The Retina in Patients With Triple A Syndrome: A Window Into Neurodegeneration?

Front Endocrinol (Lausanne). 2021 Nov 12:12:729056. doi: 10.3389/fendo.2021.729056. eCollection 2021.

Abstract

Objective: Experimental evidence suggests that the clinical manifestations of Triple A syndrome result from oxidative stress. Several conditions caused by oxidative stress display retinal involvement. Our objective was to assess the retina and optic nerve involvement in children with Triple A syndrome.

Methods: Eleven patients with genetically proven Triple A syndrome followed-up in our centre were approached for study participation. The main outcome was the measurement of the thicknesses of the different retinal layers by Optical Coherence Tomography (OCT).

Results: 9 patients with triple A syndrome had OCT measurements. 7 patients were children and 2 were adults; 4 were females and 5 were males. The 7 paediatric patients had at least two OCT measured at a mean interval of 7.9 months after the first one. The average Retinal Nerve Fibre Layer thickness was 74 ± 10 µm in patients compared to the paediatric reference range of 100 ± 2 µm (p<0.05).

Conclusions and relevance: This is the first study to document retinal layer thicknesses in a series of patients with Triple A syndrome. Nearly all retinal thickness and peripapillary RNFL measurements were very significantly inferior to the reference range in Triple A patients, whatever their age. RNFL thinning was more marked at the temporal part of the optic nerve. OCT being non-invasive, it represents a promising tool to assess the severity of neurodegeneration in patients with Triple A syndrome.

Keywords: AAAS; ALADIN; OCT; RNFL; Redox; Triple A syndrome; neurodegeneration; retina.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adrenal Insufficiency / complications*
  • Adult
  • Child
  • Child, Preschool
  • Esophageal Achalasia / complications*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Neurodegenerative Diseases / etiology
  • Neurodegenerative Diseases / pathology*
  • Prognosis
  • Retina / pathology*
  • Retrospective Studies
  • Tomography, Optical Coherence / methods*
  • Young Adult

Supplementary concepts

  • Achalasia Addisonianism Alacrimia syndrome