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Britten-Jones AC, Schultz J, Mack HG, Kearns LS, Huq AJ, Ruddle JB, Mackey DA, Hewitt AW, Edwards TL, Ayton LN. Patient experiences and perceived value of genetic testing in inherited retinal diseases: a cross-sectional survey. Sci Rep 2024; 14:5403. [PMID: 38443430 PMCID: PMC10914714 DOI: 10.1038/s41598-024-56121-2] [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: 07/12/2023] [Accepted: 02/29/2024] [Indexed: 03/07/2024] Open
Abstract
This study evaluated patient experiences with genetic testing for inherited retinal diseases (IRDs) and the association between underlying knowledge, testing outcomes, and the perceived value of the results. An online survey was distributed to adults with IRDs and parents/guardians of dependents with IRDs who had had genetic testing. Data included details of genetic testing, pre- and post- test perceptions, Decision Regret Scale, perceived value of results, and knowledge of gene therapy. Of 135 responses (85% from adults with IRDs), genetic testing was primarily conducted at no charge through public hospitals (49%) or in a research setting (30%). Key motivations for genetic testing were to confirm IRD diagnosis and to contribute towards research. Those who had received a genetic diagnosis (odds ratio: 6.71; p < 0.001) and those self-reported to have good knowledge of gene therapy (odds ratio: 2.69; p = 0.018) were more likely to have gained confidence in managing their clinical care. For over 80% of respondents, knowing the causative gene empowered them to learn more about their IRD and explore opportunities regarding clinical trials. Key genetic counselling information needs include resources for family communications, structured information provision, and ongoing genetic support, particularly in the context of emerging ocular therapies, to enhance consistency in information uptake.
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Affiliation(s)
- Alexis Ceecee Britten-Jones
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia.
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
- Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia.
| | - Joshua Schultz
- Department of Genomic Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Heather G Mack
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
- Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | - Lisa S Kearns
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
- Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | - Aamira J Huq
- Department of Genomic Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia
- Department of Medicine, University of Melbourne, Parkville, VIC, Australia
| | - Jonathan B Ruddle
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - David A Mackey
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
- Menzies Institute for Medical Research, School of Medicine, University of Tasmania, Hobart, TAS, 7000, Australia
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, The University of Western Australia, Nedlands, WA, 6009, Australia
| | - Alex W Hewitt
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
- Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
- Menzies Institute for Medical Research, School of Medicine, University of Tasmania, Hobart, TAS, 7000, Australia
| | - Thomas L Edwards
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
- Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | - Lauren N Ayton
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
- Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
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Gocuk SA, Jolly JK, Edwards TL, Ayton LN. Female carriers of X-linked inherited retinal diseases - Genetics, diagnosis, and potential therapies. Prog Retin Eye Res 2023; 96:101190. [PMID: 37406879 DOI: 10.1016/j.preteyeres.2023.101190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 07/07/2023]
Abstract
Inherited retinal diseases (IRDs) are a group of heterogeneous conditions that cause progressive vision loss, typically due to monogenic mutations. Female carriers of X-linked IRDs have a single copy of the disease-causing gene, and therefore, may exhibit variable clinical signs that vary from near normal retina to severe disease and vision loss. The relationships between individual genetic mutations and disease severity in X-linked carriers requires further study. This review summarises the current literature surrounding the spectrum of disease seen in female carriers of choroideremia and X-linked retinitis pigmentosa. Various classification systems are contrasted to accurately grade retinal disease. Furthermore, genetic mechanisms at the early embryonic stage are explored to potentially explain the variability of disease seen in female carriers. Future research in this area will provide insight into the association between genotype and retinal phenotypes of female carriers, which will guide in the management of these patients. This review acknowledges the importance of identifying which patients may be at high risk of developing severe symptoms, and therefore should be considered for emerging treatments, such as retinal gene therapy.
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Affiliation(s)
- Sena A Gocuk
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Victoria, Australia; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia; Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jasleen K Jolly
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK
| | - Thomas L Edwards
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia; Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lauren N Ayton
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Victoria, Australia; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia; Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia.
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Arthur P, Muok L, Nathani A, Zeng EZ, Sun L, Li Y, Singh M. Bioengineering Human Pluripotent Stem Cell-Derived Retinal Organoids and Optic Vesicle-Containing Brain Organoids for Ocular Diseases. Cells 2022; 11:3429. [PMID: 36359825 PMCID: PMC9653705 DOI: 10.3390/cells11213429] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/13/2022] [Accepted: 10/23/2022] [Indexed: 08/24/2023] Open
Abstract
Retinal organoids are three-dimensional (3D) structures derived from human pluripotent stem cells (hPSCs) that mimic the retina's spatial and temporal differentiation, making them useful as in vitro retinal development models. Retinal organoids can be assembled with brain organoids, the 3D self-assembled aggregates derived from hPSCs containing different cell types and cytoarchitectures that resemble the human embryonic brain. Recent studies have shown the development of optic cups in brain organoids. The cellular components of a developing optic vesicle-containing organoids include primitive corneal epithelial and lens-like cells, retinal pigment epithelia, retinal progenitor cells, axon-like projections, and electrically active neuronal networks. The importance of retinal organoids in ocular diseases such as age-related macular degeneration, Stargardt disease, retinitis pigmentosa, and diabetic retinopathy are described in this review. This review highlights current developments in retinal organoid techniques, and their applications in ocular conditions such as disease modeling, gene therapy, drug screening and development. In addition, recent advancements in utilizing extracellular vesicles secreted by retinal organoids for ocular disease treatments are summarized.
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Affiliation(s)
- Peggy Arthur
- College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL 32307, USA
| | - Laureana Muok
- Department of Chemical and Biomedical Engineering, FAMU-FSU College of Engineering, Florida State University, Tallahassee, FL 32306, USA
| | - Aakash Nathani
- College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL 32307, USA
| | - Eric Z. Zeng
- Department of Chemical and Biomedical Engineering, FAMU-FSU College of Engineering, Florida State University, Tallahassee, FL 32306, USA
| | - Li Sun
- Department of Chemical and Biomedical Engineering, FAMU-FSU College of Engineering, Florida State University, Tallahassee, FL 32306, USA
- Department of Biomedical Sciences, College of Medicine, Florida State University, Tallahassee, FL 32306, USA
| | - Yan Li
- Department of Chemical and Biomedical Engineering, FAMU-FSU College of Engineering, Florida State University, Tallahassee, FL 32306, USA
| | - Mandip Singh
- College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL 32307, USA
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Abdul-Fatah A, Esmaeilisaraji L, Juan CM, Holcik M. Mitochondrial disease registries worldwide: A scoping review. PLoS One 2022; 17:e0276883. [PMID: 36301904 PMCID: PMC9612561 DOI: 10.1371/journal.pone.0276883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Mitochondrial diseases are a large group of genetically heterogeneous and clinically diverse disorders. Diagnosis often takes many years for which treatment may not exist. Registries are often used to conduct research, establish natural disease progression, engage the patient community, and develop best disease management practices. In Canada, there are limited centralized registries for mitochondrial disease patients, presenting a challenge for patients and professionals. OBJECTIVE To support the creation of such a registry, a systematic scoping review was conducted to map the landscape of mitochondrial disease patient registries worldwide, with a focus on registry design and challenges. Furthermore, it addresses a knowledge gap by providing a narrative synthesis of published literature that describes these registries. METHODS Arksey and O'Malley's methodological framework was followed to systematically search English-language literature in PubMed and CINAHL describing the designs of mitochondrial disease patient registries, supplemented by a grey literature search. Data were extracted in Microsoft Excel. Stakeholder consultations were also performed with patient caregivers, advocates, and researchers to provide perspectives beyond those found in the literature. These data were thematically analyzed and were reported in accordance with the PRISMA-ScR reporting guidelines. RESULTS A total of 17 articles were identified describing 13 unique registries located in North America, Europe, Australia, and West Asia. These papers described the registries' designs, their strengths, and weaknesses, as well as their tangible outcomes such as facilitating recruitment for research and supporting epidemiological studies. CONCLUSION Based on our findings in this review, recommendations were formulated. These include establishing registry objectives, respecting patients and their roles in the registry, adopting international data standards, data evaluations, and considerations to privacy legislation, among others. These recommendations could be used to support designing a future Canadian mitochondrial disease patient registry, and to further research directly engaging these registries worldwide.
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Affiliation(s)
| | | | - Crisel Mae Juan
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | - Martin Holcik
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
- * E-mail:
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Heath Jeffery RC, Thompson JA, Lo J, Lamey TM, McLaren TL, De Roach JN, Azamanov DN, McAllister IL, Constable IJ, Chen FK. SIBLING CONCORDANCE IN SYMPTOM ONSET AND ATROPHY GROWTH RATES IN STARGARDT DISEASE USING ULTRA-WIDEFIELD FUNDUS AUTOFLUORESCENCE. Retina 2022; 42:1545-1559. [PMID: 35344533 PMCID: PMC9301984 DOI: 10.1097/iae.0000000000003477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To investigate concordance in symptom onset, area of dark autofluorescence (DAF), and growth rate (GR) between Stargardt disease siblings at an age-matched time point. METHODS In this retrospective longitudinal study of sibling pairs with identical biallelic ABCA4 variants, age at symptom onset, best-corrected visual acuity, atrophy area, and effective radius of DAF on ultra-widefield fundus autofluorescence were recorded. Absolute intersibling differences for both eyes were compared with absolute interocular differences using the Mann-Whitney test. RESULTS Overall 39 patients from 19 families were recruited. In 16 families, age-matched best-corrected visual acuity and DAF were compared between siblings. In 8 families, DAF GR was compared. The median (range) absolute difference in age at symptom onset between siblings was 3 (0-35) years. Absolute intersibling differences in age-matched best-corrected visual acuity were greater than interocular differences ( P = 0.01). Similarly, absolute intersibling differences in DAF area and radius were greater than interocular differences ( P = 0.04 for area and P = 0.001 for radius). Differences between absolute interocular and intersibling GR were not statistically significant ( P = 0.44 for area GR and P = 0.61 for radius GR). CONCLUSION There was significant discordance in age-matched best-corrected visual acuity and DAF beyond the expected limits of interocular asymmetry. Lack of significant intersibling differences in GR warrants further investigation.
