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[Hyperornithinaemia in patients with retinal dystrophy]
1Augenklinik mit Poliklinik, Universität Erlangen-Nürnberg, Erlangen. ursula.mayer@augen.imed.uni-erlangen.de
Background:
In our clinic for low vision we have treated 4 patients with advanced retino-choroidal dystrophy. The patients showed concentric narrowing of the visual field and alterations of the ERG.Confluent degenerative areas slightly resembled those seen in gyrate atrophy.For this reason we determined the serum levels of ornithine which were found to be elevated to twice the normal level, but never as high as described for the typical form of gyrate atrophy.
Case Histories:
The patients were three females 58-76 years old and the 11-year-old grandson of one of them. We analysed ornithine levels in the corresponding blood serum.
Results:
The results were 2.8 mg/dl, 2.0 mg/dl, 2.6 mg/dl and 3.6 mg/dl, respectively (normal value: 1.8 microg/dl).
Conclusion:
In classic gyrate atrophy the ornithine levels are much higher. Consequently we are dealing with a biochemically and symptomatically different disease or with a mild form of gyrate atrophy. Narrowing of the visual field and ERG alterations indicate a retinal dystrophy. The determination of ornithine levels does not yet belong to our clinical routine. This report is intended to enlarge the possibilities for differential diagnosis and to offer a therapy for the 11-year-old boy by giving him vitamin B6 or a special diet.