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Petrovic Pajic S, Jarc-Vidmar M, Fakin A, Sustar Habjan M, Brecelj J, Volk M, Maver A, Peterlin B, Hawlina M. Case report: Long-term follow-up of two patients with LHON caused by DNAJC30:c.152G>A pathogenic variant-case series. Front Neurol 2022; 13:1003046. [PMID: 36388184 PMCID: PMC9649972 DOI: 10.3389/fneur.2022.1003046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 09/22/2022] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND We present the disease course and long-term follow-up of two patients who were phenotypically diagnosed with atypical Leber Hereditary Optic Neuropathy (LHON) 14 and 12 years ago, respectively, whereby whole exome sequencing revealed recently described recessive DNAJC30:c.152G>A 152 A>G (p.Tyr51Cys) homozygous pathogenic variant with significant spontaneous visual acuity recovery in one. CASE PRESENTATION Two presented unrelated males with atypical LHON with sequential visual acuity (VA) loss were followed for many years. Both patients had negative family history. At the presentation at ages 17 (Case 1) and 18 years (Case 2), both had reduced visual acuity (Snellen): (Case 1) right eye (RE):CF 3m, left eye (LE):0.6, (Case 2) RE:0.2, LE:0.15; and color vision (Ishihara): (Case 1) 1/15 and 13/15; (Case 2) 2/15 and 3/15. Both had hyperemic optic disks (PNO) and central scotoma in their visual fields. Electrophysiology in the acute phase showed reduced and delayed visually evoked potentials (VEP) P100 in both patients, with reduced N95 amplitude in Case 2, and initially normal N95 amplitude in Case 1. Fluorescein angiography showed no early leakage with some late pooling at optic disks. Extensive clinical workout, including brain magnetic resonance imaging (MRI), aquaporin 4 (Aq4), and anti-myelin oligodendrocyte protein (anti-MOG) antibodies, was negative. Intravenous corticosteroids did not improve vision. Both experienced further deterioration several months after the onset accompanied by thinning of the peripapillary retinal nerve fiber layer (RNFL). Genetic testing for typical LHON pathogenic variants and whole mitochondrial DNA (mtDNA) sequencing was negative. 1 year after the onset, modest VA improvement began in Case 2 and continued over the next 3 years. VA improved bilaterally to 0.7, color vision 15/15, and islands of vision appeared within the visual field scotoma. VEP P100 peak time shortened, and amplitude increased, despite further RNFL thinning on optical coherent tomography (OCT). The patient's visual function remained stable during the entire 12-year follow-up period. Case 1 experienced modest VA improvement to 0.1 with some improvement in the visual field seven years after the disease onset, remaining stable during the entire 14-year follow-up period. VEP P100 wave remained undetectable. CONCLUSIONS Presented are two autosomal recessive LHON (arLHON, OMIM:619382) cases with the same DNAJC30:c.152G>A pathogenic variant and different degrees of spontaneous visual recovery despite progressive RNFL thinning during a long-term follow-up. This mutation should be screened in every atypical LHON patient.
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Affiliation(s)
- Sanja Petrovic Pajic
- Eye Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Clinic for Eye Diseases, University Clinical Centre of Serbia, Belgrade, Serbia
| | | | - Ana Fakin
- Eye Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | | | - Jelka Brecelj
- Eye Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Marija Volk
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Ales Maver
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Borut Peterlin
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Marko Hawlina
- Eye Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
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Petrovic Pajic S, Lapajne L, Vratanar B, Fakin A, Jarc-Vidmar M, Sustar Habjan M, Volk M, Maver A, Peterlin B, Hawlina M. The Relative Preservation of the Central Retinal Layers in Leber Hereditary Optic Neuropathy. J Clin Med 2022; 11:jcm11206045. [PMID: 36294366 PMCID: PMC9604528 DOI: 10.3390/jcm11206045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/30/2022] [Accepted: 10/08/2022] [Indexed: 11/22/2022] Open
Abstract
(1) Background: The purpose of this study was to evaluate the thickness of retinal layers in Leber hereditary optic neuropathy (LHON) in the atrophic stage compared with presumably inherited bilateral optic neuropathy of unknown cause with the aim of seeing if any LHON-specific patterns exist. (2) Methods: 14 patients (24 eyes) with genetically confirmed LHON (LHON group) were compared with 13 patients (23 eyes) with negative genetic testing results (mtDNA + WES) and without identified etiology of bilateral optic atrophy (nonLHON group). Segmentation analysis of retinal layers in the macula and peripapillary RNFL (pRNFL) measurements was performed using Heidelberg Engineering Spectralis SD-OCT. (3) Results: In the LHON group, the thickness of ganglion cell complex (GCC) (retinal nerve fiber layer (RNFL)—ganglion cell layer (GCL)—inner plexiform layer (IPL)) in the central ETDRS (Early Treatment Diabetic Retinopathy Study) circle was significantly higher than in the nonLHON group (p < 0.001). In all other ETDRS fields, GCC was thinner in the LHON group. The peripapillary RNFL (pRNFL) was significantly thinner in the LHON group in the temporal superior region (p = 0.001). Longitudinal analysis of our cohort during the follow-up time showed a tendency of thickening of the RNFL, GCL, and IPL in the LHON group in the central circle, as well as a small recovery of the pRNFL in the temporal region, which corresponds to the observed central macular thickening. (4) Conclusions: In LHON, the retinal ganglion cell complex thickness (RNFL-GCL-IPL) appears to be relatively preserved in the central ETDRS circle compared to nonLHON optic neuropathies in the chronic phase. Our findings may represent novel biomarkers as well as a structural basis for possible recovery in some patients with LHON.