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Affiliation(s)
- Rachael C. Heath Jeffery
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
- Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Jennifer A. Thompson
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Johnny Lo
- School of Science, Edith Cowan University, Perth, Western Australia, Australia
| | - Tina M. Lamey
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Terri L. McLaren
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - John N. De Roach
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Dimitar N. Azamanov
- Department of Diagnostic Genomics, PathWest, Perth, Western Australia, Australia
| | - Ian L. McAllister
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
| | - Ian J. Constable
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
| | - Fred K. Chen
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
- Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Victoria, Australia; and
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Britten‐Jones AC, O'Hare F, Edwards TL, Ayton LN. Victorian evolution of inherited retinal diseases natural history registry (VENTURE study): Rationale, methodology and initial participant characteristics. Clin Exp Ophthalmol 2022; 50:768-780. [PMID: 35621151 PMCID: PMC9796389 DOI: 10.1111/ceo.14110] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/28/2022] [Accepted: 05/15/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Emerging treatments are being developed for inherited retinal diseases, requiring a clear understanding of natural progression and a database of potential participants for clinical trials. This article describes the rationale, study design and methodology of the Victorian Evolution of inherited retinal diseases NaTUral history REgistry (VENTURE), including data from the first 150 participants enrolled. METHODS VENTURE collects retrospective and prospective data from people with inherited retinal diseases. Following registration, participants are asked to attend a baseline examination using a standardised protocol to confirm their inherited retinal disease diagnosis. Examination procedures include (i) retinal function, using visual acuity and perimetry; (ii) retinal structure, using multimodal imaging and (iii) patient-reported outcomes. Participants' molecular diagnoses are obtained from their clinical records or through targeted-panel genetic testing by an independent laboratory. Phenotype and genotype data are used to enrol participants into disease-specific longitudinal cohort sub-studies. RESULTS From 7 July 2020 to 30 December 2021, VENTURE enrolled 150 registrants (138 families) and most (63%) have a rod-cone dystrophy phenotype. From 93 participants who have received a probable molecular diagnosis, the most common affected genes are RPGR (13% of all registrants), USH2A (10%), CYP4V2 (7%), ABCA4 (5%), and CHM (5%). Most participants have early to moderate vision impairment, with over half (55%) having visual acuities of better than 6/60 (20/200) at registration. CONCLUSIONS The VENTURE study will complement existing patient registries and help drive inherited retinal disease research in Australia, facilitating access to research opportunities for individuals with inherited retinal diseases.
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Affiliation(s)
- Alexis Ceecee Britten‐Jones
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneParkvilleAustralia,Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneParkvilleAustralia,Centre for Eye Research AustraliaRoyal Victorian Eye and Ear HospitalMelbourneAustralia
| | - Fleur O'Hare
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneParkvilleAustralia,Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneParkvilleAustralia,Centre for Eye Research AustraliaRoyal Victorian Eye and Ear HospitalMelbourneAustralia
| | - Thomas L. Edwards
- Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneParkvilleAustralia,Centre for Eye Research AustraliaRoyal Victorian Eye and Ear HospitalMelbourneAustralia
| | - Lauren N. Ayton
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneParkvilleAustralia,Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneParkvilleAustralia,Centre for Eye Research AustraliaRoyal Victorian Eye and Ear HospitalMelbourneAustralia
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Heath Jeffery RC, Thompson JA, Lo J, Lamey TM, McLaren TL, McAllister IL, Constable IJ, De Roach JN, Chen FK. Genotype-Specific Lesion Growth Rates in Stargardt Disease. Genes (Basel) 2021; 12:1981. [PMID: 34946930 PMCID: PMC8701386 DOI: 10.3390/genes12121981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/03/2021] [Accepted: 12/10/2021] [Indexed: 01/10/2023] Open
Abstract
Reported growth rates (GR) of atrophic lesions in Stargardt disease (STGD1) vary widely. In the present study, we report the longitudinal natural history of patients with confirmed biallelic ABCA4 mutations from five genotype groups: c.6079C>T, c.[2588G>C;5603A>T], c.3113C>T, c.5882G>A and c.5603A>T. Fundus autofluorescence (AF) 30° × 30° images were manually segmented for boundaries of definitely decreased autofluorescence (DDAF). The primary outcome was the effective radius GR across five genotype groups. The age of DDAF formation in each eye was calculated using the x-intercept of the DDAF effective radius against age. Discordance between age at DDAF formation and symptom onset was compared. A total of 75 eyes from 39 STGD1 patients (17 male [44%]; mean ± SD age 45 ± 19 years; range 21-86) were recruited. Patients with c.3113C>T or c.6079C>T had a significantly faster effective radius GR at 0.17 mm/year (95% CI 0.12 to 0.22; p < 0.001 and 0.14 to 0.21; p < 0.001) respectively, as compared to those patients harbouring c.5882G>A at 0.06 mm/year (95% CI 0.03-0.09), respectively. Future clinical trial design should consider the effect of genotype on the effective radius GR and the timing of DDAF formation relative to symptom onset.
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Affiliation(s)
- Rachael C. Heath Jeffery
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Nedlands, WA 6009, Australia; (R.C.H.J.); (T.M.L.); (T.L.M.); (I.L.M.); (I.J.C.); (J.N.D.R.)
- Department of Ophthalmology, Royal Perth Hospital, Perth, WA 6000, Australia
| | - Jennifer A. Thompson
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia;
| | - Johnny Lo
- School of Science, Edith Cowan University, Joondalup, WA 6027, Australia;
| | - Tina M. Lamey
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Nedlands, WA 6009, Australia; (R.C.H.J.); (T.M.L.); (T.L.M.); (I.L.M.); (I.J.C.); (J.N.D.R.)
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia;
| | - Terri L. McLaren
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Nedlands, WA 6009, Australia; (R.C.H.J.); (T.M.L.); (T.L.M.); (I.L.M.); (I.J.C.); (J.N.D.R.)
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia;
| | - Ian L. McAllister
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Nedlands, WA 6009, Australia; (R.C.H.J.); (T.M.L.); (T.L.M.); (I.L.M.); (I.J.C.); (J.N.D.R.)
| | - Ian J. Constable
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Nedlands, WA 6009, Australia; (R.C.H.J.); (T.M.L.); (T.L.M.); (I.L.M.); (I.J.C.); (J.N.D.R.)
| | - John N. De Roach
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Nedlands, WA 6009, Australia; (R.C.H.J.); (T.M.L.); (T.L.M.); (I.L.M.); (I.J.C.); (J.N.D.R.)
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia;
| | - Fred K. Chen
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Nedlands, WA 6009, Australia; (R.C.H.J.); (T.M.L.); (T.L.M.); (I.L.M.); (I.J.C.); (J.N.D.R.)
- Department of Ophthalmology, Royal Perth Hospital, Perth, WA 6000, Australia
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia;
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Heath Jeffery RC, Thompson JA, Lamey TM, McLaren TL, McAllister IL, Constable IJ, Mackey DA, De Roach JN, Chen FK. CLASSIFYING ABCA4 MUTATION SEVERITY USING AGE-DEPENDENT ULTRA-WIDEFIELD FUNDUS AUTOFLUORESCENCE-DERIVED TOTAL LESION SIZE. Retina 2021; 41:2578-2588. [PMID: 34125082 DOI: 10.1097/iae.0000000000003227] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To establish a mutation-specific age-dependent ultra-widefield fundus autofluorescence (UWF-FAF) trajectory in a large Stargardt disease (STGD1) cohort using total lesion size (TLS) and to develop a clinical method for variant classification. METHODS A retrospective study of patients with biallelic ABCA4 mutations that were evaluated with UWF-FAF. Boundaries of TLS, defined by stippled hyper/hypoautofluorescence, were outlined manually. Pathogenicity was assessed according to ACMG/AMP criteria, and mutation severities were classified based on the current literature. Age-dependent trajectories in TLS were examined in patients with nullizygous, mild, and intermediate mutations. Mutations of uncertain severities were classified using a clinical criterion based on age of symptom onset and TLS. RESULTS Eighty-one patients with STGD1 (mean age = 42 ± 20 years and mean visual acuity = 20/200) were recruited from 65 unrelated families. Patients with biallelic null/severe variants (n = 6) demonstrated an increase in TLS during their second decade reaching a mean ± SD of 796 ± 29 mm2 by age 40. Those harboring mild mutations c.5882G>A or c.5603A>T had lesions confined to the posterior pole with a mean ± SD TLS of 30 ± 39 mm2. Intermediate mutations c.6079C>T or c.[2588G>C;5603A>T] in trans with a null/severe mutation had a mean ± SD TLS of 397 ± 29 mm2. Thirty-two mutations were predicted to cause severe (n = 22), intermediate (n = 6), and mild (n = 5) impairment of ABCA4 function based on age of symptom onset and TLS. CONCLUSION Age-dependent TLS showed unique ABCA4 mutation-specific trajectories. Our novel clinical criterion using age of symptom onset and TLS to segregate ABCA4 mutations into three severity groups requires further molecular studies to confirm its validity.
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Affiliation(s)
- Rachael C Heath Jeffery
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
- Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Jennifer A Thompson
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; and
| | - Tina M Lamey
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; and
| | - Terri L McLaren
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; and
| | - Ian L McAllister
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
| | - Ian J Constable
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
| | - John N De Roach
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; and
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
- Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; and
- Department of Ophthalmology, Perth Children's Hospital, Nedlands, Western Australia, Australia
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Determinants of Disease Penetrance in PRPF31-Associated Retinopathy. Genes (Basel) 2021; 12:genes12101542. [PMID: 34680937 PMCID: PMC8535263 DOI: 10.3390/genes12101542] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 09/25/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022] Open
Abstract
Retinitis pigmentosa 11 (RP11) is caused by dominant mutations in PRPF31, however a significant proportion of mutation carriers do not develop retinopathy. Here, we investigated the relationship between CNOT3 polymorphism, MSR1 repeat copy number and disease penetrance in RP11 patients and non-penetrant carriers (NPCs). We further characterized PRPF31 and CNOT3 expression in fibroblasts from eight RP11 patients and one NPC from a family carrying the c.1205C>T variant. Retinal organoids (ROs) and retinal pigment epithelium (RPE) were differentiated from induced pluripotent stem cells derived from RP11 patients, an NPC and a control subject. All RP11 patients were homozygous for the 3-copy MSR1 repeat in the PRPF31 promoter, while 3/5 NPCs carried a 4-copy MSR1 repeat. The CNOT3 rs4806718 genotype did not correlate with disease penetrance. PRFP31 expression declined with age in adult cadaveric retina. PRPF31 and CNOT3 expression was reduced in RP11 fibroblasts, RO and RPE compared with controls. Both RP11 and NPC RPE displayed shortened primary cilia compared with controls, however a subpopulation of cells with normal cilia lengths was present in NPC RPE monolayers. Our results indicate that RP11 non-penetrance is associated with the inheritance of a 4-copy MSR1 repeat, but not with CNOT3 polymorphisms.
