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Sanlialp A, Escher P, Schaller A, Todorova M. Clinical Heterogeneity in Two Siblings Harbouring a Heterozygous PRPH2 Pathogenic Variant. Klin Monbl Augenheilkd 2023; 240:536-543. [PMID: 37164409 DOI: 10.1055/a-2034-6250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
PURPOSE The aim of the study was to describe the clinical and genetic correlation of a c.469 G>A p.(Asp157Asn) heterozygous pathogenic variant in PRPH2 in two siblings of Italian origin. PATIENTS AND METHODS Both patients underwent ophthalmic examination, electrophysiological testing, autofluorescence imaging, and optical coherence tomography (OCT). Screening for pathogenic variants of the obtained DNA from the family members was carried out. RESULTS The 52-year-old (♀, index patient) and 50-year-old (♂) siblings had BCVA (OD and OS) of 20/20 and 20/16 (♀) and 20/25 and 20/40 (♂), respectively, and suffered increased sensitivity to glare. Yellow irregular macular deposits, numerous small irregular hypo- and hyperreflective spots at the posterior pole, a patchy loss of photoreceptors, and retinal pigment epithelium (RPE) in the perifoveal region were seen. Electrophysiology showed dysfunction of rods and cones, with more affected cone dysfunction in the index patient, contrary to the generalised rod dysfunction in the brother of the index patient. The clinical, electrophysiological, and multimodal imaging findings of both siblings pointed towards Stargardt retinopathy with heterogenic presentation. The DNA analysis identified an autosomal dominant c.469 G>A p.(Asp157Asn) heterozygous pathogenic variant in PRPH2 associated with autosomal dominant cone-rod dystrophy and rod-cone dystrophy. PRPH2 codes for peripherin-2, a membrane protein that consists of 346 amino acids. CONCLUSIONS Our findings confirm a heterogeneity in clinical presentation associated with pathogenic variants in PRPH2. It may follow either an autosomal dominant or an autosomal recessive mode of inheritance and show a very heterogeneous clinical manifestation of retinal degeneration, e.g., autosomal dominant retinitis pigmentosa (♂ sibling; II-3) and autosomal dominant cone-rod dystrophy (index ♀ sibling; II-2), autosomal dominant macular dystrophy, and also autosomal recessive retinitis pigmentosa.
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Affiliation(s)
- Ayse Sanlialp
- Department of Ophthalmology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Pascal Escher
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - André Schaller
- Department of Human Genetics, Department of Pediatrics, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Margarita Todorova
- Department of Ophthalmology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- Department of Ophthalmology, University Hospital Basel, Basel, Switzerland
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Hara T, Zhou HP, Kitano M, Kure K, Asaoka R, Inoue T, Obata R. Quantification of residual ellipsoid zone and its correlation with visual functions in patients with cone-rod dystrophy. Eur J Ophthalmol 2021; 31:3117-3123. [PMID: 33499660 DOI: 10.1177/1120672121990561] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cone-rod dystrophy (CORD) is one of the inherited retinal diseases that result in central visual field deterioration and decreased visual acuity (VA). In CORD patients, impaired photoreceptor cells are observed as the disruption of ellipsoid zone (EZ) on optical coherence tomography (OCT) images. In the present study, we calculated the index of residual EZ (rEZ) to quantify the function of photoreceptor cells and investigated the correlation between rEZ index and visual functions. Twenty-six eyes of 13 patients with clinical suspicion of CORD were examined. Visual field was tested with the Humphrey Visual Field Analyzer (HFA 10-2 program). We simultaneously obtained OCT images and calculated the area of decreased EZ intensity (EZa). Using the binarized OCT images, the percentage of the rEZ in a 3 × 3 mm area surrounding the macula was analyzed. To clarify interrator reproducibility, intraclass correlation coefficient (ICC) was calculated. Moreover, we investigated the association between OCT parameters and VA as well as the mean deviation (MD) value measured with HFA. The mean age of the patients was 48.5 ± 16.9 years. The mean central retinal thickness was 122.7 ± 73.2 μm. The mean EZa and rEZ were 22.2 ± 23.6 μm2 and 0.35 ± 0.31, respectively. The ICC of each rEZ index was 0.91 (95% CI: 0.89 < ICC < 0.93). Multivariate analysis indicated rEZ was significantly related to logMAR VA (p = 0.05) and rEZ and EZa were associated with the MD value (p = 0.014 and p = 0.009, linear mixed model). Furthermore, rEZ was also associated with photopic a- and b-wave amplitudes (p = 0.027 and p = 0.0024, respectively, linear mixed model). Taken together, the current results suggested the usefulness of rEZ quantification for predicting visual functions in CORD patients.
