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Keywords:

  • familial exudative vitreoretinopathy;
  • genetics;
  • pedigree;
  • retinal detachment;
  • Stickler

Abstract

Background:  To characterize the clinical and genetic abnormalities within two Australian pedigrees with high incidences of retinal detachment and visual disability.

Design:  Prospective review of two extended Australian pedigrees with high rates of retinal detachment.

Participants:  Twenty-two family members from two extended Australian pedigrees with high rates of retinal detachment were examined.

Methods:  A full ophthalmic history and examination were performed, and DNA was analysed by linkage analysis and mutation screening.

Main Outcome Measures:  Characterization of a causative hereditary gene mutation in each family.

Results:  All affected family members of one pedigree carried a C192A COL2A1 exon 2 mutation. None of the affected family members had early-onset arthritis, hearing abnormalities, abnormal clefting or facial features characteristic of classical Stickler syndrome. All affected members of the familial exudative vitreoretinopathy pedigree carried a 957delG FZD4 mutation.

Conclusions:  Patients with retinal detachment and a positive family history should be investigated for heritable conditions associated with retinal detachment such as Stickler syndrome and familial exudative vitreoretinopathy. The absence of non-ocular features of Stickler syndrome should raise the possibility of mutations in exon 2 of COL2A1. Similarly, late-onset familial exudative vitreoretinopathy may appear more like a rhegmatogenous detachment and not be correctly diagnosed. When a causative gene mutation is identified, cascade genetic screening of the family will facilitate genetic counselling and screening of high-risk relatives, allowing targeted management of the pre-detachment changes in affected patients.