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Children with mucopolysaccharidosis risk progressive visual dysfunction despite haematopoietic stem cell transplants
Author(s) -
Teär Fahnehjelm Kristina,
Olsson Monica,
Chen Enping,
Hengstler Jürg,
Naess Karin,
Winiarski Jacek
Publication year - 2018
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.14368
Subject(s) - medicine , photophobia , mucopolysaccharidosis , visual acuity , hurler syndrome , ophthalmology , retinal degeneration , mucopolysaccharidosis i , mucopolysaccharidosis type i , eye disease , surgery , retinal , enzyme replacement therapy , disease
Aim This prospective study assessed the long‐term ocular and visual outcomes of children with mucopolysaccharidoses type I Hurler syndrome ( MPS IH ) who were treated with haematopoietic stem cell transplants ( HSCT ). Methods Clinical ophthalmological assessments were performed on eight patients at the St Erik Eye Hospital, Huddinge, Stockholm, Sweden, from 2001–2018: The median age at diagnosis and HSCT were 12.2 (range 5.0–16.4) and 16.7 (8.0–20.4) months. The last eye examination was at a median of 13.4 (6.3–19.0) years and follow‐up lasted a median of 12.0 (5.0–17.4) years. Results Poor visual acuity, poor night vision and, or, photophobia were reported by six children. The best corrected visual acuity at the last visit was a median of 0.4 and 0.5 in the right and left eye and had declined significantly in two patients. Corneal opacities had increased despite HSCT in five patients. High hyperopia, at a median of +6 Dioptres, occurred in all patients and stiff corneas in all four patients that were measured. The patients’ corrected intraocular pressures were normal. Retinal degeneration was identified in two patients. Conclusion Despite HSCT , the long‐term follow‐up of patients with MPS IH showed reduced visual acuity due to corneal opacities or retinal degeneration.