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      Atypical superior iris and retinochoroidal coloboma

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          Abstract

          A 38-year-old female presented with complains of right eye defective vision since childhood with best corrected visual acuity right-eye 6/9 and left-eye 6/6. Right-eye anterior segment showed superior iris coloboma with fundus showing atypical superior retinochoroidal coloboma [Fig. 1]. Presence of typical iris and retinochoroidal coloboma is a relatively common finding resulting from the failure of the choroidal fissure closure during embryogenesis.[1] Atypical superior coloboma of iris and retinochoroid layer is a rare condition.[2 3] Recently, a study has proposed that superior retinochoroidal coloboma results from defective closure of superior ocular sulcus (a structure not defined in conventional model of ocular development) which results from the variation in gene encoding the type 1 bone morphogenetic protein (Bmp) receptor (BMPR1A) and T-box transcription factor 2(TBX2).[3] To our knowledge, this is the first case describing coexistence of superior colobomas of both iris as well as retinochoroid, and hence, supports the role of defective closure of superior ocular sulcus in the pathogenesis. Figure 1 (a) right eye pharmacologically dilated pupil with deficient iris tissue supero-temporally; (b) retino-choroidal coloboma, supero-temporal to optic disc with well demarcated pigmented margins Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

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          Chorioretinal coloboma in a paediatric population.

          To determine the validity of laser photocoagulation as a prophylactic treatment in the prevention of rhegmatogenous retinal detachment (RRD) in a group of paediatric patients presenting with chorioretinal coloboma.
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            Morphogenetic defects underlie Superior Coloboma, a newly identified closure disorder of the dorsal eye

            The eye primordium arises as a lateral outgrowth of the forebrain, with a transient fissure on the inferior side of the optic cup providing an entry point for developing blood vessels. Incomplete closure of the inferior ocular fissure results in coloboma, a disease characterized by gaps in the inferior eye and recognized as a significant cause of pediatric blindness. Here, we identify eight patients with defects in tissues of the superior eye, a congenital disorder that we term superior coloboma. The embryonic origin of superior coloboma could not be explained by conventional models of eye development, leading us to reanalyze morphogenesis of the dorsal eye. Our studies revealed the presence of the superior ocular sulcus (SOS), a transient division of the dorsal eye conserved across fish, chick, and mouse. Exome sequencing of superior coloboma patients identified rare variants in a Bone Morphogenetic Protein (Bmp) receptor (BMPR1A) and T-box transcription factor (TBX2). Consistent with this, we find sulcus closure defects in zebrafish lacking Bmp signaling or Tbx2b. In addition, loss of dorsal ocular Bmp is rescued by concomitant suppression of the ventral-specific Hedgehog pathway, arguing that sulcus closure is dependent on dorsal-ventral eye patterning cues. The superior ocular sulcus acts as a conduit for blood vessels, with altered sulcus closure resulting in inappropriate connections between the hyaloid and superficial vascular systems. Together, our findings explain the existence of superior coloboma, a congenital ocular anomaly resulting from aberrant morphogenesis of a developmental structure.
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              Unusual chorioretinal defects.

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                Author and article information

                Journal
                Indian J Ophthalmol
                Indian J Ophthalmol
                IJO
                Indian Journal of Ophthalmology
                Medknow Publications & Media Pvt Ltd (India )
                0301-4738
                1998-3689
                October 2018
                : 66
                : 10
                : 1474-1475
                Affiliations
                [1]Department of Vitreo-Retina, Aravind Eye Hospital and Post-Graduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
                Author notes
                Correspondence to: Dr. Arvind M Jain, Department of Vitreo-Retina, Aravind Eye Hospital and Post-Graduate Institute of Ophthalmology, Coimbatore - 641 014, Tamil Nadu, India. E-mail: dr.arvindjain006@ 123456gmail.com
                Article
                IJO-66-1474
                10.4103/ijo.IJO_531_18
                6173010
                30249843
                56b209a6-2364-40e9-bf46-7c084ba564b6
                Copyright: © 2018 Indian Journal of Ophthalmology

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                Categories
                Ophthalmic Image

                Ophthalmology & Optometry
                Ophthalmology & Optometry

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