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Ocular manifestations in hyperornithinemia-hyperammonemia-homocitrullinuria syndrome: a rare association
Kshitiz Kumar1, Amar Agarwal, Athiya Agarwal
1Dr. Agarwal's Retina Foundation and Dr. Agarwal's Eye Hospital, Chennai, India.
Purpose:
To report ophthalmic features in hyperornithinemia-hyperammonemia-homocitrullinuria syndrome, an uncommon presentation.
Methods:
Case report.
Results:
An 18-year-old Indian boy presented with progressive diminution of vision, night blindness, lenticular opacities, and midperipheral chorioretinal atrophy. Spectral domain optical coherence tomography revealed myopic foveoschisis, and Humphrey visual fields 30-2 showed peripheral field constriction. He had no neurocognitive disabilities. Serum biochemical analysis revealed hyperornithinemia, hyperglycinemia, and raised ornithine/citrulline ratio suggestive of hyperornithinemia-hyperammonemia-homocitrullinuria syndrome.
Conclusion:
Ocular findings of midperipheral chorioretinal degeneration with myopic foveoschisis can be the initial presenting manifesation of hyperornithinemia-hyperammonemia-homocitrullinuria syndrome.
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