Oliver McFarlane syndrome: two new cases and a review of the literature

Ophthalmic Genet. 2021 Aug;42(4):464-473. doi: 10.1080/13816810.2021.1904419. Epub 2021 Apr 5.


Background: Oliver McFarlane syndrome is a rare syndrome. Clinical presentations include trichomegaly, chorioretinal degeneration, pituitary hormone deficits, and neurological manifestations. Genetic analysis has recently placed this syndrome within the group of PNPLA6-related disorders. Here, we describe two new individuals and review the previously published cases.

Materials and methods: Clinical investigations were carried out in accordance with local guidelines and clinical information was retrieved from medical records. Genetic studies were carried out using next-generation sequencing based clinical exome sequencing. A PubMed literature search was performed with a review of the published clinical cases of Oliver McFarlane syndrome.

Results: Our first individual was a 36-year-old woman with 32 years of follow up and our second individual was a 3-year-old boy. Both individuals were born preterm and presented with prolonged neonatal respiratory distress, trichomegaly, early growth retardation, retinopathy and sparse depigmented hair. So far, none of our cases have demonstrated cognitive impairment or progressive neurological symptoms, but the child revealed persistent abnormal lung structure. Both individuals were compound heterozygous for pathogenic PNPLA6 variants, one of which was novel. We found other 31 clinically documented published cases.

Conclusions: Our two new unrelated cases of Oliver McFarlane Syndrome demonstrate early ophthalmological and systemic findings of this rare syndrome and the progressive nature of the retinopathy with a long follow-up. PNPLA6-related disorders are a phenotypically highly heterogenous group where alterations in the phosphatidylcholine metabolism can lead to manifestations in different tissues with no clear genotype-phenotype correlation.

Keywords: Oliver McFarlane; PNPLA6; lung architecture; retinal degeneration; subretinal deposits; trichomegaly.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acyltransferases / genetics*
  • Adult
  • Blepharoptosis / diagnosis*
  • Blepharoptosis / genetics*
  • Blepharoptosis / physiopathology
  • Child, Preschool
  • Developmental Disabilities / diagnosis
  • Developmental Disabilities / genetics
  • Developmental Disabilities / physiopathology
  • Dwarfism / diagnosis*
  • Dwarfism / genetics*
  • Dwarfism / physiopathology
  • Exome Sequencing
  • Female
  • Follow-Up Studies
  • Genetic Association Studies
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Hypertrichosis / diagnosis*
  • Hypertrichosis / genetics*
  • Hypertrichosis / physiopathology
  • Intellectual Disability / diagnosis*
  • Intellectual Disability / genetics*
  • Intellectual Disability / physiopathology
  • Male
  • Phospholipases / genetics*
  • Retinitis Pigmentosa / diagnosis*
  • Retinitis Pigmentosa / genetics*
  • Retinitis Pigmentosa / physiopathology
  • Tomography, Optical Coherence
  • Visual Acuity / physiology
  • Visual Field Tests
  • Visual Fields / physiology


  • Acyltransferases
  • PNPLA6 protein, human
  • Phospholipases

Supplementary concepts

  • Oliver-McFarlane syndrome