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Hereditary Affections of the Retina and Choroid

Published online by Cambridge University Press:  01 August 2014

Arnold Sorsby*
Affiliation:
Dept. of Ophthalmological Research, Royal College of Surgeons of England, London, (Great Britain)

Summary

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1. Histological studies on the developing retina in mice, rats and Irish setters affected with a hereditary retinal degeneration of the retinitis pigmentosa type do not lend any support to the view that the retina is fully developed before degenerative changes set in — as postulated by the conception of abiotrophy. In fact, the retina in these animals, though reaching functional maturity, lacks the final histological differentiation that leads to fully developed rods: the rods are present, but they are rudimentary and do not survive for the normal span of life. These studies suggest that the abiotrophies (or heredo-degenerative diseases as they are sometimes called) are in fact the mildest of congenital defects and do not therefore stand in sharp contrast to congenital abnormalities.

2. Clinical studies on the hereditary affections of the retina show that the distinction between congenital non-progressive disorders and abiotrophic progressive disorders is not valid. Most congenital abnormalities of the retina such as macular cyst, retinal aplasia, asymptomatic macular defect and congenital sex-linked detachment, show a considerable post-natal course. In fact it is difficult to find a clear example of a congenital non-progressive retinal anomaly. In the choroid, the one substantial congenital defect — macular coloboma — is non-progressive.

3. By definition all abiotrophic defects have a progressive course. This, however, varies considerably in the different affections. In the retina, retinitis pigmentosa represents not one disease but a whole series of affections. This is seen from such well differentiated types as the recessive, dominant, recessive sex-linked and intermediate sex-linked varieties. Furthermore, in different families there are different associated anomalies, such as glaucoma, cataract, ophthalmoplegia or macular dystrophy. Unilateral retinitis pigmentosa appears to be a somatic mutation. The macular dystrophies are likewise a group rather than one disease, as shown by the different genetic behaviour and the different clinical features of the recessive, dominant and sex-linked varieties of macular dystrophy. Furthermore the ophthalmoscopic reaction ranges in different families from fine granular changes to fairly heavy pigmentary changes, or whitish lesions of the exudative type. In the choroid, choroideremia and choroidal sclerosis — with its generalized, central and peripapillary types — are the two outstanding abiotrophic affections, with markedly dissimilar clinical behaviour.

4. An important abiotrophic affection coming on in middle age is dominant generalized fundus dystrophy with its stormy onset, oedematous and exudative reactions at the macula, and ultimately extensive atrophy throughout the fundus. This has to be distinguished from another dominant affection with a much milder course — Doyne's choroiditis. The choroidal nature of these two affections is not definitely established. They may possibly both be disorders of the membrane of Bruch.

5. Retinoblastoma appears to occur in both a genetic and non-genetic variety. It is likely that the bilateral case represents a germinal mutation and that the unilateral case is generally a somatic mutation; only the germinal mutation is, of course, transmitted.

6. A number of other affections may have a genetic background as yet ill-established.

Type
Research Article
Copyright
Copyright © The International Society for Twin Studies 1964

