Keratoconus associated with Williams–Beuren syndrome: First case reports

Abstract

Purpose: To report two memorable clinical comorbid cases of Williams–Beuren syndrome (WBS) associated with keratoconus (KC). WBS is known to be an abnormal systemic development caused by a microdeletion of contiguous genes in chromosome 7q11.23, which includes the elastin gene. KC is currently suspected to have a genetic origin but the responsible gene has not been clearly identified.Methods: KC and WBS is described for two cases. Risk factors for KC were investigated by interviewing parents, and WBS was confirmed by fluorescence in-situ hybridization (FISH). Histological analysis with Orcein (coloring specific to elastin) on the receiver corneal button of patient 1 was carried out.Results: Because of the rarity of both pathologies and the absence of other risk factors for developing keratoconus, we considered a possible genetic link. The association had never been reported in the literature. The first histological investigation could not confirm the presence of abnormal elastin in the cornea, but another gene could be responsible.Conclusion: This report highlights the first cases of this association. Further histological and cytogenetic investigation on the deletion should be interesting in order to argue a possible physiopathological or genomic link.