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Diseases

Genetic and Rare Diseases Information Center (GARD)

Goldmann-Favre syndrome


Other Names for this Disease
  • Enhanced S-cone syndrome
  • Retinoschisis with early hemeralopia
  • Favre hyaloideoretinal degeneration
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.

Your Question

I would appreciate receiving information about the diagnosis, prognosis and treatment of patients with Goldmann Favre vitreoretinal disorder.

Our Answer

We have identified the following information that we hope you find helpful. If you still have questions, please contact us.

What is Goldmann-Favre syndrome?

Goldmann-Favre syndrome, also known as the severe form of enhanced S-cone syndrome, is a inherited eye disease that affects the light-sensitive part of the eye (retina). Within the retina are "red," "blue," and "green" cones which allow us to see colors properly; and rods which allows us to see in dim light. People with Goldmann-Favre syndrome are born with an overabundance of blue cones, a reduced number of red and green cones, and few, if any, functional rods.[1] As a result they experience an increased sensitivity to blue light, varying degrees of red and green cone vision, night blindness occurring from early life, vision loss, and retinal degeneration.[2] Goldmann-Favre syndrome can be caused by mutations in the NR2E3 gene and is inherited in an autosomal recessive fashion.[2]Treatment may include laser photocoagulation and medication, such as acetazolamide, dorzolamide and cyclosporin A.[3][4] 
Last updated: 5/19/2016

How is Goldmann-Favre syndrome diagnosed?

Goldmann-Favre syndrome may be suspected following ophthalmoscopy examination. Ophthalmoscopy, also known as funduscopy, allows the doctor to look at the back part of the eye (fundus), which includes the retina, optic disc, choroid, and blood vessels. The architecture of the retina in people with Goldmann-Favre syndrome differs remarkably from normal at all disease stages.[5] Examples of Goldmann-Favre syndrome retinal abnormalities that can be demonstrated by opthalmoscopy include clumps of pigment and atrophic lesions.[5]

Other tests that may be used in diagnosing Goldmann-Favre syndrome include optical coherence tomographyelectroretinograms, and genetic tests. Optical coherence tomography produces specialized photos that show the layers of the retina in cross section. In people with Goldmann-Favre syndrome, optical coherence tomography shows increased retinal thickening.[5] Electroretinograms measure the activity of the cells in the retina. In Goldmann-Favre syndrome, electroretinograms may demonstrate no or diminished activity in these cells.[6][7] Genetic testing to search for disease causing mutations in the NR2E3 gene may be used to confirm a suspected diagnosis.[3460 
Last updated: 5/16/2011

How might Goldmann Favre syndrome be treated?

While treatment options for complications such as, retinoschisis and cystoid macular edema may be recommended, currently there is not a cure or specific targeted treatment for Goldmann Favre syndrome.[8][9]

Laser photocoagulation may benefit macular retinoschisis maybe because it results in the debridement of diseased retinal pigment epithelial (RPE) cells and replacement by new cells decreasing the fluid within the macular cysts that could form in the disease.[4]

Some improvement of visual acuity has been reported after treatments with cyclosporin A and bromocriptine.[10] Acetazolamide, 125 mg twice daily and topical 2% dorzolamide have also worked for some patients with macular edema.[3][4] 
Last updated: 5/19/2016

What is the typical prognosis for people with Goldmann-Favre syndrome?

It is difficult to predict how Goldmann-Favre syndrome may affect a person over time, but tipically, the disease is progressive. Symptoms and symptom severity can vary considerably from person to person. Some people with Goldmann-Favre syndrome experience vision loss and retinal involvement from childhood, while others maintain retinal function into old age.[8][11]

In general, in childhood Goldmann-Favre syndrome may cause accommodative esotropia (eye-crossing) and poor night vision.[12] Farsightedness and night blindness appears to be common features in adults. Other variable signs and symptoms in adults include reduced vision in very bright light,[13] variable degree of central vision loss,[8] astigmatism,  retinoschisis, and cystoid macular edema.[8] One review found vision (visual acuity) to range from normal to severely reduced among people with retinas affected by NR2E3 mutations. The presence of retinoschisis, may be associated with poorer vision.[8] Some studies have shown improvement of the vision with treatment.[3]

While NR2E3 mutations are not identified in all people with Goldmann-Favre syndrome, many cases are caused by mutations in this gene. Symptom and symptom severity is likely influenced by which NR2E3 mutations are carried, as well as other poorly understood genetic and environmental factors. 
Last updated: 5/19/2016

How can I find a genetics professional in my area?

