# Concurrent Wagner syndrome and retinopathy of prematurity

**Authors:** Landon J. Rohowetz, David W. Redick, Kenneth C. Fan, Audina M. Berrocal

PMC · DOI: 10.1016/j.ajoc.2025.102392 · American Journal of Ophthalmology Case Reports · 2025-07-22

## TL;DR

A 23-year-old man with a history of retinopathy of prematurity was found to also have Wagner syndrome, a rare combination that highlights the need for thorough retinal evaluation.

## Contribution

This case report documents the rare coexistence of Wagner syndrome and retinopathy of prematurity, emphasizing the importance of comprehensive retinal assessment in such patients.

## Key findings

- The patient exhibited clinical features of Wagner syndrome, including vitreous syneresis and lattice degeneration.
- A heterozygous mutation in the VCAN gene was identified through genetic testing.
- Fluorescein angiography and optical coherence tomography revealed retinal abnormalities consistent with both conditions.

## Abstract

To describe the clinical features of a patient with Wagner syndrome and a history of retinopathy of prematurity (ROP).

A 23-year-old Hispanic male was referred for retina evaluation. The patient had a history of regressed ROP in both eyes that was never treated. The patient was born at 26-weeks gestational age and received supplemental oxygen as a neonate. He also reported a history of strabismus treated with surgery at 6 years of age. Best-corrected visual acuity was 20/30 in both eyes. Manifest refraction revealed −8.25 diopters of myopia in both eyes. Posterior segment examination demonstrated vitreous syneresis, a regressed temporal ridge, pigmented lattice degeneration, and atrophic holes in both eyes. Fluorescein angiography revealed temporal small vessel leakage and staining in both eyes without exudation. Electroretinography demonstrated reduced a- and b-wave amplitudes in both eyes. Optical coherence tomography of the macula revealed a blunted foveal contour in both eyes. Genetic testing revealed a heterozygous versican (VCAN) mutation: c.425C > T (p.Thr142Met).

The current case represents a rare combination of diseases and underscores the importance of considering concurrent retinal and vitreoretinal conditions in patients with a history of ROP.

## Linked entities

- **Genes:** VCAN (versican) [NCBI Gene 1462]
- **Diseases:** Wagner syndrome (MONDO:0007740), retinopathy of prematurity (MONDO:0006952)

## Full-text entities

- **Genes:** VCAN (versican) [NCBI Gene 1462] {aka CSPG2, ERVR, GHAP, PG-M, WGN, WGN1}, FZD4 (frizzled class receptor 4) [NCBI Gene 8322] {aka CD344, EVR1, FEVR, FZD4S, Fz-4, Fz4}, CRB1 (crumbs cell polarity complex component 1) [NCBI Gene 23418] {aka CRB1-A, CRB1-B, CRB1-C, LCA8, RP12}, LRP5 (LDL receptor related protein 5) [NCBI Gene 4041] {aka BMND1, EVR1, EVR4, HBM, LR3, LRP-5}, ELOVL4 (ELOVL fatty acid elongase 4) [NCBI Gene 6785] {aka ADMD, CT118, ISQMR, SCA34, STGD2, STGD3}, NDP (norrin cystine knot growth factor NDP) [NCBI Gene 4693] {aka EVR2, FEVR, ND}, VEGFA (vascular endothelial growth factor A) [NCBI Gene 7422] {aka L-VEGF, MVCD1, VEGF, VPF}, IHH (Indian hedgehog signaling molecule) [NCBI Gene 3549] {aka BDA1, HHG2}
- **Diseases:** abnormal retinal vascular development (MESH:D058456), esotropia (MESH:D004948), high myopia (MESH:D009216), cataract (MESH:D002386), genetic abnormalities (MESH:D030342), nyctalopia (MESH:D009755), ROP (MESH:D012178), vitreous abnormalities (MESH:D014823), Leber congenital amaurosis (MESH:D057130), Stickler Syndrome (MESH:C537492), retinal and vitreoretinal conditions (MESH:D012173), pigmented (MESH:D010859), retinal pigment epithelium atrophy (MESH:C536309), Erosive vitreoretinopathy (MESH:C536075), inherited retinal diseases (MESH:D012164), rhegmatogenous retinal detachments (MESH:C563710), retinal detachment (MESH:D012163), Stargardt macular degeneration (MESH:D000080362), lattice degeneration (MESH:D009410), strabismus (MESH:D013285), retinal pigment epithelial changes (MESH:C537835), chorioretinal atrophy (MESH:C566236), genetic vitreoretinopathy (MESH:D018630), atrophic holes (MESH:D012167), degenerative vitreous abnormalities (MESH:D019636), familial exudative vitreoretinopathy (MESH:D000080345), visual field loss (MESH:D014786), hereditary vitreoretinopathy (MESH:D009386)
- **Chemicals:** Fluorescein (MESH:D019793), chondroitin sulfate (MESH:D002809), hyaluronan (MESH:D006820), oxygen (MESH:D010100)
- **Species:** Homo sapiens (human, species) [taxon 9606]
- **Mutations:** c.1465G > A, c.425C > T, p.Ala311Thr

## Full text

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## Figures

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## References

30 references — full list in the complete paper: https://tomesphere.com/paper/PMC12311443/full.md

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Source: https://tomesphere.com/paper/PMC12311443