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Affiliation(s)
- Takumi Hara
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Han Peng Zhou
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Marie Kitano
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Kana Kure
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Tatsuya Inoue
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan.,Department of Ophthalmology and Micro-Technology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Ryo Obata
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
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Boulanger-Scemama E, Mohand-Saïd S, El Shamieh S, Démontant V, Condroyer C, Antonio A, Michiels C, Boyard F, Saraiva JP, Letexier M, Sahel JA, Zeitz C, Audo I. Phenotype Analysis of Retinal Dystrophies in Light of the Underlying Genetic Defects: Application to Cone and Cone-Rod Dystrophies. Int J Mol Sci 2019; 20:ijms20194854. [PMID: 31574917 PMCID: PMC6801687 DOI: 10.3390/ijms20194854] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 09/20/2019] [Accepted: 09/25/2019] [Indexed: 12/29/2022] Open
Abstract
Phenotypes observed in a large cohort of patients with cone and cone-rod dystrophies (COD/CORDs) are described based on multimodal retinal imaging features in order to help in analyzing massive next-generation sequencing data. Structural abnormalities of 58 subjects with molecular diagnosis of COD/CORDs were analyzed through specific retinal imaging including spectral-domain optical coherence tomography (SD-OCT) and fundus autofluorescence (BAF/IRAF). Findings were analyzed with the underlying genetic defects. A ring of increased autofluorescence was mainly observed in patients with CRX and GUCY2D mutations (33% and 22% of cases respectively). “Speckled” autofluorescence was observed with mutations in three different genes (ABCA4 64%; C2Orf71 and PRPH2, 18% each). Peripapillary sparing was only found in association with mutations in ABCA4, although only present in 40% of such genotypes. Regarding SD-OCT, specific outer retinal abnormalities were more commonly observed in particular genotypes: focal retrofoveal interruption and GUCY2D mutations (50%), foveal sparing and CRX mutations (50%), and outer retinal atrophy associated with hyperreflective dots and ABCA4 mutations (69%). This study outlines the phenotypic heterogeneity of COD/CORDs hampering statistical correlations. A larger study correlating retinal imaging with genetic results is necessary to identify specific clinical features that may help in selecting pathogenic variants generated by high-throughput sequencing.
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Affiliation(s)
- Elise Boulanger-Scemama
- Institut de la Vision, Sorbonne Universités, UPMC Univ Paris 06, INSERM, CNRS, 17 rue Moreau, 75012 Paris, France.
- Fondation Ophtalmologique Adolphe de Rothschild, 75012 Paris, France.
| | - Saddek Mohand-Saïd
- Institut de la Vision, Sorbonne Universités, UPMC Univ Paris 06, INSERM, CNRS, 17 rue Moreau, 75012 Paris, France.
- CHNO des Quinze-Vingts, DHU Sight Restore, INSERM-DHOS CIC1423, 28 rue de Charenton, 75012 Paris, France.
| | - Said El Shamieh
- Institut de la Vision, Sorbonne Universités, UPMC Univ Paris 06, INSERM, CNRS, 17 rue Moreau, 75012 Paris, France.
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon.
| | - Vanessa Démontant
- Institut de la Vision, Sorbonne Universités, UPMC Univ Paris 06, INSERM, CNRS, 17 rue Moreau, 75012 Paris, France.
| | - Christel Condroyer
- Institut de la Vision, Sorbonne Universités, UPMC Univ Paris 06, INSERM, CNRS, 17 rue Moreau, 75012 Paris, France.
| | - Aline Antonio
- Institut de la Vision, Sorbonne Universités, UPMC Univ Paris 06, INSERM, CNRS, 17 rue Moreau, 75012 Paris, France.
- CHNO des Quinze-Vingts, DHU Sight Restore, INSERM-DHOS CIC1423, 28 rue de Charenton, 75012 Paris, France.
| | - Christelle Michiels
- Institut de la Vision, Sorbonne Universités, UPMC Univ Paris 06, INSERM, CNRS, 17 rue Moreau, 75012 Paris, France.
| | - Fiona Boyard
- Institut de la Vision, Sorbonne Universités, UPMC Univ Paris 06, INSERM, CNRS, 17 rue Moreau, 75012 Paris, France.
| | | | | | - José-Alain Sahel
- Institut de la Vision, Sorbonne Universités, UPMC Univ Paris 06, INSERM, CNRS, 17 rue Moreau, 75012 Paris, France.