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Roshandel D, Thompson JA, Heath Jeffery RC, Sampson DM, Chelva E, McLaren TL, Lamey TM, De Roach JN, Durkin SR, Chen FK. Multimodal Retinal Imaging and Microperimetry Reveal a Novel Phenotype and Potential Trial End Points in CRB1-Associated Retinopathies. Transl Vis Sci Technol 2021; 10:38. [PMID: 34003923 PMCID: PMC7910635 DOI: 10.1167/tvst.10.2.38] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Purpose Biallelic crumbs cell polarity complex component 1 (CRB1) mutations can present as Leber congenital amaurosis (LCA), retinitis pigmentosa (RP), or cystic maculopathy. This study reports a novel phenotype of asymptomatic fenestrated slit maculopathy (AFSM) and examines macular volume profile and microperimetry as clinical trial end points in CRB1-associated retinopathies. Methods Twelve patients from nine families with CRB1 mutation were recruited. Ultra-widefield (UWF) color fundus photography and autofluorescence (AF), spectral-domain optical coherence tomography (SD-OCT), microperimetry, and adaptive optics (AO) imaging were performed. Macular volume profiles were compared with age-matched healthy controls. Genotyping was performed using APEX genotyping microarrays, targeted next-generation sequencing, and Sanger sequencing. Results We identified one patient with LCA, five patients with RP, and four patients with macular dystrophy (MD) with biallelic CRB1 mutations. Two siblings with compound heterozygote genotype (c.[2843G>A]; [498_506del]) had AFSM characterized by localized outer retinal disruption on SD-OCT and parafoveal cone loss on AO imaging despite normal fundus appearance, visual acuity, and foveal sensitivity. UWF AF demonstrated preserved para-arteriolar retinal pigment epithelium (PPRPE) in all patients with RP. Microperimetry documented preserved central retinal function in six patients. The ratio of perifoveal-to-foveal retinal volume was greater than controls in 89% (8/9) of patients with RP or MD, whereas central subfield and total macular volume were outside normal limits in 67% (6/9). Conclusions AO imaging was helpful in detecting parafoveal cone loss in asymptomatic patients. Macular volume profile and microperimetry parameters may have utility as CRB1 trials end points. Translational Relevance Macular volume and sensitivity can be used as structural and functional end points for trials on CRB1-associated RP and MD.
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Affiliation(s)
- Danial Roshandel
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia
| | - Jennifer A Thompson
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Rachael C Heath Jeffery
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia.,Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Danuta M Sampson
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia.,Surrey Biophotonics, Centre for Vision, Speech and Signal Processing and School of Biosciences and Medicine, The University of Surrey, Guildford, UK
| | - Enid Chelva
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Terri L McLaren
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Tina M Lamey
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - John N De Roach
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Shane R Durkin
- Discipline of Ophthalmology and Visual Science, The University of Adelaide, South Australia, Australia.,Department of Ophthalmology, The Royal Adelaide and Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Australia.,Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia.,Department of Ophthalmology, Perth Children's Hospital, Nedlands, Western Australia, Australia
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11
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Mack HG, Chen FK, Grigg J, Jamieson R, De Roach J, O'Hare F, Britten-Jones AC, McGuinness M, Tindill N, Ayton L. Perspectives of people with inherited retinal diseases on ocular gene therapy in Australia: protocol for a national survey. BMJ Open 2021; 11:e048361. [PMID: 34158306 PMCID: PMC8220456 DOI: 10.1136/bmjopen-2020-048361] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 06/08/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Voretigene neparvovec-rzyl (Luxturna) was approved by the Australian Therapeutic Goods Administration on 4 August 2020 for the treatment of biallelic mutations in the RPE65 gene, a rare cause of congenital and adult-onset retinal dystrophy (predominantly Leber congenital amaurosis). Previous studies have shown that individuals who might participate in gene therapy trials overestimate clinical effect and underestimate risks. However, little is known about the perspectives of patients who may be offered approved gene therapy treatment for ocular conditions (as distinct from participating in clinical trials of gene therapy). The main objective of this study is to develop a tool to assess knowledge, attitudes and perceptions of approved and future genetic therapies among potential recipients of ocular gene therapy. In addition, we aim to assess the quality of life, attitudes towards clinical trials and vision-related quality of life among this cohort. METHODS AND ANALYSIS A new 'Attitudes to Gene Therapy for the Eye' tool will be developed following consultation with people with inherited retinal disease (IRD) and content matter experts. Australians with IRD or their guardians will be asked to complete an internet-based survey comprising existing quality of life and visual function instruments and items for the newly proposed tool. We expect to recruit 500 survey participants from patient support groups, the practices of Australian ophthalmologists who are specialists in IRD and Australian ophthalmic research institutions. Launch is anticipated early 2021. Responses will be analysed using item response theory methodology. ETHICS AND DISSEMINATION This study has received ethics approval from the University of Melbourne (#2057534). The results of the study will be published in a peer-reviewed journal and will be presented at relevant conferences. Organisations involved in recruitment, and the Patient Engagement Advisory committee will assist the research team with dissemination of the study outcomes.
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Affiliation(s)
- Heather G Mack
- Centre for Eye Research Australia Ltd, The University of Melbourne, East Melbourne, Victoria, Australia
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Nedlands, Western Australia, Australia
- Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - John Grigg
- Department of Ophthalmology, The University of Sydney, Sydney, New South Wales, Australia
- Save Sight Institute, Sydney, New South Wales, Australia
| | - Robyn Jamieson
- Children's Medical Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - John De Roach
- The Australian Inherited Retinal Disease Registry and DNA Bank, Perth, Western Australia, Australia
| | - Fleur O'Hare
- Centre for Eye Research Australia Ltd, The University of Melbourne, East Melbourne, Victoria, Australia
- Department of Surgery (Ophthalmology), The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Myra McGuinness
- Centre for Eye Research Australia Ltd, The University of Melbourne, East Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, University of Melbourne, Carlton 3053, Victoria, Australia
| | - Nicole Tindill
- Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Lauren Ayton
- Centre for Eye Research Australia Ltd, The University of Melbourne, East Melbourne, Victoria, Australia
- Department of Surgery (Ophthalmology), The University of Melbourne, Melbourne, Victoria, Australia
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12
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Roshandel D, Thompson JA, Heath Jeffery RC, Zhang D, Lamey TM, McLaren TL, De Roach JN, McLenachan S, Mackey DA, Chen FK. Clinical Evidence for the Importance of the Wild-Type PRPF31 Allele in the Phenotypic Expression of RP11. Genes (Basel) 2021; 12:genes12060915. [PMID: 34198599 PMCID: PMC8232116 DOI: 10.3390/genes12060915] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/09/2021] [Accepted: 06/12/2021] [Indexed: 11/16/2022] Open
Abstract
PRPF31-associated retinopathy (RP11) is a common form of autosomal dominant retinitis pigmentosa (adRP) that exhibits wide variation in phenotype ranging from non-penetrance to early-onset RP. Herein, we report inter-familial and intra-familial variation in the natural history of RP11 using multimodal imaging and microperimetry. Patients were recruited prospectively. The age of symptom onset, best-corrected visual acuity, microperimetry mean sensitivity (MS), residual ellipsoid zone span and hyperautofluorescent ring area were recorded. Genotyping was performed using targeted next-generation and Sanger sequencing and copy number variant analysis. PRPF31 mutations were found in 14 individuals from seven unrelated families. Four disease patterns were observed: (A) childhood onset with rapid progression (N = 4), (B) adult-onset with rapid progression (N = 4), (C) adult-onset with slow progression (N = 4) and (D) non-penetrance (N = 2). Four different patterns were observed in a family harbouring c.267del; patterns B, C and D were observed in a family with c.772_773delins16 and patterns A, B and C were observed in 3 unrelated individuals with large deletions. Our findings suggest that the RP11 phenotype may be related to the wild-type PRPF31 allele rather than the type of mutation. Further studies that correlate in vitro wild-type PRPF31 allele expression level with the disease patterns are required to investigate this association.
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Affiliation(s)
- Danial Roshandel
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA 6009, Australia; (D.R.); (R.C.H.J.); (T.M.L.); (T.L.M.); (J.N.D.R.); (S.M.); (D.A.M.)
- Ocular Tissue Engineering Laboratory, Lions Eye Institute, Nedlands, WA 6009, Australia;
| | - Jennifer A. Thompson
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia;
| | - Rachael C. Heath Jeffery
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA 6009, Australia; (D.R.); (R.C.H.J.); (T.M.L.); (T.L.M.); (J.N.D.R.); (S.M.); (D.A.M.)
- Ocular Tissue Engineering Laboratory, Lions Eye Institute, Nedlands, WA 6009, Australia;
- Department of Ophthalmology, Royal Perth Hospital, Perth, WA 6000, Australia
| | - Dan Zhang
- Ocular Tissue Engineering Laboratory, Lions Eye Institute, Nedlands, WA 6009, Australia;
| | - Tina M. Lamey
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA 6009, Australia; (D.R.); (R.C.H.J.); (T.M.L.); (T.L.M.); (J.N.D.R.); (S.M.); (D.A.M.)
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia;
| | - Terri L. McLaren
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA 6009, Australia; (D.R.); (R.C.H.J.); (T.M.L.); (T.L.M.); (J.N.D.R.); (S.M.); (D.A.M.)
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia;
| | - John N. De Roach
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA 6009, Australia; (D.R.); (R.C.H.J.); (T.M.L.); (T.L.M.); (J.N.D.R.); (S.M.); (D.A.M.)
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia;
| | - Samuel McLenachan
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA 6009, Australia; (D.R.); (R.C.H.J.); (T.M.L.); (T.L.M.); (J.N.D.R.); (S.M.); (D.A.M.)
- Ocular Tissue Engineering Laboratory, Lions Eye Institute, Nedlands, WA 6009, Australia;
| | - David A. Mackey
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA 6009, Australia; (D.R.); (R.C.H.J.); (T.M.L.); (T.L.M.); (J.N.D.R.); (S.M.); (D.A.M.)
- Ocular Tissue Engineering Laboratory, Lions Eye Institute, Nedlands, WA 6009, Australia;
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia;
| | - Fred K. Chen
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA 6009, Australia; (D.R.); (R.C.H.J.); (T.M.L.); (T.L.M.); (J.N.D.R.); (S.M.); (D.A.M.)
