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OPA1 Dominant Optic Atrophy: Diagnostic Approach in the Pediatric Population. Curr Issues Mol Biol 2023; 45:465-478. [PMID: 36661516 PMCID: PMC9857649 DOI: 10.3390/cimb45010030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/29/2022] [Accepted: 01/01/2023] [Indexed: 01/07/2023] Open
Abstract
A clinical and genetic study was conducted with pediatric patients and their relatives with optic atrophy 1 (OPA1) mutations to establish whether there is a genotype-phenotype correlation among the variants detected within and between families. Eleven children with a confirmed OPA1 mutation were identified during the study period. The main initial complaint was reduced visual acuity (VA), present in eight patients of the cohort. Eight of eleven patients had a positive family history of optic atrophy. The mean visual acuity at the start of the study was 0.40 and 0.44 LogMAR in the right and left eye, respectively. At the end of the study, the mean visual acuity was unchanged. Optical coherence tomography during the first visit showed a mean retinal nerve fiber layer thickness of 81.6 microns and 80.5 microns in the right and left eye, respectively; a mean ganglion cell layer of 52.5 and 52.4 microns, respectively, and a mean central macular thickness of 229.5 and 233.5 microns, respectively. The most common visual field defect was a centrocecal scotoma, and nine out of eleven patients showed bilateral temporal disc pallor at baseline. Sequencing of OPA1 showed seven different mutations in the eleven patients, one of which, NM_130837.3: c.1406_1407del (p.Thr469LysfsTer16), has not been previously reported. Early diagnosis of dominant optic atrophy is crucial, both for avoiding unnecessary consultations and/or treatments and for appropriate genetic counseling.
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Raviskanthan S, Ahuja P, Mortensen PW, Milea D, Lee AG. Delayed diagnosis of autosomal dominant optic atrophy until seventh decade of life. Can J Ophthalmol 2021; 57:e96-e100. [PMID: 34534508 DOI: 10.1016/j.jcjo.2021.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/05/2021] [Accepted: 08/17/2021] [Indexed: 11/16/2022]
Affiliation(s)
| | - Pranati Ahuja
- School of Medicine, University of Texas Medical Branch, Galveston, Tex
| | | | - Dan Milea
- Singapore National Eye Center, Singapore;; Singapore Eye Research Institute, Singapore;; Duke-NUS Medical School, Singapore;; Copenhagen University Hospital, Copenhagen, Denmark
| | - Andrew G Lee
- Blanton Eye Institute, Houston Methodist Hospital, Houston, Tex.;; Weill Cornell Medicine, New York, NY;; University of Texas Medical Branch, Galveston, Tex.;; University of Texas MD Anderson Cancer Center, Houston, Tex.;; Texas A&M College of Medicine, Bryan, Tex.;; University of Iowa Hospitals and Clinics, Iowa City, Iowa;.
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Zeng T, Liao L, Guo Y, Liu X, Xiong X, Zhang Y, Cen S, Li H, Wei S. Concurrent OPA1 mutation and chromosome 3q deletion leading to Behr syndrome: a case report. BMC Pediatr 2020; 20:420. [PMID: 32883255 PMCID: PMC7469303 DOI: 10.1186/s12887-020-02309-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 08/20/2020] [Indexed: 12/02/2022] Open
Abstract
Background Optic atrophy 1 (OPA1) gene mutations are associated with dominantly inherited optic neuropathy resulting in a progressive loss of visual acuity. Compound heterozygous or homozygous variants that lead to severe phenotypes, including Behr syndrome, have been reported rarely. Case presentation Here, we present a 14-month-old boy with early onset optic atrophy, congenital cataracts, neuromuscular disorders, mental retardation, and developmental delay. Combined genetic testing, including whole exome sequencing (WES) and chromosomal microarray analysis, revealed a concurrent OPA1 variant (c.2189 T > C p.Leu730Ser) and de novo chromosome 3q deletion as pathogenic variants leading to the severe phenotype. Conclusions Our case is the first reporting a novel missense OPA1 variant co-occurring with a chromosomal microdeletion leading to a severe phenotype reminiscent of Behr syndrome. This expands the mutation spectrum of OPA1 and inheritance patterns of this disease.
