Retinal pigment epithelium lesions as a biomarker of disease in patients with familial adenomatous polyposis. A follow-up report.
BACKGROUND
The sensitivity of retinal pigment epithelium (RPE) lesions as a predictive congenital marker for the development of familial adenomatous polyposis (FAP) is evaluated.


METHODS
In a prospective study, 34 patients at 50% risk of inheriting FAP were examined. Based on the presence or absence of four or more RPE lesions, patients were categorized as those who had inherited or those who lacked the FAP genes. All patients received dilated fundus examinations with binocular indirect ophthalmoscopy and all RPE lesions were documented with fundus photography. All patients underwent annual sigmoidoscopy to determine the presence or absence of polyps.


RESULTS
A 3-year follow-up analysis showed that 8 of 14 patients who were positive for RPE lesions later developed polyps. Of the 20 patients considered negative for FAP based on normal fundus examination, none has developed polyps.


CONCLUSIONS
The authors urge all patient at risk of inheriting FAP to undergo dilated fundus examination with binocular indirect ophthalmoscopy and wide-angle fundus photography at the earliest age possible. All patients with 4 or more RPE lesions should undergo annual sigmoidoscopic examinations beginning before 10 years of age.
Romania
A
A
Southwestern Eye Center, Prescott, AZ 86301.
Zakov
Z N
ZN
Church
J M
JM
Jagelman
D G
DG
D011125:Adenomatous Polyposis Coli / Q000175:diagnosis* / Q000235:genetics; D000293:Adolescent; D000328:Adult; D015415:Biomarkers; D002648:Child; D005190:Family; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D009887:Ophthalmoscopy; D010781:Photography; D010857:Pigment Epithelium of Eye / Q000473:pathology*; D011446:Prospective Studies; D012307:Risk Factors; D012812:Sigmoidoscopy
D015415:Biomarkers