Osteopathia striata with cranial sclerosis causing a compressive optic neuropathy

Ophthalmic Genet. 2023 Oct;44(5):496-500. doi: 10.1080/13816810.2022.2144902. Epub 2022 Nov 29.


Background: Osteopathia striata combined with cranial sclerosis (OS-CS) is an inherited skeletal dysplasia that manifests with macrocephaly, orofacial abnormalities, thickened craniofacial bones, and vertically oriented radiodensities of the long bones.

Case report: Here, we present a severe case of OS-CS in a 4-year-old girl causing optic neuropathy as shown by radiographic evidence, ophthalmic findings, and histopathology. Previous genetic testing in this patient revealed a de novo heterozygous mutation in AMER1 (c.1057C>T, p.Arg353Ter). Although the patient had a pre-existing, appropriately functioning, ventriculoperitoneal (VP) shunt, a subsequent MRI of the brain and orbits showed narrowing of the bilateral optic nerve canals secondary to osseous thickening causing bilateral optic nerve atrophy, worse on the left. The patient underwent staged bilateral orbital osteotomies, optic canal decompression, and bilateral frontal craniotomy, and at 11 months postoperatively, her vision remained stable. Conclusions: While up to 50% of the patients with OS-CS may experience hearing loss due to cranial nerve compression, we present a case of severe visual loss secondary to OS-CS-associated optic nerve compression.

Keywords: AMER1 mutation; Osteopathia striata with cranial sclerosis; compressive optic neuropathy; disc edema; skeletal dysplasia.

Publication types

  • Case Reports

MeSH terms

  • Child, Preschool
  • Female
  • Humans
  • Optic Nerve
  • Optic Nerve Diseases* / diagnosis
  • Optic Nerve Diseases* / etiology
  • Osteochondrodysplasias*
  • Osteosclerosis* / complications
  • Osteosclerosis* / genetics

Supplementary concepts

  • Osteopathia striata cranial sclerosis