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Autosomal recessive Stickler syndrome associated with homozygous mutations in the COL9A2 gene

Kjellström, Ulrika LU ; Martell, Susanne LU ; Brobeck, Cecilia LU and Andréasson, Sten LU (2021) In Ophthalmic Genetics 42(2). p.161-169
Abstract

Background: Stickler syndrome is a hereditary disorder of collagen tissues causing ocular, auditory, orofacial, and joint manifestations. Ocular findings typically include vitreous degeneration, high myopia, retinal detachment, and cataract. Many subjects demonstrate sensorineural or conductive hearing loss. The inheritance is autosomal dominant with mutations in COL2A1, COL11A1, or COL11A2 or autosomal recessive due to mutations in COL9A1, COL9A2, or COL9A3. We describe a family with Stickler syndrome caused by homozygous loss-of-function mutations in COL9A2. Methods: Two brothers from a consanguineous family were examined with genetic testing, visual acuity, Goldmann perimetry, full-field and multifocal electroretinography (ffERG,... (More)

Background: Stickler syndrome is a hereditary disorder of collagen tissues causing ocular, auditory, orofacial, and joint manifestations. Ocular findings typically include vitreous degeneration, high myopia, retinal detachment, and cataract. Many subjects demonstrate sensorineural or conductive hearing loss. The inheritance is autosomal dominant with mutations in COL2A1, COL11A1, or COL11A2 or autosomal recessive due to mutations in COL9A1, COL9A2, or COL9A3. We describe a family with Stickler syndrome caused by homozygous loss-of-function mutations in COL9A2. Methods: Two brothers from a consanguineous family were examined with genetic testing, visual acuity, Goldmann perimetry, full-field and multifocal electroretinography (ffERG, mERG), optical coherence tomography (OCT), fundus autofluorescence (FAF), fundus photography, and pure-tone audiograms. Results: Both subjects were homozygous for the mutation c.1332del in COL9A2. Their parents were heterozygous for the same mutation. The boys demonstrated reduced visual acuity, vitreous changes and myopia. The proband was operated for retinal detachment and cataract in one eye. FfERG revealed reduced function of both rods and cones and mERG showed reduced macular function. No morphological macular changes were found by OCT or FAF. Both brothers have severe sensorineural hearing loss with down-sloping audiograms but only subtle midface hypoplasia and no, or mild joint problems. Conclusion: Only a few families with Stickler syndrome caused by COL9A2 mutations have been reported. We confirm previous descriptions with a severe ocular and auditory phenotype but mild orofacial and joint manifestations. Moreover, we demonstrate reduced macular and overall retinal function explaining the reduced visual acuity in patients with Stickler syndrome also without retinal complications.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
autosomal recessive, COL9A2 mutation, full-field electroretinography, multifocal electroretinography, Stickler syndrome
in
Ophthalmic Genetics
volume
42
issue
2
pages
161 - 169
publisher
Taylor & Francis
external identifiers
  • pmid:33356723
  • scopus:85098510187
ISSN
1381-6810
DOI
10.1080/13816810.2020.1861309
language
English
LU publication?
yes
id
c20fa4fc-8768-423c-8344-d2bb7d3f0ab7
date added to LUP
2021-01-15 13:45:33
date last changed
2024-06-13 05:28:50
@article{c20fa4fc-8768-423c-8344-d2bb7d3f0ab7,
  abstract     = {{<p>Background: Stickler syndrome is a hereditary disorder of collagen tissues causing ocular, auditory, orofacial, and joint manifestations. Ocular findings typically include vitreous degeneration, high myopia, retinal detachment, and cataract. Many subjects demonstrate sensorineural or conductive hearing loss. The inheritance is autosomal dominant with mutations in COL2A1, COL11A1, or COL11A2 or autosomal recessive due to mutations in COL9A1, COL9A2, or COL9A3. We describe a family with Stickler syndrome caused by homozygous loss-of-function mutations in COL9A2. Methods: Two brothers from a consanguineous family were examined with genetic testing, visual acuity, Goldmann perimetry, full-field and multifocal electroretinography (ffERG, mERG), optical coherence tomography (OCT), fundus autofluorescence (FAF), fundus photography, and pure-tone audiograms. Results: Both subjects were homozygous for the mutation c.1332del in COL9A2. Their parents were heterozygous for the same mutation. The boys demonstrated reduced visual acuity, vitreous changes and myopia. The proband was operated for retinal detachment and cataract in one eye. FfERG revealed reduced function of both rods and cones and mERG showed reduced macular function. No morphological macular changes were found by OCT or FAF. Both brothers have severe sensorineural hearing loss with down-sloping audiograms but only subtle midface hypoplasia and no, or mild joint problems. Conclusion: Only a few families with Stickler syndrome caused by COL9A2 mutations have been reported. We confirm previous descriptions with a severe ocular and auditory phenotype but mild orofacial and joint manifestations. Moreover, we demonstrate reduced macular and overall retinal function explaining the reduced visual acuity in patients with Stickler syndrome also without retinal complications.</p>}},
  author       = {{Kjellström, Ulrika and Martell, Susanne and Brobeck, Cecilia and Andréasson, Sten}},
  issn         = {{1381-6810}},
  keywords     = {{autosomal recessive; COL9A2 mutation; full-field electroretinography; multifocal electroretinography; Stickler syndrome}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{161--169}},
  publisher    = {{Taylor & Francis}},
  series       = {{Ophthalmic Genetics}},
  title        = {{Autosomal recessive Stickler syndrome associated with homozygous mutations in the COL9A2 gene}},
  url          = {{http://dx.doi.org/10.1080/13816810.2020.1861309}},
  doi          = {{10.1080/13816810.2020.1861309}},
  volume       = {{42}},
  year         = {{2021}},
}