Night Blindness, Congenital Stationary, CSNB2A
Patient Information
Characteristics
Background and History
Various conditions causing poor night vision, sometimes called night blindness, have been known for centuries. Many disorders of the retina cause night blindness and most of these are progressive and associated with other ocular disease. However, several conditions causing difficulties with night vision are not progressive nor are they part of other syndromes. These are generally referred to as congenital stationary night blindness (CSNB).
Clinical Correlations
Difficulty seeing at night is the primary symptom of congenital stationary night blindness. The condition is present at birth and no progression occurs. Daytime vision may be reduced to some degree as well. Mild color vision defects can sometimes be detected.
In this disease (CSNB2A) nearsightedness is common and ‘dancing eyes’ can be present. Males with this form usually have vision in the range of 20/30 to 20/200. Some individuals have crossed eyes as well.
Genetics
Inheritance
At least 8 different mutant genes are known to cause CSNB. This type (CSNB2A) is caused by a mutant gene on the X-chromosome and therefore virtually always affects only males. Mothers who carry the mutation do not have night blindness but can pass the mutation to half their sons who will have night vision problems. Half of her daughters will likely be carriers.
Pedigree
X-linked recessive, carrier mother
X-linked disorders are caused by a mutation on the X chromosome and both sexes can pass this to their children. If the mutation is in a recessive gene and carried by the mother, she usually does not have the disease since the normal X chromosome without the mutation neutralizes the mutation in the abnormal X chromosome. However, half her sons will inherit the mutation-containing X chromosome and therefore have the X-linked disease. Half the daughters will inherit the mutation-bearing X chromosome and are usuallly healthy 'carriers'.
X-linked disorders are caused by a mutation on the X chromosome and both sexes can pass this to their children. If the mutation is in a recessive gene and carried by the mother, she usually does not have the disease since the normal X chromosome without the mutation neutralizes the mutation in the abnormal X chromosome. However, half her sons will inherit the mutation-containing X chromosome and therefore have the X-linked disease. Half the daughters will inherit the mutation-bearing X chromosome and are usuallly healthy 'carriers'.
X-linked recessive, father affected
X-linked disorders are caused by a mutation on the X chromosome and both sexes can pass this to their children. If the mutation is in a recessive gene and carried by the father, he has the disease since his only X chromosome is mutant and he has no normal X to blunt the effects of the abnormal gene. His sons only receive his Y chromosome and thus are all normal. However, all his daughters receive his one and only X chromosome and will be healthy 'carriers'. Thus such males will have no affected children but half their grandsons from those daughters will have the same disease as he does.
X-linked disorders are caused by a mutation on the X chromosome and both sexes can pass this to their children. If the mutation is in a recessive gene and carried by the father, he has the disease since his only X chromosome is mutant and he has no normal X to blunt the effects of the abnormal gene. His sons only receive his Y chromosome and thus are all normal. However, all his daughters receive his one and only X chromosome and will be healthy 'carriers'. Thus such males will have no affected children but half their grandsons from those daughters will have the same disease as he does.
Diagnosis and Prognosis
Diagnosis is based on an ophthalmological examination. An electroretinogram (ERG) test is important to establish the diagnosis and to rule out other retinal disease. This is a stationary disease without significant progression and no systemic disease is present.
Many individuals with this type of congenital night blindness are nearsighted and require glasses or contact lenses for better vision.
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