Reliability of clinical impressions and optimal genetic diagnostic strategies of heritable connective tissue disorders with ocular involvement in a large Chinese cohort

Abstract Purpose This study aimed to elucidate the reliability of clinical impressions based on ocular manifestations in patients suspected of heritable connective tissue disorders (HCTDs) compared to the final genetic diagnosis. Furthermore, it sought to determine the optimal diagnostic strategy fo...

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Main Authors: Qin-Meng Shu, Yu-Qiao Ju, Yuan Zong, Ting Zhang, Xin Huang, Feng-juan Gao, Qing Chang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Human Genomics
Subjects:
Online Access:https://doi.org/10.1186/s40246-025-00749-2
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author Qin-Meng Shu
Yu-Qiao Ju
Yuan Zong
Ting Zhang
Xin Huang
Feng-juan Gao
Qing Chang
author_facet Qin-Meng Shu
Yu-Qiao Ju
Yuan Zong
Ting Zhang
Xin Huang
Feng-juan Gao
Qing Chang
author_sort Qin-Meng Shu
collection DOAJ
description Abstract Purpose This study aimed to elucidate the reliability of clinical impressions based on ocular manifestations in patients suspected of heritable connective tissue disorders (HCTDs) compared to the final genetic diagnosis. Furthermore, it sought to determine the optimal diagnostic strategy for patients with HCTDs through pathogenicity analysis. Methods Clinical characteristics of 58 patients suspected of HCTDs were analyzed to establish provisional clinical diagnoses. Subsequently, next-generation sequence and Sanger sequence was performed to obtain genetic diagnoses. Pathogenicity of identified variants was assessed through conservation analysis and the functional impact, which was predicted using three-dimensional protein structure modeling. Results The provisional clinical diagnosis was concordant with the molecular diagnostic result in only 21 patients. Independent of the initial clinical impression, a probable genetic diagnosis was achieved for all 58 patients following comprehensive re-analysis of next-generation sequence data, combined with pathogenicity assessment using three-dimensional protein structure and conservation analysis of suspicious positive variants. Conclusion This study broadens the mutational spectrum of HCTDs with 31 novel variants. By employing innovative methodologies to delineate phenotype–genotype relationships, including the detection of potentially pathogenic variants, this work may inform future diagnostic strategies and guide comprehensive disease and organ system monitoring. Ongoing refinement and vigilant clinical oversight remain essential for patients and their families.
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spelling doaj-art-9b7e5a3891ee44f282220fa15de9d28f2025-08-20T02:17:10ZengBMCHuman Genomics1479-73642025-04-0119111810.1186/s40246-025-00749-2Reliability of clinical impressions and optimal genetic diagnostic strategies of heritable connective tissue disorders with ocular involvement in a large Chinese cohortQin-Meng Shu0Yu-Qiao Ju1Yuan Zong2Ting Zhang3Xin Huang4Feng-juan Gao5Qing Chang6Eye Institute, Department of Ophthalmology, Eye & ENT Hospital, Fudan UniversityEye Institute, Department of Ophthalmology, Eye & ENT Hospital, Fudan UniversityEye Institute, Department of Ophthalmology, Eye & ENT Hospital, Fudan UniversityEye Institute, Department of Ophthalmology, Eye & ENT Hospital, Fudan UniversityEye Institute, Department of Ophthalmology, Eye & ENT Hospital, Fudan UniversityEye Institute, Department of Ophthalmology, Eye & ENT Hospital, Fudan UniversityEye Institute, Department of Ophthalmology, Eye & ENT Hospital, Fudan UniversityAbstract Purpose This study aimed to elucidate the reliability of clinical impressions based on ocular manifestations in patients suspected of heritable connective tissue disorders (HCTDs) compared to the final genetic diagnosis. Furthermore, it sought to determine the optimal diagnostic strategy for patients with HCTDs through pathogenicity analysis. Methods Clinical characteristics of 58 patients suspected of HCTDs were analyzed to establish provisional clinical diagnoses. Subsequently, next-generation sequence and Sanger sequence was performed to obtain genetic diagnoses. Pathogenicity of identified variants was assessed through conservation analysis and the functional impact, which was predicted using three-dimensional protein structure modeling. Results The provisional clinical diagnosis was concordant with the molecular diagnostic result in only 21 patients. Independent of the initial clinical impression, a probable genetic diagnosis was achieved for all 58 patients following comprehensive re-analysis of next-generation sequence data, combined with pathogenicity assessment using three-dimensional protein structure and conservation analysis of suspicious positive variants. Conclusion This study broadens the mutational spectrum of HCTDs with 31 novel variants. By employing innovative methodologies to delineate phenotype–genotype relationships, including the detection of potentially pathogenic variants, this work may inform future diagnostic strategies and guide comprehensive disease and organ system monitoring. Ongoing refinement and vigilant clinical oversight remain essential for patients and their families.https://doi.org/10.1186/s40246-025-00749-2Heritable connective tissue disordersGenetic diagnosisStickler syndromeKnobloch syndromeWagner syndromeSevere myopia
spellingShingle Qin-Meng Shu
Yu-Qiao Ju
Yuan Zong
Ting Zhang
Xin Huang
Feng-juan Gao
Qing Chang
Reliability of clinical impressions and optimal genetic diagnostic strategies of heritable connective tissue disorders with ocular involvement in a large Chinese cohort
Human Genomics
Heritable connective tissue disorders
Genetic diagnosis
Stickler syndrome
Knobloch syndrome
Wagner syndrome
Severe myopia
title Reliability of clinical impressions and optimal genetic diagnostic strategies of heritable connective tissue disorders with ocular involvement in a large Chinese cohort
title_full Reliability of clinical impressions and optimal genetic diagnostic strategies of heritable connective tissue disorders with ocular involvement in a large Chinese cohort
title_fullStr Reliability of clinical impressions and optimal genetic diagnostic strategies of heritable connective tissue disorders with ocular involvement in a large Chinese cohort
title_full_unstemmed Reliability of clinical impressions and optimal genetic diagnostic strategies of heritable connective tissue disorders with ocular involvement in a large Chinese cohort
title_short Reliability of clinical impressions and optimal genetic diagnostic strategies of heritable connective tissue disorders with ocular involvement in a large Chinese cohort
title_sort reliability of clinical impressions and optimal genetic diagnostic strategies of heritable connective tissue disorders with ocular involvement in a large chinese cohort
topic Heritable connective tissue disorders
Genetic diagnosis
Stickler syndrome
Knobloch syndrome
Wagner syndrome
Severe myopia
url https://doi.org/10.1186/s40246-025-00749-2
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