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Affiliation(s)
- Ting Zeng
- Department of Child Healthcare, Liuzhou Maternity and Child Healthcare Hospital, 50 Boyuan Avenue, Liuzhou, 545616, China.,Key Laboratory of Developmental Disorders in Children, Liuzhou Maternity and Child Healthcare Hospital, 50 Boyuan Avenue, Liuzhou, 545616, China
| | - Linyan Liao
- Department of Child Healthcare, Liuzhou Maternity and Child Healthcare Hospital, 50 Boyuan Avenue, Liuzhou, 545616, China
| | - Yi Guo
- Department of Child Healthcare, Liuzhou Maternity and Child Healthcare Hospital, 50 Boyuan Avenue, Liuzhou, 545616, China
| | - Xuxu Liu
- Department of Child Healthcare, Liuzhou Maternity and Child Healthcare Hospital, 50 Boyuan Avenue, Liuzhou, 545616, China
| | - Xiaobo Xiong
- Department of Child Healthcare, Liuzhou Maternity and Child Healthcare Hospital, 50 Boyuan Avenue, Liuzhou, 545616, China
| | - Yu Zhang
- Department of Child Healthcare, Liuzhou Maternity and Child Healthcare Hospital, 50 Boyuan Avenue, Liuzhou, 545616, China.,Key Laboratory of Developmental Disorders in Children, Liuzhou Maternity and Child Healthcare Hospital, 50 Boyuan Avenue, Liuzhou, 545616, China
| | - Shi Cen
- Department of Child Healthcare, Liuzhou Maternity and Child Healthcare Hospital, 50 Boyuan Avenue, Liuzhou, 545616, China.,Key Laboratory of Developmental Disorders in Children, Liuzhou Maternity and Child Healthcare Hospital, 50 Boyuan Avenue, Liuzhou, 545616, China
| | - Honghui Li
- Department of Child Healthcare, Liuzhou Maternity and Child Healthcare Hospital, 50 Boyuan Avenue, Liuzhou, 545616, China.,Key Laboratory of Developmental Disorders in Children, Liuzhou Maternity and Child Healthcare Hospital, 50 Boyuan Avenue, Liuzhou, 545616, China
| | - Shuzhang Wei
- Department of Child Healthcare, Liuzhou Maternity and Child Healthcare Hospital, 50 Boyuan Avenue, Liuzhou, 545616, China. .,Key Laboratory of Developmental Disorders in Children, Liuzhou Maternity and Child Healthcare Hospital, 50 Boyuan Avenue, Liuzhou, 545616, China.
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Finsterer J, Laccone F. Autosomal dominant optic atrophy plus due to the novel OPA1 variant c.1463G>C. Metab Brain Dis 2019; 34:1023-1027. [PMID: 31152339 DOI: 10.1007/s11011-019-00425-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 04/22/2019] [Indexed: 12/25/2022]
Abstract
OPA1 variants most frequently manifest phenotypically with pure autosomal dominant optic atrophy (ADOA) or with ADOA plus. The most frequent abnormalities in ADOA plus in addition to the optic nerve affection include hypoacusis, migraine, myopathy, and neuropathy. Hypertelorism and atrophy of the acoustic nerve have not been reported. The patient is a 48yo Caucasian female with slowly progressive, visual impairment since childhood, bilateral hypoacusis since age 10y, and classical migraine since age 20y. The family history was positive for diabetes (father, mother) and visual impairment (daughter). Clinical examination revealed hypertelorism, visual impairment, hypoacusis, tinnitus, weakness for elbow flexion and finger straddling, and generally reduced tendon reflexes. MRI of the cerebrum was non-informative but hypoplasia of the acoustic nerve bilaterally was described. Visually-evoked potentials revealed markedly prolonged P100-latencies bilaterally. Acoustically-evoked potentials were distorted with poor reproducibility and prolonged latencies. Muscle biopsy revealed reduced activities of complexes I, II, and IV. Genetic work-up revealed the novel variant c.1463G>C in the OPA1 gene. This case provides novel information regarding the genotype of ADOA plus. The novel OPA1 variant c.1463G>C not only manifests with visual impairment, hypoacusis, migraine, and myopathy, but also with hypertelorisms and acoustic nerve atrophy.
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Affiliation(s)
- Josef Finsterer
- Krankenanstalt Rudolfstiftung, Messerli Institute, Postfach 20, 1180, Vienna, Austria.
| | - Franco Laccone
- Institute of Medical Genetics, Medical University of Vienna, Währinger Strasse 10, 1090, Vienna, Austria
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Ham M, Han J, Osann K, Smith M, Kimonis V. Meta-analysis of genotype-phenotype analysis of OPA1 mutations in autosomal dominant optic atrophy. Mitochondrion 2018; 46:262-269. [PMID: 30165240 DOI: 10.1016/j.mito.2018.07.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 05/20/2018] [Accepted: 07/31/2018] [Indexed: 01/21/2023]
Abstract
Autosomal Dominant Optic Atrophy (ADOA) is a neuro-ophthalmic disease characterized by progressive bilateral vision loss, pallor of the optic disc, central vision loss, and impairment of color vision. Additionally, a small percentage of patients experience hearing loss and ataxia, while recent studies suggest disruption of cardiac and neuromuscular functions. In order to obtain a better understanding of the genotype-phenotype correlation of the various mutations in the optic atrophy 1 (OPA1) gene, we obtained both clinical and genetic information of ADOA patients from published reports. We conducted a systematic review of published OPA1 literature and identified 408 individuals with confirmed OPA1 mutations, 120 of whom reported extra-ocular (ADOA 'plus') manifestations through their descriptions of visual and multi-systemic symptoms. Our results show that there is a significant variation in frequency of the specific exons involved between the ADOA classic and ADOA 'plus' patients. Classic ADOA groups were more likely to have mutations in exon 8 and 9, while ADOA 'plus' groups were more likely to have mutations in exons 14, 15 and 17. Additional comparisons revealed significant differences between mutation types/domains and specific ADOA 'plus' manifestations. We also found that individuals with maternally inherited OPA1 mutations were significantly more likely to develop 'plus' manifestations than those with paternally inherited mutations. Overall, this study provides novel information regarding genotype-phenotype correlations of ADOA which warrants additional recommendations added to the current clinical management of ADOA patients.
