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Yang HK, Seong MW, Kim JY, Park SS, Hwang JM. Poor visual prognosis of Asian patients with 3460 mitochondrial DNA mutation in Leber's hereditary optic neuropathy. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024:S0008-4182(24)00095-4. [PMID: 38593981 DOI: 10.1016/j.jcjo.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 03/07/2024] [Accepted: 03/19/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Among the 3 primary mutations of Leber's hereditary optic neuropathy (LHON), the incidence of LHON with a mutation at nucleotide position 3460 is the lowest in Asians. Therefore, information about the clinical manifestations of LHON mutations in Asians with the 3460 mutation is limited. OBJECTIVE To determine the clinical manifestations including visual prognosis of Asians with the LHON 3460 mutation. METHODS We performed a retrospective study of 5 Korean LHON patients with the 3460 mutation. RESULTS All patients were male, and the age of onset for visual impairment varied from 17 to 35 years, with an average of 25.4 ± 7.16 years. Among the 10 affected eyes, only 1 eye of 1 patient showed visual improvement to 20/50 at 2 years after onset. The remaining patients had a visual acuity of worse than 20/200. CONCLUSION The visual prognosis of Korean patients with the LHON 3460 mutation was generally poor. Further studies regarding Asian patients with the LHON 3460 mutation are necessary.
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Affiliation(s)
- Hee Kyung Yang
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Moon-Woo Seong
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Ji Yeon Kim
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Sung Sup Park
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea; Clavis Therapeutics, Inc, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Jeong-Min Hwang
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
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Yang HK, Seong MW, Hwang JM. Mitochondrial DNA mutations in Korean patients with Leber's hereditary optic neuropathy. Sci Rep 2024; 14:5702. [PMID: 38459091 PMCID: PMC10923793 DOI: 10.1038/s41598-024-56215-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 03/04/2024] [Indexed: 03/10/2024] Open
Abstract
In order to explore the spectrum of mitochondrial DNA (mtDNA) mutations in Korean patients with Leber's hereditary optic neuropathy (LHON), we investigated the spectrum of mtDNA mutations in 145 Korean probands confirmed with the diagnosis of LHON. Total genomic DNA was isolated from the peripheral blood leukocytes of the patients with suspected LHON, and mtDNA mutations were identified by direct sequencing. Analysis of mtDNA mutations revealed seven primary LHON mutations including the nucleotide positions (nps) 11778A (101 probands, 69.2%), 14484C (31 probands, 21.2%), 3460A (5 probands, 3.4%), and G3635A, G3733A, C4171A, and G13051A mutations in one proband each. In addition, two provisional mtDNA mutations at nps T3472C, and G13259A were each found in one proband, respectively. Another provisional mtDNA mutation at np T3394C was found in two probands. In conclusion, the spectrum of mtDNA mutations in Korean patients with LHON may differ from other ethnicities, which is characterized by high prevalence of 11778A and 14484C mutations, and a low prevalence of the 3460A mutation.
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Affiliation(s)
- Hee Kyung Yang
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam, Gyeonggi-do, 13620, Republic of Korea
| | - Moon-Woo Seong
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jeong-Min Hwang
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam, Gyeonggi-do, 13620, Republic of Korea.
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Watson EC, Davis RL, Ravishankar S, Copty J, Kummerfeld S, Sue CM. Low disease risk and penetrance in Leber hereditary optic neuropathy. Am J Hum Genet 2023; 110:166-169. [PMID: 36565700 PMCID: PMC9892766 DOI: 10.1016/j.ajhg.2022.11.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 11/21/2022] [Indexed: 12/24/2022] Open
Abstract
The risk of Leber hereditary optic neuropathy (LHON) has largely been extrapolated from disease cohorts, which underestimate the population prevalence of pathogenic primary LHON variants as a result of incomplete disease penetrance. Understanding the true population prevalence of primary LHON variants, alongside the rate of clinical disease, provides a better understanding of disease risk and variant penetrance. We identified pathogenic primary LHON variants in whole-genome sequencing data of a well-characterized population-based control cohort and found that the prevalence is far greater than previously estimated, as it occurs in approximately 1 in 800 individuals. Accordingly, we were able to more accurately estimate population risk and disease penetrance in LHON variant carriers, validating our findings by using other large control datasets. These findings will inform accurate counseling in relation to the risk of vision loss in LHON variant carriers and disease manifestation in their family. This Matters Arising paper is in response to Lopez Sanchez et al. (2021), published in The American Journal of Human Genetics. See also the response by Mackey et al. (2022), published in this issue.
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Affiliation(s)
- Eloise C. Watson
- Department of Neurogenetics, Kolling Institute, Faculty of Medicine and Health, University of Sydney and Northern Sydney Local Health District, Reserve Rd, St Leonards, NSW, Australia,Department of Neurology, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia,Department of Neurology, Wellington Hospital, Capital and Coast District Health Board, Newtown, Wellington, New Zealand
| | - Ryan L. Davis
- Department of Neurogenetics, Kolling Institute, Faculty of Medicine and Health, University of Sydney and Northern Sydney Local Health District, Reserve Rd, St Leonards, NSW, Australia
| | | | - Joseph Copty
- Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Sarah Kummerfeld
- Garvan Institute of Medical Research, Darlinghurst, NSW, Australia,St Vincents Clinical School, UNSW, Sydney, NSW, Australia
| | - Carolyn M. Sue
- Department of Neurogenetics, Kolling Institute, Faculty of Medicine and Health, University of Sydney and Northern Sydney Local Health District, Reserve Rd, St Leonards, NSW, Australia,Department of Neurology, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia,Corresponding author
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Mitochondrial Genetic Heterogeneity in Leber's Hereditary Optic Neuropathy: Original Study with Meta-Analysis. Genes (Basel) 2021; 12:genes12091300. [PMID: 34573281 PMCID: PMC8472268 DOI: 10.3390/genes12091300] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/06/2021] [Accepted: 08/08/2021] [Indexed: 11/17/2022] Open
Abstract
Leber’s hereditary optic neuropathy (LHON) is a mitochondrial disorder that causes loss of central vision. Three primary variants (m.3460G>A, m.11778G>A, and m.14484T>C) and about 16 secondary variants are responsible for LHON in the majority of the cases. We investigated the complete mitochondrial DNA (mtDNA) sequences of 189 LHON patients and found a total of 54 disease-linked pathogenic variants. The primary variants m.11778G>A and m.14484T>C were accountable for only 14.81% and 2.64% cases, respectively. Patients with these two variants also possessed additional disease-associated variants. Among 156 patients who lacked the three primary variants, 16.02% harboured other LHON-associated variants either alone or in combination with other disease-associated variants. Furthermore, we observed that none of the haplogroups were explicitly associated with LHON. We performed a meta-analysis of m.4216T>C and m.13708G>A and found a significant association of these two variants with the LHON phenotype. Based on this study, we recommend the use of complete mtDNA sequencing to diagnose LHON, as we found disease-associated variants throughout the mitochondrial genome.
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Lock JH, Irani NK, Newman NJ. Neuro-ophthalmic manifestations of mitochondrial disorders and their management. Taiwan J Ophthalmol 2020; 11:39-52. [PMID: 33767954 PMCID: PMC7971441 DOI: 10.4103/tjo.tjo_68_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 09/23/2020] [Indexed: 12/30/2022] Open
Abstract
The visual system has high metabolic requirements and is therefore particularly vulnerable to mitochondrial dysfunction. The most commonly affected tissues include the extraocular muscles, photoreceptors, retinal pigment epithelium, optic nerve and visual cortex. Hence, the most common manifestations of mitochondrial disorders are progressive external ophthalmoplegia, macular pattern dystrophy, pigmentary retinopathy, optic neuropathy and retrochiasmal visual field loss. With the exception of Leber hereditary optic neuropathy and stroke-like episodes seen in mitochondrial encephalopathy, lactic acidosis and stroke-like episodes, the majority of neuro-ophthalmic manifestations have an insidious onset. As such, some patients may not recognize subtle progressive visual symptoms. When mitochondrial disorders are highly suspected, meticulous examination performed by an ophthalmologist with targeted ancillary testing can help confirm the diagnosis. Similarly, neuro-ophthalmic symptoms and signs may be the first indication of mitochondrial disease and should prompt systemic investigations for potentially life-threatening associations, such as cardiac conduction defects. Finally, the ophthalmologist can offer symptomatic treatments for some of the most disabling manifestations of these disorders.