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Affiliation(s)
- Sanja Petrovic Pajic
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva ulica 46, 1000 Ljubljana, Slovenia
- Clinic for Eye Diseases, University Clinical Centre of Serbia, Pasterova 2, 11000 Belgrade, Serbia
| | - Luka Lapajne
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva ulica 46, 1000 Ljubljana, Slovenia
| | - Bor Vratanar
- Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Ana Fakin
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva ulica 46, 1000 Ljubljana, Slovenia
| | - Martina Jarc-Vidmar
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva ulica 46, 1000 Ljubljana, Slovenia
| | - Maja Sustar Habjan
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva ulica 46, 1000 Ljubljana, Slovenia
| | - Marija Volk
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Šlajmajerjeva ulica 4, 1000 Ljubljana, Slovenia
| | - Ales Maver
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Šlajmajerjeva ulica 4, 1000 Ljubljana, Slovenia
| | - Borut Peterlin
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, Šlajmajerjeva ulica 4, 1000 Ljubljana, Slovenia
| | - Marko Hawlina
- Eye Hospital, University Medical Centre Ljubljana, Grablovičeva ulica 46, 1000 Ljubljana, Slovenia
- Correspondence: ; Tel.: +386-1-522-1900; Fax: +386-1-522-1960
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Gaudric A, Audo I, Vignal C, Couturier A, Boulanger-Scemama É, Tadayoni R, Cohen SY. Non-vasogenic cystoid maculopathies. Prog Retin Eye Res 2022;:101092. [PMID: 35927124 DOI: 10.1016/j.preteyeres.2022.101092] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 11/23/2022]
Abstract
Besides cystoid macular edema due to a blood-retinal barrier breakdown, another type of macular cystoid spaces referred to as non-vasogenic cystoid maculopathies (NVCM) may be detected on optical coherence tomography but not on fluorescein angiography. Various causes may disrupt retinal cell cohesion or impair retinal pigment epithelium (RPE) and Müller cell functions in the maintenance of retinal dehydration, resulting in cystoid spaces formation. Tractional causes include vitreomacular traction, epiretinal membranes and myopic foveoschisis. Surgical treatment does not always allow cystoid space resorption. In inherited retinal dystrophies, cystoid spaces may be part of the disease as in X-linked retinoschisis or enhanced S-cone syndrome, or occur occasionally as in bestrophinopathies, retinitis pigmentosa and allied diseases, congenital microphthalmia, choroideremia, gyrate atrophy and Bietti crystalline dystrophy. In macular telangiectasia type 2, cystoid spaces and cavitations do not depend on the fluid leakage from telangiectasia. Various causes affecting RPE function may result in NVCM such as chronic central serous chorioretinopathy and paraneoplastic syndromes. Non-exudative age macular degeneration may also be complicated by intraretinal cystoid spaces in the absence of fluorescein leakage. In these diseases, cystoid spaces occur in a context of retinal cell loss. Various causes of optic atrophy, including open-angle glaucoma, result in microcystoid spaces in the inner nuclear layer due to a retrograde transsynaptic degeneration. Lastly, drug toxicity may also induce cystoid maculopathy. Identifying NVCM on multimodal imaging, including fluorescein angiography if needed, allows guiding the diagnosis of the causative disease and choosing adequate treatment when available.
