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Ophthalmic Genet. 2017 Sep-Oct;38(5):440-445. doi: 10.1080/13816810.2016.1257029. Epub 2017 Jan 23.

Spectral-domain optical coherence tomography findings in Alström syndrome.

Author information

1
a Ophthalmology Department, Tel Aviv Medical Center, Sackler School of Medicine , Tel Aviv University , Tel Aviv , Israel.
2
b Pediatric Ophthalmology and Ocular Genetics, Wills Eye Hospital , Philadelphia , Pennsylvania , USA.
3
c Department of Vitreoretina and Ocular Oncology , Sankara Nethralaya , Chennai , India.
4
d The Jackson Laboratory , Bar Harbor , Maine , USA.
5
e Diagnostic Center, Wills Eye Hosptial , Philadelphia , Pennsylvania , USA.
6
f Bioptigen, Inc., Research Triangle Park , North Carolina , USA.
7
g Sidney Kimmel Medical College of Thomas Jefferson University , Philadelphia , Pennsylvania , USA.

Abstract

BACKGROUND:

Alström syndrome is a multi-system recessive disorder caused by mutations in ALMS1 gene. The aim of this study was to characterize morphological retinal changes in Alström patients using spectral-domain optical coherence tomography.

METHODS:

We studied volunteer patients attending the conference of Alström Syndrome International, a support group for affected families, using hand-held spectral-domain optical coherence tomography (SD-OCT) in an office setting. Patients had a clinical dilated retinal examination. Past medical records were reviewed.

RESULTS:

Twenty-two Alström patients (mean age 17 years, range 2-38 years, 12 males) were studied. OCT imaging demonstrated that central macular OCT changes are often mild during the first decade of life and gradually progress, demonstrating disruption of normal retinal architecture, and progressive loss of photoreceptors and retinal pigment epithelium. Other changes found included hyperreflectivities in all retinal layers, severe retinal wrinkling, optic nerve drusen, and vitreoretinal separation. Vision correlated with severity of OCT macular changes (r = 0.89, p = 0.002).

CONCLUSIONS:

This study reports on OCT findings in a large group of patients with Alström syndrome. We document a panretinal gradual progression of retinal changes, which are often mild during the first years of life. Previously unreported observations include intraretinal opacities, optic nerve drusen, and foveal contour abnormalities. Morphological retinal changes demonstrated by SD-OCT may help in understanding the pathophysiology of the disease and defining strategies for treatment such as gene therapy.

KEYWORDS:

Alström syndrome; ocular genetics; optical coherence tomography

PMID:
28112973
PMCID:
PMC5557692
DOI:
10.1080/13816810.2016.1257029
[Indexed for MEDLINE]
Free PMC Article

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