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Affiliation(s)
- Jane H Lock
- Department of Ophthalmology, Royal Perth Hospital, Perth, WA, Australia.,Department of Ophthalmology, Sir Charles Gairdner Hospital, Perth, WA, Australia.,Department of Ophthalmology, Perth's Children's Hospital, Perth, WA, Australia
| | - Neha K Irani
- Department of Ophthalmology, Royal Perth Hospital, Perth, WA, Australia.,Department of Neurology, Fiona Stanley Hospital, Perth, WA, Australia.,Department of Neurology, Joondalup Health Campus, Perth, WA, Australia
| | - Nancy J Newman
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.,Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.,Department of Neurological Surgery, Emory University School of Medicine, Atlanta, GA, USA
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Ahn YJ, Park Y, Shin SY, Chae H, Kim M, Park SH. Genotypic and phenotypic characteristics of Korean children with childhood-onset Leber's hereditary optic neuropathy. Graefes Arch Clin Exp Ophthalmol 2020; 258:2283-2290. [PMID: 32506279 DOI: 10.1007/s00417-020-04757-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 05/11/2020] [Accepted: 05/19/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE We sought to identify the phenotypic and genotypic characteristics of Korean children with genetically confirmed Leber's hereditary optic neuropathy (LHON). METHODS The medical records of 64 genetically confirmed LHON patients were reviewed. Seventeen patients aged 13 years or younger with optic atrophy with positive mitochondrial DNA (mtDNA) mutations were considered to demonstrate childhood-onset LHON. The non-childhood-onset group included 47 patients with genetically confirmed LHON who experienced disease onset later than 13 years of age. The type of mtDNA mutation, visual acuity (VA), color vision, fundus photography, retinal nerve fiber layer (RNFL) thickness, and visual field were investigated. RESULTS Sequence analysis of the mitochondrial genome revealed five different kinds of LHON-associated mtDNA mutations among our childhood-onset patients, including m.11778G>A (58.8%), m.3496G>T (11.8%), m.3497C>T (5.9%), m.11696G>A (5.9%), and m.14502T>C (5.9%). The mean final best-corrected VA in the childhood-onset group was better than that in the non-childhood-onset group with the value of logMAR 0.29 (0.09-0.75) vs. 0.55 (0.27-1.29) (expressed as median (interquartile range); p = 0.05). Spontaneous visual recovery was observed in 35.3% of the childhood-onset group but in only 12.8% of the non-childhood-onset group (p = 0.04). Eight patients (47.1%) showed interocular asymmetry of the disease, with two presenting true unilateral involvement of the optic nerve and the other six patients demonstrating unilateral subclinical manifestations with bilateral optic atrophy. CONCLUSION Involvement of secondary mitochondrial mutations was confirmed in patients with childhood-onset LHON. Characteristic clinical features of childhood-onset LHON included a higher proportion of subacute or insidious onset of symptoms, better VA, higher spontaneous recovery, and asymmetrical ocular involvement.
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Affiliation(s)
- Ye Jin Ahn
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Yooyeon Park
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Sun Young Shin
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Hyojin Chae
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Myungshin Kim
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Shin Hae Park
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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Liu XT, Shen MX, Chen C, Huang SH, Zhuang XR, Ma QK, Chen Q, Lu F, Yuan YM. Foveal pit morphological changes in asymptomatic carriers of the G11778A mutation with Leber's hereditary optic neuropathy. Int J Ophthalmol 2020; 13:766-772. [PMID: 32420224 DOI: 10.18240/ijo.2020.05.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 03/12/2020] [Indexed: 12/31/2022] Open
Abstract
AIM To investigate the foveal pit morphology changes in unaffected carriers and affected Leber's hereditary optic neuropathy (LHON) patients with the G11778A mutation from one family. METHODS This study was a prospective cross-sectional study. Both eyes from 16 family members (age from 9 to 47y) with the G11778A mutation were analyzed and compared with 1 eye from 20 normal control subjects. Eleven family members with the G11778A mutation but without optic neuropathy were classified as unaffected carriers (n=22 eyes). Five family members (n=10 eyes) expressed the LHON phenotype and were classified as affected patients. Retinal images of all the subjects were taken by optical coherence tomography (OCT), and an automatic algorithm was used to segment the retina to eight layers. Horizontal and vertical OCT images centered on the fovea were used to measure intra-retinal layer thicknesses and foveal morphometry. RESULTS Thicker foveal thickness, thinner foveal pit depth, and flatter foveal slopes were observed in unaffected carriers and affected LHON patients (all P<0.001). Further, the slopes of all four sectors in the LHON were flatter than those in the unaffected carriers (all P<0.001). Compared with the control group, affected LHON patients had a thinner retinal nerve fiber layer (RNFL), ganglion cell layer and inner plexiform layer (GCL+IPL), and total retina (all P<0.01). The retinal nerve fiber layer (RNFL) of affected patients was 38.0% thinner than that of controls while the GCL+IPL was 40.1% thinner. CONCLUSION The foveal pit morphology shows changes in both unaffected carriers and affects patients. RNFL and GCL+IPL are thinner in affected LHON patients but not in unaffected carriers.
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Affiliation(s)
- Xin-Ting Liu
- School of Ophthalmology and Optometry, the Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Mei-Xiao Shen
- School of Ophthalmology and Optometry, the Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Chong Chen
- School of Ophthalmology and Optometry, the Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Sheng-Hai Huang
- School of Ophthalmology and Optometry, the Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Xi-Ran Zhuang
- School of Ophthalmology and Optometry, the Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Qing-Kai Ma
- School of Ophthalmology and Optometry, the Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Qi Chen
- School of Ophthalmology and Optometry, the Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Fan Lu
- School of Ophthalmology and Optometry, the Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Yi-Min Yuan
- School of Ophthalmology and Optometry, the Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
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Guo H, Li S, Dai L, Huang X, Yu T, Yin Z, Bai Y. Genetic analysis in a cohort of patients with hereditary optic neuropathies in Southwest of China. Mitochondrion 2018; 46:327-333. [PMID: 30201499 DOI: 10.1016/j.mito.2018.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 02/25/2018] [Accepted: 09/04/2018] [Indexed: 11/16/2022]
Abstract
We report the results of molecular screening in 121 patients with suspected hereditary optic neuropathies. The 34 primary and 9 secondary LHON mutations were screened in all the patients. In the familial cases, OPA1 was also tested when negative finding for the mtDNA mutations screening. Molecular defects were identified in 35 patients (28.9% of screened patients). Among these, 33 patients (94.3%) had an mtDNA mutation, including m.11778G > A (69.7%), m.14484 T > C, m.3460G > A, m.3635G > A, m.14502 T > C and three secondary mutations m.3316G > A, m.3394 T > C, m.3497C > T. Two novel OPA1 mutations, c.1301 T > G (p.Leu434Arg) and c.985-1G > A (IVS9-1G > A), were also detected in families with the evidence of father-to-son transmission. In conclusion, we reported the results of the molecular screening of 121 patients with hereditary optic neuropathies from southwest of China. Our results highlight the importance of investigating LHON-causing mtDNA mutations and OPA1 mutations in cases of suspected hereditary optic neuropathy.
