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Corneal Dystrophy, Posterior Polymorphous 3

OMIM ID:

autosomal dominant

Corneal Dystrophy, Posterior Polymorphous 3

Alternate Names

PPCD3

Defective Genes

ZEB1

Clinical Characteristics

Ocular Features

This is a genetically and clinically heterogeneous type of corneal dystrophy.  Endothelial metaplasia seems to play a role as these cells acquire some characteristics of epithelial cells.  The posterior cornea has guttae and lesions of various sizes surrounded by a grayish halo.  These may become confluent and lead to stromal edema extending into the epithelium.  The thickness of the Descemet membrane is highly variable and a retrocorneal membrane may be present.  Onset is variable as some infants will have corneal edema whereas many, if not most, adults are asymptomatic.  The condition in severely affected children may resemble congenital hereditary corneal dystrophy.

Systemic Features

No consistent systemic abnormalities have been reported.  However, some patients have been reported with inguinal hernias, hydroceles, and possible bone abnormalities suggesting that the ZEB1 mutation may have extraocular effects as well.

Genetics

Inheritance

This is an autosomal dominant disorder caused by a mutation in the ZEB1 gene (10p11.2).  Mutations in the same gene have recently been found in some cases with late-onset Fuchs endothelial dystrophy.

For other forms of posterior polymorphous dystrophy see PPCD1 (122000) and PPCD2 (609140).

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

Most patients do well and require no treatment.  Corneal transplantation may be required for the more severe cases but, as in many dystrophies, the lesions tend to recur in the graft.

Selected Resources

Publications

Displaying 1 - 3 of 3

A locus for posterior polymorphous corneal dystrophy (PPCD3) maps to chromosome 10

PubMedID: 15384081

Missense Mutations in TCF8 Cause Late-Onset Fuchs Corneal Dystrophy and Interact with FCD4 on Chromosome 9p

PubMedID: 20036349

Mutations in TCF8 cause posterior polymorphous corneal dystrophy and ectopic expression of COL4A3 by corneal endothelial cells

PubMedID: 165384081