Clinical and genetic update of corneal dystrophies.
Lisch Walter,Weiss Jayne S
Experimental eye research
The International Committee for Classification of Corneal Dystrophies (IC3D) distinguishes between 22 distinct forms of corneal dystrophy which are predominantly autosomal dominant, although autosomal recessive and X-chromosomal dominant patterns do exist. Before any genetic examination, there should be documentation of a detailed corneal exam of as many affected and unaffected family members as possible, because detailed phenotypic description is essential for accurate diagnosis. Corneal documentation should be performed in direct and indirect illumination at the slit lamp with the pharmacologically dilated pupil. For the majority of the corneal dystrophies, a phenotype-genotype correlation has not been demonstrated. However, for the dystrophies associated with mutations in the transforming growth factor, ß-induced gene (TGFBI) a general phenotype-genotype correlation is evident. The discovery of collagen, type XVII, alpha 1 mutation (COL17A1), causative in the called epithelial recurrent erosion dystrophy (ERED) was a very important step in the accurate diagnosis of corneal dystrophies. This led to the subsequent discovery that the entity previously called 10q Thiel-Behnke corneal dystrophy, was in reality actually COL17A1 ERED, and not Thiel-Behnke corneal dystrophy. In addition to the phenotypic landmarks, we describe the current genotype of the individual corneal dystrophies. Differential diagnosis can be aided by information on histopathology, optical coherence tomography (OCT), and confocal microscopy.
BIGH3 mutation spectrum in corneal dystrophies.
Munier Francis L,Frueh Beatrice E,Othenin-Girard Philippe,Uffer Sylvie,Cousin Pascal,Wang Ming X,Héon Elise,Black Graeme C M,Blasi Maria A,Balestrazzi Emilio,Lorenz Birgit,Escoto Rafael,Barraquer Rafael,Hoeltzenbein Maria,Gloor Balder,Fossarello Maurizio,Singh Arun D,Arsenijevic Yvan,Zografos Léonidas,Schorderet Daniel F
Investigative ophthalmology & visual science
PURPOSE:To investigate the molecular pathology underlying BIGH3-related corneal dystrophies (CDs) and to further delineate genotype-phenotype specificity. METHODS:Sixty-one index patients with CDs were subjected to phenotypic and genotypic characterization. The corneal phenotypes of all patients were assessed by biomicroscopy and documented by slit lamp photography. The BIGH3 gene was amplified exon by exon from constitutional DNA to perform single-strand conformation polymorphism (SSCP) analysis, followed by direct bidirectional sequencing of abnormal conformers. RESULTS:The phenotypes of CDs were classified as lattice CD in 30 patients, Groenouw type I in 12 (CDGGI), Avellino in 7 (CDA), Reis-Bückler in 8 (CDRB), and Thiel-Behnke in 4 (CDTB). Fifty occurrences of 16 distinct mutations were identified, including 8 novel mutations responsible for lattice type IIIA in three patients (CDLIIA), intermediate type I/IIIA (CDLI/IIIA) in four patients, and atypical CDL with deep deposits in one patient (CDL-deep). CONCLUSIONS:Disease-causing mutations were identified in 80% of the patients (50/61). All mutations localize in two regions of kerato-epithelin: the amino acid R124 and BIGH3 fasc domain 4. This study also confirms the mutation hot spot at positions R124 and R555 with nearly 50% of the mutations targeting these two amino acids (24/50). In addition the corneal phenotypes induced by changes at R124 and R555 are amino acid specific: R124C in CDLI, R555W and R124S in CDGGI, R124H in CDA, R124L in CRRB, and R555Q in CDTB. In CDLIIIA, CDLI/IIIA, and CDL-deep the genotype-phenotype correlation is domain specific, with all changes occurring at the boundary or within the fasc4 domain.
Analysis of TGFBI gene mutations in Chinese patients with corneal dystrophies and review of the literature.
Yang Juhua,Han Xiaoli,Huang Dinggou,Yu Lin,Zhu Yihua,Tong Yi,Zhu Binliang,Li Chuanbao,Weng Mingshe,Ma Xu
PURPOSE:To analyze human transforming growth factor b-induced (TGFBI) gene mutations in Chinese patients with corneal dystrophies (CDs). METHODS:Twenty-one families with corneal dystrophies were subjected to phenotypic and genotypic characterization. The corneal phenotypes of patients were documented by slit lamp photography. Mutation screening of the coding regions of TGFBI was performed by direct sequencing. An additional 43 families and 3 sporadic patients with TGFBI dystrophies from China reported in the literature were reviewed. RESULTS:Five mutations of TGFBI were identified in 21 families with CDs, including one novel small deletion mutation, c.delta1838-1849 (p.Delta613-616VAEP), responsible for one variant lattice CD (LCD) family and 4 known mutations, R555W mutation for 10 granular cornea dystrophy type I (GCD1) families, R124H for 5 GCD type II (GCD2), R124C for 4 LCD1, and H626R for one variant LCD. In a cohort of Chinese patients (n=355) with TGFBI dystrophies from 64 families and 3 sporadic cases, 19 distinct mutations were found in several different CD subtypes. The 3 most common phenotypes were ranked as follows: GCD1, GCD2, and LCD1. Mutation hot spots at R124 and R555 occurred in >80% of these families. CONCLUSIONS:Our findings extend the mutational spectrum of TFGBI, and this is also the first extensively delineated TGFBI mutation profile associated with the various corneal dystrophies in the Chinese population.