- Ocular Tissue Engineering Laboratory, Lions Eye Institute, Nedlands, WA 6009, Australia;
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia;
- Department of Ophthalmology, Royal Perth Hospital, Perth, WA 6000, Australia
- Department of Ophthalmology, Perth Children’s Hospital, Nedlands, WA 6009, Australia
- Correspondence: ; Tel.: +61-08-9381-0777
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Heath Jeffery RC, Mukhtar SA, McAllister IL, Morgan WH, Mackey DA, Chen FK. Inherited retinal diseases are the most common cause of blindness in the working-age population in Australia. Ophthalmic Genet 2021; 42:431-439. [PMID: 33939573 PMCID: PMC8315212 DOI: 10.1080/13816810.2021.1913610] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: This study examined the frequency of inherited retinal diseases (IRDs) as the reason for blindness registrations over the last two decades and the demographic and clinical phenotypes of inherited retinal disease (IRD)-related registrations. Materials and methods: Retrospective, observational study of individuals registered with a state-wide blind and vision-impaired registry. Low-vision or blindness-only (≤20/200 or ≤20°) certificates issued to children (0-15 years), working-age (16-64 years) and older-age (65 and older) adults were assessed. Sex and age distributions were examined for the top 20 reasons for certification. Demographic and clinical features of specific phenotypes of IRDs listed in the registry were examined. Results: Amongst 11824 low-vision certificates issued between July 1995 and January 2017, 679 (5.7%) listed an IRD as the reason for registration. In individuals with blindness-only certification (N=4919), IRDs was the second most common diagnosis (8.3%), overtaking glaucoma (8.1%) and diabetic retinopathy (5.4%). IRD was the second most common reason for low-vision certification amongst children (11.6%) and the most common reason amongst working-age population (23.3%). The mean±SD age for IRD-related blindness-only certification was 46±20 years. The top three phenotypes of IRD-related low-vision certification were non-syndromic retinitis pigmentosa (54%), Stargardt disease (12%) and macular dystrophy (8%). Conclusion: Our findings of IRDs as a common cause of blindness in all ages justify continued funding for providing low-vision services and developing treatments for these conditions.
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Affiliation(s)
- Rachael C Heath Jeffery
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Nedlands, Australia.,Department of Ophthalmology, Royal Perth Hospital, Perth, Australia
| | - Syed Aqif Mukhtar
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Nedlands, Australia
| | - Ian L McAllister
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Nedlands, Australia
| | - William H Morgan
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Nedlands, Australia.,Department of Ophthalmology, Royal Perth Hospital, Perth, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Nedlands, Australia
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Nedlands, Australia.,Department of Ophthalmology, Royal Perth Hospital, Perth, Australia.,Department of Ophthalmology, Perth Children's Hospital, Nedlands, Australia
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14
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Heath Jeffery RC, Thompson JA, Lo J, Lamey TM, McLaren TL, McAllister IL, Mackey DA, Constable IJ, De Roach JN, Chen FK. Atrophy Expansion Rates in Stargardt Disease Using Ultra-Widefield Fundus Autofluorescence. OPHTHALMOLOGY SCIENCE 2021; 1:100005. [PMID: 36246008 PMCID: PMC9559898 DOI: 10.1016/j.xops.2021.100005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/05/2021] [Accepted: 03/01/2021] [Indexed: 01/18/2023]
Abstract
Purpose Design Participants Methods Main Outcome Measures Results Conclusions
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Affiliation(s)
- Rachael C. Heath Jeffery
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Australia
- Department of Ophthalmology, Royal Perth Hospital, Perth, Australia
| | - Jennifer A. Thompson
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Australia
| | - Johnny Lo
- School of Science, Edith Cowan University, Perth, Australia
| | - Tina M. Lamey
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Australia
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Australia
| | - Terri L. McLaren
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Australia
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Australia
| | - Ian L. McAllister
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Australia
| | - David A. Mackey
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Australia
| | - Ian J. Constable
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Australia
| | - John N. De Roach
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Australia
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Australia
| | - Fred K. Chen
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Australia
- Department of Ophthalmology, Royal Perth Hospital, Perth, Australia
- Department of Ophthalmology, Perth Children’s Hospital, Nedlands, Australia
- Correspondence: Fred K. Chen, MBBS, PhD, Lions Eye Institute, 2 Verdun Street, Nedlands WA, Australia.
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15
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Pappalardo J, Heath Jeffery RC, Thompson JA, Chelva E, Pham Q, Constable IJ, McLaren TL, Lamey TM, De Roach JN, Chen FK. A novel phenotype in a family with autosomal dominant retinal dystrophy due to c.1430A > G in retinoid isomerohydrolase (RPE65) and c.37C > T in bestrophin 1 (BEST1). Doc Ophthalmol 2021; 143:61-73. [PMID: 33512609 DOI: 10.1007/s10633-021-09819-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: 09/21/2020] [Accepted: 01/08/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE The c.1430A > G (Asp477Gly) variant in RPE65 has been reported in Irish and Scottish families with either an autosomal dominant retinal dystrophy (adRD) that resembles choroideremia, a vitelliform macular dystrophy or an isolated macular atrophy. We report novel features on multimodal imaging and the natural history of a family harbouring this variant in combination with the BEST1 c.37C > T (Arg13Cys) variant. METHODS Members of a family with an adRD were examined clinically to ascertain phenotype and underwent genetic testing. Multimodal imaging included widefield colour fundus photography, quantitative autofluorescence (qAF) and spectral domain optical coherence tomography. Electrophysiology and microperimetry were also performed. RESULTS Vision loss was attributed to foveal atrophy in the proband and choroidal neovascularisation and a vitello-eruptive lesion in one affected son. Peripheral retinal white dots corresponding to subretinal deposits were seen in three patients. The median qAF8 values in the proband (I:1) were low (40 and 101 in OD and OS) at age 79. Similarly, the qAF8 values for the middle son (II:2) were also low (100 and 87 in ODS and OS) at age 60. Electrophysiology showed disproportionate reduction in Arden ratio prior to the gradual loss of full-field responses. Microperimetry demonstrated an enlarging scotoma in the proband. CONCLUSIONS The coexistence of the pathogenic BEST1 c.37C > T variant may modify clinical features observed in RPE65 adRD. This study expands our understanding of RPE65 adRD as a retinoid cycle disorder supported by the reduced qAF, fine white retinal dots and corresponding subretinal deposits on OCT in affected members.
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Affiliation(s)
- Juanita Pappalardo
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia
| | - Rachael C Heath Jeffery
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia.,Department of Ophthalmology, Royal Perth Hospital, Perth, WA, Australia
| | - Jennifer A Thompson
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Enid Chelva
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Quang Pham
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia
| | - Ian J Constable
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia
| | - Terri L McLaren
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Tina M Lamey
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - John N De Roach
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia. .,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia. .,Department of Ophthalmology, Royal Perth Hospital, Perth, WA, Australia. .,Department of Ophthalmology, Perth Children's Hospital, Nedlands, WA, Australia.
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16
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McLaren TL, De Roach JN, Thompson JA, Chen FK, Mackey DA, Hoffmann L, Urwin IR, Lamey TM. Expanding the genetic spectrum of choroideremia in an Australian cohort: report of five novel CHM variants. Hum Genome Var 2020; 7:35. [PMID: 33110609 PMCID: PMC7584600 DOI: 10.1038/s41439-020-00122-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/04/2020] [Accepted: 09/11/2020] [Indexed: 12/23/2022] Open
Abstract
Choroideremia is an X-linked chorioretinal dystrophy caused by mutations in the CHM gene. Several CHM gene replacement clinical trials are in advanced stages. In this study, we report the molecular confirmation of choroideremia in 14 Australian families sourced from the Australian Inherited Retinal Disease Registry and DNA Bank. Sixteen males (14 symptomatic) and 18 females (4 symptomatic; 14 obligate carriers) were identified for analysis. Participants' DNA was analyzed for disease-causing CHM variants by Sanger sequencing, TaqMan qPCR and targeted NGS. We report phenotypic and genotypic data for the 14 symptomatic males and four females manifesting disease symptoms. A pathogenic or likely pathogenic CHM variant was detected in all families. Eight variants were previously reported, and five were novel. Two de novo variants were identified. We previously reported the molecular confirmation of choroideremia in 11 Australian families. This study expands the CHM genetically confirmed Australian cohort to 32 males and four affected carrier females.
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Affiliation(s)
- Terri L. McLaren
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Western Australia Australia
- Centre for Ophthalmology and Visual Science, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia Australia
| | - John N. De Roach
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Western Australia Australia
- Centre for Ophthalmology and Visual Science, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia Australia
| | - Jennifer A. Thompson
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Western Australia Australia
| | - Fred K. Chen
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Western Australia Australia
- Centre for Ophthalmology and Visual Science, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia Australia
- Lions Eye Institute, 2 Verdun Street, Nedlands, Western Australia Australia
- Department of Ophthalmology, Royal Perth Hospital, Victoria Square, Perth, Western Australia Australia
- Department of Ophthalmology, Perth Children’s Hospital, Hospital Avenue, Nedlands, Western Australia Australia
| | - David A. Mackey
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Western Australia Australia
- Centre for Ophthalmology and Visual Science, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia Australia
- Lions Eye Institute, 2 Verdun Street, Nedlands, Western Australia Australia
| | - Ling Hoffmann
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Western Australia Australia
| | - Isabella R. Urwin
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Western Australia Australia
| | - Tina M. Lamey
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Western Australia Australia
- Centre for Ophthalmology and Visual Science, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, Western Australia Australia
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17
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Pappalardo J, Heath Jeffery RC, Thompson JA, Charng J, Chelva ES, Constable IJ, McLaren TL, Lamey TM, De Roach JN, Chen FK. Progressive sector retinitis pigmentosa due to c.440G>T mutation in SAG in an Australian family. Ophthalmic Genet 2020; 42:62-70. [PMID: 33047631 DOI: 10.1080/13816810.2020.1832533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Heterozygous c.440 G > T mutation in the S-antigen visual arrestin (SAG) gene has been described as a cause of autosomal dominant retinitis pigmentosa (adRP) in a series of patients of Hispanic origin. This study presents the early and late clinical features and disease progression rates in an Australian family with SAG adRP. MATERIALS AND METHODS An observational case series of four family members with adRP. They were examined clinically, with multi-modal retinal imaging and electroretinography (ERG) to ascertain phenotype. Disease progression rate was measured using optical coherence tomography (OCT) and fundus autofluorescence (FAF). A retinal dystrophy panel was used for the proband and cascade testing with targeted Sanger sequencing was conducted in other available family members. RESULTS The proband presented at 36 years of age with profoundly reduced full-field ERG responses despite a sector RP phenotype. This progressed to a classic RP pattern over several decades leaving a small residual island of central visual field. The horizontal span of the residual outer nuclear layer and the area of hyperautofluorescent ring contracted at a rate of 8-11% and 9-14% per year, respectively. DNA sequencing confirmed the segregation of SAG c.440 G > T mutation with disease. CONCLUSION SAG adRP presents with a reduced full-field ERG response consistent with a rod-cone dystrophy in mid-life despite a sector RP phenotype. Centripetal progression of the disease into the macula can be tracked by OCT and FAF imaging.
