Background: Knobloch syndrome (KS) is a rare autosomal recessive disorder associated with multiple ocular and cranial abnormalities. Occult occipital skull defect or encephalocele should raise suspicion of this disease. It is never reported in neurosurgical literature, possibly due to a lack of clinician familiarity, leading to underdiagnosis and inadequate management. Our patient also had seizures, which is a sporadic presentation of this syndrome.

Case Description: Here, we report a clinico-radiologic finding of a 7-year-old boy who presented with seizures, cataracts, and an occipital bone defect along with bilateral subependymal heterotopias and polymicrogyria.

Conclusions: This case highlights the importance of consideration of this syndrome in children with a midline occipital bone defect with or without encephalocele and seizures. Early recognition of this presentation is critical for obtaining access to appropriate genetic counseling and subsequent monitoring and prevention of complications by surgical intervention.

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http://dx.doi.org/10.1159/000512719DOI Listing

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Background/objectives: Knobloch syndrome 1 (KS) is an autosomal recessive inherited ocular syndrome characterized by a combination of high myopia, vitreoretinal degeneration, and occipital encephalocele. KS is caused by biallelic pathogenic variants in the gene. Diagnosing KS can be challenging due to its clinical heterogeneity and the rarity of the syndrome.

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J AAPOS

December 2024

Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates; Department of Ophthalmology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio. Electronic address:

We report the case of a 7-year-old girl with Knobloch syndrome who presented with retinal detachment due to a macular hole, which was treated with vitrectomy and silicone oil tamponade. The macular hole persisted, and recurrent silicone oil emulsification required exchanges, with two subsequent vitrectomies. Finally, an amniotic membrane graft was used to seal the macular hole in an effort to avoid silicone oil dependence for retinal attachment.

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Article Synopsis
  • - The p21-activated kinase (PAK) family regulates important cellular processes, including cell adhesion, movement, growth, and programmed cell death, with PAK2 specifically playing a role in apoptosis and angiogenesis.
  • - A new missense variant, p.(Thr406Met), was discovered in a newborn with symptoms of Knobloch syndrome, alongside another variant, p.(Asp425Asn), both leading to significantly reduced PAK2 protein activity.
  • - These findings suggest that deficiencies in PAK2 are linked to a second form of Knobloch syndrome, known as KNO2, supporting previous research on related PAK2 variants.
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P21-activated kinase 2 (PAK2) is a serine/threonine kinase essential for a variety of cellular processes including signal transduction, cellular survival, proliferation, and migration. A recent report proposed monoallelic variants cause Knobloch syndrome type 2 (KNO2)-a developmental disorder primarily characterized by ocular anomalies. Here, we identified a novel heterozygous missense variant in NM_002577.

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Background: Knobloch syndrome (KNO, OMIM # 267,750) is a rare ciliopathy group sydrome characterized by a collagen synthesis disorder. It represents an uncommon cause of pediatric retinal detachment. This report presents two cases with different COL18A1 gene mutations, complicated by retinal detachment.

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