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- $Unique_ID{BRK04340}
- $Pretitle{}
- $Title{X-linked Juvenile Retinoschisis}
- $Subject{X-linked Juvenile Retinoschisis RS Juvenile Retinoschisis X-linked
- Retinoschisis Familial Foveal Retinoschisis Macular Degeneration }
- $Volume{}
- $Log{}
-
- Copyright (C) 1991 National Organization for Rare Disorders, Inc.
-
- 797:
- X-linked Juvenile Retinoschisis
-
- ** IMPORTANT **
- It is possible that the main title of the article (X-linked Juvenile
- Retinoschisis) is not the name you expected. Please check the SYNONYM
- listing to find the alternate names and disorder subdivisions covered by this
- article.
-
- Synonyms
-
- RS
- Juvenile Retinoschisis
- X-linked Retinoschisis
-
- Information on the following disorders can be found in the Related
- Disorders section of this report:
-
- Familial Foveal Retinoschisis
- Macular Degeneration
-
- General Discussion
-
- ** REMINDER **
- The information contained in the Rare Disease Database is provided for
- educational purposes only. It should not be used for diagnostic or treatment
- purposes. If you wish to obtain more information about this disorder, please
- contact your personal physician and/or the agencies listed in the "Resources"
- section of this report.
-
- X-linked Juvenile Retinoschisis (RS) is a genetic disorder affecting
- males. Major symptoms may include poor eyesight and degeneration of the
- retina. The retina consists of membrane layers in the eye that receive
- visual images after passing through the lens. It is composed of supportive
- and protective structures, nervous system components and layers including
- "rods" and "cones". RS is due to splitting of the retina which in turn
- causes slow, progressive loss of parts of the fields of vision corresponding
- to the areas of the retina which have become split. Often, RS is associated
- with the development of cysts (sac-like blisters) in the retina.
-
- Symptoms
-
- Symptoms of X-linked Juvenile Retinoschisis (RS) may include poor eyesight,
- detachment of all or part of the retina from the rest of the eye, and
- eventually complete retinal atrophy (wasting away) with hardening of the
- choroid (the membrane between the white part of the eye and the retina).
-
- The patient may develop cysts in the macula (an oval area of the retina)
- and other areas of the retina. The cysts lead to splits within the retina.
- The cystic manifestations may also appear in other family members. Bleeding
- within the eye may occur.
-
- Problems with vision are usually mild up until the age of 40 or 50, after
- which the condition may slowly worsen.
-
- Causes
-
- X-linked Juvenile Retinoschisis (RS) is inherited as an X-linked recessive
- trait. Human traits, including the classic genetic diseases, are the product
- of the interaction of two genes, one received from the father and one from
- the mother.
-
- X-linked recessive disorders are conditions which are coded on the X
- chromosome. Females have two X chromosomes, but males have one X chromosome
- and one Y chromosome. Therefore, in females, disease traits on the X
- chromosome can be masked by the normal gene on the other X chromosome. Since
- males only have one X chromosome, if they inherit a gene for a disease
- present on the X, it will be expressed. Men with X-linked disorders transmit
- the gene to all their daughters, who are carriers, but never to their sons.
- Women who are carriers of an X-linked disorder have a fifty percent risk of
- transmitting the carrier condition to their daughters, and a fifty percent
- risk of transmitting the disease to their sons.
-
- Affected Population
-
- X-linked Juvenile Retinoschisis (RS) is a rare disorder present at birth.
- The disorder affects males. Men of Finnish heritage are affected more often
- than those of other heritages. Until the age of 40 or 50, visual handicap is
- usually mild.
-
- Related Disorders
-
- Symptoms of the following disorders can be similar to those of X-linked
- Juvenile Retinoschisis (RS).
-
- Familial Foveal Retinoschisis is another type of Juvenile Retinoschisis
- which involves splitting of tissue within the fovea (the center of the macula
- and the area of clearest vision) of the retina. It is very similar to X-
- linked Juvenile RS, but the changes in the retina are not as severe. A
- completely blind area (scotoma), with a sharp edge in the area where
- splitting occurs, is evident in the patient's visual field. Foveal RS can
- also occur in patients with X-linked Juvenile RS. (For more information on
- this disorder, choose "retinoschisis" as your search term in the Rare Disease
- Database).
-
- Macular Degeneration (MD) is characterized by a gradual decrease of
- vision. It is inherited as a dominant trait. MD can be a static condition
- for many years, but then becomes slowly progressive with age. Central vision
- is impaired or absent in MD while peripheral vision remains normal. A vision
- disturbance in which shapes seem distorted or changing (metamorphopsia) can
- occur. An area of depressed vision within the visual field surrounded by an
- area of normal vision (central scotoma) is also symptomatic of this disorder.
