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Published on: August 9, 2024
An update on ocular involvement in mucopolysaccharidoses
Anuradha Ganesh1, Zandre Bruwer, Khalid Al-Thihli
1Department of Ophthalmology, Sultan Qaboos University Hospital, Muscat, Oman. aganesh@squ.edu.om
Purpose Of Review:
The purpose of this review is to provide an update on ocular manifestations of mucopolysaccharidoses (MPS), to highlight diagnostic pitfalls in the evaluation of affected patients, and to briefly review etiopathogenesis, systemic manifestations, and therapeutic interventions in MPS.
Recent Findings:
Advances in hematopoietic stem cell transplantation and enzyme replacement therapy for MPS have led to decreased morbidity and increased life-span of patients. Besides other causes, visual impairment because of corneal opacification, retinal degeneration, and optic atrophy remains a common cause of disability in MPS. The application of a standard ophthalmic evaluation protocol may serve as an important diagnostic and disease monitoring tool in patients.
Summary:
Diagnostic delays are not uncommon in patients with MPS. Given the early ocular involvement in MPS, ophthalmologists play a crucial role in early detection and follow-up of patients with MPS. Ophthalmic evaluation can be impeded by corneal opacification and patient cooperation. Altered corneal biomechanics confound intraocular pressure measurements. Recently developed therapies have made early detection increasingly important. Accurate diagnosis of specific MPS subtypes is of paramount importance for initiating appropriate therapy. Combined with advances in supportive care of ocular and systemic manifestations, the prognosis for patients with MPS has vastly improved.
Insights
Early ocular manifestations in mucopolysaccharidoses (MPS) are key for diagnosis. Ophthalmologists are vital for early detection and monitoring, improving patient prognosis with new therapies.
Area of Science:
- Ophthalmology
- Genetics
- Pediatrics
Background:
- Mucopolysaccharidoses (MPS) are a group of rare genetic disorders.
- Ocular manifestations are common and can lead to significant visual impairment.
Purpose of the Study:
- To update knowledge on ocular manifestations of MPS.
- To highlight diagnostic challenges and review etiopathogenesis, systemic effects, and treatments.
Main Methods:
- Review of current literature on MPS ocular findings.
- Emphasis on diagnostic protocols and monitoring tools.
Main Results:
- Advances in therapies (HSCT, ERT) improve lifespan and reduce morbidity.
- Corneal opacification, retinal degeneration, and optic atrophy cause visual impairment.
- Standard ophthalmic evaluation is crucial for diagnosis and monitoring.
Conclusions:
- Diagnostic delays in MPS are frequent; early ocular signs are critical.
- Ophthalmologists play a key role in early detection and management.
- Improved therapies and supportive care enhance patient prognosis significantly.
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