scholarly journals Multiple Vitelliform Lesions as a Retinal Manifestation of Alport Syndrome

2020 ◽  
Vol 11 (1) ◽  
pp. 79-84
Author(s):  
Kathrine O. Eriksen ◽  
Øystein Kalsnes Jørstad
Keyword(s):  
Case Report ◽  
Alport Syndrome ◽  
Bruch's Membrane ◽  
Bruch’S Membrane ◽  
Phenotypic Features ◽  
Underlying Pathophysiology ◽  
Fundoscopic Examination ◽  
Anterior Lenticonus

Alport syndrome is associated with various ocular phenotypic features, including several retinal manifestations. The purpose of this case report was to describe a case of multiple vitelliform lesions in Alport syndrome. This particular finding has, to our knowledge, not been reported previously. A 63-year-old man with known Alport syndrome presented with symptomatic, bilateral anterior lenticonus. Fundoscopic examination revealed multiple vitelliform lesions, which were symmetrically distributed at the posterior poles. Additional retinal findings included an irregular foveal contour and central macular thinning in both eyes, as well as a multilayered retinoschisis in the left eye. The underlying pathophysiology of the vitelliform lesions may be a dysfunctional Bruch’s membrane.

Bull’s eye and pigment maculopathy are further retinal manifestations of an abnormal Bruch’s membrane in Alport syndrome

2016 ◽  
Vol 38 (3) ◽  
pp. 238-244 ◽  
Author(s):  
Judy Savige ◽  
Yanyan Wang ◽  
Andrew Crawford ◽  
James Smith ◽  
Andrew Symons ◽  
...  
Keyword(s):  
Alport Syndrome ◽  
Bruch's Membrane ◽  
Bruch’S Membrane ◽  
Bull's Eye

Corneal cross-linking for treatment of progressive keratoconus in a patient with Alport syndrome: A case report

2021 ◽  
pp. 112067212199767
Author(s):  
Iva Krolo ◽  
Aida Kasumović ◽  
Ivana Radman ◽  
Pavao Pavić
Keyword(s):  
Case Report ◽  
Alport Syndrome ◽  
Contact Lenses ◽  
Corneal Dystrophy ◽  
Clinical Findings ◽  
Cross Linking ◽  
Posterior Polymorphous Corneal Dystrophy ◽  
One Year ◽  
Corneal Tomography

Purpose: Ocular features of Alport syndrome include anterior lenticonus, posterior polymorphous corneal dystrophy, and fleck-and-dot retinopathy in most cases. Keratoconus in such patients has been rarely mentioned in previous studies. To our knowledge, this is the first report of corneal cross-linking for halting the progression of keratoconus in a patient with Alport syndrome. Case report: A 22-year-old male was referred for his initial corneal topography, after he was already prescribed with rigid gas-permeable contact lenses. Alport syndrome was diagnosed in his infancy and gene COL4A5 mutation was confirmed. Ophthalmological evaluation confirmed keratoconus. One-year follow-up showed a progression on his right eye and standard corneal cross-linking was performed. Stabilization of the disease marked by normalization in visual function and corneal tomography values was noticed 1 year after the procedure. Conclusions: When diagnosing ocular clinical findings of Alport syndrome, keratoconus should be considered. Standard corneal cross-linking protocol can halt its progression.

scholarly journals FHL-1 interacts with human RPE cells through the α5β1 integrin and confers protection against oxidative stress

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rawshan Choudhury ◽  
Nadhim Bayatti ◽  
Richard Scharff ◽  
Ewa Szula ◽  
Viranga Tilakaratna ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Cell Fate ◽  
Retinal Pigment ◽  
Factor H ◽  
Age Related Macular Degeneration ◽  
Bruch's Membrane ◽  
Bruch’S Membrane ◽  
Rpe Cells ◽  
Age Related

AbstractRetinal pigment epithelial (RPE) cells that underlie the neurosensory retina are essential for the maintenance of photoreceptor cells and hence vision. Interactions between the RPE and their basement membrane, i.e. the inner layer of Bruch’s membrane, are essential for RPE cell health and function, but the signals induced by Bruch’s membrane engagement, and their contributions to RPE cell fate determination remain poorly defined. Here, we studied the functional role of the soluble complement regulator and component of Bruch’s membrane, Factor H-like protein 1 (FHL-1). Human primary RPE cells adhered to FHL-1 in a manner that was eliminated by either mutagenesis of the integrin-binding RGD motif in FHL-1 or by using competing antibodies directed against the α5 and β1 integrin subunits. These short-term experiments reveal an immediate protein-integrin interaction that were obtained from primary RPE cells and replicated using the hTERT-RPE1 cell line. Separate, longer term experiments utilising RNAseq analysis of hTERT-RPE1 cells bound to FHL-1, showed an increased expression of the heat-shock protein genes HSPA6, CRYAB, HSPA1A and HSPA1B when compared to cells bound to fibronectin (FN) or laminin (LA). Pathway analysis implicated changes in EIF2 signalling, the unfolded protein response, and mineralocorticoid receptor signalling as putative pathways. Subsequent cell survival assays using H2O2 to induce oxidative stress-induced cell death suggest hTERT-RPE1 cells had significantly greater protection when bound to FHL-1 or LA compared to plastic or FN. These data show a non-canonical role of FHL-1 in protecting RPE cells against oxidative stress and identifies a novel interaction that has implications for ocular diseases such as age-related macular degeneration.

Neuropsychiatric Derangement by Polycythemia Vera: A Case Report of an Unexpected Disease Presentation and Review of the Literature

2021 ◽  
pp. 1-6
Author(s):  
Heleen De Lil ◽  
Michelle van Beek ◽  
Alexandra Herbers ◽  
Ellen van der Holst ◽  
Karen Keijsers
Keyword(s):  
Case Report ◽  
Chronic Disease ◽  
Cerebral Infarction ◽  
Polycythemia Vera ◽  
Neuropsychiatric Symptoms ◽  
Unusual Presentation ◽  
Review Of The Literature ◽  
Remarkable Recovery ◽  
Visual Complaints ◽  
Underlying Pathophysiology

Cerebral infarction as well as other thromboses, headaches, and visual complaints are well-known symptoms of polycythemia vera. However, chorea and neuropsychiatric disturbances are less recognized consequences of this chronic disease. Whereas chorea is a rare but acknowledged symptom of polycythemia vera, neuropsychiatric symptoms have only sporadically been reported. We depict 2 patients with an unusual presentation of polycythemia vera. Our first patient presented with right-sided hemiballism and psychosis, and the second patient had a long diagnostic trajectory of unexplained chorea. In both cases diagnosis of JAK2 positive polycythemia vera was established, and in both cases remarkable recovery occurred after the initiation of phlebotomies. The underlying pathophysiology of these symptoms has not been clearly elucidated. Because of the unfamiliarity of the link between especially neuropsychiatric symptoms and polycythemia, current reported numbers are probably an underestimation. Benefit of treatment appears to be large. We seek to create more awareness among physicians about this phenomenon.

Comparative histogenesis of Bruch's membrane (complexus basalis)

1991 ◽  
Vol 53 (1) ◽  
pp. 47-54 ◽  
Author(s):  
Jack V. Greiner ◽  
Thomas A. Weidman
Keyword(s):  
Bruch's Membrane ◽  
Bruch’S Membrane
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