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Eckmann-Hansen C, Bek T, Sander B, Grønskov K, Larsen M. Prevalence of Macular Microcystoid Lacunae in Autosomal Dominant Optic Atrophy Assessed With Adaptive Optics. J Neuroophthalmol 2022. [PMID: 35439206 DOI: 10.1097/WNO.0000000000001592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND To assess the prevalence of macular microcystoid lacunae in patients with autosomal dominant optic atrophy (ADOA) and its association with visual function and inner retinal morphology. METHODS The study included 140 participants with ADOA, with a mean age of 44 (SD ±19, range 7-82) years. Study participants with a genetically verified sequence variant in the OPA1 gene were examined with best-corrected visual acuity, contrast sensitivity, optical coherence tomography (Spectralis, Heidelberg) and adaptive optics fundus photography (rtx1, Imagine Eyes). Optically empty microcystoid spaces in the ganglion cell layer and inner plexiform layer were mapped by inspection of the 2 sets of images. Data were analyzed with a mixed model adjusted for age and sex with family and individual as random effect. RESULTS Microcystoid lacunae were present in 32 of 140 participants (23%) including 18 males and 14 females. Microcystoid lacunae were associated with younger age (P = 0.0503) and a smaller nerve fiber layer volume (P = 0.035). No association was found between presence of microcystoid lacunae and visual acuity (P = 0.2), contrast sensitivity (P = 0.8), axial length (P = 0.7), or ganglion cell layer volume (P = 0.2). The analysis showed moderately reduced visual acuity in patients with microcystoid lacunae. Normal and severely impaired visual function were seen only in participants without microcystoid lacunae. CONCLUSION In ADOA, macular microcystoid lacunae were found in 23% of the study participants and tended to be present in younger participants with moderate visual acuity reduction and a smaller nerve fiber layer volume. Further studies are needed to investigate whether cavities left by dead ganglion cells are predictors of decrease in visual function.
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Monteiro MLR, Sousa RM, Araújo RB, Ferraz D, Sadiq MA, Zacharias LC, Preti RC, Cunha LP, Nguyen QD. Diagnostic ability of confocal near-infrared reflectance fundus imaging to detect retrograde microcystic maculopathy from chiasm compression. A comparative study with OCT findings. PLoS One 2021; 16:e0253323. [PMID: 34166408 PMCID: PMC8224958 DOI: 10.1371/journal.pone.0253323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 06/02/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To evaluate the ability of confocal near-infrared reflectance (NIR) to diagnose retrograde microcystic maculopathy (RMM) in eyes with temporal visual field (VF) loss and optic atrophy from chiasmal compression. To compare NIR findings with optical coherence tomography (OCT) findings in the same group of patients. METHODS Thirty-four eyes (26 patients) with temporal VF loss from chiasmal compression and 41 healthy eyes (22 controls) underwent NIR fundus photography, and macular OCT scanning. VF loss was estimated and retinal layers thickness were measured on OCT. Two examiners blinded to the diagnosis randomly examined NIR images for the presence of hyporeflective abnormality (HA) and OCT scans for the presence of microcystic macular abnormalities (MMA). The total average and hemi-macular HA area and number of microcysts were determined. The groups were compared and the level of agreement was estimated. RESULTS The OCT-measured macular retinal nerve fiber and ganglion cell layers were thinner and the inner nuclear layer was thicker in patients compared to controls. HA and MMA were detected in 22 and 12 patient eyes, respectively, and in 0 controls (p<0.001, both comparisons). HA was significantly more frequent than MMA in patients with optic atrophy, and agreement between HA and MMA (both total and hemi-macular) was fair (kappa range: 0.24-0.29). The mean HA area was significantly greater in the nasal than temporal hemi-macula. A re-analysis of the 14 eyes with discrepant findings allowed to confirm RMM in 20 eyes (20/34) indicating that OCT detected RMM in 12 and missed it in 8 eyes. On the other hand, NIR correctly detected 18 out of 20 eyes, overcalled 4 and missed 2. CONCLUSIONS RMM is a frequent finding in eyes with severe VF loss from long-standing chiasmal compression. NIR photography appears to be more sensitive than OCT for detecting RMM and may be useful as screening method for its presence.