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Affiliation(s)
- Hong Guo
- Department of Medical Genetics, Army Medical University, 30#, Gaotanyan St., Shapingba District, Chongqing 400038, PR China
| | - Shiying Li
- Southwest Eye Hospital, Southwest Hospital, Army Medical University, 30#, Gaotanyan St., Shapingba District 400038, Chongqing, PR China
| | - Limeng Dai
- Department of Medical Genetics, Army Medical University, 30#, Gaotanyan St., Shapingba District, Chongqing 400038, PR China
| | - Xiaoyong Huang
- Southwest Eye Hospital, Southwest Hospital, Army Medical University, 30#, Gaotanyan St., Shapingba District 400038, Chongqing, PR China
| | - Tao Yu
- Southwest Eye Hospital, Southwest Hospital, Army Medical University, 30#, Gaotanyan St., Shapingba District 400038, Chongqing, PR China
| | - Zhengqin Yin
- Southwest Eye Hospital, Southwest Hospital, Army Medical University, 30#, Gaotanyan St., Shapingba District 400038, Chongqing, PR China.
| | - Yun Bai
- Department of Medical Genetics, Army Medical University, 30#, Gaotanyan St., Shapingba District, Chongqing 400038, PR China.
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Evaluation of Vision-Related Quality of Life in Chinese Patients With Leber Hereditary Optic Neuropathy and the G11778A Mutation. J Neuroophthalmol 2018; 39:56-59. [PMID: 29554000 DOI: 10.1097/wno.0000000000000644] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess quality of life (QoL) measures in Chinese Leber hereditary optic neuropathy (LHON) patients with the G11778A mutation. METHODS Chinese LHON patients with the G11778A mutation were prospectively evaluated using the Visual Function Index (VF-14) at 6 months, 1 year, and 3 years after the involvement of the second eye. Patients who completed the VF-14 at all 3 follow-up time designations were included in the analysis. RESULTS Fifty-five patients met the inclusion criteria. The median age of patients when their vision was bilaterally affected was 16.3 years old (interquartile range: 13.9-18.3 years). In our patient cohort, 89.1% (n = 49) were male, and the ratio of males to females was 8.2:1. The median logMAR visual acuity was 2.0 (interquartile range: 1.0-2.6). The mean VF-14 scores of patients with LHON at 6-month, 1-year, and 3-year follow-ups were 18.0 ± 19.2 (range 0-85.4), 19.9 ± 20.0 (range 0-85.4), and 20.7 ± 20.2 (range 0-85.4), and the differences were statistically significant (P < 0.001). VF-14 score at 6 months was significantly correlated with visual acuity of the better eye (P < 0.001) but not with age of onset (P = 0.43). Overall, the QoL improvement was significantly correlated with age of onset (P = 0.006) but not with visual acuity of the better eye (P = 0.134). Several abilities were significantly improved at the 1-year follow-up compared with the 6-month follow-up, including seeing steps, curbs, or stairs (P < 0.01), doing handiwork (P < 0.05), playing sports (P < 0.05), cooking (P < 0.01), and watching television (P < 0.05). When these scores were further compared between 1- and 3-year follow-ups, only scores for cooking (P < 0.05) and watching television (P < 0.05) were higher at the 3-year follow-up than that at the 1-year follow-up. No changes were found during the follow-up for reading small print, reading a newspaper or book, or reading signs. CONCLUSIONS Our results indicate that although most of our Chinese LHON patients with the G11778A mutation had permanent central visual loss, visual-related quality of life improved over time, especially in younger patients.
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Mishra A, Devi S, Saxena R, Gupta N, Kabra M, Chowdhury MR. Frequency of primary mutations of Leber's hereditary optic neuropathy patients in North Indian population. Indian J Ophthalmol 2017; 65:1156-1160. [PMID: 29133642 PMCID: PMC5700584 DOI: 10.4103/ijo.ijo_380_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose: Leber's hereditary optic neuropathy (LHON) is an inherited optic neuropathy characterized by subacute painless vision loss. The majority of LHON is caused due to one of the three primary mutations in the mitochondrial DNA (m.G3460A, m.G11778A, and m.T14484C). The frequency of these mutations differs in different populations. The purpose of this study is to observe the frequency of three common primary mutations in the North Indian population. Methods: Forty LHON patients within the age group of 10–50 years underwent molecular testing for primary mutations. For two patients, testing for mother and other siblings was also carried out, using bidirectional sequencing. Results: A total of 11 out of 40 (27.5%) patients were found to be carrying m.G11778A mutation. Siblings of two probands were also positive for the same mutation. In one family, two primary mutations (m.G11778A and m.T14484C) were found in the proband and in the mother as well. Conclusion: In this study, 27.5% mutation was detected in North Indian LHON families. These results suggest that m.G11778A mutation is more frequent in this population. The results of the present study are compatible with studies of an Asian population and Northern European population.
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Affiliation(s)
- Anushree Mishra
- Department of Paediatrics, Division of Genetics, All India Institute of Medical Sciences, New Delhi, India
| | - Saranya Devi
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All Indian Institute of Medical Sciences, New Delhi, India
| | - Rohit Saxena
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All Indian Institute of Medical Sciences, New Delhi, India
| | - Neerja Gupta
- Department of Paediatrics, Division of Genetics, All India Institute of Medical Sciences, New Delhi, India
| | - Madhulika Kabra
- Department of Paediatrics, Division of Genetics, All India Institute of Medical Sciences, New Delhi, India
| | - Madhumita Roy Chowdhury
- Department of Paediatrics, Division of Genetics, All India Institute of Medical Sciences, New Delhi, India
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Manickam AH, Michael MJ, Ramasamy S. Mitochondrial genetics and therapeutic overview of Leber's hereditary optic neuropathy. Indian J Ophthalmol 2017; 65:1087-1092. [PMID: 29133631 PMCID: PMC5700573 DOI: 10.4103/ijo.ijo_358_17] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 09/09/2017] [Indexed: 12/22/2022] Open
Abstract
Leber's hereditary optic neuropathy (LHON) is a common inherited mitochondrial disorder that is characterized by the degeneration of the optic nerves, leading to vision loss. The major mutations in the mitochondrial genes ND1, ND4, and ND6 of LHON subjects are found to increase the oxidative stress experienced by the optic nerve cell, thereby leading to nerve cell damage. Accurate treatments are not available and drugs that are commercially available like Idebenone, EPI-743, and Bendavia with their antioxidant role help in reducing the oxidative stress experienced by the cell thereby preventing the progression of the disease. Genetic counseling plays an effective role in making the family members aware of the inheritance pattern of the disease. Gene therapy is an alternative for curing the disease but is still under study. This review focuses on the role of mitochondrial genes in causing LHON and therapeutics available for treating the disease. A systematic search has been adopted in various databases using the keywords "LHON," "mitochondria," "ND1," "ND4," "ND6," and "therapy" and the following review on mitochondrial genetics and therapeutics of LHON has been developed with obtained articles from 1988 to 2017.
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Affiliation(s)
- Agaath Hedina Manickam
- Molecular Genetics and Cancer Biology Laboratory, Department of Human Genetics and Molecular Biology, Bharathiar University, Coimbatore, Tami Nadu, India
| | - Minu Jenifer Michael
- Molecular Genetics and Cancer Biology Laboratory, Department of Human Genetics and Molecular Biology, Bharathiar University, Coimbatore, Tami Nadu, India
| | - Sivasamy Ramasamy
- Department of Human Genetics and Molecular Biology, Bharathiar University, Coimbatore, Tami Nadu, India
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THREE-DIMENSIONAL CHARACTERISTICS OF FOUR MACULAR INTRARETINAL LAYER THICKNESSES IN SYMPTOMATIC AND ASYMPTOMATIC CARRIERS OF G11778A MUTATION WITH LEBER'S HEREDITARY OPTIC NEUROPATHY. Retina 2017; 36:2409-2418. [PMID: 27870803 DOI: 10.1097/iae.0000000000001111] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE To characterize by spectral domain optical coherence tomography the three-dimensional thicknesses of four macular intraretinal layers in symptomatic and asymptomatic carriers of G11778A mutation with Leber's hereditary optic neuropathy. METHODS Twenty-five eyes (7 symptomatic eyes and 18 asymptomatic eyes) of patients with Leber's hereditary optic neuropathy from one Chinese family and 16 normal eyes were enrolled. Macular radial scans by spectral domain optical coherence tomography and custom software produced intraretinal three-dimensional thickness maps. The macula was divided into nine regions, and each region included four intraretinal layers: nerve fiber layer, ganglion cell layer and inner plexiform layer, inner nuclear layer and outer plexiform layer, and the outer retinal layer. RESULTS Nerve fiber layer in the symptomatic eyes was significantly thinner than in normal eyes for most of the macular regions; however in the asymptomatic eyes, it was increased in three regions. Ganglion cell layer and inner plexiform layers in all regions of symptomatic eyes were significant thinner than in asymptomatic eyes and controls. Inner nuclear layer and outer plexiform layers in six regions of symptomatic and asymptomatic eyes were significantly thicker than in controls. The outer retinal layer of asymptomatic eyes was thicker than in most control regions. CONCLUSION Intraretinal thickness changes in asymptomatic patients could be prodromal events that indicate the imminent conversion to symptomatic patients with Leber's hereditary optic neuropathy.
