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Corneal Dystrophy, Posterior Polymorphous 2

OMIM ID:

autosomal dominant

Corneal Dystrophy, Posterior Polymorphous 2

Alternate Names

PPCD2

Defective Genes

COL8A2

Clinical Characteristics

Ocular Features

This is primarily a disease of the posterior cornea although the secondary edema may extend to the epithelium.  The disease may be apparent at birth or shortly thereafter by the presence of excrescences or nodules in the endothelial layer with stromal edema.  Descemet membrane can be highly irregular in thickness.  The endothelial cells in PPCD may acquire some characteristics of epithelial cells.

Systemic Features

No systemic abnormalities have been reported for PPCD2.

Genetics

Inheritance

This is a rare autosomal dominant disorder and few families have been reported.  The mutant gene, COL8A2 (1p34.3-p32.3) is the same as that causing early onset Fuchs endothelial dystrophy (136800) and both dystrophies have been described in the same family.   The mutation alters the synthesis of alpha 2 chains, part of type VIII collagen, a major component of the Descemet membrance.

For other forms of posterior polymorphous corneal dystrophy, see PPCD3 (609141), and PPPCD1 (122000).

Pedigree

Autosomal dominant

Autosomal dominant disorders require only one mutation for the disease to be expressed.  Since an affected parent has two chromosomes, only one of which has the mutant gene, parents can expect that half (50%) of their children will receive that one and inherit the disease.  It is common for individuals that inherit the mutation, however, to not have evidence of the disease (nonpenetrance).

Image
Sample pedigree of autosomal dominant inheritance

Autosomal dominant inheritance leads to a vertical pattern of transmission

Treatment & Management

Corneal transplantation may be indicated by the third decade or later.  The corneal lesions tend to recur, however.

Selected Resources

Publications

Displaying 1 - 1 of 1

Missense mutations in COL8A2, the gene encoding the alpha2 chain of type VIII collagen, cause two forms of corneal endothelial dystrophy

PubMedID: 11689488