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Affiliation(s)
- Mário L. R. Monteiro
- Division of Ophthalmology and the Laboratory for Investigation in Ophthalmology (LIM-33), Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
- * E-mail:
| | - Rafael M. Sousa
- Division of Ophthalmology and the Laboratory for Investigation in Ophthalmology (LIM-33), Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Rafael B. Araújo
- Division of Ophthalmology and the Laboratory for Investigation in Ophthalmology (LIM-33), Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Daniel Ferraz
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Mohammad A. Sadiq
- Department of Ophthalmology, University of Louisville, Louisville, Kentucky, United States of America
| | - Leandro C. Zacharias
- Division of Ophthalmology and the Laboratory for Investigation in Ophthalmology (LIM-33), Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Rony C. Preti
- Division of Ophthalmology and the Laboratory for Investigation in Ophthalmology (LIM-33), Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Leonardo P. Cunha
- Division of Ophthalmology and the Laboratory for Investigation in Ophthalmology (LIM-33), Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
- Department of Ophthalmology, Federal University of Juiz de Fora Medical School, Juiz de Fora, Minas Gerais, Brazil
| | - Quan D. Nguyen
- Byers Eye Institute, Stanford University, Palo Alto, California, United States of America
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Khanna RK, Hage A, Cook AR, Zuber K, Audren F, Vignal-Clermont C, Hage R. Microcystic macular degeneration in autosomal hereditary optic neuropathies: A cross-sectional retrospective study. J Fr Ophtalmol 2021; 44:995-1000. [PMID: 34147274 DOI: 10.1016/j.jfo.2020.10.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/22/2020] [Accepted: 10/11/2020] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Patients with autosomal optic neuropathies (AON) may develop microcystic macular degeneration (MMD), observed on retinal optical coherence tomography (OCT) examination. This study aimed to report the prevalence of MMD in AON patients and to assess the consequences of MMD on retinal architecture. METHODS Retrospective single-center study conducted between 2001 and 2018. Patients affected by AON secondary to OPA1 or WFS1 gene mutations were included. The following data were collected: visual acuity, macular volume, vitreomacular interface and presence or absence of MMD. RESULTS Forty-two subjects (34 OPA1, 8 WFS1) were included. MMD was found in 12 (29%) patients, i.e. 6 of the 8 WFS1 patients (75%) and 6 of the 34 OPA1 patients (17%). In cases with MMD, total retinal volume was greater (P=0.02) in accordance with thickening of the inner nuclear layer (P<0.001). WFS1 subjects had the highest total retinal volume (P=0.01), in relation to a thickening of the inner plexiform layer (P=0.02), inner nuclear layer (P<0.001) and outer plexiform layer (P=0.002). MMD was significantly associated with the WFS1 mutation (P<0.001). No significant association was found between the presence of vitreomacular adhesion and MMD. CONCLUSION MMD was found in 29% of patients affected by AON and was more frequent in cases with a WFS1 gene mutation. MMD appears to be related to primary ganglion cell degeneration and Müller cell dysfunction. The vitreomacular interface does not appear to play a role in the occurrence of MMD.
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Affiliation(s)
- R K Khanna
- Department of Neuro-ophthalmology, Fondation Adolphe de Rothschild Hospital, Paris, France; Department of Ophthalmology, Centre Hospitalier Régional Universitaire, Bretonneau Hospital, Tours, France.
