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Ophthalmic manifestations of Gaucher disease: the most common lysosomal storage disorder
  1. Aaron W Winter1,
  2. Ali Salimi2,
  3. Luis H Ospina3,
  4. Jonathan C P Roos4,5
  1. 1 Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
  2. 2 Faculty of Medicine, McGill University, Montréal, Québec, Canada
  3. 3 Department of Pediatric Ophthalmology and Neuro-Ophthalmology, Sainte-Justine Hospital, University of Montréal, Montréal, Québec, Canada
  4. 4 Department of Ophthalmology, Norfolk & Norwich University Hospitals, Norfolk, UK
  5. 5 Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
  1. Correspondence to Jonathan C P Roos, Department of Ophthalmology, Norfolk & Norwich University Hospitals, Norfolk NR4 7UY, UK; jcpr2{at}cam.ac.uk

Abstract

Gaucher disease (GD) results from a deficiency of glucocerebrosidase activity and the subsequent accumulation of the enzyme’s metabolites, principally glucosylsphingosine and glucosylceramide. There are three principal forms: Type I, which is the most common, is usually considered non-neuronopathic. Type II, III and IIIc manifest earlier and have neurological sequelae due to markedly reduced enzyme activity. Gaucher’s can be associated with ophthalmological sequelae but these have not been systematically reviewed. We therefore performed a comprehensive literature review of all such ophthalmic abnormalities associated with the different types of Gaucher disease. We systematically searched the literature (1950 – present) for functional and structural ocular abnormalities arising in patients with Gaucher disease and found that all subtypes can be associated with ophthalmic abnormalities; these range from recently described intraocular lesions to disease involving the adnexae, peripheral nerves and brain. In summary, Gaucher can affect most parts of the eye. Rarely is it sight-threatening; some but not all manifestations are amenable to treatment, including with enzyme replacement and substrate reduction therapy. Retinal involvement is rare but patients with ocular manifestations should be monitored and treated early to reduce the risk of progression and further complications. As Gaucher disease is also associated with Parkinsons disease and may also confer an increased risk of malignancy (particularly haematological forms and melanoma), any ocular abnormalities should be fully investigated to exclude these potential underlying conditions.

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Footnotes

  • Contributors Conception and design: JCPR, LHO. Literature search and data acquisition: AWW, AS, JCPR. Analysis and interpretation: all authors. Drafting and revising the manuscript: all authors. We confirm that the manuscript has been read and approved by all authors.

  • Funding The authors have no specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors to declare.

  • Competing interests None declared.

  • Patient consent Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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