- Fondation Ophtalmologique Adolphe de Rothschild, 75012 Paris, France.
- CHNO des Quinze-Vingts, DHU Sight Restore, INSERM-DHOS CIC1423, 28 rue de Charenton, 75012 Paris, France.
- Académie des Sciences-Institut de France, 75006 Paris, France.
- Department of Ophthalmology, The University of Pittsburgh School of Medicine, Pittsburg, PA 15213, USA.
| | - Christina Zeitz
- Institut de la Vision, Sorbonne Universités, UPMC Univ Paris 06, INSERM, CNRS, 17 rue Moreau, 75012 Paris, France.
| | - Isabelle Audo
- Institut de la Vision, Sorbonne Universités, UPMC Univ Paris 06, INSERM, CNRS, 17 rue Moreau, 75012 Paris, France.
- CHNO des Quinze-Vingts, DHU Sight Restore, INSERM-DHOS CIC1423, 28 rue de Charenton, 75012 Paris, France.
- University College London Institute of Ophthalmology, 11-43 Bath Street, London EC1V 9EL, UK.
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Gill JS, Georgiou M, Kalitzeos A, Moore AT, Michaelides M. Progressive cone and cone-rod dystrophies: clinical features, molecular genetics and prospects for therapy. Br J Ophthalmol 2019; 103:bjophthalmol-2018-313278. [PMID: 30679166 PMCID: PMC6709772 DOI: 10.1136/bjophthalmol-2018-313278] [Citation(s) in RCA: 108] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/23/2018] [Accepted: 11/29/2018] [Indexed: 12/16/2022]
Abstract
Progressive cone and cone-rod dystrophies are a clinically and genetically heterogeneous group of inherited retinal diseases characterised by cone photoreceptor degeneration, which may be followed by subsequent rod photoreceptor loss. These disorders typically present with progressive loss of central vision, colour vision disturbance and photophobia. Considerable progress has been made in elucidating the molecular genetics and genotype-phenotype correlations associated with these dystrophies, with mutations in at least 30 genes implicated in this group of disorders. We discuss the genetics, and clinical, psychophysical, electrophysiological and retinal imaging characteristics of cone and cone-rod dystrophies, focusing particularly on four of the most common disease-associated genes: GUCA1A, PRPH2, ABCA4 and RPGR Additionally, we briefly review the current management of these disorders and the prospects for novel therapies.
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Affiliation(s)
- Jasdeep S Gill
- UCL Institute of Ophthalmology, University College London, London, UK
| | - Michalis Georgiou
- UCL Institute of Ophthalmology, University College London, London, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Angelos Kalitzeos
- UCL Institute of Ophthalmology, University College London, London, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Anthony T Moore
- UCL Institute of Ophthalmology, University College London, London, UK
- Ophthalmology Department, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Michel Michaelides
- UCL Institute of Ophthalmology, University College London, London, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
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Mucciolo DP, Sodi A, Passerini I, Murro V, Cipollini F, Borg I, Pelo E, Contini E, Virgili G, Rizzo S. Fundus phenotype in retinitis pigmentosa associated with EYS mutations. Ophthalmic Genet 2018; 39:589-602. [PMID: 30153090 DOI: 10.1080/13816810.2018.1509351] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE to report phenotypic and genotypic features in a group of autosomal recessive retinitis pigmentosa (arRP) patients associated with EYS mutations. METHODS we retrospectively reviewed the clinical records and the molecular genetic data of arRP patients carrying mutations in the EYS gene. All the patients underwent a comprehensive opthalmological examination. Additional investigation included color fundus photography, fundus autofluorescence, Goldmann visual field, OCT scans and full-field standard electroretinography. RESULTS we studied 10 RP patients (20 eyes) characterized by mutations in the EYS gene. Thirteen different sequence variants in the EYS gene were identified. In total, nine mutations found in our series had not previously been reported in the literature. All patients in our series complained of typical RP symptoms at the onset of the disease, namely night blindness and progressive constriction of the visual field. Visual acuity ranged from light perception to 20/20. Relevant findings reported in our series are Interdigitation-zone (IZ band) involvement, present even in the milder phenotypes and an estimated prevalence of 6.2% of arRP associated with EYS mutations. CONCLUSIONS we reported the mutation spectrum of a group of EYS-related RP patients including nine novel mutations and the associated clinical phenotypes. Our series is the largest group of EYS-related arRP patients in the Italian population.
