rss
Br J Ophthalmol 2006;90:1119-1124 doi:10.1136/bjo.2006.091637
  • Clinical science
    • Scientific reports

Batten disease: features to facilitate early diagnosis

  1. J Collins1,
  2. G E Holder1,
  3. H Herbert2,
  4. G G W Adams3
  1. 1Moorfields Eye Hospital, London EC1V 2PD, UK
  2. 2Electrophysiology Department, Moorfields Eye Hospital, London EC1V 2PD, UK
  3. 3Strabismus and Paediatric Service, Moorfields Eye Hospital, City Road, London EC1V 2PD, UK
  1. Correspondence to: MissGillian G W Adams Strabismus and Paediatric Service, Moorfields Eye Hospital, City Road, London EC1V 2PD, UK; gill.adams{at}blueyonder.co.uk
  • Accepted 16 May 2006
  • Published Online First 5 June 2006

Abstract

Aims: To ascertain the clinical and electrophysiological features in patients with juvenile neuronal ceroid lipofuscinosis (jNCL/Batten disease) and to identify those features that facilitate early diagnosis.

Methods: Nine patients with jNCL were identified retrospectively and their case notes reviewed. All had undergone an extensive clinical examination, including electrophysiology. Blood and molecular genetic testing confirmed the diagnosis.

Results: Age at onset ranged from 4–8 years. At presentation, two of nine patients had normal fundi; only two of nine patients had a bull’s eye maculopathy. The electroretinogram (ERG) findings in this series included undetectable rod specific ERGs, an electronegative maximal response, reduced and delayed cone flicker ERGs, reduction in the b:a ratio in the photopic single flash ERG, and an undetectable pattern ERG. Vacuolated lymphocytes on peripheral blood film testing were present in eight of nine patients. Five of eight patients were homozygous for the 1.02 kb deletion on the CLN3 gene on molecular genetic testing; two of eight patients were heterozygous for that deletion.

Conclusion: jNCL should be considered in children of 10 years and under presenting with visual loss and fundal changes ranging from normal through to pigmentary/atrophic changes or a bull’s eye maculopathy. Electrophysiology may suggest jNCL. Although currently untreatable, early diagnosis is important to institute appropriate counselling and support.

Footnotes

    This Article

    1. Abstract
    2. Full text
    3. PDF
    4. All versions of this article:
      1. bjo.2006.091637v1
      2. 90/9/1119 most recent

    Responses

    1. Submit a response
    2. No responses published

    Register for free content

    The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

    Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.