Clinical Biochemical and Pathologic Correlations in Bietti's Crystalline Dystrophy

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We examined three affected members of a Chinese-American family with Bietti's crystalline retinopathy. The clinical characteristics of a 24-year-old proband are contrasted to the clinical findings of her grandmother, for whom we have 26 years of follow-up data. Lymphocytes and fibroblasts from a skin biopsy of the grandmother contained crystalline lysosomal material, which supports the diagnosis. Biochemical studies of the crystalline lysosomal material failed to identify the stored compounds but did not show them to be cholesterol or cholesterol ester. Finally, histopathologic studies performed for this condition demonstrated advanced panchorioretinal atrophy, with crystals and complex lipid inclusions seen in choroidal fibroblasts.

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      Citation Excerpt :

      The main sites of expression of this gene in the eye are the RPE and choroid. In advanced cases, histopathology demonstrates severe panchorioretinal atrophy, with crystals and complex lipid inclusions seen in choroidal fibroblasts, corneal keratocytes, and conjunctival fibroblasts (Kaiser-Kupfer et al., 1994; Wilson et al., 1989). Choroidal involvement is thought to be central to the pathogenesis of this condition.

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    Reprint requests to Muriel I. Kaiser-Kupfer, M.D., NEI-NIH, 10 Center Drive, Bldg. 10, Rm. 10N226, Bethesda, MD 20892.

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