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LEYS ANITA MD; GILBERT, HOWARD D. MD; DE SOMPEL, WIVINE VAN MD; VEROUGSTRAETE, CLAIRE MD; DEVRIENDT, KOEN MD; LAGAE, LIEVEN MD; GASS, DONALD J. M. MD
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Purpose:To describe a previously unreported condition involving familial spastic paraplegia and a peculiar type of maculopathy.

Methods:Two pairs of siblings were studied. All four cases underwent serial clinical examinations, fundus photography, and fluorescein angiography. Two siblings had extensive investigations.

Results:Characteristics of the four cases include spastic paraplegia diagnosed in the first decade of life and visual loss at about age 9 due to a maculopathy with an abnormal vascular complex. In the early stages, parafoveal dilatation of the capillary network was noted. The later stages were characterized by cystic macular degeneration, and seven of eight eyes developed fibrovascular scars with retinochoroidal anastomoses, pigment migration, and atrophic changes. In two siblings, electro-oculographic findings were subnormal, whereas results of electroretinography, magnetic resonance imaging of the brain and spinal cord, and metabolic and karyotype studies were normal. These siblings were an Indonesian girl and boy; the other siblings were white males. There was no consanguinity of the parents and family history was unremarkable.

Conclusions:This study suggests that the two pairs of siblings have an identical familial and probably recessive disorder with neurodegenerative changes that have caused paraplegia and a peculiar maculopathy associated with anomalous retinal vascular complexes, retinochoroidal anastomoses, and subretinal neovascularization.

From the Departments of *Ophthalmology. ¶Human Genetics, and #Pediatrics, University Hospital Leuven, Belgium; †the Phillips Eye Institute, Minneapolis, Minnesota; the ‡Department of Ophthalmology, Middelheim Hospital. Antwerp, Belgium; the §Department of Ophthalmology. Brugman Hospital, Brussels, Belgium; and the ¶Department of Ophthalmology, Vanderbilt University, Nashville, Tennessee.

Presented at the annual meeting of the Macula Society; Boca Raton. Florida; February 1998.

Correspondence: Anita Leys, MD, Department of Ophthalmology, Universitaire Ziekenhuizen Leuven, Capucijnenvoer 33, 3000 Leuven, Belgium.

© The Ophthalmic Communications Society, Inc.