Genetics clinics are a source of information for individuals and families regarding genetic conditions, treatment, inheritance, and genetic risks to other family members. More information about genetic consultations is available from Genetics Home Reference. To find a genetics clinic, we recommend that you contact your primary healthcare provider for a referral.

The following online resources can help you find a genetics professional in your community:
Last updated: 6/5/2014

References
  • Sharon D, Sandberg M, Caruso R, Berson EL & Dryja TP. Shared Mutations in NR2E3 in Enhanced S-cone Syndrome, Goldmann-Favre Syndrome, and Many Cases of Clumped Pigmentary Retinal Degeneration. Arch Ophthalmol. 2003 Sept; 121(9):1316-23. http://www.ncbi.nlm.nih.gov/pubmed/12963616.
  • NR2E3. Genetics Home Reference. January 2016; http://ghr.nlm.nih.gov/gene/NR2E3.
  • Bušic M, Bjeloš M, Bosnar D, Ramic S & Bušic I. Cystoid macular lesions are resistant to topical dorzolamide treatment in enhanced S-cone syndrome child. Doc Ophthalmol. February, 2016; 132(1):67-73.
  • Salvatore S, Fishman GA & Genead MA. Treatment of cystic macular lesions in hereditary retinal dystrophies. Surv Ophthalmol. November-December, 2013; 58(6):560-84.
  • Jacobson SG, Sumaroka A, Aleman TS, Cideciyan AV, Schwartz SB, Roman AJ, McInnes RR, Sheffield VC, Stone EM, Swaroop A, Wright AF. Nuclear receptor NR2E3 gene mutations distort human retinal laminar architecture and cause an unusual degeneration . Hum Mol Genet. 2004 Sep 1; http://hmg.oxfordjournals.org/content/13/17/1893.long. Accessed 5/13/2011.
  • Enhanced S-cone syndrome. Online Mendelian Inheritance in Man. 2016; http://www.ncbi.nlm.nih.gov/omim/268100.
  • Sustar M, Perovšek D, Cima I, Stirn-Kranjc B, Hawlina M & Brecelj J. lectroretinography and optical coherence tomography reveal abnormal post-photoreceptoral activity and altered retinal lamination in patients with enhanced S-cone syndrome. Doc Ophthalmol. June, 2015; 130(3):165-77.
  • Audo I, Michaelides M, Robson AG, Hawlina M, Vaclavik V, Sandbach JM, Neveu MM, Hogg CR, Hunt DM, Moore AT, Bird AC, Webster AR, Holder GE. Phenotypic Variation in Enhanced S-cone Syndrome. Invest Ophthalmol Vis Sci. 2008 May;49(5):2082-93; http://www.iovs.org/content/49/5/2082.long. Accessed 5/13/2011.
  • Iannaccone A, Fung KH, Eyestone ME, Stone EM. Treatment of adult-onset acute macular retinoschisis in enhanced s-cone syndrome with oral acetazolamide. Am J Ophthalmol. 2009 Feb;147(2):307-312.e2.; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2677970/?tool=pubmed. Accessed 5/16/2011.
  • Goldmann-Favre syndrome. Orphanet. 2009; http://www.orpha.net/consor/cgi-bin/Disease_Search.php?lng=EN&data_id=10723.
  • Sato T, Kuniyoshi K, Nakao A, Shimomura Y, Tomemori R. Long-term observation of two cases of enhanced S-cone syndrome. Nippon Ganka Gakkai Zasshi. 2009 Oct;113(10):980-90; http://www.ncbi.nlm.nih.gov/pubmed/19882934. Accessed 5/13/2011.
  • Khan AO, Aldahmesh M & Meyer B. The enhanced S-cone syndrome in children. Br J Ophthalmol. March, 2007; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1857689/?tool=pubmed.
  • Pachydaki SI, Klaver CC, Barbazetto IA, Roy MS, Gouras P, Allikmets R, Yannuzzi LA. Phenotypic Features of Patients With NR2E3 Mutations. Arch Ophthalmol. 2009 Jan;127(1):71-5; http://archopht.ama-assn.org/cgi/content/full/127/1/71.
Other Names for this Disease
  • Enhanced S-cone syndrome
  • Retinoschisis with early hemeralopia
  • Favre hyaloideoretinal degeneration
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.