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Systemic Diagnostic Testing in Patients With Apparently Isolated Uveal Coloboma - 15/11/13

Doi : 10.1016/j.ajo.2013.06.037 
Nancy Huynh a, Delphine Blain a, Tanya Glaser a, E. Lauren Doss a, Wadih M. Zein a, David M. Lang b, Eva H. Baker c, Suvimol Hill c, Carmen C. Brewer d, Jeffrey B. Kopp e, Tanya M. Bardakjian f, Irene H. Maumenee g, Bronwyn J. Bateman h, Brian P. Brooks a,
a Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, Maryland 
b Pediatric Consult Service, Clinical Center, National Institutes of Health, Bethesda, Maryland 
c Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland 
d Otolaryngology Branch, National Institute on Deafness and other Communication Disorders, Bethesda, Maryland 
e Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland 
f Einstein Medical Center Philadelphia, Genetics Division, Philadelphia, Pennsylvania 
g Department of Ophthalmology, University of Illinois College of Medicine, Chicago, Illinois 
h Children's Hospital, Rocky Mountain Lions Eye Institute, University of Colorado School of Medicine, Aurora, Colorado 

Inquiries to Brian P. Brooks, National Eye Institute, National Institutes of Health, 10 Center Drive, Building 10, Room 10N226, MSC 1860, Bethesda, MD 20892

Abstract

Purpose

To investigate the frequency and types of systemic findings in patients with apparently isolated uveal coloboma.

Design

Cross-sectional observational study.

Methods

setting: Single-center ophthalmic genetics clinic. study population: Ninety-nine patients with uveal coloboma seen at the National Eye Institute. observational procedure: Results of audiology testing, echocardiogram, brain magnetic resonance imaging, renal ultrasound, and total spine radiographs. main outcome measure: Prevalence of abnormal findings on systemic testing.

Results

Uveal coloboma affected only the anterior segment in 8 patients, only the posterior segment in 23 patients, and both anterior and posterior segments in 68 patients. Best-corrected visual acuity (BCVA) of eyes with coloboma was ≥20/40 in 45% of eyes; 23% of eyes had BCVA of ≤20/400. The majority of patients (74%) had good vision (>20/60) in at least 1 eye. Ten of the 19 patients (53%) who underwent echocardiography had abnormalities, with ventral septal defects being the most prevalent. Abnormal findings were observed in 5 of 72 patients (7%) who had a renal ultrasound and in 5 of 29 patients (17%) who underwent a brain MRI. Audiology testing revealed abnormalities in 13 of 75 patients (17%), and spine radiographs showed anomalies in 10 of 77 patients (13%). Most findings required no acute intervention.

Conclusions

Although some patients with coloboma had evidence of extraocular abnormalities, the majority of findings on routine clinical examination did not require acute intervention, but some warranted follow-up. Results from the systemic evaluation of patients with coloboma should be interpreted with caution and in view of their clinical context.

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 Supplemental Material available at AJO.com.
 Bronwyn Bateman is currently affiliated with the Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, California.


© 2013  Pubblicato da Elsevier Masson SAS.
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Vol 156 - N° 6

P. 1159 - dicembre 2013 Ritorno al numero
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