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Abstract
Ischaemic heart disease and stroke are vascular events with serious health consequences worldwide. Recent genetic and epigenetic techniques have revealed many genetic determinants of these vascular events and simplified the approaches to research focused on ischaemic heart disease and stroke. The pathogenetic mechanisms of ischaemic heart disease and stroke are complex, with mitochondrial involvement (partially or entirely) recently gaining substantial support. Not only can mitochondrial reactive oxygen species give rise to ischaemic heart disease and stroke by production of oxidised low-density lipoprotein and induction of apoptosis, but the impact on pericytes contributes directly to the pathogenesis. Over the past two decades, publications implicate the causative role of nuclear genes in the development of ischaemic heart disease and stroke, in contrast to the potential role of mitochondrial DNA (mtDNA) in the pathophysiology of the disorders, which is much less understood, although recent studies do demonstrate that the involvement of mitochondria and mtDNA in the development of ischaemic heart disease and stroke is likely to be larger than originally thought, with the novel discovery of links among mitochondria, mtDNA and vascular events. Here we explore the molecular events and mtDNA alterations in relation to the role of mitochondria in ischaemic heart disease and stroke.
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Andalib S, Emamhadi M, Yousefzadeh-Chabok S, Salari A, Sigaroudi AE, Vafaee MS. MtDNA T4216C variation in multiple sclerosis: a systematic review and meta-analysis. Acta Neurol Belg 2016; 116:439-443. [PMID: 27457485 DOI: 10.1007/s13760-016-0675-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Accepted: 07/10/2016] [Indexed: 01/22/2023]
Abstract
MtDNA T4216C variation has frequently been investigated in Multiple Sclerosis (MS) patients; nonetheless, controversy has existed about the evidence of association of this variation with susceptibility to MS. The present systematic review and meta-analysis converge the results of the preceding publications, pertaining to association of mtDNA T4216C variation with susceptibility to MS, into a common conclusion. A computerized literature search in English was carried out to retrieve relevant publications from which required data were extracted. Using a fixed effect model, pooled odds ratio (OR), 95 % confidence interval (95 % CI), and P value were calculated for association of mtDNA T4216C variation with susceptibility to MS. The pooled results showed that there was a significant association between mtDNA T4216C variation and MS (OR = 1.38, 95 % CI = 1.13-1.67, P = 0.001). The present systematic review and meta-analysis suggest that mtDNA T4216C variation is a contributory factor in susceptibility to MS.
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Affiliation(s)
- Sasan Andalib
- Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammadreza Emamhadi
- Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
| | - Shahrokh Yousefzadeh-Chabok
- Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Arsalan Salari
- Department of Cardiology and Cardiology Research Center, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Abdolhosein Emami Sigaroudi
- Department of Health and Social Determinants of Health Research Center, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Manouchehr Seyedi Vafaee
- Department of Psychiatry, University of Southern Denmark & Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
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Whole mitochondrial genome analysis in South Indian patients with Leber's hereditary optic neuropathy. Mitochondrion 2016; 36:21-28. [PMID: 27989883 DOI: 10.1016/j.mito.2016.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 10/22/2016] [Accepted: 10/26/2016] [Indexed: 11/27/2022]
Abstract
Leber's hereditary optic neuropathy (LHON) is a mitochondrial DNA (mtDNA) associated neurodegenerative disorder of retinal ganglion cells. In this study, whole mitochondrial genome sequencing of 75 LHON patients and 40 controls was performed to identify the mutation frequency and haplogroup background of South Indian population. Analysis of mtDNA revealed 559 different variants in LHON patients, including 7 pathogenic mutations, 30 private, and 22 other disease associated variants. A significantly higher (p=0.0008) overall variation load per individual was noted among LHON patients versus controls. We reported for the first time, the association of M haplogroup (p=0.028) with LHON in this cohort.
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Andalib S, Talebi M, Sakhinia E, Farhoudi M, Sadeghi-Bazargani H, Gjedde A. Lack of association between mitochondrial DNA G15257A and G15812A variations and multiple sclerosis. J Neurol Sci 2015; 356:102-6. [DOI: 10.1016/j.jns.2015.06.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 06/05/2015] [Accepted: 06/11/2015] [Indexed: 12/19/2022]
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Andalib S, Vafaee MS, Gjedde A. Parkinson's disease and mitochondrial gene variations: A review. J Neurol Sci 2014; 346:11-9. [DOI: 10.1016/j.jns.2014.07.067] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Revised: 07/29/2014] [Accepted: 07/31/2014] [Indexed: 01/09/2023]
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Schurr TG, Dulik MC, Cafaro TA, Suarez MF, Urrets-Zavalia JA, Serra HM. Genetic background and climatic droplet keratopathy incidence in a Mapuche population from Argentina. PLoS One 2013; 8:e74593. [PMID: 24040292 PMCID: PMC3764023 DOI: 10.1371/journal.pone.0074593] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 08/05/2013] [Indexed: 11/18/2022] Open
Abstract
Purpose To determine whether the incidence of and susceptibility to climatic droplet keratopathy (CDK), an acquired, often bilateral degenerative corneal disease, is influenced by the genetic background of the individuals who exhibit the disorder. Methods To determine whether the disease expression was influenced by the genetic ancestry of CDK cases in native Mapuche of the northwest area of Patagonia in Argentina, we examined mitochondrial DNA and Y-chromosome variation in 53 unrelated individuals. Twenty-nine of them were part of the CDK (patient) population, while 24 were part of the control group. The analysis revealed the maternal and paternal lineages that were present in the two study groups. Results This analysis demonstrated that nearly all persons had a Native American mtDNA background, whereas 50% of the CDK group and 37% of the control group had Native American paternal ancestry, respectively. There was no significant difference in the frequencies of mtDNA haplogroups between the CDK patient and control groups. Although the Y-chromosome data revealed differences in specific haplogroup frequencies between these two groups, there was no statistically significant relationship between individual paternal genetic backgrounds and the incidence or stage of disease. Conclusions These results indicate a lack of correlation between genetic ancestry as represented by haploid genetic systems and the incidence of CDK in Mapuche populations. In addition, the mtDNA appears to play less of a role in CDK expression than for other complex diseases linked to bioenergetic processes. However, further analysis of the mtDNA genome sequence and other genes involved in corneal function may reveal the more precise role that mitochondria play in the expression of CDK.
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Affiliation(s)
- Theodore G. Schurr
- Department of Anthropology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Matthew C. Dulik
- Department of Anthropology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Thamara A. Cafaro
- CIBICI (Centro de Investigaciones en Bioquímica Clínica e Inmunología), Faculty of Chemistry, National University of Córdoba, Córdoba, Argentina
| | - María F. Suarez
- CIBICI (Centro de Investigaciones en Bioquímica Clínica e Inmunología), Faculty of Chemistry, National University of Córdoba, Córdoba, Argentina
| | | | - Horacio M. Serra
- CIBICI (Centro de Investigaciones en Bioquímica Clínica e Inmunología), Faculty of Chemistry, National University of Córdoba, Córdoba, Argentina
- * E-mail:
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Lin HZ, Pang CY, Chen SP, Tsai RK. Vision improvement in a Taiwanese (Han Chinese) family with Leber's hereditary optic neuropathy. Kaohsiung J Med Sci 2012; 28:679-82. [PMID: 23217361 DOI: 10.1016/j.kjms.2012.04.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Accepted: 10/26/2011] [Indexed: 11/16/2022] Open
Abstract
In this report, we describe a Taiwanese (Han Chinese) family with Leber's hereditary optic neuropathy. The family carried a mitochondrial DNA mutation (mtDNA m.14484T>C) associated with spontaneous visual improvement. A 15-year-old boy from this family was diagnosed with Leber's hereditary optic neuropathy 6 months after losing his vision. His vision recovered after 8 months of supportive treatment. His mother, older brother, and two sisters also had the same mutation and had previously experienced vision loss. In this family, there was no male predominance.
