Early vitrectomy effective for Norrie disease

Arch Ophthalmol. 2010 Apr;128(4):456-60. doi: 10.1001/archophthalmol.2009.403.

Abstract

Objective: To review our experience with Norrie disease to determine if early vitrectomy abrogates the natural history of this rare disease; namely, bilateral no light perception visual acuity and phthisis bulbi.

Methods: We retrospectively reviewed the medical records of all patients seen in our tertiary care pediatric retinal clinical practice from 1988 through 2008 with a potential diagnosis of Norrie disease. Inclusion required not only clinical findings consistent with Norrie disease but also genetics and/or a family history consistent with Norrie disease.

Results: Medical record review revealed 14 boys with clinically diagnosed Norrie disease and either Norrie disease gene (NDP) mutations noted on genetic testing (13 patients) and/or a clear family history consistent with Norrie disease (4 patients). All 14 boys with definite Norrie disease had vitrectomy with or without lensectomy in at least 1 eye prior to 12 months of age. Of the 14 boys with definite Norrie disease, 7 maintained at least light perception visual acuity in 1 eye and 3 had no light perception visual acuity bilaterally; visual acuity data were not available for 4 patients. Only 2 of 24 (8%) eyes became phthisical.

Conclusions: Historically, no treatment has been offered to mitigate the dismal natural history of Norrie disease. We recommend consideration of early vitrectomy in Norrie disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blindness / genetics
  • Blindness / physiopathology
  • Child, Preschool
  • Eye Proteins / genetics
  • Female
  • Functional Laterality
  • Genetic Diseases, X-Linked / genetics
  • Genetic Diseases, X-Linked / physiopathology
  • Genetic Diseases, X-Linked / surgery*
  • Hearing Loss / genetics
  • Hearing Loss / physiopathology
  • Humans
  • Infant
  • Intellectual Disability / genetics
  • Intellectual Disability / physiopathology
  • Lens, Crystalline / surgery
  • Male
  • Nerve Tissue Proteins / genetics
  • Retinal Dysplasia / genetics
  • Retinal Dysplasia / physiopathology
  • Retinal Dysplasia / surgery*
  • Retrospective Studies
  • Treatment Outcome
  • Visual Acuity / physiology
  • Vitrectomy*

Substances

  • Eye Proteins
  • NDP protein, human
  • Nerve Tissue Proteins