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Nuclear cataract

MedGen UID:
140274
Concept ID:
C0392557
Acquired Abnormality; Finding
Synonym: Cataract, nuclear
SNOMED CT: NS - Nuclear sclerosis (53889007); Nuclear cataract (53889007)
 
HPO: HP:0100018
Monarch Initiative: MONDO:0045050

Definition

A nuclear cataract is an opacity or clouding that develops in the lens nucleus. That is, a nuclear cataract is one that is located in the center of the lens. The nucleus tends to darken changing from clear to yellow and sometimes brown. [from HPO]

Conditions with this feature

Cataract 5 multiple types
MedGen UID:
78608
Concept ID:
C0266537
Congenital Abnormality
Congenital cataracts cause 10 to 30% of all blindness in children, with one-third of cases estimated to have a genetic cause (summary by Bu et al., 2002). Mutations in the HSF4 gene have been found to cause multiple types of cataract, which have been described as infantile, lamellar, zonular, nuclear, anterior polar, stellate, and Marner-type. The preferred title for this entry was formerly 'Lamellar Cataract,' with 'Cataract, Marner Type; CAM; CTM' an included title.
Cataract 20 multiple types
MedGen UID:
101117
Concept ID:
C0524524
Disease or Syndrome
Mutation in the CRYGS gene has been identified in multiple types of cataract, which have been described as progressive polymorphic anterior, posterior, peripheral cortical, sutural, and lamellar.
Early-onset non-syndromic cataract
MedGen UID:
371326
Concept ID:
C1832423
Pathologic Function
A type of age-related cataract that primarily affects the nucleus of the lens.
Hereditary hyperferritinemia with congenital cataracts
MedGen UID:
318812
Concept ID:
C1833213
Disease or Syndrome
Hyperferritinemia-cataract syndrome is a disorder characterized by an excess of an iron storage protein called ferritin in the blood (hyperferritinemia) and tissues of the body. A buildup of this protein begins early in life, leading to clouding of the lenses of the eyes (cataracts). In affected individuals, cataracts usually develop in infancy, rather than after age 60 as typically occurs in the general population. Cataracts that are not removed surgically cause progressive dimming and blurriness of vision because the clouded lenses reduce and distort incoming light.\n\nAlthough the hyperferritinemia in this disorder does not usually cause any health problems other than cataracts, the elevated ferritin levels in the blood can be mistaken for a sign of certain liver disorders. These conditions result in excess iron in the body and may be treated by blood-drawing. However, individuals with hyperferritinemia-cataract syndrome do not have an excess of iron, and with repeated blood draws will develop reduced iron levels leading to a low number of red blood cells (anemia). Therefore, correct diagnosis of hyperferritinemia-cataract syndrome is important to avoid unnecessary treatments or invasive test procedures such as liver biopsies.
Cataract 10 multiple types
MedGen UID:
318817
Concept ID:
C1833229
Disease or Syndrome
Mutations in the CRYBA1 gene have been found to cause multiple types of cataract, which have been described as congenital zonular with sutural opacities, congenital nuclear progressive, and progressive lamellar. The preferred title/symbol of this entry was formerly 'Cataract, Congenital Zonular, with Sutural Opacities; CCZS.'
Hereditary cryohydrocytosis with reduced stomatin
MedGen UID:
332390
Concept ID:
C1837206
Disease or Syndrome
Stomatin-deficient cryohydrocytosis with neurologic defects is an autosomal dominant disorder characterized by delayed psychomotor development, seizures, cataracts, and pseudohyperkalemia resulting from defects in the red blood cell membrane. The disorder combines the neurologic features of Glut1 deficiency syndrome-1 (GLUT1DS1; 606777), resulting from impaired glucose transport at the blood-brain barrier, and hemolytic anemia/pseudohyperkalemia with stomatocytosis, resulting from a cation leak in erythrocytes (summary by Bawazir et al., 2012). For a discussion of clinical and genetic heterogeneity of red cell stomatocyte disorders, see 194380.
