Vitreoretinal Degeneration, Snowflake Type

Background and History: 

This is a rare and recently described disorder that has only ocular manifestations.  It has some clinical similarities to other degenerative disorders of the retina and vitreous (jelly-like material that fills the posterior part of the eye) but is considered unique.

Clinical Correlations: 

The age of onset is unknown but changes in the eye have been seen as early as the second decade of life.  These include the appearance of yellow –white crystalline-like (hence the name) spots in the retina and thickening of the peripheral part of the vitreous.  Vision remains excellent throughout life unless the retina detaches (a relatively small risk), or unless cataracts develop.  The latter are frequently present and may occur as early as the 4th or 5th decades.  Many patients experience ‘floaters” which are shadows cast by debris in the vitreous.  There is some progressive deterioration of the vitreous with the appearance of fibers which cause few symptoms.  There is a lifelong risk of developing a retinal detachment.

 

Genetics: 

This disorder is caused by a mutant gene in single dose and hence is passed from parent to child in an autosomal dominant pattern.  Affected parents can expect that there is a 50% chance of the disease appearing in each of their children.

Diagnosis and Prognosis: 

The diagnosis can only be made by an ophthalmologist based on a complete eye examination.  All children and parents of individuals with snowflake degeneration should be examined for on average half will be affected.  The prognosis is excellent although those with the disease must be monitored throughout life because of the small but significant risk of developing a retinal detachment.  The prognosis is usually good when detachments are repaired promptly.

When visually significant opacities of the lens (cataracts) develop as they do in midlife in about 80% of individuals they can be safely removed.

Additional Information
Inheritance/Pedigree: 
Autosomal dominant