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Affiliation(s)
- Hong-Zin Lin
- Department of Ophthalmology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
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Abstract
Leber's hereditary optic neuropathy (LHON) is a rare disease primarily affecting the retinal ganglion cells. In most cases patients with LHON develop permanent visual loss with a large central scotoma in the visual field of both eyes. The optic disc becomes partially or completely pale. At the onset of the disease many patients are considered to suffer from an optic neuritis and are treated under the diagnostic and therapeutic regimen of optic neuritis. LHON is mostly only considered when high dose cortisone therapy fails to be effective or the second eye is affected. Thereafter, molecular genetic analysis will prove LHON in these cases. Detailed anamnesis including pedigree analysis in combination with observance of the peripapillary microangiopathic alterations at the fundus will help to speed up the diagnosis of LHON, but even after exact clinical and molecular genetic diagnosis of LHON some aspects of the disease still remain a mystery today.
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Affiliation(s)
- B Leo-Kottler
- Department für Augenheilkunde, Augenklinik, Schleichstr. 12-16, 72076, Tübingen, Deutschland.
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Zhang AM, Jia X, Guo X, Zhang Q, Yao YG. Mitochondrial DNA mutation m.10680G > A is associated with Leber hereditary optic neuropathy in Chinese patients. J Transl Med 2012; 10:43. [PMID: 22400981 PMCID: PMC3372436 DOI: 10.1186/1479-5876-10-43] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Accepted: 03/09/2012] [Indexed: 01/01/2023] Open
Abstract
Background Leber hereditary optic neuropathy (LHON) is a mitochondrial disorder with gender biased and incomplete penetrance. The majority of LHON patients are caused by one of the three primary mutations (m.3460G > A, m.11778G > A and m.14484T > C). Rare pathogenic mutations have been occasionally reported in LHON patients. Methods We screened mutation m.10680G > A in the MT-ND4L gene in 774 Chinese patients with clinical features of LHON but lacked the three primary mutations by using allele specific PCR (AS-PCR). Patients with m.10680G > A were further determined entire mtDNA genome sequence. Results The optimal AS-PCR could detect as low as 10% heteroplasmy of mutation m.10680G > A. Two patients (Le1263 and Le1330) were identified to harbor m.10680G > A. Analysis of the complete mtDNA sequences of the probands suggested that they belonged to haplogroups B4a1 and D6a1. There was no other potentially pathogenic mutation, except for a few private yet reported variants in the MT-ND1 and MT-ND5 genes, in the two lineages. A search in reported mtDNA genome data set (n = 9277; excluding Chinese LHON patients) identified no individual with m.10680G > A. Frequency of m.10680G > A in Chinese LHON patients analyzed in this study and our previous studies (3/784) was significantly higher than that of the general populations (0/9277) (P = 0.0005). Conclusion Taken together, we speculated that m.10680G > A may be a rare pathogenic mutation for LHON in Chinese. This mutation should be included in future clinical diagnosis.
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Affiliation(s)
- A-Mei Zhang
- Key Laboratory of Animal Models and Human Disease Mechanisms of Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan 650223, China
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Yu-Wai-Man P, Griffiths PG, Chinnery PF. Mitochondrial optic neuropathies - disease mechanisms and therapeutic strategies. Prog Retin Eye Res 2011; 30:81-114. [PMID: 21112411 PMCID: PMC3081075 DOI: 10.1016/j.preteyeres.2010.11.002] [Citation(s) in RCA: 426] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Leber hereditary optic neuropathy (LHON) and autosomal-dominant optic atrophy (DOA) are the two most common inherited optic neuropathies in the general population. Both disorders share striking pathological similarities, marked by the selective loss of retinal ganglion cells (RGCs) and the early involvement of the papillomacular bundle. Three mitochondrial DNA (mtDNA) point mutations; m.3460G>A, m.11778G>A, and m.14484T>C account for over 90% of LHON cases, and in DOA, the majority of affected families harbour mutations in the OPA1 gene, which codes for a mitochondrial inner membrane protein. Optic nerve degeneration in LHON and DOA is therefore due to disturbed mitochondrial function and a predominantly complex I respiratory chain defect has been identified using both in vitro and in vivo biochemical assays. However, the trigger for RGC loss is much more complex than a simple bioenergetic crisis and other important disease mechanisms have emerged relating to mitochondrial network dynamics, mtDNA maintenance, axonal transport, and the involvement of the cytoskeleton in maintaining a differential mitochondrial gradient at sites such as the lamina cribosa. The downstream consequences of these mitochondrial disturbances are likely to be influenced by the local cellular milieu. The vulnerability of RGCs in LHON and DOA could derive not only from tissue-specific, genetically-determined biological factors, but also from an increased susceptibility to exogenous influences such as light exposure, smoking, and pharmacological agents with putative mitochondrial toxic effects. Our concept of inherited mitochondrial optic neuropathies has evolved over the past decade, with the observation that patients with LHON and DOA can manifest a much broader phenotypic spectrum than pure optic nerve involvement. Interestingly, these phenotypes are sometimes clinically indistinguishable from other neurodegenerative disorders such as Charcot-Marie-Tooth disease, hereditary spastic paraplegia, and multiple sclerosis, where mitochondrial dysfunction is also thought to be an important pathophysiological player. A number of vertebrate and invertebrate disease models has recently been established to circumvent the lack of human tissues, and these have already provided considerable insight by allowing direct RGC experimentation. The ultimate goal is to translate these research advances into clinical practice and new treatment strategies are currently being investigated to improve the visual prognosis for patients with mitochondrial optic neuropathies.
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MESH Headings
- Animals
- DNA, Mitochondrial/genetics
- Disease Models, Animal
- Humans
- Optic Atrophy, Autosomal Dominant/pathology
- Optic Atrophy, Autosomal Dominant/physiopathology
- Optic Atrophy, Autosomal Dominant/therapy
- Optic Atrophy, Hereditary, Leber/pathology
- Optic Atrophy, Hereditary, Leber/physiopathology
- Optic Atrophy, Hereditary, Leber/therapy
- Optic Nerve/pathology
- Phenotype
- Point Mutation
- Retinal Ganglion Cells/pathology
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Affiliation(s)
- Patrick Yu-Wai-Man
- Mitochondrial Research Group, Institute for Ageing and Health, The Medical School, Newcastle University, UK.
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Sundaresan P, Kumar SM, Thompson S, Fingert JH. Reduced frequency of known mutations in a cohort of LHON patients from India. Ophthalmic Genet 2010; 31:196-9. [DOI: 10.3109/13816810.2010.510818] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Fraser JA, Biousse V, Newman NJ. The neuro-ophthalmology of mitochondrial disease. Surv Ophthalmol 2010; 55:299-334. [PMID: 20471050 PMCID: PMC2989385 DOI: 10.1016/j.survophthal.2009.10.002] [Citation(s) in RCA: 173] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Revised: 09/21/2009] [Accepted: 10/01/2009] [Indexed: 01/16/2023]
Abstract
Mitochondrial diseases frequently manifest neuro-ophthalmologic symptoms and signs. Because of the predilection of mitochondrial disorders to involve the optic nerves, extraocular muscles, retina, and even the retrochiasmal visual pathways, the ophthalmologist is often the first physician to be consulted. Disorders caused by mitochondrial dysfunction can result from abnormalities in either the mitochondrial DNA or in nuclear genes which encode mitochondrial proteins. Inheritance of these mutations will follow patterns specific to their somatic or mitochondrial genetics. Genotype-phenotype correlations are inconstant, and considerable overlap may occur among these syndromes. The diagnostic approach to the patient with suspected mitochondrial disease entails a detailed personal and family history, careful ophthalmic, neurologic, and systemic examination, directed investigations, and attention to potentially life-threatening sequelae. Although curative treatments for mitochondrial disorders are currently lacking, exciting research advances are being made, particularly in the area of gene therapy. Leber hereditary optic neuropathy, with its window of opportunity for timely intervention and its accessibility to directed therapy, offers a unique model to study future therapeutic interventions. Most patients and their relatives benefit from informed genetic counseling.
