EDICT Syndrome

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 um 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

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

Treatment
Treatment Options: 

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

References
Article Title: 

References

Iliff BW, Riazuddin SA, Gottsch JD. A single-base substitution in the seed region of miR-184 causes EDICT syndrome. Invest Ophthalmol Vis Sci. 2012 Jan 25;53(1):348-53.

PubMedID: 22131394

Akpek EK, Jun AS, Goodman DF, Green WR, Gottsch JD. Clinical and ultrastructural features of a novel hereditary anterior segment dysgenesis. Ophthalmology. 2002 Mar;109(3):513-9.

PubMedID: 11874753

Jun AS, Broman KW, Do DV, Akpek EK, Stark WJ, Gottsch JD. Endothelial dystrophy, iris hypoplasia, congenital cataract, and stromal thinning (edict) syndrome maps to chromosome 15q22.1-q25.3. Am J Ophthalmol. 2002 Aug;134(2):172-6.

PubMedID: 12140022