| | - A Hage
- Department of Neuro-ophthalmology, Fondation Adolphe de Rothschild Hospital, Paris, France
| | - A R Cook
- Department of Ophthalmology, Centre Hospitalier Régional Universitaire, Bretonneau Hospital, Tours, France
| | - K Zuber
- Clinical Research Unit, Fondation Adolphe de Rothschild Hospital, Paris, France
| | - F Audren
- Department of Neuro-ophthalmology, Fondation Adolphe de Rothschild Hospital, Paris, France
| | - C Vignal-Clermont
- Department of Neuro-ophthalmology, Fondation Adolphe de Rothschild Hospital, Paris, France; Centre for Clinical Research Investigations, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France
| | - R Hage
- Department of Neuro-ophthalmology, Fondation Adolphe de Rothschild Hospital, Paris, France; Centre for Clinical Research Investigations, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France
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Pilania RK, Arora A, Agarwal A, Jindal AK, Aggarwal K, Krishnan G, Suri D, Gupta A, Singh S, Gupta V. LINEZOLID-INDUCED MITOCHONDRIAL TOXICITY PRESENTING AS RETINAL NERVE FIBER LAYER MICROCYSTS AND OPTIC AND PERIPHERAL NEUROPATHY IN A PATIENT WITH CHRONIC GRANULOMATOUS DISEASE. Retin Cases Brief Rep 2021; 15:224-229. [PMID: 30048406 DOI: 10.1097/icb.0000000000000777] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE To report a case with unique changes in the retinal nerve fiber layer observed on optical coherence tomography in a 22-year-old patient on chronic linezolid therapy for recurrent pyogenic liver abscesses with underlying chronic granulomatous disease. METHODS History and clinical examination, laboratory evaluation, fluorescein angiography, and optical coherence tomography. RESULTS The patient presented with best-corrected visual acuity of 20/200 in the right eye and 20/125 in the left eye. He had moderate optic disk edema and superotemporal field defects bilaterally. Swept-source optical coherence tomography revealed the presence of retinal nerve fiber layer microcystic spaces. Laboratory tests showed no positive findings except for an elevated lactic acid level. Linezolid-induced optic neuropathy was suspected, and the drug was discontinued. Six weeks after termination of oral linezolid therapy, the optic disk edema and the microcystic spaces in the retinal nerve fiber layer resolved, and the best-corrected visual acuity improved to 20/50 in the right and 20/40 in the left eye, respectively. CONCLUSION Linezolid is a widely used antibiotic with broad-spectrum action. However, chronic use can lead to mitochondrial toxicity that may have protean manifestations. Ocular examination, particularly of the optic nerve and nerve fiber layer using multimodal imaging, is critical in diagnosing such toxicity.
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Affiliation(s)
- Rakesh K Pilania
- Department of Pediatrics, Division of Allergy and Immunology, Post Graduate Institute of Medical Education and Research, Chandigarh, India; and
| | - Atul Arora
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Aniruddha Agarwal
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ankur K Jindal
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Kanika Aggarwal
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Gopala Krishnan
- Department of Pediatrics, Division of Allergy and Immunology, Post Graduate Institute of Medical Education and Research, Chandigarh, India; and
| | - Deepti Suri
- Department of Pediatrics, Division of Allergy and Immunology, Post Graduate Institute of Medical Education and Research, Chandigarh, India; and
| | - Anju Gupta
- Department of Pediatrics, Division of Allergy and Immunology, Post Graduate Institute of Medical Education and Research, Chandigarh, India; and
| | - Surjit Singh
- Department of Pediatrics, Division of Allergy and Immunology, Post Graduate Institute of Medical Education and Research, Chandigarh, India; and
| | - Vishali Gupta
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Haritoglou C, Hubschman JP, Schumann RG, Maier M. [Optical coherence tomography biomarkers in epimacular membranes and vitreomacular traction syndrome]. Ophthalmologe 2021; 118:308-19. [PMID: 33688969 DOI: 10.1007/s00347-021-01349-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2021] [Indexed: 10/21/2022]
Abstract
Using high-resolution imaging, such as optical coherence tomography (OCT), the different layers of the retina as well as the vitreoretinal interface and its alterations can be very clearly differentiated. This includes the morphological characteristics of tractive maculopathies, such as epiretinal gliosis and vitreomacular traction syndrome. Additionally, structural alterations of the various layers of the neurosensory retina as a result of traction due to these pathologies can be demarcated. The latter have been investigated in clinical trials and evaluated as OCT biomarkers with respect to their prognostic and predictive value. In this review we would like to present and discuss various OCT biomarkers in the context of epimacular membranes and vitreomacular traction syndrome.
