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Ocular Phenotype Associated with DYRK1A Variants
Cécile Méjécase1, Christopher M Way1, Nicholas Owen1
1UCL Institute of Ophthalmology, London EC1V E9L, UK.
Abstract:
Dual-specificity tyrosine phosphorylation-regulated kinase 1A or DYRK1A, contributes to central nervous system development in a dose-sensitive manner. Triallelic DYRK1A is implicated in the neuropathology of Down syndrome, whereas haploinsufficiency causes the rare DYRK1A-related intellectual disability syndrome (also known as mental retardation 7). It is characterised by intellectual disability, autism spectrum disorder and microcephaly with a typical facial gestalt. Preclinical studies elucidate a role for DYRK1A in eye development and case studies have reported associated ocular pathology. In this study families of the DYRK1A Syndrome International Association were asked to self-report any co-existing ocular abnormalities. Twenty-six patients responded but only 14 had molecular confirmation of a DYRK1A pathogenic variant. A further nineteen patients from the UK Genomics England 100,000 Genomes Project were identified and combined with 112 patients reported in the literature for further analysis. Ninety out of 145 patients (62.1%) with heterozygous DYRK1A variants revealed ocular features, these ranged from optic nerve hypoplasia (13%, 12/90), refractive error (35.6%, 32/90) and strabismus (21.1%, 19/90). Patients with DYRK1A variants should be referred to ophthalmology as part of their management care pathway to prevent amblyopia in children and reduce visual comorbidity, which may further impact on learning, behaviour, and quality of life.
Insights
DYRK1A variants are linked to significant ocular abnormalities in individuals with DYRK1A-related intellectual disability syndrome. Early ophthalmology referrals are crucial for managing visual impairments and improving patient outcomes.
Area of Science:
- Genetics
- Neurodevelopmental Disorders
- Ophthalmology
Background:
- DYRK1A (Dual-specificity tyrosine phosphorylation-regulated kinase 1A) plays a critical role in central nervous system development.
- DYRK1A gene variations are associated with Down syndrome and DYRK1A-related intellectual disability syndrome, characterized by intellectual disability, autism, and specific facial features.
- Preclinical and case studies suggest a link between DYRK1A and ocular development, with reported ocular pathologies.
Purpose of the Study:
- To investigate the prevalence and spectrum of ocular abnormalities in patients with pathogenic variants in the DYRK1A gene.
- To determine the frequency of ocular features in individuals diagnosed with DYRK1A-related intellectual disability syndrome.
Main Methods:
- A study combining self-reported data from DYRK1A Syndrome International Association families, molecularly confirmed cases, and literature review.
- Analysis of ocular features in a cohort of 145 patients with heterozygous DYRK1A variants.
- Categorization and quantification of reported ocular abnormalities including optic nerve hypoplasia, refractive errors, and strabismus.
Main Results:
- Ocular features were identified in 62.1% (90/145) of patients with heterozygous DYRK1A variants.
- The most common ocular findings included refractive error (35.6%), strabismus (21.1%), and optic nerve hypoplasia (13%).
- Data was aggregated from 26 self-reporting families, 19 UK Genomics England participants, and 112 literature-reported patients.
Conclusions:
- Heterozygous pathogenic variants in DYRK1A are frequently associated with a range of ocular abnormalities.
- Routine ophthalmological evaluation is recommended for patients with DYRK1A variants to prevent amblyopia and manage visual comorbidities.
- Addressing visual impairments is essential for optimizing learning, behavior, and overall quality of life in individuals with DYRK1A-related disorders.
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