Visual function in children with Joubert syndrome.

AIM To describe visual function in children with Joubert syndrome and to investigate its possible association with diagnostic and developmental aspects. METHOD This retrospective cross-sectional work included 59 patients (33 male; mean age 9 years 2 months, standard deviation 6 years 3 months, range 4 months to 23 years) diagnosed with Joubert syndrome from January 2002 to December 2020. Data about clinical (neurological, neuro-ophthalmological, developmental/cognitive) and diagnostic (e.g. genetic testing, neuroimaging, systemic involvement) evaluations were collected in a data set during a review of medical records. Clinical and diagnostic variables were described in terms of raw counts and percentages. A χ2 test was conducted to investigate their association with neuropsychological skills. RESULTS Ocular motor apraxia was highly represented in our cohort (75%), with a high prevalence of refractive defects and retinal abnormalities. Developmental delay/intellectual disability was frequent (in 69.5% of the sample), associated with retinal dystrophy (p = 0.047) and reduced visual acuity both for near (p = 0.014) and for far distances (p = 0.017). INTERPRETATION On the basis of the relevance of oculomotor and perceptual alterations and their impact on overall and cognitive impairment, we encourage early and multidisciplinary assessment and follow-up of visual function in children with Joubert syndrome. This would help in planning a personalized rehabilitation to sustain functional vision. Further studies will be important to explore the link between biological aspects and global functioning in children with Joubert syndrome.

[1]  M. Koyama,et al.  Rehabilitation Approach for Children With Joubert Syndrome and Related Disorders , 2023, Cureus.

[2]  E. Perotto,et al.  Visual Function and Neuropsychological Profile in Children with Cerebral Visual Impairment , 2022, Children.

[3]  R. Borgatti,et al.  Visual Function Score: A New Clinical Tool to Assess Visual Function and Detect Visual Disorders in Children , 2022, Frontiers in Pediatrics.

[4]  R. Borgatti,et al.  Get Your Molar Tooth Right: Joubert Syndrome Misdiagnosis Unmasked by Whole-Exome Sequencing , 2021, The Cerebellum.

[5]  Caitlin V. Miller,et al.  SUFU haploinsufficiency causes a recognisable neurodevelopmental phenotype at the mild end of the Joubert syndrome spectrum , 2021, Journal of Medical Genetics.

[6]  J. Wood,et al.  Eye movement patterns and reading ability in children , 2021, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[7]  D. Piñero,et al.  Distribution of Visual and Oculomotor Alterations in a Clinical Population of Children with and without Neurodevelopmental Disorders , 2021, Brain sciences.

[8]  M. Gori,et al.  A Multidimensional, Multisensory and Comprehensive Rehabilitation Intervention to Improve Spatial Functioning in the Visually Impaired Child: A Community Case Study , 2020, Frontiers in Neuroscience.

[9]  G. Ruberto,et al.  Electroretinographic Assessment in Joubert Syndrome: A Suggested Objective Method to Evaluate the Effectiveness of Future Targeted Treatment , 2020, Advances in Therapy.

[10]  I. Glass,et al.  Healthcare recommendations for Joubert syndrome , 2019, American journal of medical genetics. Part A.

[11]  Michelle de Haan,et al.  Adaptive behaviour and quality of life in school-age children with congenital visual disorders and different levels of visual impairment. , 2019, Research in developmental disabilities.

[12]  V. Mahajan,et al.  Review of Ocular Manifestations of Joubert Syndrome , 2018, Genes.

[13]  Valldeflors Vinuela-Navarro Eye movements in children: characteristics in typical and atypical development and assessment in practice , 2018 .

[14]  J. Mullikin,et al.  Joubert Syndrome: Ophthalmological Findings in Correlation with Genotype and Hepatorenal Disease in 99 Patients Prospectively Evaluated at a Single Center. , 2018, Ophthalmology.

[15]  Nathan A Hotaling,et al.  Primary Cilium-Mediated Retinal Pigment Epithelium Maturation Is Disrupted in Ciliopathy Patient Cells , 2018, Cell reports.

[16]  Gabriëlle H S Buitendijk,et al.  Development of Refractive Errors-What Can We Learn From Inherited Retinal Dystrophies? , 2017, American journal of ophthalmology.

[17]  M. Michaelides,et al.  Leber congenital amaurosis/early-onset severe retinal dystrophy: clinical features, molecular genetics and therapeutic interventions , 2017, British Journal of Ophthalmology.

[18]  J. Mullikin,et al.  Neuropsychological phenotypes of 76 individuals with Joubert syndrome evaluated at a single center , 2017, American journal of medical genetics. Part A.

[19]  J. Mullikin,et al.  Molecular genetic findings and clinical correlations in 100 patients with Joubert syndrome and related disorders prospectively evaluated at a single center , 2017, Genetics in Medicine.

[20]  E. Valente,et al.  Motile and non‐motile cilia in human pathology: from function to phenotypes , 2017, The Journal of pathology.

[21]  E. Bertini,et al.  Cognitive, adaptive, and behavioral features in Joubert syndrome , 2016, American journal of medical genetics. Part A.

[22]  T. Mazza,et al.  Mutations in CEP120 cause Joubert syndrome as well as complex ciliopathy phenotypes , 2016, Journal of Medical Genetics.

[23]  R. Borgatti,et al.  Cognitive rehabilitation in a child with Joubert Syndrome: Developmental trends and adaptive changes in a single case report. , 2015, Research in developmental disabilities.

[24]  J. Shendure,et al.  Joubert syndrome: a model for untangling recessive disorders with extreme genetic heterogeneity , 2015, Journal of Medical Genetics.

[25]  I. Gottlob,et al.  Nystagmus in childhood. , 2014, Pediatrics and neonatology.

[26]  Harjinder Gill,et al.  Joubert Syndrome Presenting with Motor Delay and Oculomotor Apraxia , 2012, Case reports in pediatrics.

[27]  A. Weiss,et al.  Eye movement abnormalities in Joubert syndrome. , 2009, Investigative ophthalmology & visual science.

[28]  F. Shawkat,et al.  Joubert syndrome: long‐term follow‐up , 2004 .

[29]  M. Moseley,et al.  Contrast sensitivity testing in clinical practice. , 1994, The British journal of ophthalmology.

[30]  O. P. Gray,et al.  Griffiths Scales of Mental Development and different users. , 1980, Child: care, health and development.