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Botelho GIS, Salomão SR, Tengan CH, Karanjia R, Moura FV, Rocha DM, da Silva PBE, Fernandes AG, Watanabe SES, Sacai PY, Belfort R, Carelli V, Sadun AA, Berezovsky A. Impaired Ganglion Cell Function Objectively Assessed by the Photopic Negative Response in Affected and Asymptomatic Members From Brazilian Families With Leber's Hereditary Optic Neuropathy. Front Neurol 2021; 11:628014. [PMID: 33584522 PMCID: PMC7874135 DOI: 10.3389/fneur.2020.628014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/21/2020] [Indexed: 01/13/2023] Open
Abstract
Purpose: The photopic negative response (PhNR) is an electrophysiological method that provides retinal ganglion cell function assessment using full-field stimulation that does not require clear optics or refractive correction. The purpose of this study was to assess ganglion cell function by PhNR in affected and asymptomatic carriers from Brazilian families with LHON. Methods: Individuals either under suspicion or previously diagnosed with LHON and their family members were invited to participate in this cross-sectional study. Screening for the most frequent LHON mtDNA mutations was performed. Visual acuity, color discrimination, visual fields, pattern-reversal visual evoked potentials (PRVEP), full-field electroretinography and PhNR were tested. A control group of healthy subjects was included. Full-field ERG PhNR were recorded using red (640 nm) flashes at 1 cd.s/m2, on blue (470 nm) rod saturating background. PhNR amplitude (μV) was measured using baseline-to-trough (BT). Optical coherence tomography scans of both the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) were measured. PhNR amplitudes among affected, carriers and controls were compared by Kruskal-Wallis test followed by post-hoc Dunn test. The associations between PhNR amplitude and OCT parameters were analyzed by Spearman rank correlation. Results: Participants were 24 LHON affected patients (23 males, mean age=30.5 ± 11.4 yrs) from 19 families with the following genotype: m.11778G>A [N = 15 (62%), 14 males]; m.14484T>C [N = 5 (21%), all males] and m.3460G>A [N = 4 (17%), all males] and 14 carriers [13 females, mean age: 43.2 ± 13.3 yrs; m.11778G>A (N = 11); m.3460G>A (N = 2) and m.14484T>C (N = 1)]. Controls were eight females and seven males (mean age: 32.6 ± 11.5 yrs). PhNR amplitudes were significantly reduced (p = 0.0001) in LHON affected (-5.96 ± 3.37 μV) compared to carriers (-16.53 ± 3.40 μV) and controls (-23.91 ± 4.83; p < 0.0001) and in carriers compared to controls (p = 0.01). A significant negative correlation was found between PhNR amplitude and total macular ganglion cell thickness (r = -0.62, p < 0.05). Severe abnormalities in color discrimination, visual fields and PRVEPs were found in affected and subclinical abnormalities in carriers. Conclusions: In this cohort of Brazilian families with LHON the photopic negative response was severely reduced in affected patients and mildly reduced in asymptomatic carriers suggesting possible subclinical abnormalities in the latter. These findings were similar among pathogenic mutations.
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Affiliation(s)
- Gabriel Izan Santos Botelho
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Solange Rios Salomão
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Célia Harumi Tengan
- Departamento de Neurologia e Neurocirurgia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Rustum Karanjia
- Doheny Eye Institute, University of California Los Angeles, Los Angeles, CA, United States.,Department of Ophthalmology, Doheny Eye Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.,Ottawa Eye Institute, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Felipo Victor Moura
- Departamento de Neurologia e Neurocirurgia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Daniel Martins Rocha
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Paula Baptista Eliseo da Silva
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Arthur Gustavo Fernandes
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sung Eun Song Watanabe
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Paula Yuri Sacai
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Rubens Belfort
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.,Instituto da Visão-IPEPO, São Paulo, Brazil
| | - Valerio Carelli
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna School of Medicine, Bologna, Italy
| | - Alfredo Arrigo Sadun
- Doheny Eye Institute, University of California Los Angeles, Los Angeles, CA, United States.,Department of Ophthalmology, Doheny Eye Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Adriana Berezovsky
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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10
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Kim US, Mahroo OA, Mollon JD, Yu-Wai-Man P. Retinal Ganglion Cells-Diversity of Cell Types and Clinical Relevance. Front Neurol 2021; 12:661938. [PMID: 34093409 PMCID: PMC8175861 DOI: 10.3389/fneur.2021.661938] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 04/06/2021] [Indexed: 11/24/2022] Open
Abstract
Retinal ganglion cells (RGCs) are the bridging neurons that connect the retinal input to the visual processing centres within the central nervous system. There is a remarkable diversity of RGCs and the various subtypes have unique morphological features, distinct functions, and characteristic pathways linking the inner retina to the relevant brain areas. A number of psychophysical and electrophysiological tests have been refined to investigate this large and varied population of RGCs. Technological advances, such as high-resolution optical coherence tomography imaging, have provided additional tools to define the pattern of RGC involvement and the chronological sequence of events in both inherited and acquired optic neuropathies. The mechanistic insights gained from these studies, in particular the selective vulnerability and relative resilience of particular RGC subtypes, are of fundamental importance as they are directly relevant to the development of targeted therapies for these invariably progressive blinding diseases. This review provides a comprehensive description of the various types of RGCs, the developments in proposed methods of classification, and the current gaps in our knowledge of how these RGCs are differentially affected depending on the underlying aetiology. The synthesis of the current body of knowledge on the diversity of RGCs and the pathways that are potentially amenable to therapeutic modulation will hopefully lead to much needed effective treatments for patients with optic neuropathies.