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Affiliation(s)
- Juanita Pappalardo
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia , Nedlands, Australia
| | - Rachael C Heath Jeffery
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia , Nedlands, Australia
| | - Jennifer A Thompson
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital , Perth, Australia
| | - Jason Charng
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia , Nedlands, Australia
| | - Enid S Chelva
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital , Perth, Australia
| | - Ian J Constable
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia , Nedlands, Australia
| | - Terri L McLaren
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia , Nedlands, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital , Perth, Australia
| | - Tina M Lamey
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia , Nedlands, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital , Perth, Australia
| | - John N De Roach
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia , Nedlands, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital , Perth, Australia
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia , Nedlands, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital , Perth, Australia.,Department of Ophthalmology, Royal Perth Hospital , Perth, Australia.,Department of Ophthalmology, Perth Children's Hospital , Nedlands, Australia
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18
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Charng J, Xiao D, Mehdizadeh M, Attia MS, Arunachalam S, Lamey TM, Thompson JA, McLaren TL, De Roach JN, Mackey DA, Frost S, Chen FK. Deep learning segmentation of hyperautofluorescent fleck lesions in Stargardt disease. Sci Rep 2020; 10:16491. [PMID: 33020556 PMCID: PMC7536408 DOI: 10.1038/s41598-020-73339-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 09/16/2020] [Indexed: 12/19/2022] Open
Abstract
Stargardt disease is one of the most common forms of inherited retinal disease and leads to permanent vision loss. A diagnostic feature of the disease is retinal flecks, which appear hyperautofluorescent in fundus autofluorescence (FAF) imaging. The size and number of these flecks increase with disease progression. Manual segmentation of flecks allows monitoring of disease, but is time-consuming. Herein, we have developed and validated a deep learning approach for segmenting these Stargardt flecks (1750 training and 100 validation FAF patches from 37 eyes with Stargardt disease). Testing was done in 10 separate Stargardt FAF images and we observed a good overall agreement between manual and deep learning in both fleck count and fleck area. Longitudinal data were available in both eyes from 6 patients (average total follow-up time 4.2 years), with both manual and deep learning segmentation performed on all (n = 82) images. Both methods detected a similar upward trend in fleck number and area over time. In conclusion, we demonstrated the feasibility of utilizing deep learning to segment and quantify FAF lesions, laying the foundation for future studies using fleck parameters as a trial endpoint.
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Affiliation(s)
- Jason Charng
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia
| | - Di Xiao
- The Australian E-Health Research Centre, Health and Biosecurity, CSIRO, Brisbane, QLD, Australia
| | - Maryam Mehdizadeh
- The Australian E-Health Research Centre, Health and Biosecurity, CSIRO, Brisbane, QLD, Australia
| | - Mary S Attia
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia
| | - Sukanya Arunachalam
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia
| | - Tina M Lamey
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Jennifer A Thompson
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Terri L McLaren
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - John N De Roach
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.,Department of Ophthalmology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.,Department of Ophthalmology, Perth Children's Hospital, Perth, WA, Australia
| | - Shaun Frost
- The Australian E-Health Research Centre, Health and Biosecurity, CSIRO, Brisbane, QLD, Australia
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, 2 Verdun Street, Nedlands, WA, Australia. .,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, WA, Australia. .,Department of Ophthalmology, Royal Perth Hospital, Perth, WA, Australia. .,Department of Ophthalmology, Perth Children's Hospital, Perth, WA, Australia.
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19
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Roshandel D, Thompson JA, Charng J, Zhang D, Chelva E, Arunachalam S, Attia MS, Lamey TM, McLaren TL, De Roach JN, Mackey DA, Wilton SD, Fletcher S, McLenachan S, Chen FK. Exploring microperimetry and autofluorescence endpoints for monitoring disease progression in PRPF31-associated retinopathy. Ophthalmic Genet 2020; 42:1-14. [PMID: 32985313 DOI: 10.1080/13816810.2020.1827442] [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] [Indexed: 01/24/2023]
Abstract
BACKGROUND Mutations in the splicing factor pre-messenger RNA processing factor 31 (PRPF31) gene cause autosomal dominant retinitis pigmentosa 11 (RP11) through a haplo-insufficiency mechanism. We describe the phenotype and progression of microperimetry and autofluorescence endpoints in an Indigenous Australian RP11 family. PATIENTS AND METHODS Ophthalmic examination, optical coherence tomography, fundus autofluorescence and microperimetry were performed at baseline and every 6-12 months. Baseline and annual change in best-corrected visual acuity (BCVA), microperimetry mean sensitivity (MS) and number of scotoma loci, residual ellipsoid zone (EZ) span and hyperautofluorescent ring (HAR) area were reported. Next-generation and Sanger sequencing were performed in available members. RESULTS 12 affected members from three generations were examined. Mean (SD, range) age at onset of symptoms was 11 (4.5, 4-19) years. MS declined steadily from the third decade and EZ span and HAR area declined rapidly during the second decade. Serial microperimetry showed negligible change in MS over 2-3 years. However, mean EZ span, near-infrared and short-wavelength HAR area reduction was 203 (6.4%) µm/year, 1.8 (8.7%) mm2/year and 1.1 (8.6%) mm2/year, respectively. Genetic testing was performed on 11 affected and 10 asymptomatic members and PRPF31 c.1205 C > A (p.Ser402Ter) mutation was detected in all affected and two asymptomatic members (non-penetrant carriers). CONCLUSIONS Our findings suggest that in the studied cohort, the optimal window for therapeutic intervention is the second decade of life and residual EZ span and HAR area can be considered as efficacy outcome measures. Further studies on larger samples with different PRPF31 mutations and longer follow-up duration are recommended.
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Affiliation(s)
- Danial Roshandel
- Centre for Ophthalmology and Visual Science, The University of Western Australia , Perth, Australia.,Ocular Tissue Engineering Laboratory, Lions Eye Institute , Nedlands, Australia
| | - Jennifer A Thompson
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital , Nedlands, Australia
| | - Jason Charng
- Centre for Ophthalmology and Visual Science, The University of Western Australia , Perth, Australia.,Ocular Tissue Engineering Laboratory, Lions Eye Institute , Nedlands, Australia
| | - Dan Zhang
- Centre for Ophthalmology and Visual Science, The University of Western Australia , Perth, Australia.,Ocular Tissue Engineering Laboratory, Lions Eye Institute , Nedlands, Australia
| | - Enid Chelva
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital , Nedlands, Australia
| | - Sukanya Arunachalam
- Centre for Ophthalmology and Visual Science, The University of Western Australia , Perth, Australia.,Ocular Tissue Engineering Laboratory, Lions Eye Institute , Nedlands, Australia
| | - Mary S Attia
- Centre for Ophthalmology and Visual Science, The University of Western Australia , Perth, Australia.,Ocular Tissue Engineering Laboratory, Lions Eye Institute , Nedlands, Australia
| | - Tina M Lamey
- Centre for Ophthalmology and Visual Science, The University of Western Australia , Perth, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital , Nedlands, Australia
| | - Terri L McLaren
- Centre for Ophthalmology and Visual Science, The University of Western Australia , Perth, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital , Nedlands, Australia
| | - John N De Roach
- Centre for Ophthalmology and Visual Science, The University of Western Australia , Perth, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital , Nedlands, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Science, The University of Western Australia , Perth, Australia.,Ocular Tissue Engineering Laboratory, Lions Eye Institute , Nedlands, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital , Nedlands, Australia
| | - Steve D Wilton
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University , Murdoch, Australia.,The Perron Institute, The University of Western Australia , Nedlands, Australia
| | - Sue Fletcher
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University , Murdoch, Australia.,The Perron Institute, The University of Western Australia , Nedlands, Australia
| | - Samuel McLenachan
- Centre for Ophthalmology and Visual Science, The University of Western Australia , Perth, Australia.,Ocular Tissue Engineering Laboratory, Lions Eye Institute , Nedlands, Australia
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science, The University of Western Australia , Perth, Australia.,Ocular Tissue Engineering Laboratory, Lions Eye Institute , Nedlands, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital , Nedlands, Australia.,Department of Ophthalmology, Royal Perth Hospital , Perth, Australia.,Department of Ophthalmology, Perth Children's Hospital , Nedlands, Australia
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20
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Charng J, Lamey TM, Thompson JA, McLaren TL, Attia MS, McAllister IL, Constable IJ, Mackey DA, De Roach JN, Chen FK. Edge of Scotoma Sensitivity as a Microperimetry Clinical Trial End Point in USH2A Retinopathy. Transl Vis Sci Technol 2020; 9:9. [PMID: 32974081 PMCID: PMC7488629 DOI: 10.1167/tvst.9.10.9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/14/2020] [Indexed: 01/05/2023] Open
Abstract
Purpose Microperimetry is commonly used to assess retinal function. We perform cross-sectional and longitudinal analysis on microperimetry parameters in USH2A retinopathy and explore end points suitable for future clinical trials. Methods Microperimetry was performed using two grids, Grid 1 (18° diameter) and Grid 2 (6° diameter). In Grid 1, four parameters (number of nonscotomatous loci, mean sensitivity [MS], responding point sensitivity [RPS], and edge of scotoma sensitivity [ESS]) were analyzed. In Grid 2, number of nonscotomatous loci and MS were examined. Interocular symmetry was also examined. Longitudinal analysis was conducted in a subset of eyes. Results Microperimetry could be performed in 16 of 21 patients. In Grid 1 (n = 15; average age, 35.6 years), average number of nonscotomatous loci, MS, RPS, and ESS were 46.6 loci, 10.0 dB, 14.7 and 9.6 dB, respectively. In Grid 2 (n = 13; average age, 37.4 years), 12 eyes had measurable sensitivity across the entire grid. Average MS was 23.8 dB. Interocular analysis revealed large 95% confidence intervals for all parameters. Longitudinally, Grid 1 (n = 12, average follow-up 2.6 years) ESS showed the fastest rate of decline (–1.84 dB/y) compared with MS (–0.34 dB/y) and RPS (–0.90 dB/y). Conclusions Our data suggest that ESS may be more useful than MS and RPS in test grids that cover a large extent of the macula. We caution the use of contralateral eye as an internal control. Translational Relevance ESS may decrease the duration or sample size of treatment trials in USH2A retinopathy.
