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Abstract #18035 Published in IGR 9-2
Familial cavitary optic disk anomalies: Clinical features of a large family with examples of progressive optic nerve head cupping
Honkanen RA; Jampol LM; Fingert JH; Moore MD; Taylor CM; Stone EM; Alward WLAmerican Journal of Ophthalmology 2007; 143: 788-794
PURPOSE: To describe a multigenerational family with autosomal dominant inheritance of cavitary optic nerve head (ONH) anomalies and abnormal ONH vasculature. DESIGN: Description of a single family with inherited eye disease. METHODS: A four-generation pedigree was investigated. Examination included visual acuity, slit-lamp biomicroscopy, intraocular pressure (IOP) measurement, and ophthalmoscopy. Visual fields and fundus photography were obtained when possible. RESULTS: Seventeen clinically affected individuals and two obligate carriers were identified. Most (64.7%) affected persons had bilateral involvement. Visual acuity in affected eyes ranged from 20/20 to no light perception. Although the appearance of affected nerves varied greatly, most lacked a well-formed central retinal artery and instead had multiple radial cilioretinal arteries. Prominent cupping was seen in most affected nerves. Four individuals for whom information was available were treated for glaucoma, but none had documented elevated IOP. Four eyes of two patients demonstrated progressive ONH cupping at normal IOPs. Nine (56.3%) of the 16 individuals for whom we had data had evidence of serous macular detachments; five of these had bilateral macular disease. CONCLUSIONS: A large family with autosomal dominant inheritance of cavitary ONH anomalies and abnormal vasculature is presented. Clinical phenotypes varied markedly. Progressive ONH cupping was documented in four eyes of two patients. Genetic linkage analysis of this family has identified the chromosomal location of a gene responsible for ONH development. This may provide insight into the pathogenesis of glaucomatous ONH damage.
Dr. R.A. Honkanen, Department of Ophthalmology, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
Classification:
10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy
2.14 Optic disc (Part of: 2 Anatomical structures in glaucoma)
3.4.1 Linkage studies (Part of: 3 Laboratory methods > 3.4 Molecular genetics)