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July 1997

Familial Internal Limiting Membrane Dystrophy: A New Sheen Retinal Dystrophy

Author Affiliations

From the Bascom Palmer Eye Institute, University of Miami School of Medicine, Fla (Drs Polk and Gass); the Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, Md (Dr Green); the Retina Associates of Cleveland, Cleveland, Ohio (Dr Novak); and the W. K. Kellogg Eye Center, University of Michigan School of Medicine, Ann Arbor, (Dr Johnson). Dr Polk is now affiliated with The Retina Center, Baltimore, Md.; Dr Gass is now affiliated with the Vanderbilt University School of Medicine, Nashville, Tenn.

Arch Ophthalmol. 1997;115(7):878-885. doi:10.1001/archopht.1997.01100160048007

Objective:  To describe the clinicopathologic features of a previously unreported retinal dystrophy.

Methods:  Fourteen members of a single family were examined. The medical records of 2 additional family members were reviewed. Pathologic examination was performed on 2 eyes of 1 affected patient.

Results:  Five individuals were identified with a retinal dystrophy characterized by a glistening inner retinal surface throughout the posterior pole. Visual loss occurred in 3 affected patients in later life owing to superficial polycystic retinal edema and retinal folds. Electroretinographic testing revealed a selective diminution of the b wave. Pathologic examination revealed an abnormal internal limiting membrane with schisis cavities in the inner retina. Endothelial cell swelling, pericyte degeneration, and basement membrane thickening were present in retinal capillaries.

Conclusions:  A previously unreported sheen retinal dystrophy is described. Pedigree analysis suggests an autosomal dominant mode of inheritance. A primary defect in Müller cells is the suspected, but unproved, cause. No effective treatment for the associated visual loss is known. The term familial internal limiting membrane dystrophy is proposed to describe this condition.

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