Axenfeld-Rieger syndrome in the pediatric population: A review

Abstract

Axenfeld-Rieger syndrome (ARS) is a rare autosomal-dominant neurocristopathy that presents with a variety of classical ocular and systemic findings. The pathophysiology of the disease involves anterior segment dysgenesis, and patients may present with ophthalmic complications early in life, including secondary glaucoma, high refractive errors, amblyopia, and permanent visual damage. There are a limited number of studies in the literature that focus primarily on pediatric patients with ARS. The purpose of this article was to review the current literature on clinical presentation, genetic associations, diagnosis, secondary complications, and treatment of ARS in pediatric patients. Evaluating the essential clinical aspects of the disease in children may allow for earlier diagnosis and treatment and prevent visual morbidity from amblyopia and secondary glaucoma that may result in permanent visual damage.

Keywords: Amblyopia; Axenfeld–Rieger syndrome; pediatric glaucoma; secondary glaucoma.

Figure 1

Posterior embryotoxon (black arrows)

Figure 2

Iris atrophy, corectopia, and posterior embryotoxon (black arrows)

Figure 3

Gonioscopy showing iris processes (black arrows)

Figure 4

Dental abnormalities in Axenfeld–Rieger syndrome. Example of patient with Axenfeld–Rieger syndrome presenting with oligodontia and microdontia