Hereditary Ocular Diseases
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Cataracts, Congenital Sutural with Punctate and Cerulean Opacities

Clinical Characteristics
Ocular Features: 

The anterior and posterior Y sutures have prominent, dense white opacities.  The embryonal and fetal nuclei are clear but the cortex contains gray-bluish, sharply defined and elongated as well as punctate opacities.  These are denser near the posterior pole and the posterior Y suture is also more heavily involved.  The cortical opacities may be arranged in concentric lamellae.  Considerable variation in density of opacities has been noted among patients.

Systemic Features: 

None reported.

Genetics

A large Indian family consisting of 5 generations containing 33 affected individuals has been described.  This is an autosomal dominant disorder in which a mutation has been found in exon 6 of the CRYBB2 [1] gene (22q11.2-q12/22q11.23).  This region contains four crystallin genes as well as the CRYBP1 pseudogene.  It has been suggested that gene conversion between exon 6 of the CRYBB2 [1] gene and CRYBR1 may be responsible for the phenotype.  Three additional families with identical mutations in the same CRYBB2 [1] exon have been reported and, since each family seems to have a unique phenotype, it is likely that more than a simple bp mutation is responsible for the cataracts.  

Some Coppock-like cataracts [2] (604307 [3]) also result from mutations in CRYBB2 [1] at the same location but others have  mutations in the CRYGC [4] gene.  Type 2 congenital cerulean cataracts [5] (601547 [6]) have also been associated with mutations in the CRYBB2 [1] gene. 

Another autosomal dominant congenital cataract with sutural opacities [7] (600881 [8]) has a slightly different phenotype and results from a mutation on chromosome 17.  

Treatment
Treatment Options: 

Visually significant cataracts may need to be removed.

References
Article Title: 

A unique form of autosomal dominant cataract explained by gene conversion between beta-crystallin B2 and its pseudogene [9]

Vanita, Sarhadi V, Reis A, Jung M, Singh D, Sperling K, Singh JR, B?orger J. A unique form of autosomal dominant cataract explained by gene conversion between beta-crystallin B2 and its pseudogene. J Med Genet. 2001 Jun;38(6):392-6.

PubMed ID: 
11424921
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Source URL:https://disorders.eyes.arizona.edu/disorders/cataracts-congenital-sutural-punctate-and-cerulean-opacities

Links
[1] http://ghr.nlm.nih.gov/gene/CRYBB2 [2] https://disorders.eyes.arizona.edu/disorders/cataracts-coppock [3] http://omim.org/entry/604307 [4] http://ghr.nlm.nih.gov/gene/CRYGC [5] https://disorders.eyes.arizona.edu/disorders/cataracts-congenital-cerulean [6] http://www.ncbi.nlm.nih.gov/omim/601547 [7] https://disorders.eyes.arizona.edu/disorders/cataracts-congenital-zonular-sutural-opacities [8] http://omim.org/entry/600881 [9] https://disorders.eyes.arizona.edu/references/unique-form-autosomal-dominant-cataract-explained-gene-conversion-between-beta-crystallin