Laser photocoagulation at birth prevents blindness in Norrie's disease diagnosed using amniocentesis.

Abstract

OBJECTIVE:

To report the first case of prophylactic laser treatment to prevent blindness in a patient who was diagnosed with Norrie's disease by genetic testing with amniocentesis.

DESIGN:

Case report.

PARTICIPANTS:

A 2-year-old white boy with Norrie's disease.

METHODS:

A 37-week gestational age male with a family history of Norrie's disease was born via Cesarean section after the mother had undergone prenatal amniocentesis fetal-genetic testing at 23 weeks of gestation. A C520T (nonsense) mutation was found in the Norrie's disease gene. After examination under anesthesia confirmed the diagnosis on the first day of life, laser photocoagulation was applied to the avascular retina bilaterally. The patient was followed closely by ophthalmology, pediatrics, and occupational therapy departments.

MAIN OUTCOME MEASURES:

Functional outcome, as documented by Teller visual acuity and formal occupational therapy testing, and anatomic outcome, as documented by Retcam photography and fluorescein angiography.

RESULTS:

Complete regression of extraretinal fibrovascular proliferation was observed 1 month after laser treatment. No retinal detachment had occurred to date at 24 months. Teller visual acuity at 23 months of life was 20/100 in both eyes. The patient's vision and developmental milestones were age appropriate.

CONCLUSIONS:

Pre-term genetic diagnosis with immediate laser treatment after birth may preserve vision in individuals affected with Norrie's disease.

• Authors: Clement C Chow, Daniel F Kiernan, Felix Y Chau, Michael P Blair, Benjamin H Ticho, John M Galasso, Michael J Shapiro
• Journal: Ophthalmology (Ophthalmology) Vol. 117 Issue 12 Pg. 2402-6 (Dec 2010) ISSN: 1549-4713 [Electronic] United States
• PMID: 20619898 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Chemical References

• Codon, Nonsense

Topics

• Amniocentesis
• Blindness (congenital, diagnosis, genetics, physiopathology, prevention & control, surgery)
• Codon, Nonsense
• Eye (growth & development)
• Fluorescein Angiography
• Follow-Up Studies
• Genetic Diseases, X-Linked
• Gestational Age
• Humans
• Infant, Newborn
• Laser Coagulation
• Male
• Nervous System Diseases (diagnosis, genetics, physiopathology, surgery)
• Retinal Degeneration
• Retinal Detachment (prevention & control)
• Retinal Dysplasia (diagnosis, genetics, physiopathology, surgery)
• Spasms, Infantile (diagnosis, genetics, physiopathology, surgery)
• Vision, Ocular (physiology)
• Visual Acuity (physiology)