Oculocutaneous Albinism

What is oculocutaneous albinism?

Oculocutaneous albinism is a group of conditions that affect colouring (pigmentation) of the skin, hair, and eyes. Affected individuals typically have very fair skin and white or light-coloured hair. They have an increased risk of skin damage and skin cancers, including melanoma, with sun exposure. Oculocutaneous albinism also reduces pigmentation of the coloured part of the eye (the iris) and the light-sensitive tissue at the back of the eye (the retina). People with this condition usually have vision problems such as reduced sharpness; rapid, involuntary eye movements (nystagmus); and increased sensitivity to light (photophobia).

The four types of oculocutaneous albinism are designated as type 1 (OCA1) through type 4 (OCA4). Oculocutaneous albinism type 1 is characterised by white hair, very pale skin, and light-coloured irises. Type 2 is generally less severe than type 1; the skin is usually a creamy white colour and hair may be light yellow, blond, or light brown. Type 3 includes a form of albinism called rufous oculocutaneous albinism, which usually affects dark-skinned people. Affected individuals have reddish-brown skin, ginger or red hair, and hazel or brown irises. Type 3 is often associated with milder vision abnormalities than the other forms of oculocutaneous albinism. Type 4 has signs and symptoms similar to those seen with type 2. Because their features overlap, the four types of oculocutaneous albinism are most accurately distinguished by their genetic cause.

How common is oculocutaneous albinism?

Overall, an estimated 1 in 20,000 people worldwide are born with oculocutaneous albinism. The condition affects people in many ethnic groups and geographical regions. Types 1 and 2 are the most common forms of this condition; types 3 and 4 are less common. Type 2 occurs more frequently in African Americans, some Native American groups, and people from sub-Saharan Africa. Type 3 (rufous oculocutaneous albinism) has been described in people from southern Africa and Papua New Guinea. Studies suggest that type 4 occurs more frequently in the Japanese and Korean populations than in people from other parts of the world.

What genes are related to oculocutaneous albinism?

Mutations in the OCA2, SLC45A2, TYR, and TYRP1 genes cause oculocutaneous albinism.

Mutations in the MC1R gene modify the course of oculocutaneous albinism.

The four types of oculocutaneous albinism each result from mutations in a single gene: TYR, OCA2, TYRP1, or SLC45A2. Changes in the TYR gene cause type 1; mutations in the OCA2 gene are responsible for type 2; TYRP1 mutations cause type 3; and changes in the SLC45A2 gene result in type 4. These genes are involved in producing a pigment called melanin, which is the substance that gives skin, hair, and eyes their colour. In the retina, melanin also plays a role in normal vision. Mutations in any of these genes disrupts the ability of cells to make melanin, which reduces pigmentation in the skin, hair, and eyes. A lack of melanin in the retina leads to the vision problems characteristic of oculocutaneous albinism.

Alterations in the MC1R gene can change the appearance of people with oculocutaneous albinism type 2. This gene helps regulate melanin production and is responsible for some normal variation in pigmentation. People with genetic changes in both the OCA2 and MC1R genes have many of the usual features of oculocutaneous albinism type 2, including light-coloured eyes and vision problems; however, they typically have red hair instead of the usual yellow, blond, or light brown hair seen with this condition.

How do people inherit oculocutaneous albinism?

Each of the four types of oculocutaneous albinism is inherited in an autosomal recessive pattern, which means two copies of the gene in each cell are altered. Most often, the parents of an individual with an autosomal recessive disorder are carriers of one copy of the altered gene but do not show signs and symptoms of the disorder.

What other names do people use for oculocutaneous albinism?

• Albinism, Oculocutaneous
• OCA - Oculocutaneous albinism