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Affiliation(s)
- J. Alexander Fraser
- Departments of Ophthalmology (J.A.F., V.B., N.J.N.), Neurology (V.B., N.J.N.), and Neurological Surgery (N.J.N.), Emory University School of Medicine, Atlanta, GA
| | - Valérie Biousse
- Departments of Ophthalmology (J.A.F., V.B., N.J.N.), Neurology (V.B., N.J.N.), and Neurological Surgery (N.J.N.), Emory University School of Medicine, Atlanta, GA
| | - Nancy J. Newman
- Departments of Ophthalmology (J.A.F., V.B., N.J.N.), Neurology (V.B., N.J.N.), and Neurological Surgery (N.J.N.), Emory University School of Medicine, Atlanta, GA
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Yu-Wai-Man P, Griffiths PG, Hudson G, Chinnery PF. Inherited mitochondrial optic neuropathies. J Med Genet 2009; 46:145-58. [PMID: 19001017 PMCID: PMC2643051 DOI: 10.1136/jmg.2007.054270] [Citation(s) in RCA: 281] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2008] [Revised: 09/08/2008] [Accepted: 10/07/2008] [Indexed: 02/02/2023]
Abstract
Leber hereditary optic neuropathy (LHON) and autosomal dominant optic atrophy (DOA) are the two most common inherited optic neuropathies and they result in significant visual morbidity among young adults. Both disorders are the result of mitochondrial dysfunction: LHON from primary mitochondrial DNA (mtDNA) mutations affecting the respiratory chain complexes; and the majority of DOA families have mutations in the OPA1 gene, which codes for an inner mitochondrial membrane protein critical for mtDNA maintenance and oxidative phosphorylation. Additional genetic and environmental factors modulate the penetrance of LHON, and the same is likely to be the case for DOA which has a markedly variable clinical phenotype. The selective vulnerability of retinal ganglion cells (RGCs) is a key pathological feature and understanding the fundamental mechanisms that underlie RGC loss in these disorders is a prerequisite for the development of effective therapeutic strategies which are currently limited.
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MESH Headings
- DNA, Mitochondrial
- Female
- GTP Phosphohydrolases/genetics
- Humans
- Male
- Optic Atrophy, Autosomal Dominant/diagnosis
- Optic Atrophy, Autosomal Dominant/epidemiology
- Optic Atrophy, Autosomal Dominant/genetics
- Optic Atrophy, Autosomal Dominant/pathology
- Optic Atrophy, Hereditary, Leber/diagnosis
- Optic Atrophy, Hereditary, Leber/epidemiology
- Optic Atrophy, Hereditary, Leber/genetics
- Optic Atrophy, Hereditary, Leber/pathology
- Point Mutation
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Affiliation(s)
- P Yu-Wai-Man
- Mitochondrial Research Group, The Medical School, Newcastle University, Newcastle upon Tyne, UK
- Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - P G Griffiths
- Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - G Hudson
- Mitochondrial Research Group, The Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - P F Chinnery
- Mitochondrial Research Group, The Medical School, Newcastle University, Newcastle upon Tyne, UK
- Institute of Human Genetics, Newcastle University, Newcastle upon Tyne, NE1 3BZ, UK
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Hudson G, Yu-Wai-Man P, Chinnery PF. Leber hereditary optic neuropathy. EXPERT OPINION ON MEDICAL DIAGNOSTICS 2008; 2:789-99. [PMID: 23495818 DOI: 10.1517/17530059.2.7.789] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Leber hereditary optic neuropathy (LHON) is a cause of inherited blindness that typically presents with bilateral, painless, subacute visual failure in young adult males. Males are about four times more likely to be affected than females and 95% of LHON carriers become affected before the age of 50. Affected patients may have characteristic ocular fundal appearances and have evidence of optic nerve dysfunction in the form of impaired colour vision (dyschromatopsia), dense visual field defects (central or caecocentral scotoma) and abnormal visual electrophysiology. OBJECTIVES To summarise the current clinical approach to the molecular diagnosis and clinical management of LHON. METHODS To review the literature and present a review of current understanding. RESULTS/CONCLUSIONS The diagnosis of LHON is usually confirmed by molecular genetic analysis for one of three common mitochondrial DNA (mtDNA) mutations that all affect genes coding for complex I subunits of the respiratory chain: m.3460G > A, m.11778G > A and m.14484T > C. Sequencing of the entire mitochondrial genome can reveal the underlying cause in the minority of patients (∼ 5%) who do not harbour one of these three primary mutations, but a molecular diagnosis is not always possible. A minority of LHON patients exhibit a more widespread multi-system involvement with extra neurological features such as dystonia or a multiple sclerosis-like illness. Management is largely supportive, with the provision of low-vision aids, registration with the relevant social services and an important role for genetic counselling.
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Affiliation(s)
- Gavin Hudson
- Newcastle University, Mitochondrial Research Group, M4014, The Medical School, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK +44 191 222 8233 ; +44 191 222 8553 ;
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Wang W, Cui SL, Yang L, Shang J, Wei WB, Zhang XJ. Clinical Features of Genetically Proved Leber Hereditary Optic Neuropathy in China. Neuroophthalmology 2007. [DOI: 10.1080/01658100701648660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Jia X, Li S, Xiao X, Guo X, Zhang Q. Molecular epidemiology of mtDNA mutations in 903 Chinese families suspected with Leber hereditary optic neuropathy. J Hum Genet 2006; 51:851-856. [PMID: 16972023 DOI: 10.1007/s10038-006-0032-2] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2006] [Accepted: 06/14/2006] [Indexed: 11/26/2022]
Abstract
We report the molecular epidemiology of three primary mutations in mitochondrial DNA (mtDNA) responsible for Leber hereditary optic neuropathy (LHON) based on analysis of probands suspected with LHON from 903 Chinese families. Most of them had optic neuropathy of unknown cause, and only 128 had a family history of optic neuropathy. Mutations in the mtDNA were detected in 346 probands. Of the 346 cases, 340 were homoplasmic and only six were heteroplasmic; 284 were male and 62 were female; 120 had a family history and 226 were sporadic. G11778A, T14484C and G3460A mutations were detected in 312 (90.2%), 30, and four families, respectively. The majority (226/346, 65.3%) of all LHON cases in Chinese are sporadic. These 226 probands (29.2%) were identified from 775 probands with sporadic optic neuropathy. Affected male-to-female ratio was 4.6:1 for all probands but was 2.2:1 for family members. Average age at onset was 18.5 years, ranging from 4.5 to 47 years old.
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Affiliation(s)
- Xiaoyun Jia
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China
| | - Shiqiang Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China
| | - Xueshan Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China
| | - Xiangming Guo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China
| | - Qingjiong Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China.
- Ophthalmic Genetic and Molecular Biology, Eye Research Institute, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 Xianlie Road, Guangzhou, 510060, China.
