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EDICT Syndrome

OMIM ID:

autosomal dominant

EDICT Syndrome

Alternate Names

KTCNCT
keratoconus with cataract
familial keratoconus with early-onset anterior polar cataract
endothelial dystrophy iris hypoplasia congenital cataract and stromal thinning syndrome

Defective Genes

MIR184

Clinical Characteristics

Ocular Features

This is a rare disorder with multiple anterior segment anomalies.  The corneal stroma is thinned in the range of 330 to 460 µm with uniform steepening (no cone).  The epithelium may be irregular and edematous, the stroma is diffusely hazy, and the endothelium is irregular with many guttae.  Anterior polar cataracts are likely congenital and often require removal before the age of 20 years.  The pupils are often eccentric and difficult to dilate.  The iris stroma may appear atrophic.  Visual acuity, even in the aphakic condition, is in the range of 20/30 to 20/160.

Histological studies show attenuation of the endothelium with cellular overlapping and aggregates of fibrillar material that stains for cytokeratin.  Descemet membrane is thickened as is the epithelial basement membrane and both intracellular and extracellular lipid deposition is seen throughout the stroma and the Bowman membrane.

Systemic Features

No systemic abnormalities have been reported.

Genetics

Inheritance

This is an autosomal dominant disorder resulting from a heterozygous single base substitution (57C-T) in the MIR184 gene (15q25.1).

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

Cataract removal and penetrating keratoplasty can be helpful.  It is unknown whether the donor corneal tissue develops similar opacities.

Selected Resources

Web Resources

Publications

Displaying 1 - 3 of 3

A Single-Base Substitution in the Seed Region of miR-184 Causes EDICT Syndrome

PubMedID: 22131394

Clinical and ultrastructural features of a novel hereditary anterior segment dysgenesis

PubMedID: 11874753

Endothelial dystrophy, iris hypoplasia, congenital cataract, and stromal thinning (edict) syndrome maps to chromosome 15q22.1–q25.3

PubMedID: 12140022