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Affiliation(s)
- Ungsoo Samuel Kim
- Kim's Eye Hospital, Seoul, South Korea
- John van Geest Centre for Brain Repair and MRC Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
- Cambridge Eye Unit, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- *Correspondence: Ungsoo Samuel Kim
| | - Omar A. Mahroo
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- Institute of Ophthalmology, University College London, London, United Kingdom
- Section of Ophthalmology, King's College London, St. Thomas' Hospital Campus, London, United Kingdom
| | - John D. Mollon
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Patrick Yu-Wai-Man
- John van Geest Centre for Brain Repair and MRC Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
- Cambridge Eye Unit, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- Institute of Ophthalmology, University College London, London, United Kingdom
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11
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Charif M, Gueguen N, Ferré M, Elkarhat Z, Khiati S, LeMao M, Chevrollier A, Desquiret-Dumas V, Goudenège D, Bris C, Kane S, Alban J, Chupin S, Wetterwald C, Caporali L, Tagliavini F, LaMorgia C, Carbonelli M, Jurkute N, Barakat A, Gohier P, Verny C, Barth M, Procaccio V, Bonneau D, Zanlonghi X, Meunier I, Weisschuh N, Schimpf-Linzenbold S, Tonagel F, Kellner U, Yu-Wai-Man P, Carelli V, Wissinger B, Amati-Bonneau P, Reynier P, Lenaers G. Dominant ACO2 mutations are a frequent cause of isolated optic atrophy. Brain Commun 2021; 3:fcab063. [PMID: 34056600 PMCID: PMC8152918 DOI: 10.1093/braincomms/fcab063] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 02/11/2021] [Accepted: 02/12/2021] [Indexed: 12/24/2022] Open
Abstract
Biallelic mutations in ACO2, encoding the mitochondrial aconitase 2, have been identified in individuals with neurodegenerative syndromes, including infantile cerebellar retinal degeneration and recessive optic neuropathies (locus OPA9). By screening European cohorts of individuals with genetically unsolved inherited optic neuropathies, we identified 61 cases harbouring variants in ACO2, among whom 50 carried dominant mutations, emphasizing for the first time the important contribution of ACO2 monoallelic pathogenic variants to dominant optic atrophy. Analysis of the ophthalmological and clinical data revealed that recessive cases are affected more severely than dominant cases, while not significantly earlier. In addition, 27% of the recessive cases and 11% of the dominant cases manifested with extraocular features in addition to optic atrophy. In silico analyses of ACO2 variants predicted their deleterious impacts on ACO2 biophysical properties. Skin derived fibroblasts from patients harbouring dominant and recessive ACO2 mutations revealed a reduction of ACO2 abundance and enzymatic activity, and the impairment of the mitochondrial respiration using citrate and pyruvate as substrates, while the addition of other Krebs cycle intermediates restored a normal respiration, suggesting a possible short-cut adaptation of the tricarboxylic citric acid cycle. Analysis of the mitochondrial genome abundance disclosed a significant reduction of the mitochondrial DNA amount in all ACO2 fibroblasts. Overall, our data position ACO2 as the third most frequently mutated gene in autosomal inherited optic neuropathies, after OPA1 and WFS1, and emphasize the crucial involvement of the first steps of the Krebs cycle in the maintenance and survival of retinal ganglion cells.