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Phasukkijwatana N, Chuenkongkaew WL, Suphavilai R, Suktitipat B, Pingsuthiwong S, Ruangvaravate N, Atchaneeyasakul LO, Warrasak S, Poonyathalang A, Sura T, Lertrit P. The unique characteristics of Thai Leber hereditary optic neuropathy: analysis of 30 G11778A pedigrees. J Hum Genet 2006; 51:298-304. [PMID: 16477364 DOI: 10.1007/s10038-006-0361-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2005] [Accepted: 12/13/2005] [Indexed: 01/30/2023]
Abstract
Leber hereditary optic neuropathy (LHON) is characterized by acute or subacute bilateral visual loss, and affects mostly young males. The most common mitochondrial DNA mutation responsible for LHON worldwide is G11778A. Despite different genetic backgrounds, which are believed to influence the disease expression, most features of LHON are quite common in different populations. However, there seem to be a few ethnic-specific differences. Analyses of our 30 G11778A LHON pedigrees in Thailand showed some characteristics different from those of Caucasians and Japanese. In particular, our pedigrees showed a lower male to female ratio of affected persons (2.6:1) and much higher prevalence of G11778A blood heteroplasmy (37% of the pedigrees contained at least one heteroplasmic G11778A individual). Heteroplasmicity seemed to influence disease manifestation in our patients but did not appear to alter the onset of the disease. The estimated overall penetrance of our G11778A LHON population was 37% for males and 13% for females. When each of our large pedigrees were considered separately, disease penetration varied from 9 to 45% between the pedigrees, and also varied between different branches of the same large pedigree. Survival analysis showed that the secondary LHON mutations G3316A and C3497T had a synergistic deleterious effect with the G11778A mutation, accelerating the onset of the disease in our patients.
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Affiliation(s)
- Nopasak Phasukkijwatana
- Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Wanicha L Chuenkongkaew
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
- Siriraj Neurogenetics Network, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Rungnapa Suphavilai
- Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Bhoom Suktitipat
- Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Sarinee Pingsuthiwong
- Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Ngamkae Ruangvaravate
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - La-Ongsri Atchaneeyasakul
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Sukhuma Warrasak
- Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Anuchit Poonyathalang
- Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Thanyachai Sura
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Patcharee Lertrit
- Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
- Siriraj Neurogenetics Network, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
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31
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Laberge AM, Jomphe M, Houde L, Vézina H, Tremblay M, Desjardins B, Labuda D, St-Hilaire M, Macmillan C, Shoubridge EA, Brais B. A "Fille du Roy" introduced the T14484C Leber hereditary optic neuropathy mutation in French Canadians. Am J Hum Genet 2005; 77:313-7. [PMID: 15954041 PMCID: PMC1224533 DOI: 10.1086/432491] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2005] [Accepted: 06/02/2005] [Indexed: 11/03/2022] Open
Abstract
The predominance of the T14484C mutation in French Canadians with Leber hereditary optic neuropathy is due to a founder effect. By use of genealogical reconstructions of maternal lineages, a woman married in Quebec City in 1669 is identified as the shared female ancestor for 11 of 13 affected individuals, who were previously not known to be related. These individuals carry identical mitochondrial haplogroups. The current geographic distribution of French Canadian cases overlaps with that of the founder's female descendants in 1800. This is the first example of genealogical reconstruction to identify the introduction of a mitochondrial mutation by a woman in a founder population.
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Affiliation(s)
- Anne-Marie Laberge
- Laboratoire de Neurogénétique, Centre Hospitalier de l’Université de Montréal, Department of Demography, Faculty of Arts and Sciences, and Department of Pediatrics, Faculty of Medicine, Université de Montréal, and Montreal Neurological Institute and Departments of Human Genetics and Neurology and Neurosurgery, McGill University, Montreal; Institute for Public Health Genetics, Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle; Projet BALSAC and Groupe de Recherche Interdisciplinaire en Démographie et en Épidémiologie Génétique, Université du Québec à Chicoutimi, Saguenay; Department of Geography, Université Laval, Quebec City; and Departments of Neurology and Pediatrics, University of Illinois at Chicago, Chicago
| | - Michèle Jomphe
- Laboratoire de Neurogénétique, Centre Hospitalier de l’Université de Montréal, Department of Demography, Faculty of Arts and Sciences, and Department of Pediatrics, Faculty of Medicine, Université de Montréal, and Montreal Neurological Institute and Departments of Human Genetics and Neurology and Neurosurgery, McGill University, Montreal; Institute for Public Health Genetics, Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle; Projet BALSAC and Groupe de Recherche Interdisciplinaire en Démographie et en Épidémiologie Génétique, Université du Québec à Chicoutimi, Saguenay; Department of Geography, Université Laval, Quebec City; and Departments of Neurology and Pediatrics, University of Illinois at Chicago, Chicago
| | - Louis Houde
- Laboratoire de Neurogénétique, Centre Hospitalier de l’Université de Montréal, Department of Demography, Faculty of Arts and Sciences, and Department of Pediatrics, Faculty of Medicine, Université de Montréal, and Montreal Neurological Institute and Departments of Human Genetics and Neurology and Neurosurgery, McGill University, Montreal; Institute for Public Health Genetics, Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle; Projet BALSAC and Groupe de Recherche Interdisciplinaire en Démographie et en Épidémiologie Génétique, Université du Québec à Chicoutimi, Saguenay; Department of Geography, Université Laval, Quebec City; and Departments of Neurology and Pediatrics, University of Illinois at Chicago, Chicago
| | - Hélène Vézina
- Laboratoire de Neurogénétique, Centre Hospitalier de l’Université de Montréal, Department of Demography, Faculty of Arts and Sciences, and Department of Pediatrics, Faculty of Medicine, Université de Montréal, and Montreal Neurological Institute and Departments of Human Genetics and Neurology and Neurosurgery, McGill University, Montreal; Institute for Public Health Genetics, Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle; Projet BALSAC and Groupe de Recherche Interdisciplinaire en Démographie et en Épidémiologie Génétique, Université du Québec à Chicoutimi, Saguenay; Department of Geography, Université Laval, Quebec City; and Departments of Neurology and Pediatrics, University of Illinois at Chicago, Chicago
| | - Marc Tremblay
- Laboratoire de Neurogénétique, Centre Hospitalier de l’Université de Montréal, Department of Demography, Faculty of Arts and Sciences, and Department of Pediatrics, Faculty of Medicine, Université de Montréal, and Montreal Neurological Institute and Departments of Human Genetics and Neurology and Neurosurgery, McGill University, Montreal; Institute for Public Health Genetics, Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle; Projet BALSAC and Groupe de Recherche Interdisciplinaire en Démographie et en Épidémiologie Génétique, Université du Québec à Chicoutimi, Saguenay; Department of Geography, Université Laval, Quebec City; and Departments of Neurology and Pediatrics, University of Illinois at Chicago, Chicago
| | - Bertrand Desjardins
- Laboratoire de Neurogénétique, Centre Hospitalier de l’Université de Montréal, Department of Demography, Faculty of Arts and Sciences, and Department of Pediatrics, Faculty of Medicine, Université de Montréal, and Montreal Neurological Institute and Departments of Human Genetics and Neurology and Neurosurgery, McGill University, Montreal; Institute for Public Health Genetics, Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle; Projet BALSAC and Groupe de Recherche Interdisciplinaire en Démographie et en Épidémiologie Génétique, Université du Québec à Chicoutimi, Saguenay; Department of Geography, Université Laval, Quebec City; and Departments of Neurology and Pediatrics, University of Illinois at Chicago, Chicago
| | - Damian Labuda
- Laboratoire de Neurogénétique, Centre Hospitalier de l’Université de Montréal, Department of Demography, Faculty of Arts and Sciences, and Department of Pediatrics, Faculty of Medicine, Université de Montréal, and Montreal Neurological Institute and Departments of Human Genetics and Neurology and Neurosurgery, McGill University, Montreal; Institute for Public Health Genetics, Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle; Projet BALSAC and Groupe de Recherche Interdisciplinaire en Démographie et en Épidémiologie Génétique, Université du Québec à Chicoutimi, Saguenay; Department of Geography, Université Laval, Quebec City; and Departments of Neurology and Pediatrics, University of Illinois at Chicago, Chicago
| | - Marc St-Hilaire