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Affiliation(s)
- Dario Pasquale Mucciolo
- a Department of Surgery and Translational Medicine , Eye Clinic, University of Florence , Florence , Italy
| | - Andrea Sodi
- a Department of Surgery and Translational Medicine , Eye Clinic, University of Florence , Florence , Italy
| | - Ilaria Passerini
- b Department of Genetic Diagnosis , Careggi Teaching Hospital , Florence , Italy
| | - Vittoria Murro
- a Department of Surgery and Translational Medicine , Eye Clinic, University of Florence , Florence , Italy
| | - Francesca Cipollini
- a Department of Surgery and Translational Medicine , Eye Clinic, University of Florence , Florence , Italy
| | - Isabella Borg
- c Medical Genetics Unit, Department of Pathology , Mater Dei Hospital , Malta.,d Department of Pathology, Faculty of Medicine and Surgery , University of Malta , Malta
| | - Elisabetta Pelo
- b Department of Genetic Diagnosis , Careggi Teaching Hospital , Florence , Italy
| | - Elisa Contini
- b Department of Genetic Diagnosis , Careggi Teaching Hospital , Florence , Italy
| | - Gianni Virgili
- a Department of Surgery and Translational Medicine , Eye Clinic, University of Florence , Florence , Italy
| | - Stanislao Rizzo
- a Department of Surgery and Translational Medicine , Eye Clinic, University of Florence , Florence , Italy
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Ogino K, Oishi M, Oishi A, Morooka S, Sugahara M, Gotoh N, Kurimoto M, Yoshimura N. Radial fundus autofluorescence in the periphery in patients with X-linked retinitis pigmentosa. Clin Ophthalmol 2015; 9:1467-74. [PMID: 26316687 PMCID: PMC4544811 DOI: 10.2147/opth.s89371] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To describe the peripheral autofluorescence images and clinical features of patients with retinal dystrophy who showed radial fundus autofluorescence (FAF) at the posterior pole. Methods The authors retrospectively reviewed pooled wide-field FAF images of 711 patients with retinal dystrophy and 56 family members. Results Eleven eyes of seven women exhibited radial FAF at the posterior pole. Wide-field FAF showed extension of the radial pattern to the periphery in all eyes except one. One woman showed radial hyper-FAF only in the periphery, not at the posterior pole. These eight individuals were X-linked retinitis pigmentosa patients or carriers. The tapetal-like reflex was not observed in their color fundus photographs. The peripheral visual field showed wedge-shaped restriction in some individuals. Conclusion Wide-field FAF imaging can depict radial FAF not only at the posterior pole but also in the periphery in X-linked retinitis pigmentosa carriers. The authors therefore agree with previous reports that radial FAF may be a hallmark of X-linked retinitis pigmentosa.
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Affiliation(s)
- Ken Ogino
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Maho Oishi
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akio Oishi
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Satoshi Morooka
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masako Sugahara
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Norimoto Gotoh
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan ; Center for Genomic Medicine, Kyoto University, Kyoto, Japan
| | | | - Nagahisa Yoshimura
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Saxena S, Srivastav K, Cheung CM, Ng JY, Lai TY. Photoreceptor inner segment ellipsoid band integrity on spectral domain optical coherence tomography. Clin Ophthalmol 2014; 8:2507-22. [PMID: 25525329 PMCID: PMC4266419 DOI: 10.2147/opth.s72132] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Spectral domain optical coherence tomography cross-sectional imaging of the macula has conventionally been resolved into four bands. However, some doubts were raised regarding authentication of the existence of these bands. Recently, a number of studies have suggested that the second band appeared to originate from the inner segment ellipsoids of the foveal cone photoreceptors, and therefore the previously called inner segment-outer segment junction is now referred to as inner segment ellipsoidband. Photoreceptor dysfunction may be a significant predictor of visual acuity in a spectrum of surgical and medical retinal diseases. This review aims to provide an overview and summarizes the role of the photoreceptor inner segment ellipsoid band in the management and prognostication of various vitreoretinal diseases.
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Affiliation(s)
- Sandeep Saxena
- Retina Service, Department of Ophthalmology, King George's Medical University Lucknow, India
| | - Khushboo Srivastav
- Retina Service, Department of Ophthalmology, King George's Medical University Lucknow, India
| | | | - Joanne Yw Ng
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
| | - Timothy Yy Lai
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
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