摘要常染色体显性视神经萎缩常在儿童期发病,发病率约1:10 000～1:50 000,表现为隐匿性渐进性视力减退,双颞侧视盘苍白,中心或旁中心暗点,色觉障碍(常表现为蓝黄色盲).组织病理学表现为:视网膜神经节细胞退行性变.OPA1编码一种保守的动力相关GTPase,OPA1突变是ADOA发病的主要原因,目前已发现117个ADOA相关OPA1突变,包括:31.6%缺失和插人突变,16.2%无义突变,25.6%错义突变和28.8%剪接突变.这些突变分布于OPA1基因编码区,但多数位于GTPase区.另外,本病还与OPA3(19q13.2-q13.3)、OPA4(18q12.2-q12.3)及OPA5(22q12.1-q13.1)基因突变有关.个体间的表型差异表明:其他遗传因素、个人因素以及环境因素可能与ADOA发病有关.

abstractsAutosomal dominant optic atrophy (ADOA), also called Kjer optic neuropathy, is the most common form of inherited optic neuropathy with a prevalence between 1: 10 000 and 1 : 50 000. The optic atrophy often occurs in the childhood (the average age-of-onset: 7 years old) and with an insidious onset of variable visual loss, temperal optic nerve pallor, central or caecocentral visual field scotoma and dyschromatopsia (often appears tetartanopia). Histopathological studies suggest that the underlying defect is retinal ganglion cell degeneration. Mutations in OPA1 encoding a conserved mitochondrial dynamin-related GTPase are the major cause of ADOA. 117 OPA1 ADOA-associated mutations consisted of 31.6% of deletions/insertions, 16.2% of nonsense, 25.6% of missense and 28. 8% of splicing mutations. The majority of mutations reside at the ceding sequence of this gene, especially in the GTPase domain. Other ADOA-associated genes were OPA3 (19q13. 2-q13.3), OPA4 (18q12.2-q12.3) and OPA5 (22q12.1-q13.1). The variable phenotypes of vision loss suggest the involvement of other genetic factors, personal factors and environmental factors in the pathogcnesis of ADOA.