- Laboratoire de Neurogénétique, Centre Hospitalier de l’Université de Montréal, Department of Demography, Faculty of Arts and Sciences, and Department of Pediatrics, Faculty of Medicine, Université de Montréal, and Montreal Neurological Institute and Departments of Human Genetics and Neurology and Neurosurgery, McGill University, Montreal; Institute for Public Health Genetics, Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle; Projet BALSAC and Groupe de Recherche Interdisciplinaire en Démographie et en Épidémiologie Génétique, Université du Québec à Chicoutimi, Saguenay; Department of Geography, Université Laval, Quebec City; and Departments of Neurology and Pediatrics, University of Illinois at Chicago, Chicago
| | - Carol Macmillan
- Laboratoire de Neurogénétique, Centre Hospitalier de l’Université de Montréal, Department of Demography, Faculty of Arts and Sciences, and Department of Pediatrics, Faculty of Medicine, Université de Montréal, and Montreal Neurological Institute and Departments of Human Genetics and Neurology and Neurosurgery, McGill University, Montreal; Institute for Public Health Genetics, Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle; Projet BALSAC and Groupe de Recherche Interdisciplinaire en Démographie et en Épidémiologie Génétique, Université du Québec à Chicoutimi, Saguenay; Department of Geography, Université Laval, Quebec City; and Departments of Neurology and Pediatrics, University of Illinois at Chicago, Chicago
| | - Eric A. Shoubridge
- Laboratoire de Neurogénétique, Centre Hospitalier de l’Université de Montréal, Department of Demography, Faculty of Arts and Sciences, and Department of Pediatrics, Faculty of Medicine, Université de Montréal, and Montreal Neurological Institute and Departments of Human Genetics and Neurology and Neurosurgery, McGill University, Montreal; Institute for Public Health Genetics, Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle; Projet BALSAC and Groupe de Recherche Interdisciplinaire en Démographie et en Épidémiologie Génétique, Université du Québec à Chicoutimi, Saguenay; Department of Geography, Université Laval, Quebec City; and Departments of Neurology and Pediatrics, University of Illinois at Chicago, Chicago
| | - Bernard Brais
- Laboratoire de Neurogénétique, Centre Hospitalier de l’Université de Montréal, Department of Demography, Faculty of Arts and Sciences, and Department of Pediatrics, Faculty of Medicine, Université de Montréal, and Montreal Neurological Institute and Departments of Human Genetics and Neurology and Neurosurgery, McGill University, Montreal; Institute for Public Health Genetics, Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle; Projet BALSAC and Groupe de Recherche Interdisciplinaire en Démographie et en Épidémiologie Génétique, Université du Québec à Chicoutimi, Saguenay; Department of Geography, Université Laval, Quebec City; and Departments of Neurology and Pediatrics, University of Illinois at Chicago, Chicago
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Abstract
AIMS To provide a clinical update on the hereditary optic neuropathies. METHODS Review of the literature. RESULTS The hereditary optic neuropathies comprise a group of disorders in which the cause of optic nerve dysfunction appears to be hereditable, based on familial expression or genetic analysis. In some hereditary optic neuropathies, optic nerve dysfunction is typically the only manifestation of the disease. In others, various neurologic and systemic abnormalities are regularly observed. CONCLUSION The most common hereditary optic neuropathies are autosomal dominant optic atrophy (Kjer's disease) and maternally inherited Leber's hereditary optic neuropathy. We review the clinical phenotypes of these and other inherited disorders with optic nerve involvement.
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MESH Headings
- Dysautonomia, Familial/complications
- Dysautonomia, Familial/genetics
- Female
- Friedreich Ataxia/complications
- Friedreich Ataxia/genetics
- Humans
- Male
- Muscular Dystrophies/complications
- Muscular Dystrophies/genetics
- Optic Atrophies, Hereditary/complications
- Optic Atrophies, Hereditary/genetics
- Optic Atrophies, Hereditary/physiopathology
- Optic Atrophy, Autosomal Dominant/complications
- Optic Atrophy, Autosomal Dominant/genetics
- Optic Atrophy, Autosomal Dominant/physiopathology
- Optic Atrophy, Hereditary, Leber/complications
- Optic Atrophy, Hereditary, Leber/genetics
- Optic Atrophy, Hereditary, Leber/physiopathology
- Pedigree
- Spinocerebellar Ataxias/complications
- Spinocerebellar Ataxias/genetics
- Vision Disorders/etiology
- Vision Disorders/genetics
- Vision Disorders/physiopathology
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Affiliation(s)
- N J Newman
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA 30022, USA.
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Teive HAG, Troiano AR, Raskin S, Werneck LC. Leber's hereditary optic neuropathy--case report and literature review. SAO PAULO MED J 2004; 122:276-9. [PMID: 15692724 DOI: 10.1590/s1516-31802004000600010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
CONTEXT Leber's hereditary optic neuropathy is an important cause of progressive painless visual loss among young male patients. OBJECTIVE To report on a case of a young patient with a clinical and neurophysiological condition suggestive of Leber's hereditary optic neuropathy, confirmed by genetic testing. CASE REPORT We describe a 17-year-old male with progressive bilateral visual loss. Two maternal uncles had had similar patterns of visual loss. The patient had a history of smoking and alcohol abuse. Neuro-ophthalmological examination revealed visual acuity of 20/800 in both eyes, with decreased direct and consensual pupillary light reflexes. Fundus examination demonstrated pale optic discs. The visual evoked potential test showed signs of conduction disturbances in both optic nerves and campimetric study showed complete visual loss in all fields of both eyes. A diagnosis of bilateral optic neuropathy with a clinical suspicion of Leber's hereditary optic neuropathy was made. A blood sample was submitted to genetic analysis in relation to the principal mutations of this disorder, and homoplasmic mutation in 11778 was detected, thereby confirming the diagnosis of Leber's hereditary optic neuropathy.
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Affiliation(s)
- Hélio Afonso Ghizoni Teive
- Neurology Outpatient Clinic, Neurology Service, Department of Internal Medicine, Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
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34
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Houshmand M, Sharifpanah F, Tabasi A, Sanati MH, Vakilian M, Lavasani SH, Joughehdoust S. Leber's hereditary optic neuropathy: the spectrum of mitochondrial DNA mutations in Iranian patients. Ann N Y Acad Sci 2004; 1011:345-9. [PMID: 15126312 DOI: 10.1007/978-3-662-41088-2_35] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
We studied 14 patients with Leber's hereditary optic neuropathy (LHON) to investigate the mtDNA haplotypes associated with the primary mutation(s). Eleven patients carried the mitochondrial DNA (mtDNA) G11778A mutation, while one had the T14484C mutation; one patient had the G3460A mutation and one the G14459A mutation. The Iranian G11778A LHON mutation was not associated with two mtDNA haplogroups-M (0.0% compared with 3.2% in healthy controls) and J (7.7% compared with 10% in healthy controls). Our results showed a similarity in the pattern of LHON primary point mutations between Iranian families with LHON and those of Russian, European, and North American origin. Our results also do not support an association between mtDNA haplogroups J and M with LHON primary point mutations.
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Affiliation(s)
- M Houshmand
- National Research Center for Genetic Engineering and Biotechnology, Tehran, Iran.
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35
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HOUSHMAND M, SHARIFPANAH F, TABASI A, SANATI MH, VAKILIAN M, LAVASANI SH, JOUGHEHDOUST S. Leber's Hereditary Optic Neuropathy: The Spectrum of Mitochondrial DNA Mutations in Iranian Patients. Ann N Y Acad Sci 2004. [DOI: 10.1196/annals.1293.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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36
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Abstract
Leber's hereditary optic neuropathy (LHON) is a maternally inherited mitochondrial disease that primarily affects the optic nerve, causing bilateral vision loss in juveniles and young adults. A 12-year-old boy had complained of blurred vision in both eyes for more than 1 year. His best-corrected visual acuity was 0.08 in the right eye and 0.1 in the left. Ophthalmologic examination showed bilateral optic disc hyperemia and margin blurring, peripapillary telangiectasis, and a relative afferent pupil defect in his right eye. Fluorescein angiography showed no stain or leakage around the optic disc in the late phase. Visual field analysis showed central scotoma in the left eye and a near-total defect in the right. Upon examination of the patient's mitochondrial DNA, a point mutation at nucleotide position 11778 was found, and the diagnosis of LHON was confirmed. Coenzyme Q10 was used to treat the patient.
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Affiliation(s)
- Chi-Wu Chang
- Department of Ophthalmology, Chung Shan Medical University, Taichung, Taiwan
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