References

LITERATURE

General

François, J.: L'hérédité en ophtalmologie. Paris, Masson & Cie, 1958. Contains full bibliographies. The references to retinal and choroidal affections are on pp. 244, 558 and 578.Google Scholar
Bourne, M.C., Campbell, D.R. and Tansley, K.: Retinitis pigmentosa in rats. Trans. Ophthal. U. K., 58, 234, 1938.Google Scholar
Lucas, D.R.: Retinal dystrophy in the Irish setter: histology. J. Exp. Zool., 126: 537, 1954.CrossRefGoogle Scholar
Lucas, D.R. Attfield, M., and Davey, J.B.: Retinal dystrophy in the rat. J. Path. & Bact., 70: 469, 1955.Google Scholar
Noell, W.K.: Differentiation, metabolic organization and viability of visual cells. A.M.A. Arch. Ophthal., 60: 724, 1958.CrossRefGoogle Scholar
Sorsby, A., Koller, P.C., Attfield, M., Davey, J.B. and Lucas, D.R.: Retinal dystrophy in the mouse: histological and genetic aspects. J. Exp. Zool., 123: 171, 1954.CrossRefGoogle Scholar
Tansley, K.: An inherited retinal degeneration in the mouse. J. Hered., 45: 123, 1954.Google Scholar
Alström, C. H., and Olson, O.: Heredo-retinopathia congenitalis monohybrida recessiva autosomalis. Hereditas (Lund) 43: 1, 1957.Google Scholar
Chase, H. B. and Chase, E. B.: Studies on an anophthalmic strain of mice. I. Embryology of the eye region. J. Morph. 68: 279, 1941.Google Scholar
Schappert-Kimmijser, J., Henkes, H. E. and van den Bosch, J.: Amaurosis congenita (Leber) A.M.A. Arch. Ophthal., 61: 211, 1959.Google Scholar
Sorsby, A.: Congenital coloboma of the macula: together with an account of the familial occurrence of bilateral macular coloboma in association with apical dystrophy of hands and feet. Brit. J. Ophthal., 19: 65, 1935.Google Scholar
Sorsby, A., Klein, M., Gann, J. H. and Siggins, G.: Unusual retinal detachment, possibly sex-linked. Brit. J. Ophthal., 35: 1 1951.Google Scholar
Sorsby, A., Savory, M., Davey, J. B. and Fraser, R. J. L.: Macular cysts: a dominantly inherited affection with a progressive course. Brit. J. Ophthal., 40: 144, 1956.Google Scholar
Sorsby, A.: and Williams, C.: Retinal aplasia as a clinical entity. Brit. Med. J. 1: 293, 1960.Google Scholar
Sorsby, A.: and Wren, N.: A family group with asymptomatic macular defects inherited dominantly. A.M.A. Arch. Ophthal., 63: 918, 1960.CrossRefGoogle ScholarPubMed
Falls, H. F. and Cotterman, C. W.: Choroidoretinal degeneration. A, sex-linked form in which heterozygous women exhibit a tapetal-like retinal reflex. A.M.A. Arch. Ophthal., 40: 685, 1948.CrossRefGoogle Scholar
Sorsby, A.: The dystrophies of the macula. Brit. J. Ophthal., 24: 469, 1940.Google Scholar
Sorsby, A.: and Davey, J. B.: Dominant macular dystrophy. Brit. J. Ophthal., 39: 385, 1955.Google Scholar
Stargardt, K.: Über familiäre progressive Degeneration in der Maculagegend des Auges. Arch. f. Oph., 71: 534, 1909.Google Scholar
Stargardt, K.: Über familiäre Degeneration in der Maculagegend des Auges mit und ohne psychische Störungen. Arch. f. Psychiatrie und Nervenkrankh., 58: 852, 1917.Google Scholar
McCulloch, C., and McCulloch, R. J. P.: A hereditary and clinical study of choroideremia. Trans. Amer. Acad. Ophthal, and Otolaryng. 52: 160, 1948.Google Scholar
Sorsby, A.: Choroidal angio-sclerosis with spacial reference to its hereditary character. Brit. J. Ophthal., 23: 433, 1939.Google Scholar
Sorsby, A.: and Crick, R. P.: Central areolar choroidal sclerosis. Brit. J. Ophthal., 57: 129, 1953.CrossRefGoogle Scholar
Sorsby, A.: and Davey, J. B.: Generalized choroidal sclerosis. Course and mode of inheritance. Brit. J. Ophthal., 39: 257, 1955.Google Scholar
Sorsby, A., Franceschetti, A., Joseph, R., and Davey, J. B.: Choroideremia. Clinical and genetic aspects. Brit. J. Ophthal., 36: 547, 1952.CrossRefGoogle ScholarPubMed
Sorsby, A. and Mason, M. E. J.: A fundus dystrophy with unusual features. Brit. J. Ophthal., 33: 67, 1949.Google Scholar
Tree, M.: Familial hyaline dystrophy in the fundus oculi or Doyne's family honeycomb ‘choroiditis’. Brit. J. Ophthal., 21, 65, 1937.Google Scholar
Griffith, A. D. and Sorsby, A.: The genetics of retinoblastoma. Brit. J. Ophthal., 28: 279, 1944.Google Scholar
Smith, S. M. and Sorsby, A.: Retinoblastoma: some genetic aspects. Ann. Hum. Gene., 23: 50, 1958.Google Scholar
Vogel, F.: Über Genetik und Mutationsrate des Retinoblastoms (Glioma retinae). Z. ges. Anat. 2. Z. Konst-Lehre, 32: 308, 1954.Google Scholar
Vogel, F.: Neue Untersuchungen zur Genetik des Retinoblastoms. Z. ges. Anat. 2. Z. Konst-Lehre, 34: 205, 1957.Google Scholar
Benedict, W. H. and Benedict, W. L.: Uveitis, poliosis and alopecia in siblings. A.M.A. Arch. Ophthal., 46: 510, 1951.Google Scholar
Nordlow, W.: Fall von spontaner Netzhautablösung bei eineiigen Zwillingen. Acta Ophth. 16: 579, 1938.Google Scholar
Vogt, A.: Die operative Therapie und die Pathogenese der Netzhautablösung (Vererbung der Netzhautablösung), pp. 157163. Stuttgart, Ferdinand Enke, 1936.Google Scholar