Cataract 31 multiple types
MedGen UID:
343089
Concept ID:
C1854311
Disease or Syndrome
Mutations in the CHMP4B gene have been found to cause multiple types of cataract, which have been described as posterior polar, progressive posterior subcapsular, nuclear, and anterior subcapsular. The preferred title/symbol of this entry was formerly 'Cataract, Posterior Polar, 3; CTPP3.'
Cataract 22 multiple types
MedGen UID:
341862
Concept ID:
C1857853
Disease or Syndrome
Mutations in the CRYBB3 gene have been identified in families with cataract, described as congenital nuclear cataract with cortical riders, nuclear, posterior polar, anterior polar, and cortical. The preferred title/symbol of this entry was formerly 'Cataract, Congenital Nuclear, Autosomal Recessive 2; CATCN2.'
Cataract 1 multiple types
MedGen UID:
349374
Concept ID:
C1861828
Disease or Syndrome
Mutations in the GJA8 gene have been found to cause several types of autosomal dominant cataract, which have been described as congenital, zonular pulverulent, nuclear progressive, nuclear pulverulent, stellate nuclear, nuclear total, total, and posterior subcapsular. Cataract associated with microcornea, sometimes called the cataract-microcornea syndrome, is also caused by mutation in the GJA8 gene. Before it was known that mutation in the GJB8 gene caused multiple types of cataract, this entry was titled 'Cataract, zonular pulverulent, 1,' with the symbols CZP1, CZP, and CAE1.
Cataract 8 multiple types
MedGen UID:
396230
Concept ID:
C1861833
Disease or Syndrome
The Volkmann type of cataract has been variously described as progressive, central, or zonular, with opacities in the embryonic, fetal, and juvenile nucleus and around the anterior and posterior Y-suture. Expression is highly variable, ranging from hardly recognizable opacities in the lens to dense cataracts. Affected members may thus be unaware of having the disease (Eiberg et al., 1995). The preferred title/symbol of this entry was formerly 'Cataract, Congenital, Volkmann Type; CCV.'
Cataract 18
MedGen UID:
351249
Concept ID:
C1864908
Disease or Syndrome
Mutations in the FYCO1 gene have been identified in families with autosomal recessive cataract described as congenital and congenital nuclear. The preferred title/symbol of this entry was formerly 'Cataract, Autosomal Recessive Congenital 2; CATC2.'
Tricho-oculo-dermo-vertebral syndrome
MedGen UID:
355714
Concept ID:
C1866427
Disease or Syndrome
Mevalonic aciduria
MedGen UID:
368373
Concept ID:
C1959626
Disease or Syndrome
Mevalonic aciduria (MEVA), the first recognized defect in the biosynthesis of cholesterol and isoprenoids, is a consequence of a deficiency of mevalonate kinase (ATP:mevalonate 5-phosphotransferase; EC 2.7.1.36). Mevalonic acid accumulates because of failure of conversion to 5-phosphomevalonic acid, which is catalyzed by mevalonate kinase. Mevalonic acid is synthesized from 3-hydroxy-3-methylglutaryl-CoA, a reaction catalyzed by HMG-CoA reductase (142910). Mevalonic aciduria is characterized by dysmorphology, psychomotor retardation, progressive cerebellar ataxia, and recurrent febrile crises, usually manifesting in early infancy, accompanied by hepatosplenomegaly, lymphadenopathy, arthralgia, and skin rash. The febrile crises are similar to those observed in hyperimmunoglobulinemia D and to periodic fever syndrome (HIDS; 260920), which is also caused by mutation in the MVK gene (summary by Prietsch et al., 2003).
Retinitis pigmentosa 37
MedGen UID:
410004
Concept ID:
C1970163
Disease or Syndrome
Any retinitis pigmentosa in which the cause of the disease is a mutation in the NR2E3 gene.
Retinitis pigmentosa 56
MedGen UID:
462169
Concept ID:
C3150819
Disease or Syndrome
Retinitis pigmentosa-56 (RP56) is an early-onset form of RP with progressive visual-field loss and deterioration of visual acuity (Bandah-Rozenfeld et al., 2010). For a general phenotypic description and a discussion of genetic heterogeneity of retinitis pigmentosa, see 268000.
Cataract 41
MedGen UID:
811742
Concept ID:
C3805412
Disease or Syndrome
