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Late-Onset Lattice Corneal Dystrophy Without Typical Lattice Lines Caused by a Novel Mutation in the TGFBI Gene

Ołdak, Monika MD, PhD; Szaflik, Jacek P. MD, PhD; Ścieżyńska, Aneta MSc; Udziela, Monika MD; Maksym, Radosław B. MD; Rymgayłło-Jankowska, Beata MD, PhD; Hofmann-Rummelt, Carmen; Menzel-Severing, Johannes MD, PhD; Płoski, Rafał MD, PhD; Żarnowski, Tomasz MD, PhD; Kruse, Friedrich E. MD, PhD; Szaflik, Jerzy MD, PhD

doi: 10.1097/ICO.0000000000000062
Basic Investigation

Purpose: The aim of this study was to report the clinical, histopathological, and molecular findings in a patient with late-onset lattice corneal dystrophy (LCD) without typical lattice lines and a novel mutation in the TGFBI gene.

Methods: Corneal lesions were visualized by slit-lamp examination and by in vivo confocal microscopy. Histopathological examination was performed on the patient's corneal specimen obtained during a deep anterior lamellar keratoplasty. By using genomic DNA as a template, all coding regions of the TGFBI gene were amplified and directly sequenced. The presence of the mutation was verified using restriction endonuclease digestion. Eight different computational methods and multiple sequence alignments were used to predict the pathogenicity of the novel genetic variant.

Results: The corneal phenotype was characterized by the presence within the stroma of round, oval, and short comma-shaped structures with indistinct margins. Lattice lines were not visible. Histopathological study revealed positive Congo red areas of amyloid deposits typical for LCD. A novel heterozygous missense mutation p.Leu565Pro was identified in exon 13 of the TGFBI gene. The amino acid substitution was unambiguously predicted to have a high pathogenic potential.

Conclusions: The mutant codon 565 is located at the C-terminus in the region corresponding to a highly conserved amino acid in the fourth fascilin domain of the TGFBI protein. The novel variant expands the spectrum of TGFBI mutations causing LCD and located in this region. An increased number of known mutations will facilitate future studies of genotype–phenotype correlations and molecular pathogenesis of corneal dystrophies.

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Departments of *Histology and Embryology; and

Ophthalmology, Medical University of Warsaw, Warsaw, Poland;

Department of Ophthalmology, Medical University of Lublin, Lublin, Poland;

§Department of Ophthalmology, University of Erlangen-Nürnberg, Erlangen, Germany; and

Department of Medical Genetics, Medical University of Warsaw, Warsaw, Poland.

Reprints: Monika Ołdak, Department of Histology and Embryology, Center of Biostructure Research, Medical University of Warsaw, Chałubińskiego 5, Warsaw 02-004, Poland (e-mail:

Supported by the Medical University of Warsaw Grants No 1M15/N/2010 and 2WF/W1/10.

Presented in part at the European Association for Vision and Eye Research Annual Meeting, October 6–9, 2010, Crete, Greece.

The authors have no funding or conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

Received April 17, 2013

Accepted December 02, 2013

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