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Keratitis fugax hereditaria(KEFH)

MedGen UID:
372107
Concept ID:
C1835697
Disease or Syndrome
Synonym: KERATOENDOTHELIITIS FUGAX HEREDITARIA
 
Gene (location): NLRP3 (1q44)
 
Monarch Initiative: MONDO:0007849
OMIM®: 148200

Definition

Keratoendotheliitis fugax hereditaria (KEFH) is an autosomal dominant corneal disease that periodically and fleetingly affects the corneal endothelium, stroma, and vision, eventually resulting in central corneal stromal opacities in some patients. The disease is characterized by episodes of unilateral ocular pain, pericorneal injection, and photophobia. The acute symptoms vanish in 1 to 2 days, but vision remains blurry for several weeks. Onset occurs between ages 3 and 12 years, and may involve either eye. Episodes generally decrease in frequency and become more mild with age (summary by Turunen et al., 2018). [from OMIM]

Clinical features

From HPO
Photophobia
MedGen UID:
43220
Concept ID:
C0085636
Sign or Symptom
Excessive sensitivity to light with the sensation of discomfort or pain in the eyes due to exposure to bright light.
Keratitis
MedGen UID:
44013
Concept ID:
C0022568
Disease or Syndrome
Inflammation of the cornea.
Epiphora
MedGen UID:
57518
Concept ID:
C0152227
Disease or Syndrome
Abnormally increased lacrimation, that is, excessive tearing (watering eye).
Preretinal fibrosis
MedGen UID:
87388
Concept ID:
C0339543
Anatomical Abnormality
An epiretinal membrane is a thin sheet of fibrous tissue that can develop on the surface of the macular area of the retina and cause a disturbance in vision. An epiretinal membrane area can develop on the thin macular area of the retin. An epiretinal membrane is also sometimes called a macular pucker, premacular fibrosis, surface wrinkling retinopathy or cellophane maculopathy.
Blurred vision
MedGen UID:
91020
Concept ID:
C0344232
Finding
Lack of sharpness of vision resulting in the inability to see fine detail.
Opacification of the corneal stroma
MedGen UID:
602191
Concept ID:
C0423250
Finding
Reduced transparency of the stroma of cornea.
Conjunctival hyperemia
MedGen UID:
315653
Concept ID:
C1761613
Finding
Dilatation of the blood vessels of the conjunctiva leading to a red appearance of the sclera.

Recent clinical studies

Etiology

Immonen AT, Kawan S, Vesaluoma M, Heiskanen JM, Taipale C, Koskinen M, Majander A, Kivelä TT, Turunen JA
Am J Ophthalmol 2022 Apr;236:309-318. Epub 2021 Nov 3 doi: 10.1016/j.ajo.2021.10.025. PMID: 34740632

Diagnosis

Jatavallabhula K, Onyia O, Chung DD, Williams D, Wang K, Aldave AJ
Cornea 2024 Feb 1;43(2):253-256. Epub 2023 Oct 11 doi: 10.1097/ICO.0000000000003399. PMID: 37823852
Moltrasio C, Romagnuolo M, Marzano AV
Front Immunol 2022;13:1007705. Epub 2022 Oct 6 doi: 10.3389/fimmu.2022.1007705. PMID: 36275641Free PMC Article
Kivelä TT
Acta Ophthalmol 2022 Sep;100(6):603-604. doi: 10.1111/aos.15064. PMID: 35946334
Turunen JA, Wedenoja J, Repo P, Järvinen RS, Jäntti JE, Mörtenhumer S, Riikonen AS, Lehesjoki AE, Majander A, Kivelä TT
Am J Ophthalmol 2018 Apr;188:41-50. Epub 2018 Jan 31 doi: 10.1016/j.ajo.2018.01.017. PMID: 29366613

Therapy

Kawan S, Backlund MP, Immonen AT, Kivelä TT, Turunen JA
Br J Ophthalmol 2024 Jan 29;108(2):323-328. doi: 10.1136/bjo-2022-321825. PMID: 36385001
Moltrasio C, Romagnuolo M, Marzano AV
Front Immunol 2022;13:1007705. Epub 2022 Oct 6 doi: 10.3389/fimmu.2022.1007705. PMID: 36275641Free PMC Article
Valle O
Ophthalmologica 1966;151(5):537-47. doi: 10.1159/000304912. PMID: 4380911

Clinical prediction guides

Jatavallabhula K, Onyia O, Chung DD, Williams D, Wang K, Aldave AJ
Cornea 2024 Feb 1;43(2):253-256. Epub 2023 Oct 11 doi: 10.1097/ICO.0000000000003399. PMID: 37823852
Kawan S, Backlund MP, Immonen AT, Kivelä TT, Turunen JA
Br J Ophthalmol 2024 Jan 29;108(2):323-328. doi: 10.1136/bjo-2022-321825. PMID: 36385001
Immonen AT, Kawan S, Vesaluoma M, Heiskanen JM, Taipale C, Koskinen M, Majander A, Kivelä TT, Turunen JA
Am J Ophthalmol 2022 Apr;236:309-318. Epub 2021 Nov 3 doi: 10.1016/j.ajo.2021.10.025. PMID: 34740632
Turunen JA, Immonen AT, Järvinen RS, Kawan S, Repo P, Korsbäck A, Ala-Fossi O, Jaakkola AM, Majander A, Vesaluoma M, Kivelä TT
Am J Ophthalmol 2020 May;213:217-225. Epub 2020 Feb 12 doi: 10.1016/j.ajo.2020.02.002. PMID: 32059980
Turunen JA, Wedenoja J, Repo P, Järvinen RS, Jäntti JE, Mörtenhumer S, Riikonen AS, Lehesjoki AE, Majander A, Kivelä TT
Am J Ophthalmol 2018 Apr;188:41-50. Epub 2018 Jan 31 doi: 10.1016/j.ajo.2018.01.017. PMID: 29366613

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