ObjectiveTo observe the clinical manifestations of a Wagner syndrome (WS) family. MethodsA retrospective clinical study. Four patients (the proband, his father, sister, and brother) and one family member (the proband's mother) from a WS family diagnosed by clinical examination in Chengdu Aidi Eye Hospital in June 2023 were included in the study. The proband's medical history was examined in detail, followed by best corrected visual acuity (BCVA), fundus color photography, optical coherence tomography (OCT), and OCT angiography (OCTA). The proband underwent full field electroretinogram (ERG) examination. The proband and his sister and brother underwent blood glucose, blood pressure, hearing, face, joint, exercise and general physical examination at the same time. Peripheral venous blood was collected from the proband and 4 other family members. The proband extracts genomic DNA samples, conducts target region capture, library construction and high-throughput sequencing after qualified quality control. The suspected pathogenic mutation sites were verified by Sanger. According to the selected mutation sites, other family members in this family were co-isolated and verified. The pathogenicity of the mutation site was analyzed using the guidelines of the American College of Medical Genetics and Genomics (ACMG). ResultsProband (Ⅱ-1) was 23 years old female. Both eyes BCVA were 0.1. The waveforms of ERG in both eyes were basically normal, and some amplitudes were reduced. Sister of the proband (Ⅱ-2) was 20 years old. Both eyes BCVA 1.0. Fundus examination showed no obvious abnormality. Brother of the proband (Ⅱ-3) was 19 years old. The left eye underwent pars plana vitrectomy combined with silicone oil filling 2 years ago due to retinal detachment and severe vitreous hyperplasia. BCVA light sensitivity, complicated cataract, and fundus opacity were observed. Right eye BCVA was 0.1. The lenses of the proband and his younger sister and brother were pointed and wedged, and the younger brother was heavier. Vitreous cavity of lens. The retina color of both eyes and the right eye of the younger brother of the protor was dark, with flaky dark areas on the side of the nose and the posterior pole, and the symmetrical retinal veil membrane hyperplasia and pulling on the periphery, showing small retinal splits. The choroidal retina showed focal and segmental symmetrically large atrophy. The optic disc was tilted. By OCT examination, the ellipsoid band was partially missing and broken, and the thickness of the choroid layer was reduced. Retinal cortical atrophy in 1 eye (younger brother of proband). By OCTA examination, the mesovascular layer of choroid was atrophied seriously and the blood density decreased. The results of laboratory and general examination of the three siblings showed no obvious abnormalities. The results of genetic testing showed that the proband, his father (Ⅱ-1), his sister and his brother carried a heterozygous mutation of the VCAN gene c.9264A>G (p.Pro3088=). According to ACMG guidelines, the pathogenicity of this variant was unknown. The mother of proband (Ⅰ-2) was wild type. ConclusionsThe abnormal manifestations of WS eyes are diverse, and both anterior and posterior segments could be involved. The pathogenicity of the heterozygous variation of VCAN gene c.9264A>G (P.RO3088 =) in this family is unknown.
Tweenty-one SD rats with streptozotocin-induced diabetes were investigated for the influence of magnesium in cAMP level in the retina of the diabetic rats. The diabetic rats were divided into 3 groups: group 1, drinking tap hehwater; group 2, drinking 0.5% MgSO4 solution and group 3, receiving intramuscular MgSO4(0.1g/kg) once a month. In addition, group 4, a controlgroup of normal nondiabetic rats fed with tap water. In aperiod of 5 months examination, the growth and health conditions of diabetic rats were found to be nearly normal in group 2, 3 and 4, manifested by gaining weight and soft, smooth hairs on the skin, in contrast with loss in weight, rough hairs and even dying of infection in 2 of the diabetic rats in group 1. furthermore, the level of cAMP content in retina was found significantly higher in the diabetic rats taking Mg++ in spite of the route of administration(group 2, 3), as well as in the control group(group 4) than that of the diabetic rats which were fed with tap water. These results demonstrated that Mg++ might play an important role in improving the metabolism of diabetic rats including the retinal tissue by influencing the level of cAMP content, which is necessary in nuclear acid metabolism, protein synthesis, proliferation and differentiation, and other intracellular metabolic processes.
（Chin J Ocul Fundus Dis,1992,8:141-143）
The retina of SD rats was incubated in four types of the Eagle solution respectively. The results showed the cAMP level of retinas was the lowest in the hGnMg(high glucose with normal magnesium) solution but the cAMP level was significantly increased in the hGhMg(high glucose with high magnesium) and higher than that of normal control group. The cAMP level was the highest in the nGhMg(normal glucose with high magnesium). The results suggested that magnesium might play an important role in maintaining the normal metabolism of glucose of the retinal tissue.
（Chin J Ocul Fundus Dis,1992,8:138-140）
