Norrie Disease Treatment

This month we reported a case of Norrie Disease that we treated at the first day of birth and was measured to have 20/100 at 2 years.  The retina remains attached.  This is the best visual results reported for Norrie Disease.  While enthusiastic I would like an opportunity to help another child and also learn if this success is repeatable.

For the details please check this months edition of Ophthalmology:  Here is the abstract.

Ophthalmology. 2010 Dec;117(12):2402-6.

Laser photocoagulation at birth prevents blindness in Norrie's disease diagnosed using amniocentesis.

Chow CC, Kiernan DF, Chau FY, Blair MP, Ticho BH, Galasso JM, Shapiro MJ.

Illinois Eye and Ear Infirmary, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA.

Abstract

OBJECTIVE: To report the first case of prophylactic laser treatment to prevent blindness in a patient who was diagnosed with Norrie's disease by genetic testing with amniocentesis.

DESIGN: Case report.

PARTICIPANTS: A 2-year-old white boy with Norrie's disease.

METHODS: A 37-week gestational age male with a family history of Norrie's disease was born via Cesarean section after the mother had undergone prenatal amniocentesis fetal-genetic testing at 23 weeks of gestation. A C520T (nonsense) mutation was found in the Norrie's disease gene. After examination under anesthesia confirmed the diagnosis on the first day of life, laser photocoagulation was applied to the avascular retina bilaterally. The patient was followed closely by ophthalmology, pediatrics, and occupational therapy departments.

MAIN OUTCOME MEASURES: Functional outcome, as documented by Teller visual acuity and formal occupational therapy testing, and anatomic outcome, as documented by Retcam photography and fluorescein angiography.

RESULTS: Complete regression of extraretinal fibrovascular proliferation was observed 1 month after laser treatment. No retinal detachment had occurred to date at 24 months. Teller visual acuity at 23 months of life was 20/100 in both eyes. The patient's vision and developmental milestones were age appropriate.

CONCLUSIONS: Pre-term genetic diagnosis with immediate laser treatment after birth may preserve vision in individuals affected with Norrie's disease.

Copyright © 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

PMID: 20619898 [PubMed - in process]


I am trying to link a pdf. for more details.  The photos may be poor quality, the Ophthalmology website is better.
 Laser for Norrie Disease PDF file