Retinale Ziliopathien

Zusammenfassung

Ziliopathien umfassen Erkrankungen und Fehlbildungen einzelner oder mehrerer Organe. Isolierte oder syndromale progressive Netzhautdystrophien stellen die häufigste okuläre Manifestation der Ziliopathien dar. Hierbei ist insbesondere die Struktur der Photorezeptoren mit dem Verbindungscilium (connecting cilium) bedeutend. Durch die dysfunktionalen Zilien besteht eine meist schwere Form der Netzhautdystrophie, der Leberʼschen kongenitalen Amaurose (LCA). Die häufigsten syndromalen Ziliopathien mit okulärer Manifestation sind das Bardet-Biedl-Syndrom (BBS) und das Usher-Syndrom. Die molekulargenetischen Analysen wiesen bisher eine Vielzahl von Genen für ziliäre Proteine nach. Mutationen in diesen Genen sind mit einer klinischen Heterogenität verbunden. Die Diagnose einer LCA oder einer Netzhautdystrophie im Kindesalter sollte immer eine multidisziplinäre Untersuchung und Betreuung einschließen. Eine kausale Therapie der Ziliopathien befindet sich in einem erfolgversprechenden Anfangsstadium, sodass zum jetzigen Zeitpunkt nur unterstützende und rehabilitierende Maßnahmen zur Verfügung stehen.

Abstract

Ciliopathies are disorders caused by ciliary dysfunction and can affect an organ system or tissues. Isolated or syndromic retinal dystrophies are the most common ocular manifestation of ciliopathies. The photoreceptor connecting cilium plays a leading role in these ciliopathy-related retinal dystrophies. Dysfunctional photoreceptor cilia cause the most severe type of retinal dystrophy: Leberʼs congenital amaurosis (LCA). The most common syndromic ciliopathies with an ocular manifestation are Bardet-Biedl syndrome (BBS) and Usher syndrome. Molecular-genetic analysis revealed a large number of cilia genes with a high phenotype heterogeneity. Diagnosis of ciliopathies require a multi-disciplinary approach. Causative treatment of ciliopathies is not yet available; therefore, rehabilitative and supportive treatment is mandatory.

Schlüsselwörter

Genetik - Leberʼsche kongenitale Amaurose - Usher-Syndrom - Bardet-Biedl-Syndrom - Ziliopathie

Key words

primary cilium - Leberʼs congenital amaurosis - Usher syndrome - Bardet-Biedl syndrome - ciliopathy

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