Stickler syndrome is an autosomal dominantly inherited condition chara
cterised by ocular, articular, facial, auditory and oral features. The
re is locus heterogeneity with about two thirds of families showing li
nkage to the gene encoding type II procollagen (COL 2A1), Clinical ove
rlap with Marshall's, Wagner's and other syndromes has caused consider
able confusion but the importance of the congenital vitreous anomaly,
as first described by Scott, has not previously been emphasised. This
study examines the linkage of two vitreo-retinal phenotype subgroups o
f Stickler syndrome to COL 2A1. A total of 97 affected patients from 2
4 pedigrees were examined. This is the largest published series of Sti
ckler syndrome patients to date and all have undergone full clinical a
nd ophthalmological examination by a single investigator, A clinical c
lassification is proposed based on vitreoretinal phenotype, All patien
ts demonstrating the congenital vitreous anomaly have been designated
Stickler syndrome type 1 and those without the congenital vitreous ano
maly as Stickler syndrome type 2 patients, There were 69 affected pati
ents from 20 unrelated type 1 pedigrees and 28 affected patients from
4 unrelated type 2 pedigrees, Using two markers at the COL 2A1 locus,
Stickler syndrome type 1 pedigrees showed complete linkage to COL 2A1
with a maximum lod score of 12.33 at zero recombination, Linkage to CO
L 2A1 was excluded in the two type 2 pedigrees that were informative,
From these data it appears that this clinical classification is a usef
ul first step in resolving the genetic heterogeneity in this condition
.