c. 34C ＞T, but the unaffected and normal individuals did not. Conclusion Mutation (p. R12C) of CRYAA is the genetic change that causes the occurrence of congenital cataract with microcornea in this family.     

Recurrent FBN1 mutation (R62C) in a Chinese family with isolated ectopia lentis

PURPOSE: To examine the fibrillin-1 (FBN1) gene for mutations in members of a Chinese family with isolated ectopia lentis. DESIGN: Clinically relevant laboratory investigation. METHODS: Family members underwent clinical examinations. Genomic DNA was extracted from leukocytes of peripheral blood from the available members and 100 controls for mutation analysis. The 65 exons of FBN1 were amplified by polymerase chain reaction and screened for mutations by a combination of denaturing high-performance liquid chromatography analysis and direct DNA sequencing. RESULTS: A mutation, c.184C-->T in exon 2 of FBN1, which results in substitution of arginine by cysteine at position 62 of the fibrillin-1 protein (p.R62C) in all affected family members but in none of the unaffected individuals. CONCLUSIONS: A recurrent mutation of FBN1 gene resulted in an arginine-to-cysteine residue (p.R62C), is responsible for the patients with isolated ectopia lentis in a Chinese family.     

A novel mutation of LIM2 causes autosomal dominant membranous cataract in a Chinese family

AIM: To determine the prevalence and associations of non-retinopathy ocular conditions among older Australian adults with diabetes. METHODS: Multistage random-cluster sampling was used to select 3098 non-indigenous Australians aged 50y or older (46.4% male) and 1738 indigenous Australians aged 40y or older (41.1% male) from all levels of geographic remoteness in Australia. Participants underwent a standardised questionnaire to ascertain diabetes history, and a clinical examination to identify eye disease. We determined the prevalence of uncorrected refractive error, visually significant cataract, cataract surgery, age-related macular degeneration, glaucoma, ocular hypertension, retinal vein occlusion and epiretinal membrane among those with and without self-reported diabetes. RESULTS: Participants with self-reported diabetes had a higher prevalence of cataract surgery than those without diabetes (28.8% vs 16.9%, OR 1.78, 95%CI: 1.35-2.34 among non-indigenous Australians, and 11.3% vs 5.2%, OR 1.62, 95%CI: 1.22-2.14 among indigenous Australians). Diabetic retinopathy (DR) increased the odds of cataract surgery among self-reported diabetic indigenous and non-indigenous Australians (OR 1.89, P=0.004 and OR 2.33, P<0.001 respectively). Having diabetes for ≥20y and having vision-threatening DR increased the odds of cataract surgery among indigenous Australians with diabetes (OR 3.73, P=0.001 and 7.58, P<0.001, respectively). CONCLUSION: Most non-retinopathy ocular conditions are not associated with self-reported diabetes. However, to account for Australia’s worsening diabetes epidemic, interventions to reduce the impact of diabetes-related blindness should include increased cataract surgery services.     

Central choroidal thickness in children and adolescents with anxiety disorders: enhanced depth imaging optical coherence tomography findings

AIM: To measure the central choroidal thickness (ChT) in children and adolescents with anxiety disorders. METHODS: Totally 41 anxiety patients (8-16y) and 35 healthy controls (age-matched) were evaluated. Complete ophthalmic examination was performed. Inclusion criteria were best corrected visual acuity ≥20/20, normal intraocular pressure (IOP; 10-21 mm Hg), and no systemic or ocular diseases according to history. The diagnosis of psychiatric disorders was determined using Schedule for Affective Disorders and Schizophrenia for School Aged Children Present-Lifetime Version (K-SADS-PL). Enhanced depth imaging optical coherence tomography (EDI-OCT) was used to measure the central ChT. RESULTS: The mean age was 12.18±3.24y in the patient group and 12.86±3.15y in the control group. Age and gender distribution of the two groups was similar. Central ChT mean value was 353.26±31.9 μm in anxiety patients while 318.75±60.9 μm in the control group. Mean central ChT was statistically significantly higher in the children and adolescents with anxiety disorders than healthy controls (P=0.002). CONCLUSION: The children and adolescents with anxiety disorders have significantly thicker central ChT than controls. In the larger sample, longitudinal studies will contribute to the use of choroidal differences as a clinical marker for monitoring anxiety disorders.     

Mutation analysis of FBN1 gene in two Chinese families with congenital ectopia lentis in northern China

AIM: To summarize the phenotypes and identify the underlying genetic cause of the fibrillin-1 (FBN1) gene responsible for congenital ectopia lentis (EL) in two Chinese families in northern China. METHODS: A detailed family history and clinical data from all participants were collected by clinical examination. The candidate genes were captured and sequenced by targeted next-generation sequencing, and the results were confirmed by Sanger sequencing. Haplotyping was used to confirm the mutation sequence. Real-time PCR was used to determine the FBN1 messenger ribonucleic acid (mRNA) levels in patients with EL and in unaffected family members. RESULTS: The probands and other patients in the two families were affected with congenital isolated EL. A heterozygous FBN1 mutation in exon 21 (c.2420_IVS20-8 delTCTGAAACAinsCGAAAG) was identified in FAMILY-1. A heterozygous FBN1 mutation in exon 14 (c.1633C>T, p.R545C) was identified in FAMILY-2. Each mutation co-segregated with the affected individuals in the family and did not exist in unaffected family members and 200 unrelated normal controls. CONCLUSION: The insertion-deletion mutation (c.2420 IVS20-8delTCTGAAACA insCGAAAG) in the FBN1 gene is first identified in isolated EL. The mutation (c.1633C>T) in the FBN1 gene was a known mutation in EL patient. The variable phenotypes among the patients expand the phenotypic spectrum of EL in a different ethnic background.