Night Blindness, Congenital Stationary, CSNB2B
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 does not progress. Daytime vision may be reduced to some degree as well. Mild color vision defects can sometimes be detected.
In this disease (CSNB2B) the daytime vision is rarely normal and may be severely reduced. However, night vision is seriously impaired. A few patients have ‘dancing eyes’ (nystagmus) and crossed eyes. Both sexes are affected. Some patients are nearsighted.
Genetics
Inheritance
Mutations in at least 8 different gene are known to cause CSNB. This type (CSNB2B) is inherited in an autosomal recessive pattern which requires that both parents contribute the specific mutation.
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.
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.
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.
The only treatment is correction of refractive errors if needed.
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