Genetic testing confirmed osteopetrosis with initial presentation of nystagmus

Osteopetrosis (OS) is a rare heritable disorder characterized by osteoclast dysfunction and increased bone density on radiography. Optic nerve osseous compression is the most frequent ocular complication of OS, with nystagmus, strabismus, ptosis, proptosis, and lagophthalmos occurring less frequentl...

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Main Authors: Kai-Yen Chiu, Yu-Yang Lin, Yao-Lin Liu, Ni-Chung Lee, Tzu-Hsun Tsai
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-04-01
Series:Taiwan Journal of Ophthalmology
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Online Access:https://journals.lww.com/10.4103/tjo.TJO-D-22-00152
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author Kai-Yen Chiu
Yu-Yang Lin
Yao-Lin Liu
Ni-Chung Lee
Tzu-Hsun Tsai
author_facet Kai-Yen Chiu
Yu-Yang Lin
Yao-Lin Liu
Ni-Chung Lee
Tzu-Hsun Tsai
author_sort Kai-Yen Chiu
collection DOAJ
description Osteopetrosis (OS) is a rare heritable disorder characterized by osteoclast dysfunction and increased bone density on radiography. Optic nerve osseous compression is the most frequent ocular complication of OS, with nystagmus, strabismus, ptosis, proptosis, and lagophthalmos occurring less frequently. However, it is uncommon for patients to have neurological or ocular symptoms at initial presentation. Herein, we present the case of a 3-year-old girl with the initial presentation of ocular symptoms who was confirmed to have OS through genetic testing. She was born full-term and found to have nystagmus since the age of 1 year. Her best-corrected visual acuity was 1.2/60 for both eyes. Exotropia of the left eye and bilateral small-amplitude pendular nystagmus were also noted. Color fundoscopy revealed a tessellated fundus and pale discs with cup-to-disc ratios of 0.5–0.6. Magnetic resonance imaging revealed bilateral optic canal stenosis and optic nerve atrophy. Whole-exome sequencing revealed a biallelic chloride voltage-gated channel 7 mutation, c.2297T > C (p.Leu766Pro) and c.1577G > A (p.Arg526Gln), and autosomal recessive OS was diagnosed. The patient is currently being evaluated for possible hematopoietic stem cell transplantation. We suggest that OS should be considered a differential diagnosis for unexplained nystagmus and optic nerve atrophy.
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2211-5072
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spelling doaj-art-c9823637db2e499f9dba2af8d953ca222025-08-20T01:48:04ZengWolters Kluwer Medknow PublicationsTaiwan Journal of Ophthalmology2211-50562211-50722023-04-0114343744010.4103/tjo.TJO-D-22-00152Genetic testing confirmed osteopetrosis with initial presentation of nystagmusKai-Yen ChiuYu-Yang LinYao-Lin LiuNi-Chung LeeTzu-Hsun TsaiOsteopetrosis (OS) is a rare heritable disorder characterized by osteoclast dysfunction and increased bone density on radiography. Optic nerve osseous compression is the most frequent ocular complication of OS, with nystagmus, strabismus, ptosis, proptosis, and lagophthalmos occurring less frequently. However, it is uncommon for patients to have neurological or ocular symptoms at initial presentation. Herein, we present the case of a 3-year-old girl with the initial presentation of ocular symptoms who was confirmed to have OS through genetic testing. She was born full-term and found to have nystagmus since the age of 1 year. Her best-corrected visual acuity was 1.2/60 for both eyes. Exotropia of the left eye and bilateral small-amplitude pendular nystagmus were also noted. Color fundoscopy revealed a tessellated fundus and pale discs with cup-to-disc ratios of 0.5–0.6. Magnetic resonance imaging revealed bilateral optic canal stenosis and optic nerve atrophy. Whole-exome sequencing revealed a biallelic chloride voltage-gated channel 7 mutation, c.2297T > C (p.Leu766Pro) and c.1577G > A (p.Arg526Gln), and autosomal recessive OS was diagnosed. The patient is currently being evaluated for possible hematopoietic stem cell transplantation. We suggest that OS should be considered a differential diagnosis for unexplained nystagmus and optic nerve atrophy.https://journals.lww.com/10.4103/tjo.TJO-D-22-00152nystagmusoptic nerve atrophyosteopetrosis
spellingShingle Kai-Yen Chiu
Yu-Yang Lin
Yao-Lin Liu
Ni-Chung Lee
Tzu-Hsun Tsai
Genetic testing confirmed osteopetrosis with initial presentation of nystagmus
Taiwan Journal of Ophthalmology
nystagmus
optic nerve atrophy
osteopetrosis
title Genetic testing confirmed osteopetrosis with initial presentation of nystagmus
title_full Genetic testing confirmed osteopetrosis with initial presentation of nystagmus
title_fullStr Genetic testing confirmed osteopetrosis with initial presentation of nystagmus
title_full_unstemmed Genetic testing confirmed osteopetrosis with initial presentation of nystagmus
title_short Genetic testing confirmed osteopetrosis with initial presentation of nystagmus
title_sort genetic testing confirmed osteopetrosis with initial presentation of nystagmus
topic nystagmus
optic nerve atrophy
osteopetrosis
url https://journals.lww.com/10.4103/tjo.TJO-D-22-00152
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AT nichunglee genetictestingconfirmedosteopetrosiswithinitialpresentationofnystagmus
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