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Affiliation(s)
- Jason Charng
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Western Australia, Australia
| | - Tina M Lamey
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Western Australia, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Jennifer A Thompson
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Terri L McLaren
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Western Australia, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Mary S Attia
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Western Australia, Australia
| | - Ian L McAllister
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Western Australia, Australia
| | - Ian J Constable
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Western Australia, Australia
| | - David A Mackey
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Western Australia, Australia
| | - John N De Roach
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Western Australia, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Fred K Chen
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Western Australia, Australia.,Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia.,Department of Ophthalmology, Perth Children's Hospital, Perth, Western Australia, Australia
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21
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Huang D, Thompson JA, Charng J, Chelva E, McLenachan S, Chen S, Zhang D, McLaren TL, Lamey TM, Constable IJ, De Roach JN, Aung‐Htut MT, Adams A, Fletcher S, Wilton SD, Chen FK. Phenotype-genotype correlations in a pseudodominant Stargardt disease pedigree due to a novel ABCA4 deletion-insertion variant causing a splicing defect. Mol Genet Genomic Med 2020; 8:e1259. [PMID: 32627976 PMCID: PMC7336727 DOI: 10.1002/mgg3.1259] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Deletion-insertion (delins) variants in the retina-specific ATP-binding cassette transporter gene, subfamily A, member 4 (ABCA4) accounts for <1% in Stargardt disease. The consequences of these delins variants on splicing cannot be predicted with certainty without supporting in vitro data. METHODS Candidate ABCA4 variants were revealed by genetic and segregation analysis of a family with pseudodominant Stargardt disease using a commercial panel and Sanger sequencing. RNA extracted from patient-derived fibroblasts was analyzed by RT-PCR to evaluate splicing behavior of the ABCA4 variants. RESULTS Affected members carrying the novel c.6031_6044delinsAGTATTTAACCAATATTT variant in exon 44 presented with contrasting phenotypes; from early-onset cone-rod dystrophy to late-onset macular dystrophy. This variant resulted in a 56-nucleotide deletion in the mutant allele by activation of a cryptic splice acceptor site which disrupts the reading frame and results in a premature termination codon (p.Ile2003LeufsTer41). If translated, the crucial functional domains near the C-terminus would be truncated from the ABCA4 protein. CONCLUSION This work demonstrates the intrafamilial phenotypic variability in a pseudodominant Stargardt disease pedigree and the use of patient-derived fibroblasts to evaluate the effect of a novel ABCA4 delins variant on splicing to complement in silico pathogenicity assessment.
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Affiliation(s)
- Di Huang
- Centre for Molecular Medicine and Innovative TherapeuticsMurdoch UniversityMurdochWestern AustraliaAustralia
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute)The University of Western AustraliaNedlandsWestern AustraliaAustralia
- Centre for Neuromuscular and Neurological DisordersThe University of Western Australia and Perron Institute for Neurological and Translational ScienceNedlandsWestern AustraliaAustralia
| | - Jennifer A. Thompson
- Australian Inherited Retinal Disease Registry and DNA BankDepartment of Medical Technology and PhysicsSir Charles Gairdner HospitalNedlandsWestern AustraliaAustralia
| | - Jason Charng
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute)The University of Western AustraliaNedlandsWestern AustraliaAustralia
| | - Enid Chelva
- Australian Inherited Retinal Disease Registry and DNA BankDepartment of Medical Technology and PhysicsSir Charles Gairdner HospitalNedlandsWestern AustraliaAustralia
| | - Samuel McLenachan
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute)The University of Western AustraliaNedlandsWestern AustraliaAustralia
| | - Shang‐Chih Chen
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute)The University of Western AustraliaNedlandsWestern AustraliaAustralia
| | - Dan Zhang
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute)The University of Western AustraliaNedlandsWestern AustraliaAustralia
| | - Terri L. McLaren
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute)The University of Western AustraliaNedlandsWestern AustraliaAustralia
- Australian Inherited Retinal Disease Registry and DNA BankDepartment of Medical Technology and PhysicsSir Charles Gairdner HospitalNedlandsWestern AustraliaAustralia
| | - Tina M. Lamey
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute)The University of Western AustraliaNedlandsWestern AustraliaAustralia
- Australian Inherited Retinal Disease Registry and DNA BankDepartment of Medical Technology and PhysicsSir Charles Gairdner HospitalNedlandsWestern AustraliaAustralia
| | - Ian J. Constable
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute)The University of Western AustraliaNedlandsWestern AustraliaAustralia
- Department of OphthalmologySir Charles Gairdner HospitalNedlandsWestern AustraliaAustralia
| | - John N. De Roach
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute)The University of Western AustraliaNedlandsWestern AustraliaAustralia
- Australian Inherited Retinal Disease Registry and DNA BankDepartment of Medical Technology and PhysicsSir Charles Gairdner HospitalNedlandsWestern AustraliaAustralia
| | - May Thandar Aung‐Htut
- Centre for Molecular Medicine and Innovative TherapeuticsMurdoch UniversityMurdochWestern AustraliaAustralia
- Centre for Neuromuscular and Neurological DisordersThe University of Western Australia and Perron Institute for Neurological and Translational ScienceNedlandsWestern AustraliaAustralia
| | - Abbie Adams
- Centre for Molecular Medicine and Innovative TherapeuticsMurdoch UniversityMurdochWestern AustraliaAustralia
| | - Sue Fletcher
- Centre for Molecular Medicine and Innovative TherapeuticsMurdoch UniversityMurdochWestern AustraliaAustralia
- Centre for Neuromuscular and Neurological DisordersThe University of Western Australia and Perron Institute for Neurological and Translational ScienceNedlandsWestern AustraliaAustralia
| | - Steve D. Wilton
- Centre for Molecular Medicine and Innovative TherapeuticsMurdoch UniversityMurdochWestern AustraliaAustralia
- Centre for Neuromuscular and Neurological DisordersThe University of Western Australia and Perron Institute for Neurological and Translational ScienceNedlandsWestern AustraliaAustralia
| | - Fred K. Chen
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute)The University of Western AustraliaNedlandsWestern AustraliaAustralia
- Australian Inherited Retinal Disease Registry and DNA BankDepartment of Medical Technology and PhysicsSir Charles Gairdner HospitalNedlandsWestern AustraliaAustralia
- Department of OphthalmologyRoyal Perth HospitalPerthWestern AustraliaAustralia
- Department of OphthalmologyPerth Children's HospitalNedlandsWestern AustraliaAustralia
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22
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Affiliation(s)
- Mark Gillies
- Macula Research Group, Save Sight Institute, University of Sydney, Sydney, Australia
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23
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Holtan JP, Selmer KK, Heimdal KR, Bragadóttir R. Inherited retinal disease in Norway - a characterization of current clinical and genetic knowledge. Acta Ophthalmol 2020; 98:286-295. [PMID: 31429209 DOI: 10.1111/aos.14218] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 07/23/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE The purpose of this study was to characterize current clinical and genetic knowledge of patients with inherited retinal disease in Norway and give an estimate of the prevalence. These data are necessary to identify patients eligible for new personalized medicines, to facilitate genetic counselling for their families and to plan clinical follow-up. METHODS A patient registry including clinical and genetic data was established. Clinical data were retrieved during 2003-2018. Genetic testing was performed in the period 2007-2018. RESULTS The material included 866 patients with 41 clinical diagnoses at the cut-off date. The most prevalent diseases were as follows: retinitis pigmentosa (54%), Stargardt macular dystrophy (6.5%) and Leber congenital amaurosis (5.2%). A genetic diagnosis was identified in 32% of patients. In total, 207 disease-causing variants in 56 genes were reported. The most commonly reported disease-causing genes were ABCA4, USH2A and BEST1. The estimated adjusted minimum prevalence of inherited retinal disease in the south-east region of Norway was 1: 3,856 (2.6/10 000). CONCLUSION This population-based study demonstrated an estimated prevalence for all inherited retinal diseases in south-east Norway and described the distribution of clinical diagnoses, onset of symptoms, inheritance patterns and genetic data and thereby expands our knowledge of inherited retinal disease in Norway. The newly established registry and biobank will support patient feasibility for future clinical trials, treatment selection and counselling of families.
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Affiliation(s)
- Josephine Prener Holtan
- Department of Ophthalmology Oslo University Hospital Oslo Norway
- University of Oslo Oslo Norway
| | - Kaja Kristine Selmer
- Department of Medical Genetics Oslo University Hospital Oslo Norway
- Department of Research and Development Oslo University Hospital Oslo Norway
| | | | - Ragnheiður Bragadóttir
- Department of Ophthalmology Oslo University Hospital Oslo Norway
- University of Oslo Oslo Norway
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24
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Tranchevent LC, Azuaje F, Rajapakse JC. A deep neural network approach to predicting clinical outcomes of neuroblastoma patients. BMC Med Genomics 2019; 12:178. [PMID: 31856829 PMCID: PMC6923884 DOI: 10.1186/s12920-019-0628-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 11/15/2019] [Indexed: 01/16/2023] Open
Abstract
Background The availability of high-throughput omics datasets from large patient cohorts has allowed the development of methods that aim at predicting patient clinical outcomes, such as survival and disease recurrence. Such methods are also important to better understand the biological mechanisms underlying disease etiology and development, as well as treatment responses. Recently, different predictive models, relying on distinct algorithms (including Support Vector Machines and Random Forests) have been investigated. In this context, deep learning strategies are of special interest due to their demonstrated superior performance over a wide range of problems and datasets. One of the main challenges of such strategies is the “small n large p” problem. Indeed, omics datasets typically consist of small numbers of samples and large numbers of features relative to typical deep learning datasets. Neural networks usually tackle this problem through feature selection or by including additional constraints during the learning process. Methods We propose to tackle this problem with a novel strategy that relies on a graph-based method for feature extraction, coupled with a deep neural network for clinical outcome prediction. The omics data are first represented as graphs whose nodes represent patients, and edges represent correlations between the patients’ omics profiles. Topological features, such as centralities, are then extracted from these graphs for every node. Lastly, these features are used as input to train and test various classifiers. Results We apply this strategy to four neuroblastoma datasets and observe that models based on neural networks are more accurate than state of the art models (DNN: 85%-87%, SVM/RF: 75%-82%). We explore how different parameters and configurations are selected in order to overcome the effects of the small data problem as well as the curse of dimensionality. Conclusions Our results indicate that the deep neural networks capture complex features in the data that help predicting patient clinical outcomes.
