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Lenticonus

MedGen UID:
116078
Concept ID:
C0239119
Congenital Abnormality
SNOMED CT: Lenticonus (253221000)
 
HPO: HP:0001142

Definition

A conical projection of the anterior or posterior surface of the lens, occurring as a developmental anomaly. [from HPO]

Conditions with this feature

X-linked diffuse leiomyomatosis-Alport syndrome
MedGen UID:
333429
Concept ID:
C1839884
Disease or Syndrome
A rare renal disease characterized by the association of X-linked Alport syndrome (glomerular nephropathy, sensorineural deafness and ocular anomalies) and benign proliferation of visceral smooth muscle cells along the gastrointestinal, respiratory, and female genital tracts and clinically manifests with dysphagia, dyspnea, cough, stridor, postprandial vomiting, retrosternal or epigastric pain, recurrent pneumonia, and clitoral hypertrophy in females.
Cataract 16 multiple types
MedGen UID:
814707
Concept ID:
C3808377
Disease or Syndrome
Mutations in the CRYAB gene have been found to cause multiple types of cataract, which have been described as congenital posterior polar, congenital lamellar, and juvenile. Autosomal dominant and autosomal recessive forms have been described. The preferred title/symbol of this entry was formerly 'Cataract, Posterior Polar, 2; CTPP2.'
X-linked Alport syndrome
MedGen UID:
1648433
Concept ID:
C4746986
Disease or Syndrome
In Alport syndrome (AS) a spectrum of phenotypes ranging from progressive renal disease with extrarenal abnormalities to isolated hematuria with a non-progressive or very slowly progressive course is observed. Approximately two thirds of AS is X-linked (XLAS); approximately 15% is autosomal recessive (ARAS), and approximately 20% is autosomal dominant (ADAS). In the absence of treatment, renal disease progresses from microscopic hematuria (microhematuria) to proteinuria, progressive renal insufficiency, and end-stage renal disease (ESRD) in all males with XLAS, and in all males and females with ARAS. Progressive sensorineural hearing loss (SNHL) is usually present by late childhood or early adolescence. Ocular findings include anterior lenticonus (which is virtually pathognomonic), maculopathy (whitish or yellowish flecks or granulations in the perimacular region), corneal endothelial vesicles (posterior polymorphous dystrophy), and recurrent corneal erosion. In individuals with ADAS, ESRD is frequently delayed until later adulthood, SNHL is relatively late in onset, and ocular involvement is rare.
Autosomal dominant Alport syndrome
MedGen UID:
1848787
Concept ID:
C5882663
Disease or Syndrome
In Alport syndrome (AS) a spectrum of phenotypes ranging from progressive renal disease with extrarenal abnormalities to isolated hematuria with a non-progressive or very slowly progressive course is observed. Approximately two thirds of AS is X-linked (XLAS); approximately 15% is autosomal recessive (ARAS), and approximately 20% is autosomal dominant (ADAS). In the absence of treatment, renal disease progresses from microscopic hematuria (microhematuria) to proteinuria, progressive renal insufficiency, and end-stage renal disease (ESRD) in all males with XLAS, and in all males and females with ARAS. Progressive sensorineural hearing loss (SNHL) is usually present by late childhood or early adolescence. Ocular findings include anterior lenticonus (which is virtually pathognomonic), maculopathy (whitish or yellowish flecks or granulations in the perimacular region), corneal endothelial vesicles (posterior polymorphous dystrophy), and recurrent corneal erosion. In individuals with ADAS, ESRD is frequently delayed until later adulthood, SNHL is relatively late in onset, and ocular involvement is rare.

Professional guidelines

PubMed

Zhang Y, Ding J
Pediatr Nephrol 2018 Aug;33(8):1309-1316. Epub 2017 Sep 1 doi: 10.1007/s00467-017-3784-3. PMID: 28864840
Mistr SK, Trivedi RH, Wilson ME
J AAPOS 2008 Feb;12(1):58-61. Epub 2007 Oct 29 doi: 10.1016/j.jaapos.2007.08.003. PMID: 18029213
Cheng KP, Hiles DA, Biglan AW, Pettapiece MC
J Pediatr Ophthalmol Strabismus 1991 May-Jun;28(3):143-9; discussion 150. doi: 10.3928/0191-3913-19910501-07. PMID: 1890571

Recent clinical studies

Etiology

Savige J, Colville D, Rheault M, Gear S, Lennon R, Lagas S, Finlay M, Flinter F
Clin J Am Soc Nephrol 2016 Sep 7;11(9):1713-1720. Epub 2016 Jun 10 doi: 10.2215/CJN.00580116. PMID: 27287265Free PMC Article
Savige J, Sheth S, Leys A, Nicholson A, Mack HG, Colville D
Clin J Am Soc Nephrol 2015 Apr 7;10(4):703-9. Epub 2015 Feb 3 doi: 10.2215/CJN.10581014. PMID: 25649157Free PMC Article
Travi GM, Schnall BM, Lehman SS, Kelly CJ, Hug D, Hirakata VN, Calhoun JH
J AAPOS 2005 Oct;9(5):449-54. doi: 10.1016/j.jaapos.2005.06.001. PMID: 16213394
Parmar P, Salman A
Indian J Ophthalmol 2005 Sep;53(3):193-4. doi: 10.4103/0301-4738.16679. PMID: 16137965
Teekhasaenee C, Nimmanit S, Wutthiphan S, Vareesangthip K, Laohapand T, Malasitr P, Ritch R
Ophthalmology 1991 Aug;98(8):1207-15. doi: 10.1016/s0161-6420(91)32152-3. PMID: 1923357

