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Primary congenital glaucoma is an important cause of childhood blindness worldwide. In congenital glaucoma, the anterior segment of the eye fails to develop completely; this results, in particular, in malformation of the trabecular meshwork and aqueous outflow pathways.1,2 Although sporadic cases arise frequently, many cases of congenital glaucoma are inherited as an autosomal recessive trait, and the disease is common, particularly in countries in which consanguinity is customary.3
One gene responsible for autosomal recessive congenital glaucoma, CYP1B1, has been discovered.4,5 This gene codes for cytochrome P450 1B1, a monooxygenase that may be involved in the metabolism of a variety of substrates, including steroids and retinoids.6 Although the role the gene product plays in congenital glaucoma is not well understood, the protein is likely to be responsible for the metabolism of another compound or compounds that perform critical functions in the developing eye. Interestingly, heterozygous carriers of mutations of CYP1B1 do not have clinically evident ocular or systemic phenotypic abnormalities.7
The CYP1B1 gene is composed of three exons, two of which are translated to produce the protein. Mutations that cause congenital glaucoma have been found in exons 2 and 3. Missense and frameshift mutations have been identified, with most of the missense mutations occurring in highly conserved functional regions of the gene.8 Mutations were first found in this gene in a population of Turkish patients with congenital glaucoma.4 Subsequently, different mutations have been found in a variety of ethnic groups, including Saudi Arabians, Japanese people, and Slovakian gypsies.5,9–11
Most of the mutations of CYP1B1 in patients with congenital glaucoma have been identified in ethnically homogeneous populations. In an earlier study, we screened American and Brazilian families with congenital glaucoma for mutations of the CYP1B1 gene to determine the …
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