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Myopia, AR, with Cataracts and Vitreoretinal Degeneration

OMIM ID:

autosomal recessive

Myopia, AR, with Cataracts and Vitreoretinal Degeneration

Alternate Names

high myopia with cataract and vitreoretinal degeneration
MCVD

Defective Genes

LEPREL1

Clinical Characteristics

Ocular Features

Axial myopia and poor vision are noted during childhood.  Most individuals have refractive errors in the range of-5 to -18 diopters with a mean spherical equivalent of -11.3 diopters.  The axial length ranges from 25.1 and 30.5 mm.  Peripheral vitreoretinal degeneration and cataracts are usually present after the onset of myopia.  Lenticular opacities may necessitate cataract surgery in 11 of the 13 myopic patients in one kindred, usually by the second decade of life.  Lens instability or frank subluxation was noted in 8 patients.  At least five eyes suffered retinal detachments secondary to retinal dialyses and blindness of at least one eye occurred in 23% of patients.

Systemic Features

Deafness was reported in a single patient.

Genetics

Inheritance

This condition results from homozygous mutations in the gene LEPREL1 (3q28) encoding prolyl 3-hydroxylase.  It was identified in a large consanguineous Israeli Bedouin kindred containing seven affected males and 6 affected females.

Pedigree

Autosomal recessive

In order for autosomal recessive disorders to be expressed, offspring generally must inherit two mutations, one from each carrier parent.  Carriers with only one mutation, such as the parents, do not have clinical disease.  Note that carrier parents can expect that 1 in 4 children (25%) will inherit both mutations and have the disorder, 2 in 4 children (50%) will be carriers like their parents, while 1 in 4 children (25%) inherit neither mutation.

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Sample pedigree of autosomal recessive inheritance

In order for autosomal recessive disorders to be expressed, offspring generally must inherit two mutations, one from each carrier parent. Carriers with only one mutation, such as the parents, do not have clinical disease. Note that carrier parents can expect that 1 in 4 children (25%) will inherit both mutations and have the disorder, 2 in 4 children (50%) will be carriers like their parents, while 1 in 4 children (25%) inherit neither mutation.

Treatment & Management

Cataract and retinal surgery may be indicated. However, the instability of the lens can lead to complications. The nature and location of retinal tears likewise make repairs difficult and blindness is a relatively frequent complication.

Selected Resources

Web Resources

Publications

Displaying 1 - 2 of 2

High Myopia Caused by a Mutation in LEPREL1, Encoding Prolyl 3-Hydroxylase 2

PubMedID: 21885030

Recessive Mutations inLEPREL1Underlie a Recognizable Lens Subluxation Phenotype

PubMedID: 25469533