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Affiliation(s)
- Léon-Charles Tranchevent
- Proteome and Genome Research Unit, Department of Oncology, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, Strassen, L-1445, Luxembourg.,Current affiliation: Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, 7, avenue des Hauts Fourneaux, Esch-sur-Alzette, L-4362, Luxembourg
| | - Francisco Azuaje
- Proteome and Genome Research Unit, Department of Oncology, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, Strassen, L-1445, Luxembourg.,Current affiliation: Data and Translational Sciences, UCB Celltech, 208 Bath Road, Slough, SL1 3WE, UK
| | - Jagath C Rajapakse
- Bioinformatics Research Center, School of Computer Science and Engineering, Nanyang Technological University, 50, Nanyang Avenue, Singapore, 639798, Singapore.
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Chiang JPW, Lamey TM, Wang NK, Duan J, Zhou W, McLaren TL, Thompson JA, Ruddle J, De Roach JN. Development of High-Throughput Clinical Testing of RPGR ORF15 Using a Large Inherited Retinal Dystrophy Cohort. Invest Ophthalmol Vis Sci 2019; 59:4434-4440. [PMID: 30193314 DOI: 10.1167/iovs.18-24555] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Mutations in the ORF15 region of RPGR account for approximately half of all X-linked retinitis pigmentosa cases. However, a robust high-throughput method for the detection of ORF15 mutations has yet to be validated. We set out to develop the first clinically validated next-generation sequencing (NGS) method for the detection of mutations in this difficult-to-sequence region, including test accuracy and coverage data. Methods As part of a blind-test, 145 research samples, previously tested by Sanger sequencing, and 81 clinical samples were evaluated using NGS of long-range PCR products fragmented with Illumina's Nextera library preparation kit (method 1), or with Centrillion's OneTube technology, supplemented with duplication analysis using an ORF15-specific in-silico array (method 2). DNA fragments were analyzed using Agilent's DNA 1000 assay, and sequencing was done on Illumina's MiSeq 2×150 or HiSeq2500 2×100. NextGENe by SoftGenetics was used for data analysis and variant calling. Results The Nextera library preparation method produced 24 cases of discordance due to (in order of decreasing occurrence) false-negatives, incorrectly called variants, and a false-positive. Subsequent use of a new, OneTube NGS library preparation method, supplemented with duplication analyses, resolved discordance between Sanger and NGS data in all cases. This improvement in variant detection accuracy was largely attributed to improvement in random fragmentation offered by the enzymatic OneTube method, resulting in more complete coverage of the highly repetitive ORF15 region. Minimum coverage was roughly 320 reads for Nextera and 6800 reads for OneTube (normalized for total read counts). Conclusions This paper documents the first clinically validated NGS method for reliable, high-throughput sequencing of RPGR ORF15. Sensitivity and specificity of the new method were 100%, with the caveat of unclear zygosity calling for one large duplication case. These findings demonstrate a reliable and practical implementation for NGS-based diagnosis of RPGR ORF15 mutations. They also provide the foundation for targeted, high-coverage sequencing of any other repetitive regions within the genome.
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Affiliation(s)
- John P W Chiang
- Molecular Vision Laboratory, Hillsboro, Oregon, United States
| | - Tina M Lamey
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.,Centre for Ophthalmology and Visual Science, The University of Western Australia, Crawley, Western Australia, Australia
| | - Nicholas K Wang
- Molecular Vision Laboratory, Hillsboro, Oregon, United States
| | - Jie Duan
- Molecular Vision Laboratory, Hillsboro, Oregon, United States
| | - Wei Zhou
- Centrillion Technologies, Palo Alto, California, United States
| | - Terri L McLaren
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Jennifer A Thompson
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | | | - John N De Roach
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.,Centre for Ophthalmology and Visual Science, The University of Western Australia, Crawley, Western Australia, Australia
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Thompson JA, Chiang JPW, De Roach JN, McLaren TL, Chen FK, Hoffmann L, Campbell I, Lamey TM. Analysis of the ABCA4 c.[2588G>C;5603A>T] Allele in the Australian Population. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1185:269-273. [PMID: 31884623 DOI: 10.1007/978-3-030-27378-1_44] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Inherited retinal diseases (IRDs) are genetically and phenotypically diverse, and they cause significant morbidity worldwide. Importantly, IRDs may be amenable to precision medicine strategies, and thus the molecular characterisation of causative variants is becoming increasingly important with the promise of personalised therapies on the horizon. ABCA4, involved in the translocation of visual cycle derivatives, is a well-established, frequent cause of IRDs worldwide, with pathogenic variants implicated in phenotypically diverse diseases. Identification of causative ABCA4 variants in some individuals, however, has been enigmatic, and resolution of this issue is currently a hotbed of research. Recent evidence has indicated that hypomorphic alleles, which cause disease under certain conditions, may account for some of the missing causal variants. It has been postulated that the ABCA4 c.5603A>T (p.Asn1868Ile) variant, previously considered benign, be reclassified as hypomorphic when in cis configuration with c.2588G>C (p.Gly863Ala/Gly863del), a variant previously considered to be pathogenic in its own right. We are exploring this relationship within an Australian cohort to test this theory.
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Affiliation(s)
- Jennifer A Thompson
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia.
| | | | - John N De Roach
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia.,Centre for Ophthalmology and Visual Science, University of Western Australia, Crawley, WA, Australia
| | - Terri L McLaren
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia.,Centre for Ophthalmology and Visual Science, University of Western Australia, Crawley, WA, Australia
| | - Fred K Chen
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia.,Centre for Ophthalmology and Visual Science, University of Western Australia, Crawley, WA, Australia.,Ocular Tissue Engineering Laboratory, Lions Eye Institute, Perth, WA, Australia.,Department of Ophthalmology, Royal Perth Hospital, Perth, WA, Australia
| | - Ling Hoffmann
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Isabella Campbell
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Tina M Lamey
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia.,Centre for Ophthalmology and Visual Science, University of Western Australia, Crawley, WA, Australia
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Chen FK, Zhang X, Eintracht J, Zhang D, Arunachalam S, Thompson JA, Chelva E, Mallon D, Chen SC, McLaren T, Lamey T, De Roach J, McLenachan S. Clinical and molecular characterization of non-syndromic retinal dystrophy due to c.175G>A mutation in ceroid lipofuscinosis neuronal 3 (CLN3). Doc Ophthalmol 2018; 138:55-70. [PMID: 30446867 DOI: 10.1007/s10633-018-9665-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 11/06/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE Mutation of the CLN3 gene, associated with juvenile neuronal ceroid lipofuscinosis, has recently been associated with late-onset, non-syndromic retinal dystrophy. Herein we describe the multimodal imaging, immunological and systemic features of an adult with compound heterozygous CLN3 mutations. METHODS A 50-year-old female with non-syndromic retinal dystrophy from the age of 36 years underwent multimodal retinal imaging, electroretinography, neuroimaging, immunological studies and genetic testing. CLN3 transcripts were amplified from patient leukocytes by reverse transcriptase polymerase chain reaction and characterized by Sanger sequencing. RESULTS Visual acuity declined to 6/12 and 6/76 due to asymmetrical central scotoma. ERG responses became electronegative and patient's serum contained anti-retinal antibodies. Final visual acuity stabilized at 6/60 bilaterally 3 years after peri-ocular steroid and rituximab infusion. Genetic testing revealed compound heterozygous CLN3 mutations: the 1.02 kb deletion and a novel missense mutation (c.175G>A). In silico, analyses predicted the c.175G>A mutation disrupted an exonic splice enhancer site in exon 3. In patient leukocytes, CLN3 expression was reduced and novel CLN3 transcripts lacking exon 3 were detected. CONCLUSIONS Our case study shows that (1) non-syndromic CLN3 disease leads to rod and delayed primary cone degeneration resulting in constricting peripheral field and enlarging central scotoma and, (2) the c.175G>A CLN3 mutation, altered splicing of the CLN3 gene. Overall, we provide comprehensive clinical characterization of a patient with non-syndromic CLN3 disease.
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Affiliation(s)
- Fred K Chen
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA, Australia.,Ocular Tissue Engineering Laboratory, Lions Eye Institute, 2 Verdun Street, Perth, Nedlands, WA, Australia.,Department of Ophthalmology, Royal Perth Hospital, Perth, WA, Australia
| | - Xiao Zhang
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA, Australia.,Ocular Tissue Engineering Laboratory, Lions Eye Institute, 2 Verdun Street, Perth, Nedlands, WA, Australia
| | - Jonathan Eintracht
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA, Australia.,Ocular Tissue Engineering Laboratory, Lions Eye Institute, 2 Verdun Street, Perth, Nedlands, WA, Australia
| | - Dan Zhang
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA, Australia.,Ocular Tissue Engineering Laboratory, Lions Eye Institute, 2 Verdun Street, Perth, Nedlands, WA, Australia
| | - Sukanya Arunachalam
- Ocular Tissue Engineering Laboratory, Lions Eye Institute, 2 Verdun Street, Perth, Nedlands, WA, Australia
| | - Jennifer A Thompson
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Enid Chelva
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Dominic Mallon
- Department of Immunology, Fiona Stanley Hospital, Perth, WA, Australia
| | - Shang-Chih Chen
- Ocular Tissue Engineering Laboratory, Lions Eye Institute, 2 Verdun Street, Perth, Nedlands, WA, Australia
| | - Terri McLaren
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Tina Lamey
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - John De Roach
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA, Australia.,Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Samuel McLenachan
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, WA, Australia. .,Ocular Tissue Engineering Laboratory, Lions Eye Institute, 2 Verdun Street, Perth, Nedlands, WA, Australia.
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Bickerstaffe A, Ranaweera T, Endersby T, Ellis C, Maddumarachchi S, Gooden GE, White P, Moses EK, Hewitt AW, Hopper JL. The Ark: a customizable web-based data management tool for health and medical research. Bioinformatics 2018; 33:624-626. [PMID: 28003258 DOI: 10.1093/bioinformatics/btw675] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 10/28/2016] [Indexed: 11/14/2022] Open
Abstract
Summary The Ark is an open-source web-based tool that allows researchers to manage health and medical research data for humans and animals without specialized database skills or programming expertise. The system provides data management for core research information including demographic, phenotype, biospecimen and pedigree data, in addition to supporting typical investigator requirements such as tracking participant consent and correspondence, whilst also being able to generate custom data exports and reports. The Ark is 'study generic' by design and highly configurable via its web interface, allowing researchers to tailor the system to the specific data management requirements of their study. Availability and Implementation Source code for The Ark can be obtained freely from the website https://github.com/The-Ark-Informatics/ark/ . The source code can be modified and redistributed under the terms of the GNU GPL v3 license. Documentation and a pre-configured virtual appliance can be found at the website http://sphinx.org.au/the-ark/ . Contact adrianb@unimelb.edu.au. Supplementary information Supplementary data are available at Bioinformatics online.