-
- Polymorphic Macular Degeneration (PMD) is a dominant hereditary vision
- disorder which includes Best Disease and Sorsby Disease. PMD usually affects
- the macular region in both eyes. In Sorsby Disease swelling (edema),
- hemorrhage, and cyst formation are noted. The cysts may vary in size and
- appearance. The cystic manifestations may also appear in other family
- members. In advanced stages considerable atrophy occurs. In Best Disease,
- changes in the macular region, as well as other areas of the eye, may be
- noted before visual impairment occurs. The macular area may show a yellow
- mass resembling the yolk of an egg. This lesion may possibly be present at
- birth. Deep irregular pigmentation inside the eye may develop later. (For
- more information on these disorders, choose "Macular Degeneration" as your
- search term in the Rare Disease Database).
-
- Therapies: Standard
-
- Diagnosis of X-linked Juvenile Retinoschisis (RS) can be made by an
- ophthalmologist through various tests:
-
- Measuring visual acuity with the Snellen chart, the patient is asked to
- look through a pinhole to determine where on the retina a lesion may exist.
-
- Ultrasonography or ultrasound may show abnormalities when a hemorrhage
- has occurred in the eye.
-
- A recording of the electrical impulses emitted by the retina in response
- to light stimulus (electroretinogram; ERG) can be made. ERG's can indicate
- abnormalities of the retina.
-
- A Visual Evoked Response (VER) measures slow electric potentials from the
- brain cortex in response to light stimulation. The VER depends on the
- integrity of the entire visual system from the cornea to the occipital part
- of the brain's cortex. The VER can detect a malfunction of the macular
- portion of the retina which controls central vision.
-
- A photographic picture made with an ophthalmoscope of the back portion of
- the inside of the eyeball (fundus) is another way to gather information about
- the retina.
-
- When bleeding occurs within the eyeball, keeping the eye still helps to
- reduce damage. Later, treatment with laser or cold (cryotherapy) can be
- applied to close off the damaged area of the retina. It is imperative to
- avoid jarring the head or inflicting injury to the eye to slow down the
- degenerative process of RS.
-
- Genetic counseling may be of benefit for patients with X-linked Juvenile
- Retinoschisis and their families. Other treatment is symptomatic and
- supportive.
-
- Therapies: Investigational
-
- Sulfur Hexafluoride is an experimental medical device for treatment of
- patients with detached retinas. For information about clinical trials being
- conducted, please contact:
-
- Airco Welding Products
- 575 Mountain Ave.
- Murray Hill, NY 07974
-
- This disease entry is based upon medical information available through
- June 1991. Since NORD's resources are limited, it is not possible to keep
- every entry in the Rare Disease Database completely current and accurate.
- Please check with the agencies listed in the Resources section for the most
- current information about this disorder.
-
- Resources
-
- For more information on X-Linked Juvenile Retinoschisis, please contact:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- NIH/National Eye Institute
- 9000 Rockville Pike
- Bethesda, MD 20892
- (301) 496-5248
-
- Association for Macular Disease, Inc.
- 210 East 64th Street
- New York, NY 10021
- (212) 605-3719
-
- For genetic information and genetic counseling referrals:
-
- March of Dimes Birth Defects Foundation
- 1275 Mamaroneck Avenue
- White Plains, NY 10605
- (914) 428-7100
-
- Alliance of Genetic Support Groups
- 35 Wisconsin Circle, Suite 440
- Chevy Chase, MD 20815
- (800) 336-GENE
- (301) 652-5553
-
- References
-
- MENDELIAN INHERITANCE IN MAN, 8th Ed.: Victor A. McKusick; Johns Hopkins
- University Press, 1986. Pp. 1173, 1373, 1375.
-
- AUTOSOMAL JUVENILE RETINOSCHISIS WITHOUT FOVEAL RETINOSCHISIS. S. Hara
- and K. Yamaguchi; Br J Ophthalmol (June 1989; issue 73 (6)). Pp. 470-473.
-
- LINKAGE RELATIONSHIPS AND GENE ORDER AROUND THE LOCUS FOR X-LINKED
- RETINOSCHISIS. T. Alitalo, et al.; Am J Hum Genet (Oct 1988; issue 43 (4)).
- Pp. 476-483.
-
- USE OF LINKED DNA PROBES FOR CARRIER DETECTION AND DIAGNOSIS OF X-LINKED
- JUVENILE RETINOSCHISIS. N. Dahl and U. Pettersson; Arch Ophthalmol (Oct
- 1988; issue 106 (10)). Pp. 1414-1416.
-
-