Cataract is an opacification of the lens or lens capsule in the eye and is the most common cause of childhood blindness in the world, with an incidence of 1 to 3 per 10,000 live births. If untreated in infancy or childhood, it frequently causes visual impairment and can result in irreversible amblyopia. Nuclear cataract refers to opacification within the embryonal and/or fetal nuclei of the lens (summary by Berry et al., 2013).
Cataract 23
MedGen UID:
814342
Concept ID:
C3808012
Disease or Syndrome
Mutation in the CRYBA4 gene has been found in families with cataract described as congenital, lamellar, and nuclear.
Cataract 33
MedGen UID:
814437
Concept ID:
C3808107
Disease or Syndrome
Mutations in the BFSP1 gene have been found to cause multiple types of cataract, which have been described as cortical, nuclear, and progressive punctate lamellar. Both autosomal dominant and autosomal recessive modes of inheritance have been reported.
Cataract 15 multiple types
MedGen UID:
815331
Concept ID:
C3809001
Disease or Syndrome
Mutations in the MIP gene have been found to cause multiple types of cataract, which have been described as 'polymorphic,' progressive punctate lamellar, cortical, anterior and posterior polar, nonprogressive lamellar with sutural opacities, embryonic nuclear, and pulverulent cortical.
Cataract 17 multiple types
MedGen UID:
854781
Concept ID:
C3888124
Disease or Syndrome
Mutations in the CRYBB1 gene have been found to cause multiple types of cataract, which have been described as congenital nuclear, congenital nuclear with anterior and posterior Y-suture and polar opacities, and pulverulent. The preferred title/symbol for this entry was formerly 'Cataract, Congenital Nuclear, Autosomal Recessive 3; CATCN3.'
Cataract 40
MedGen UID:
886621
Concept ID:
C4049004
Congenital Abnormality
Any early-onset non-syndromic cataract in which the cause of the disease is a mutation in the NHS gene.
Exudative vitreoretinopathy 6
MedGen UID:
902559
Concept ID:
C4225316
Disease or Syndrome
Familial exudative vitreoretinopathy is a hereditary disorder that can cause vision loss that worsens over time. This condition affects the retina, the specialized light-sensitive tissue that lines the back of the eye. In people with this disorder, blood vessels do not fully develop at the outer edges (periphery) of the retina, which reduces the blood supply to this tissue. This prolonged reduction in blood supply (chronic ischemia) causes continued damage to the retina and can lead to worsening of the condition. \n\nThe signs and symptoms of familial exudative vitreoretinopathy vary widely, even within the same family. In many affected individuals, the retinal abnormalities never cause any vision problems. Other people with this condition develop abnormal vessels that leak. This  causes chronic inflammation which, over time, can lead to fluid under the retina (exudate). A reduction in the retina's blood supply causes the retina to fold, tear, or separate from the back of the eye (retinal detachment). The resulting retinal damage can lead to vision loss and blindness. Other eye abnormalities are also possible, including eyes that do not look in the same direction (strabismus) and a visible whiteness (leukocoria) in the normally black pupil.\n\nSome people with familial exudative vitreoretinopathy also have a condition known as osteoporosis-pseudoglioma syndrome, which is characterized by reduced bone density. People with this condition have weakened bones and an increased risk of fractures.
Retinal dystrophy with or without macular staphyloma
MedGen UID:
1381980
Concept ID:
C4479651
Disease or Syndrome
Cataract 2, multiple types
MedGen UID:
1648415
Concept ID:
C4721890
Disease or Syndrome
Mutations in the CRYGC gene have been found to cause several types of cataract, which have been described as Coppock-like; embryonic, fetal, infantile nuclear; zonular pulverulent; and lamellar. Some patients also exhibit microcornea. Before it was known that mutations in the CRYGC gene cause several types of cataract, this entry was titled 'Cataract, Coppock-like,' with the symbol CCL.