Diagnosis

Srinivasan K, Sakthivel S
J Fr Ophtalmol 2024 Apr;47(4):104120. Epub 2024 Mar 5 doi: 10.1016/j.jfo.2024.104120. PMID: 38447292
Ghoreishi M, Peyman A, Sadeghi A, Pourazizi M
Eur J Ophthalmol 2022 May;32(3):1386-1389. Epub 2022 Mar 3 doi: 10.1177/11206721221081195. PMID: 35238220
Shekhar M, R S, Menon P R
Can J Ophthalmol 2021 Jun;56(3):213. Epub 2020 Oct 17 doi: 10.1016/j.jcjo.2020.09.012. PMID: 33080174
Khokhar S, Dhull C, Mahalingam K, Agarwal P
Indian J Ophthalmol 2018 Sep;66(9):1335-1336. doi: 10.4103/ijo.IJO_276_18. PMID: 30127164Free PMC Article
Leichter HE, Vargas J, Cohen AH, Ament M, Salusky IB
Pediatr Nephrol 1988 Jul;2(3):312-4. doi: 10.1007/BF00858684. PMID: 3153032

Therapy

Krolo I, Kasumović A, Radman I, Pavić P
Eur J Ophthalmol 2021 Jul;31(4):1584-1587. Epub 2021 Feb 25 doi: 10.1177/1120672121997672. PMID: 33631984
Zhang Y, Ding J
Pediatr Nephrol 2018 Aug;33(8):1309-1316. Epub 2017 Sep 1 doi: 10.1007/s00467-017-3784-3. PMID: 28864840
Boss JD, McDermott M
Eur J Ophthalmol 2016 Apr 12;26(3):e39-41. doi: 10.5301/ejo.5000720. PMID: 26692055
Miner JH, Baigent C, Flinter F, Gross O, Judge P, Kashtan CE, Lagas S, Savige J, Blatt D, Ding J, Gale DP, Midgley JP, Povey S, Prunotto M, Renault D, Skelding J, Turner AN, Gear S
Kidney Int 2014 Oct;86(4):679-84. Epub 2014 Jul 2 doi: 10.1038/ki.2014.229. PMID: 24988067Free PMC Article
Travi GM, Schnall BM, Lehman SS, Kelly CJ, Hug D, Hirakata VN, Calhoun JH
J AAPOS 2005 Oct;9(5):449-54. doi: 10.1016/j.jaapos.2005.06.001. PMID: 16213394

Prognosis

Nicklason E, Mack H, Beltz J, Jacob J, Farahani M, Colville D, Savige J
Ophthalmic Genet 2020 Feb;41(1):13-19. Epub 2020 Mar 11 doi: 10.1080/13816810.2019.1709126. PMID: 32159412
Savige J, Sheth S, Leys A, Nicholson A, Mack HG, Colville D
Clin J Am Soc Nephrol 2015 Apr 7;10(4):703-9. Epub 2015 Feb 3 doi: 10.2215/CJN.10581014. PMID: 25649157Free PMC Article
Sonarkhan S, Ramappa M, Chaurasia S, Mulay K
BMJ Case Rep 2014 Jun 26;2014 doi: 10.1136/bcr-2013-202036. PMID: 24969069Free PMC Article
Travi GM, Schnall BM, Lehman SS, Kelly CJ, Hug D, Hirakata VN, Calhoun JH
J AAPOS 2005 Oct;9(5):449-54. doi: 10.1016/j.jaapos.2005.06.001. PMID: 16213394
Kalyanasundaram TS, Bearn MA
J Cataract Refract Surg 2002 Jun;28(6):1069-70. doi: 10.1016/s0886-3350(00)00794-x. PMID: 12036657

Clinical prediction guides

Al Akeely A, Schatz P, Alhazimi A
Middle East Afr J Ophthalmol 2021 Oct-Dec;28(4):257-259. Epub 2022 Apr 30 doi: 10.4103/meajo.meajo_7_21. PMID: 35719281Free PMC Article
Savige J, Sheth S, Leys A, Nicholson A, Mack HG, Colville D
Clin J Am Soc Nephrol 2015 Apr 7;10(4):703-9. Epub 2015 Feb 3 doi: 10.2215/CJN.10581014. PMID: 25649157Free PMC Article
Rosado C, Bueno E, Fraile P, García-Cosmes P, González-Sarmiento R
Eur J Med Genet 2015 Jan;58(1):35-8. Epub 2014 Oct 28 doi: 10.1016/j.ejmg.2014.10.003. PMID: 25450602
Wang Y, Sivakumar V, Mohammad M, Colville D, Storey H, Flinter F, Dagher H, Savige J
Pediatr Nephrol 2014 Mar;29(3):391-6. Epub 2013 Nov 2 doi: 10.1007/s00467-013-2643-0. PMID: 24178893
Kalyanasundaram TS, Bearn MA
J Cataract Refract Surg 2002 Jun;28(6):1069-70. doi: 10.1016/s0886-3350(00)00794-x. PMID: 12036657

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