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Recognizable Patterns of Submacular Fibrosis in Enhanced S-Cone Syndrome

Alsalamah, Abrar K. ; Khan, Arif O. ; Bakar, Abdullah Abu ; Schatz, Patrik LU orcid and Nowilaty, Sawsan R. (2021) In Ophthalmology Retina 5(9). p.918-927
Abstract

Purpose: To highlight recognizable patterns of subretinal fibrosis in enhanced S-cone syndrome (ESCS). Design: Retrospective case series. Participants: Forty-seven patients with subretinal fibrosis identified from 101 patients with clinically diagnosed ESCS, confirmed by full-field electroretinography (35/47), genetic testing (34/47), or both. Methods: Multimodal retinal imaging, electroretinography, and genetic analysis. Main Outcome Measures: Patterns of subretinal fibrosis with angiographic, OCT, and genetic correlations. Results: Eighty-five eyes of 47 patients (24 male patients; 36 unrelated consanguineous families) had subretinal fibrosis. Mean age at presentation was 14 years. Best-corrected visual acuity ranged from 20/20 to... (More)

Purpose: To highlight recognizable patterns of subretinal fibrosis in enhanced S-cone syndrome (ESCS). Design: Retrospective case series. Participants: Forty-seven patients with subretinal fibrosis identified from 101 patients with clinically diagnosed ESCS, confirmed by full-field electroretinography (35/47), genetic testing (34/47), or both. Methods: Multimodal retinal imaging, electroretinography, and genetic analysis. Main Outcome Measures: Patterns of subretinal fibrosis with angiographic, OCT, and genetic correlations. Results: Eighty-five eyes of 47 patients (24 male patients; 36 unrelated consanguineous families) had subretinal fibrosis. Mean age at presentation was 14 years. Best-corrected visual acuity ranged from 20/20 to hand movements. All 34 genetically tested patients were homozygous for pathogenic NR2E3 variants. Subretinal fibrosis was always in the macular area, although it extended beyond in some patients. Six recurrent patterns of submacular fibrosis were noted: central unifocal nodular, circumferential unifocal nodular, multifocal nodular, arcuate, helicoid, and thick geographic. Some patients showed a combination of patterns. Previous misdiagnosis as inflammatory disease was common. Fibrosis was fairly symmetrical in a given patient but not always present or identical in other affected individuals with a given homozygous mutation from the same or other families. Conclusions: These recognizable patterns of submacular fibrosis are part of the ESCS phenotypic spectrum and strongly suggest the disease. In addition to facilitating diagnosis, recognition of these patterns can spare patients unnecessary workup for an inflammatory cause.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Autosomal recessive NR2E3, Enhanced S-cone syndrome, Goldmann-Favre syndrome, Subretinal fibrosis
in
Ophthalmology Retina
volume
5
issue
9
pages
10 pages
publisher
Elsevier
external identifiers
  • scopus:85110359027
  • pmid:33819700
ISSN
2468-6530
DOI
10.1016/j.oret.2021.03.014
language
English
LU publication?
yes
id
a16e4008-f7ec-491d-bc43-732c593b8eb5
date added to LUP
2021-09-07 13:25:58
date last changed
2024-06-15 15:52:54
@article{a16e4008-f7ec-491d-bc43-732c593b8eb5,
  abstract     = {{<p>Purpose: To highlight recognizable patterns of subretinal fibrosis in enhanced S-cone syndrome (ESCS). Design: Retrospective case series. Participants: Forty-seven patients with subretinal fibrosis identified from 101 patients with clinically diagnosed ESCS, confirmed by full-field electroretinography (35/47), genetic testing (34/47), or both. Methods: Multimodal retinal imaging, electroretinography, and genetic analysis. Main Outcome Measures: Patterns of subretinal fibrosis with angiographic, OCT, and genetic correlations. Results: Eighty-five eyes of 47 patients (24 male patients; 36 unrelated consanguineous families) had subretinal fibrosis. Mean age at presentation was 14 years. Best-corrected visual acuity ranged from 20/20 to hand movements. All 34 genetically tested patients were homozygous for pathogenic NR2E3 variants. Subretinal fibrosis was always in the macular area, although it extended beyond in some patients. Six recurrent patterns of submacular fibrosis were noted: central unifocal nodular, circumferential unifocal nodular, multifocal nodular, arcuate, helicoid, and thick geographic. Some patients showed a combination of patterns. Previous misdiagnosis as inflammatory disease was common. Fibrosis was fairly symmetrical in a given patient but not always present or identical in other affected individuals with a given homozygous mutation from the same or other families. Conclusions: These recognizable patterns of submacular fibrosis are part of the ESCS phenotypic spectrum and strongly suggest the disease. In addition to facilitating diagnosis, recognition of these patterns can spare patients unnecessary workup for an inflammatory cause.</p>}},
  author       = {{Alsalamah, Abrar K. and Khan, Arif O. and Bakar, Abdullah Abu and Schatz, Patrik and Nowilaty, Sawsan R.}},
  issn         = {{2468-6530}},
  keywords     = {{Autosomal recessive NR2E3; Enhanced S-cone syndrome; Goldmann-Favre syndrome; Subretinal fibrosis}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{9}},
  pages        = {{918--927}},
  publisher    = {{Elsevier}},
  series       = {{Ophthalmology Retina}},
  title        = {{Recognizable Patterns of Submacular Fibrosis in Enhanced S-Cone Syndrome}},
  url          = {{http://dx.doi.org/10.1016/j.oret.2021.03.014}},
  doi          = {{10.1016/j.oret.2021.03.014}},
  volume       = {{5}},
  year         = {{2021}},
}