Professional guidelines

PubMed

Karadag N, Zenciroglu A, Eminoglu FT, Dilli D, Karagol BS, Kundak A, Dursun A, Hakan N, Okumus N
Clin Lab 2013;59(9-10):1139-46. doi: 10.7754/clin.lab.2013.121235. PMID: 24273939
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J AAPOS 2011 Oct;15(5):421-6. doi: 10.1016/j.jaapos.2011.05.016. PMID: 22108352Free PMC Article
Jonas JB
Acta Ophthalmol Scand 2005 Dec;83(6):645-63. doi: 10.1111/j.1600-0420.2005.00592.x. PMID: 16396641

Recent clinical studies

Etiology

Augustin VA, Weller JM, Kruse FE, Tourtas T
Br J Ophthalmol 2021 Oct;105(10):1365-1370. Epub 2020 Sep 9 doi: 10.1136/bjophthalmol-2019-315206. PMID: 32907813
Haarman AEG, Enthoven CA, Tideman JWL, Tedja MS, Verhoeven VJM, Klaver CCW
Invest Ophthalmol Vis Sci 2020 Apr 9;61(4):49. doi: 10.1167/iovs.61.4.49. PMID: 32347918Free PMC Article
Hashemi H, Pakzad R, Yekta A, Aghamirsalim M, Pakbin M, Ramin S, Khabazkhoob M
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Song E, Sun H, Xu Y, Ma Y, Zhu H, Pan CW
PLoS One 2014;9(11):e112054. Epub 2014 Nov 4 doi: 10.1371/journal.pone.0112054. PMID: 25369040Free PMC Article
Michael R, Bron AJ
Philos Trans R Soc Lond B Biol Sci 2011 Apr 27;366(1568):1278-92. doi: 10.1098/rstb.2010.0300. PMID: 21402586Free PMC Article

Diagnosis

Shimizu E, Tanji M, Nakayama S, Ishikawa T, Agata N, Yokoiwa R, Nishimura H, Khemlani RJ, Sato S, Hanyuda A, Sato Y
Sci Rep 2023 Dec 12;13(1):22046. doi: 10.1038/s41598-023-49563-7. PMID: 38086904Free PMC Article
Cantrell LS, Schey KL
Expert Rev Proteomics 2021 Feb;18(2):119-135. Epub 2021 Apr 14 doi: 10.1080/14789450.2021.1913062. PMID: 33849365Free PMC Article
Augustin VA, Weller JM, Kruse FE, Tourtas T
Br J Ophthalmol 2021 Oct;105(10):1365-1370. Epub 2020 Sep 9 doi: 10.1136/bjophthalmol-2019-315206. PMID: 32907813
Haarman AEG, Enthoven CA, Tideman JWL, Tedja MS, Verhoeven VJM, Klaver CCW
Invest Ophthalmol Vis Sci 2020 Apr 9;61(4):49. doi: 10.1167/iovs.61.4.49. PMID: 32347918Free PMC Article
Zetterström C, Lundvall A, Kugelberg M
J Cataract Refract Surg 2005 Apr;31(4):824-40. doi: 10.1016/j.jcrs.2005.01.012. PMID: 15899463

Therapy

Yuan Y, Wang W, Xiong R, Zhang J, Li C, Yang S, Friedman DS, Foster PJ, He M
Ophthalmology 2023 Aug;130(8):786-794. Epub 2023 Apr 6 doi: 10.1016/j.ophtha.2023.03.024. PMID: 37030454
Haarman AEG, Enthoven CA, Tideman JWL, Tedja MS, Verhoeven VJM, Klaver CCW
Invest Ophthalmol Vis Sci 2020 Apr 9;61(4):49. doi: 10.1167/iovs.61.4.49. PMID: 32347918Free PMC Article
Franks PW, Atabaki-Pasdar N
J Intern Med 2017 Mar;281(3):222-232. Epub 2016 Dec 8 doi: 10.1111/joim.12577. PMID: 27933671
Wei L, Liang G, Cai C, Lv J
Acta Ophthalmol 2016 May;94(3):e170-6. Epub 2015 Mar 4 doi: 10.1111/aos.12688. PMID: 25735187
Song E, Sun H, Xu Y, Ma Y, Zhu H, Pan CW
PLoS One 2014;9(11):e112054. Epub 2014 Nov 4 doi: 10.1371/journal.pone.0112054. PMID: 25369040Free PMC Article