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Affiliation(s)
- Adrian Bickerstaffe
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Carlton, 3010, Australia
| | - Thilina Ranaweera
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Carlton, 3010, Australia
| | - Travis Endersby
- Curtin UWA Centre for Genetic Origins of Health and Disease, Faculty of Health Sciences, Curtin University, Bentley, 6102, Australia.,Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, 6000, Australia
| | - Christopher Ellis
- Curtin UWA Centre for Genetic Origins of Health and Disease, Faculty of Health Sciences, Curtin University, Bentley, 6102, Australia.,Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, 6000, Australia
| | - Sanjaya Maddumarachchi
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Carlton, 3010, Australia
| | - George E Gooden
- Genetics and Epidemiology, Lions Eye Institute, Nedlands, 6009, Australia
| | - Paul White
- Curtin UWA Centre for Genetic Origins of Health and Disease, Faculty of Health Sciences, Curtin University, Bentley, 6102, Australia.,Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, 6000, Australia
| | - Eric K Moses
- Curtin UWA Centre for Genetic Origins of Health and Disease, Faculty of Health Sciences, Curtin University, Bentley, 6102, Australia.,Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, 6000, Australia
| | - Alex W Hewitt
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, 3002, Australia
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, The University of Melbourne, Carlton, 3010, Australia
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Thompson JA, De Roach JN, McLaren TL, Montgomery HE, Hoffmann LH, Campbell IR, Chen FK, Mackey DA, Lamey TM. The genetic profile of Leber congenital amaurosis in an Australian cohort. Mol Genet Genomic Med 2017; 5:652-667. [PMID: 29178642 PMCID: PMC5702575 DOI: 10.1002/mgg3.321] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 06/27/2017] [Accepted: 06/29/2017] [Indexed: 12/21/2022] Open
Abstract
Background Leber congenital amaurosis (LCA) is a severe visual impairment responsible for infantile blindness, representing ~5% of all inherited retinal dystrophies. LCA encompasses a group of heterogeneous disorders, with 24 genes currently implicated in pathogenesis. Such clinical and genetic heterogeneity poses great challenges for treatment, with personalized therapies anticipated to be the best treatment candidates. Unraveling the individual genetic etiology of disease is a prerequisite for personalized therapies, and could identify potential treatment candidates, inform patient management, and discriminate syndromic forms of disease. Methods We have genetically analyzed 45 affected and 82 unaffected individuals from 34 unrelated LCA pedigrees using predominantly next‐generation sequencing and Array CGH technology. Results We present the molecular findings for an Australian LCA cohort, sourced from the Australian Inherited Retinal Disease Registry & DNA Bank. CEP290 and GUCY2D mutations, each represent 19% of unrelated LCA cases, followed by NMNAT1 (12%). Genetic subtypes were consistent with other reports, and were resolved in 90% of this cohort. Conclusion The high resolution rate achieved, equivalent to recent findings using whole exome/genome sequencing, reflects the progression from hypothesis (LCA Panel) to non‐hypothesis (RD Panel) testing and, coupled with Array CGH analysis, is a highly effective first‐tier test for LCA.
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Affiliation(s)
- Jennifer A Thompson
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - John N De Roach
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,Centre for Ophthalmology and Visual Science, The University of Western Australia, Crawley, Western Australia, Australia
| | - Terri L McLaren
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Hannah E Montgomery
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Ling H Hoffmann
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Isabella R Campbell
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Fred K Chen
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,Centre for Ophthalmology and Visual Science, The University of Western Australia, Crawley, Western Australia, Australia.,Lions Eye Institute, Nedlands, Western Australia, Australia.,Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - David A Mackey
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,Centre for Ophthalmology and Visual Science, The University of Western Australia, Crawley, Western Australia, Australia.,Lions Eye Institute, Nedlands, Western Australia, Australia
| | - Tina M Lamey
- Australian Inherited Retinal Disease Registry and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,Centre for Ophthalmology and Visual Science, The University of Western Australia, Crawley, Western Australia, Australia
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Sampson DM, Alonso-Caneiro D, Chew AL, Lamey T, McLaren T, De Roach J, Chen FK. Enhanced Visualization of Subtle Outer Retinal Pathology by En Face Optical Coherence Tomography and Correlation with Multi-Modal Imaging. PLoS One 2016; 11:e0168275. [PMID: 27959968 PMCID: PMC5154571 DOI: 10.1371/journal.pone.0168275] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 11/29/2016] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To present en face optical coherence tomography (OCT) images generated by graph-search theory algorithm-based custom software and examine correlation with other imaging modalities. METHODS En face OCT images derived from high density OCT volumetric scans of 3 healthy subjects and 4 patients using a custom algorithm (graph-search theory) and commercial software (Heidelberg Eye Explorer software (Heidelberg Engineering)) were compared and correlated with near infrared reflectance, fundus autofluorescence, adaptive optics flood-illumination ophthalmoscopy (AO-FIO) and microperimetry. RESULTS Commercial software was unable to generate accurate en face OCT images in eyes with retinal pigment epithelium (RPE) pathology due to segmentation error at the level of Bruch's membrane (BM). Accurate segmentation of the basal RPE and BM was achieved using custom software. The en face OCT images from eyes with isolated interdigitation or ellipsoid zone pathology were of similar quality between custom software and Heidelberg Eye Explorer software in the absence of any other significant outer retinal pathology. En face OCT images demonstrated angioid streaks, lesions of acute macular neuroretinopathy, hydroxychloroquine toxicity and Bietti crystalline deposits that correlated with other imaging modalities. CONCLUSIONS Graph-search theory algorithm helps to overcome the limitations of outer retinal segmentation inaccuracies in commercial software. En face OCT images can provide detailed topography of the reflectivity within a specific layer of the retina which correlates with other forms of fundus imaging. Our results highlight the need for standardization of image reflectivity to facilitate quantification of en face OCT images and longitudinal analysis.
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Affiliation(s)
- Danuta M. Sampson
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Crawley, Western Australia, Australia
- Lions Eye Institute, Nedlands, Western Australia, Australia
| | - David Alonso-Caneiro
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Avenell L. Chew
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Crawley, Western Australia, Australia
- Lions Eye Institute, Nedlands, Western Australia, Australia
| | - Tina Lamey
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, Western Australia, Australia
| | - Terri McLaren
- Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, Western Australia, Australia
| | - John De Roach
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Crawley, Western Australia, Australia
- Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, Western Australia, Australia
| | - Fred K. Chen
- Centre for Ophthalmology and Visual Science, The University of Western Australia, Crawley, Western Australia, Australia
- Lions Eye Institute, Nedlands, Western Australia, Australia
- Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia
- * E-mail:
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Clark A, Ng JQ, Morlet N, Semmens JB. Big data and ophthalmic research. Surv Ophthalmol 2016; 61:443-65. [DOI: 10.1016/j.survophthal.2016.01.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 01/16/2016] [Accepted: 01/25/2016] [Indexed: 02/07/2023]
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Huynh E, De Roach J, McLaren T, Thompson J, Montgomery H, Kap C, Hoffmann L, Lamey T. A computer-assisted method for pathogenicity assessment and genetic reporting of variants stored in the Australian Inherited Retinal Disease Register. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2016; 39:239-45. [PMID: 26728880 DOI: 10.1007/s13246-015-0420-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 12/21/2015] [Indexed: 11/25/2022]
Abstract
The assignment of pathogenicity to variants suspected of causing an inherited retinal disease and the subsequent creation of molecular genetic reports sent to clinical geneticists and ophthalmologists has traditionally been time-consuming and subject to error and ambiguity. The purpose of this paper is to describe a computer-assisted method we have developed for (1) assessment of the predicted pathogenicity of genetic variants identified in patients diagnosed with an inherited retinal disease and (2) the incorporation of these results into the Australian Inherited Retinal Disease Register and DNA Bank's databases, for the production of molecular genetics reports. This method has significantly accelerated the assessment of variant pathogenicity prediction and subsequent patient report generation for the Australian Inherited Retinal Disease Register and DNA Bank, and has reduced the potential for human error. The principles described in this paper may be applied in any situation where genetic variants and patient information are stored in a well-organised database.
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Affiliation(s)
- Emily Huynh
- Australian Inherited Retinal Disease Register and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia.
- Centre for Ophthalmology and Visual Science, University of Western Australia/Lions Eye Institute, Perth, WA, Australia.
| | - John De Roach
- Australian Inherited Retinal Disease Register and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Terri McLaren
- Australian Inherited Retinal Disease Register and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Jennifer Thompson
- Australian Inherited Retinal Disease Register and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Hannah Montgomery
- Australian Inherited Retinal Disease Register and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Caitlyn Kap
- Australian Inherited Retinal Disease Register and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Ling Hoffmann
- Australian Inherited Retinal Disease Register and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Tina Lamey
- Australian Inherited Retinal Disease Register and DNA Bank, Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Perth, WA, Australia
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McLaren TL, De Roach JN, Montgomery H, Hoffmann L, Kap C, Lamey TM. Genetic analysis of choroideremia families in the Australian population. Clin Exp Ophthalmol 2015; 43:727-34. [DOI: 10.1111/ceo.12542] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 04/12/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Terri L McLaren
- Australian Inherited Retinal Disease Register and DNA Bank; Department of Medical Technology and Physics; Sir Charles Gairdner Hospital; Perth Western Australia Australia
| | - John N De Roach
- Australian Inherited Retinal Disease Register and DNA Bank; Department of Medical Technology and Physics; Sir Charles Gairdner Hospital; Perth Western Australia Australia
| | - Hannah Montgomery
- Australian Inherited Retinal Disease Register and DNA Bank; Department of Medical Technology and Physics; Sir Charles Gairdner Hospital; Perth Western Australia Australia
| | - Ling Hoffmann
- Australian Inherited Retinal Disease Register and DNA Bank; Department of Medical Technology and Physics; Sir Charles Gairdner Hospital; Perth Western Australia Australia
| | - Caitlyn Kap
- Australian Inherited Retinal Disease Register and DNA Bank; Department of Medical Technology and Physics; Sir Charles Gairdner Hospital; Perth Western Australia Australia
| | - Tina M Lamey
- Australian Inherited Retinal Disease Register and DNA Bank; Department of Medical Technology and Physics; Sir Charles Gairdner Hospital; Perth Western Australia Australia
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