1. First reported case of Doyne honeycomb retinal dystrophy (Malattia Leventinese/autosomal dominant drusen) in Scandinavia
- Author
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Henrik Okkels, Ihab Bishara Yousef Lolas, Ligor Pradeep Kiruparajan, Michael B. Petersen, Søren Kromann Opstrup Abildgaard, and Inger Norlyk Sheyanth
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Retinal Disorder ,genetic structures ,Mutation, Missense ,Scandinavian and Nordic Countries ,030105 genetics & heredity ,Drusen ,QH426-470 ,Retina ,Clinical Reports ,03 medical and health sciences ,Ophthalmology ,medicine ,Genetics ,Humans ,Metamorphopsia ,Molecular Biology ,Genetics (clinical) ,Exome sequencing ,Extracellular Matrix Proteins ,Clinical Report ,EFEMP1 ,Optic Disk Drusen ,business.industry ,Macular hyperpigmentation ,Malattia leventinese ,Middle Aged ,medicine.disease ,eye diseases ,030104 developmental biology ,medicine.anatomical_structure ,Choroidal neovascularization ,Doyne honeycomb retinal dystrophy ,Female ,sense organs ,medicine.symptom ,business ,Optic disc - Abstract
Background Doyne honeycomb retinal dystrophy (DHRD)/malattia leventinese (ML) is an autosomal dominant, progressive retinal disorder characterized by massive central retinal drusen often partly coalescent forming a characteristic honeycomb‐like pattern. Debut of vision loss often occurs in early to mid‐adulthood, and the degree varies. A single variant in EFEMP1: c.1033C>T (R345W) has been identified as the cause in all cases. Methods Following DNA isolation, exome sequencing was performed in seven genes associated with flecked retina. Direct sequencing was used for variant verification. Results We report the first Scandinavian case of molecular genetically verified DHRD/ML: a 57‐year‐old woman debuting with vision loss and metamorphopsia. On both eyes, ophthalmological findings included massive hard drusen in the macular region and nasal to the optic disc as well as macular hyperpigmentation. Secondary choroidal neovascularizations were identified on both eyes, and anti‐vascular endothelial growth factor was administered, without effect. Conclusion Molecular genetic investigation revealed heterozygosity for the known pathogenic missense variant in EFEMP1: c.1033C>T (R345W) previously reported in relation to DHRD/ML. Family history revealed no other cases of similar visual impairment suggesting a de novo mutation. Furthermore, there was no correlation between the unique DHRD/ML haplotypes reported in the literature and our patient., To the best of our knowledge, this case represents the first molecular genetically verified case of DHRD/ML in Scandinavia. A haplotype comparison to the originally described Swiss R345W haplotype suggest a de novo mutation in our index.
- Published
- 2021
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