Prognosis

Yuan Y, Wang W, Xiong R, Zhang J, Li C, Yang S, Friedman DS, Foster PJ, He M
Ophthalmology 2023 Aug;130(8):786-794. Epub 2023 Apr 6 doi: 10.1016/j.ophtha.2023.03.024. PMID: 37030454
Zhang X, Xiao Z, Fu H, Hu Y, Yuan J, Xu Y, Higashita R, Liu J
Med Image Anal 2022 Aug;80:102499. Epub 2022 May 29 doi: 10.1016/j.media.2022.102499. PMID: 35704990
Haarman AEG, Enthoven CA, Tideman JWL, Tedja MS, Verhoeven VJM, Klaver CCW
Invest Ophthalmol Vis Sci 2020 Apr 9;61(4):49. doi: 10.1167/iovs.61.4.49. PMID: 32347918Free PMC Article
Franks PW, Atabaki-Pasdar N
J Intern Med 2017 Mar;281(3):222-232. Epub 2016 Dec 8 doi: 10.1111/joim.12577. PMID: 27933671
Zetterström C, Lundvall A, Kugelberg M
J Cataract Refract Surg 2005 Apr;31(4):824-40. doi: 10.1016/j.jcrs.2005.01.012. PMID: 15899463

Clinical prediction guides

Yuan Y, Wang W, Xiong R, Zhang J, Li C, Yang S, Friedman DS, Foster PJ, He M
Ophthalmology 2023 Aug;130(8):786-794. Epub 2023 Apr 6 doi: 10.1016/j.ophtha.2023.03.024. PMID: 37030454
Wen K, Zhang L, Cai Y, Teng H, Liang J, Yue Y, Li Y, Huang Y, Liu M, Zhang Y, Wei R, Sun J
Epigenetics 2023 Dec;18(1):2192324. doi: 10.1080/15592294.2023.2192324. PMID: 36945837Free PMC Article
Schey KL, Wang Z, Rose KL, Anderson DMG
Cells 2022 Dec 14;11(24) doi: 10.3390/cells11244042. PMID: 36552806Free PMC Article
Hashemi H, Pakzad R, Yekta A, Aghamirsalim M, Pakbin M, Ramin S, Khabazkhoob M
Eye (Lond) 2020 Aug;34(8):1357-1370. Epub 2020 Feb 13 doi: 10.1038/s41433-020-0806-3. PMID: 32055021Free PMC Article
Franks PW, Atabaki-Pasdar N
J Intern Med 2017 Mar;281(3):222-232. Epub 2016 Dec 8 doi: 10.1111/joim.12577. PMID: 27933671

Recent systematic reviews

Haarman AEG, Enthoven CA, Tideman JWL, Tedja MS, Verhoeven VJM, Klaver CCW
Invest Ophthalmol Vis Sci 2020 Apr 9;61(4):49. doi: 10.1167/iovs.61.4.49. PMID: 32347918Free PMC Article
Hashemi H, Pakzad R, Yekta A, Aghamirsalim M, Pakbin M, Ramin S, Khabazkhoob M
Eye (Lond) 2020 Aug;34(8):1357-1370. Epub 2020 Feb 13 doi: 10.1038/s41433-020-0806-3. PMID: 32055021Free PMC Article
Beltrán-Zambrano E, García-Lozada D, Ibáñez-Pinilla E
Arch Soc Esp Oftalmol (Engl Ed) 2019 Feb;94(2):60-74. Epub 2018 Dec 7 doi: 10.1016/j.oftal.2018.10.020. PMID: 30528895
Franks PW, Atabaki-Pasdar N
J Intern Med 2017 Mar;281(3):222-232. Epub 2016 Dec 8 doi: 10.1111/joim.12577. PMID: 27933671
Song E, Sun H, Xu Y, Ma Y, Zhu H, Pan CW
PLoS One 2014;9(11):e112054. Epub 2014 Nov 4 doi: 10.1371/journal.pone.0112054. PMID: 25369040Free PMC Article

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