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Affiliation(s)
- Michelle Ham
- Division of Genetics and Genomic Medicine, Department of Pediatrics, University of California, Irvine, CA, USA
| | - Julia Han
- Division of Genetics and Genomic Medicine, Department of Pediatrics, University of California, Irvine, CA, USA
| | - Kathryn Osann
- Department of Medicine, Division of Hematology-Oncology, University of California, Irvine, CA, USA
| | - Moyra Smith
- Division of Genetics and Genomic Medicine, Department of Pediatrics, University of California, Irvine, CA, USA
| | - Virginia Kimonis
- Division of Genetics and Genomic Medicine, Department of Pediatrics, University of California, Irvine, CA, USA.
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Finsterer J, Zarrouk-Mahjoub S. Leigh-like syndrome due to OPA1 mutations. Eur J Paediatr Neurol 2017; 21:921-922. [PMID: 28711503 DOI: 10.1016/j.ejpn.2017.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 06/29/2017] [Indexed: 10/19/2022]
Affiliation(s)
| | - Sinda Zarrouk-Mahjoub
- University of Tunis El Manar and Genomics Platform, Pasteur Institute of Tunis, Tunisia
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Finsterer J, Mancuso M, Pareyson D, Burgunder JM, Klopstock T. Mitochondrial disorders of the retinal ganglion cells and the optic nerve. Mitochondrion 2017; 42:1-10. [PMID: 29054473 DOI: 10.1016/j.mito.2017.10.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 10/02/2017] [Accepted: 10/06/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To summarise and discuss recent findings and future perspectives concerning mitochondrial disorders (MIDs) affecting the retinal ganglion cells and the optic nerve (mitochondrial optic neuropathy. MON). METHOD Literature review. RESULTS MON in MIDs is more frequent than usually anticipated. MON may occur in specific as well as non-specific MIDs. In specific and non-specific MIDs, MON may be a prominent or non-prominent phenotypic feature and due to mutations in genes located either in the mitochondrial DNA (mtDNA) or the nuclear DNA (nDNA). Clinically, MON manifests with painless, bilateral or unilateral, slowly or rapidly progressive visual impairment and visual field defects. In some cases, visual impairment may spontaneously recover. The most frequent MIDs with MON include LHON due to mutations in mtDNA-located genes and autosomal dominant optic atrophy (ADOA) or autosomal recessive optic atrophy (AROA) due to mutations in nuclear genes. Instrumental investigations for diagnosing MON include fundoscopy, measurement of visual acuity, visual fields, and color vision, visually-evoked potentials, optical coherence tomography, fluorescein angiography, electroretinography, and MRI of the orbita and cerebrum. In non-prominent MON, work-up of the muscle biopsy with transmission electron microscopy may indicate mitochondrial destruction. Treatment is mostly supportive but idebenone has been approved for LHON and experimental approaches are promising. CONCLUSIONS MON needs to be appreciated, requires extensive diagnostic work-up, and supportive treatment should be applied although loss of vision, as the most severe outcome, can often not be prevented.
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Affiliation(s)
| | - Michelangelo Mancuso
- Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Italy
| | - Davide Pareyson
- Department of Clinical Neurosciences, C. Besta Neurological Institute, IRCCS Foundation, Milan, Italy.
| | - Jean-Marc Burgunder
- Department of Neurology, University of Bern, Switzerland; Department of Neurology, Sun Yat Sen University, Guangzhou, China; Department of Neurology, Sichuan University, Chendgu, China.
| | - Thomas Klopstock
- Department of Neurology, Friedrich-Baur Institute, Ludwig-Maximilians-Universität München, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
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Ng YS, Turnbull DM. Mitochondrial disease: genetics and management. J Neurol 2016; 263:179-91. [PMID: 26315846 PMCID: PMC4723631 DOI: 10.1007/s00415-015-7884-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 08/18/2015] [Accepted: 08/18/2015] [Indexed: 12/14/2022]
Abstract
Mitochondrial disease is one of the most common groups of genetic diseases with a minimum prevalence of greater than 1 in 5000 in adults. Whilst multi-system involvement is often evident, neurological manifestation is the principal presentation in most cases. The multiple clinical phenotypes and the involvement of both the mitochondrial and nuclear genome make mitochondrial disease particularly challenging for the clinician. In this review article we cover mitochondrial genetics and common neurological presentations associated with adult mitochondrial disease. In addition, specific and supportive treatments are discussed.
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Affiliation(s)
- Yi Shiau Ng
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, The Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Doug M Turnbull
- Wellcome Trust Centre for Mitochondrial Research, Institute of Neuroscience, The Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK.
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