Ophthalmic findings in patients with arterial tortuosity syndrome and carriers: A case series

ABSTRACT

Introduction: Arterial tortuosity syndrome (ATS) is a rare autosomal recessive disease hallmarked by tortuosity, stenosis, and aneurysm development of large- and medium-sized arteries. Mutations in SLC2A10, a gene that encodes the facilitative glucose transporter GLUT10, cause ATS. Several case reports have noted associated ophthalmic findings such as keratoconus, keratoglobus, and myopia without detailed descriptions or standardized examinations. We report the ophthalmic findings in a cohort of compound heterozygous ATS patients and heterozygous carriers of SLC2A10 mutations.

Methods: Five ATS patients and three carriers were identified through an ATS specialty clinic at the Arkansas Children’s Hospital in Little Rock, Arkansas. Patients underwent complete eye examinations, including corneal pachymetry, topography, and optical coherence tomography when indicated.

Results: All five patients with ATS had myopia and thin corneas with an average central corneal thickness of 426 µm, and three had corneal ectasia, two with early keratoconus and one with keratoglobus and deep stromal corneal opacities. One patient had bilateral high irregular astigmatism, and one had unilateral high regular astigmatism. All carriers had myopia, one had corneal thinning, and one developed keratectasia in one eye many years after laser-assisted in situ keratomileusis (LASIK) surgery.

Conclusion: We document a spectrum of ophthalmic manifestations of ATS with universal findings of myopia, corneal thinning, and a propensity for corneal ectasia leading to keratoconus or keratoglobus. Heterozygous carriers may develop keratectasia after corneal refractive surgery. Our data support regular eye examinations for all patients carrying SLC2A10 mutations with follow-up tailored to clinical findings.

KEYWORDS:

• Arterial tortuosity syndrome
• corneal thinning
• keratectasia
• keratoconus
• keratoglobus
• SLC2A10 mutation

Acknowledgments

We wish to acknowledge Dr. Eudice Fontenot and Dr. Tom Collins who were instrumental in establishing the specialty clinic for arterial tortuosity syndrome at Arkansas Children’s Hospital. We also wish to acknowledge Andrea Taylor and her work in establishing “A Twist of Fate,” a non-profit foundation dedicated to the study and treatment of arterial tortuosity syndrome.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Funding

This research supported in part by the Department of Ophthalmology, Harvey & Bernice Jones Eye Institute, UAMS, and Research to Prevent Blindness. Bert Callewaert is a senior clinical investigator of the Fund for Scientific Research—Flanders.

Additional information

Funding

This research supported in part by the Department of Ophthalmology, Harvey & Bernice Jones Eye Institute, UAMS, and Research to Prevent Blindness. Bert Callewaert is a senior clinical investigator of the Fund for Scientific Research—Flanders.