Opinion: Ocular features aid the diagnosis of Alport syndrome.
Alport syndrome is a common cause of inherited kidney failure but often goes unrecognized. Most affected families show an X-linked pattern of inheritance where affected males develop renal failure and hearing loss, and often lenticonus and retinopathy. Lenticonus is evident on both ophthalmoscopy and slit-lamp examination but retinal abnormalities are more obvious on imaging. Such abnormalities include a perimacular dot-and-fleck retinopathy and a peripheral fleck retinopathy, which might occur independently of each other; a 'dull macular reflex' or 'lozenge', when the perimacular flecks are confluent; and, rarely, a macular hole caused by retinal thinning. Imaging of the central and peripheral retina including 'red-free' views is a rapid, noninvasive and inexpensive test that might aid the diagnosis of Alport syndrome, particularly in male individuals with early-onset renal failure. The assistance of an interested ophthalmologist is invaluable in the diagnosis of Alport syndrome.
Savige
Judy
J
The University of Melbourne Department of Medicine (Northern Health), The Northern Hospital, Epping, Vic, Australia. jasavige@unimelb.edu.au
Colville
Deb
D
D006801:Humans; D007905:Lens Diseases / Q000209:etiology*; D009394:Nephritis, Hereditary / Q000150:complications* / Q000175:diagnosis*; D012164:Retinal Diseases / Q000209:etiology*