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Affiliation(s)
- Majida Charif
- Université Angers, MitoLab Team, UMR CNRS 6015 - INSERM U1083, Institut MitoVasc, SFR ICAT, Angers, France
- Genetics and Immuno-Cell Therapy Team, Mohammed First University, Oujda, Morocco
| | - Naïg Gueguen
- Université Angers, MitoLab Team, UMR CNRS 6015 - INSERM U1083, Institut MitoVasc, SFR ICAT, Angers, France
- Département de Biochimie et Génétique, CHU d'Angers, Angers, France
| | - Marc Ferré
- Université Angers, MitoLab Team, UMR CNRS 6015 - INSERM U1083, Institut MitoVasc, SFR ICAT, Angers, France
| | - Zouhair Elkarhat
- Laboratory of Genomics and Human Genetics, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Salim Khiati
- Université Angers, MitoLab Team, UMR CNRS 6015 - INSERM U1083, Institut MitoVasc, SFR ICAT, Angers, France
| | - Morgane LeMao
- Université Angers, MitoLab Team, UMR CNRS 6015 - INSERM U1083, Institut MitoVasc, SFR ICAT, Angers, France
| | - Arnaud Chevrollier
- Université Angers, MitoLab Team, UMR CNRS 6015 - INSERM U1083, Institut MitoVasc, SFR ICAT, Angers, France
| | - Valerie Desquiret-Dumas
- Université Angers, MitoLab Team, UMR CNRS 6015 - INSERM U1083, Institut MitoVasc, SFR ICAT, Angers, France
- Département de Biochimie et Génétique, CHU d'Angers, Angers, France
| | - David Goudenège
- Université Angers, MitoLab Team, UMR CNRS 6015 - INSERM U1083, Institut MitoVasc, SFR ICAT, Angers, France
- Département de Biochimie et Génétique, CHU d'Angers, Angers, France
| | - Céline Bris
- Université Angers, MitoLab Team, UMR CNRS 6015 - INSERM U1083, Institut MitoVasc, SFR ICAT, Angers, France
- Département de Biochimie et Génétique, CHU d'Angers, Angers, France
| | - Selma Kane
- Université Angers, MitoLab Team, UMR CNRS 6015 - INSERM U1083, Institut MitoVasc, SFR ICAT, Angers, France
| | - Jennifer Alban
- Université Angers, MitoLab Team, UMR CNRS 6015 - INSERM U1083, Institut MitoVasc, SFR ICAT, Angers, France
| | - Stéphanie Chupin
- Département de Biochimie et Génétique, CHU d'Angers, Angers, France
| | | | - Leonardo Caporali
- Unit of Neurology, Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Francesca Tagliavini
- Unit of Neurology, Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Chiara LaMorgia
- Unit of Neurology, Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
| | - Michele Carbonelli
- Unit of Neurology, Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Neringa Jurkute
- Moorfields Eye Hospital, London, UK
- UCL Institute of Ophthalmology, University College London, London, UK
- Cambridge Eye Unit, Addenbrooke’s Hospital, Cambridge University Hospitals, Cambridge, UK
- Cambridge Centre for Brain Repair and MRC Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Abdelhamid Barakat
- Laboratory of Genomics and Human Genetics, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Philippe Gohier
- Université Angers, MitoLab Team, UMR CNRS 6015 - INSERM U1083, Institut MitoVasc, SFR ICAT, Angers, France
| | - Christophe Verny
- Université Angers, MitoLab Team, UMR CNRS 6015 - INSERM U1083, Institut MitoVasc, SFR ICAT, Angers, France
- Centre de référence des Maladies Neurogénétiques, Département de Neurologie, CHU d’Angers, Angers, France
| | - Magalie Barth
- Department of Pediatrics, Competence Center of Inherited Metabolic Disorders, Angers Hospital, Angers, France
| | - Vincent Procaccio
- Université Angers, MitoLab Team, UMR CNRS 6015 - INSERM U1083, Institut MitoVasc, SFR ICAT, Angers, France
- Département de Biochimie et Génétique, CHU d'Angers, Angers, France
| | - Dominique Bonneau
- Université Angers, MitoLab Team, UMR CNRS 6015 - INSERM U1083, Institut MitoVasc, SFR ICAT, Angers, France
- Département de Biochimie et Génétique, CHU d'Angers, Angers, France
| | | | - Isabelle Meunier
- National Center for Rare Diseases, Genetics of Sensory Diseases, University Hospital, Montpellier, France
| | - Nicole Weisschuh
- Institute for Ophthalmic Research, Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
| | | | - Felix Tonagel
- Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
| | - Ulrich Kellner
- Rare Retinal Disease Center, AugenZentrum Siegburg, MVZ ADTC Siegburg GmbH, Siegburg, Germany
- RetinaScience, 53113 Bonn, Germany
| | - Patrick Yu-Wai-Man
- Moorfields Eye Hospital, London, UK
- UCL Institute of Ophthalmology, University College London, London, UK
- Cambridge Eye Unit, Addenbrooke’s Hospital, Cambridge University Hospitals, Cambridge, UK
- Cambridge Centre for Brain Repair and MRC Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Valerio Carelli
- Unit of Neurology, Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
- IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Bologna, Italy
| | - Bernd Wissinger
- Institute for Ophthalmic Research, Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
| | - Patrizia Amati-Bonneau
- Université Angers, MitoLab Team, UMR CNRS 6015 - INSERM U1083, Institut MitoVasc, SFR ICAT, Angers, France
- Département de Biochimie et Génétique, CHU d'Angers, Angers, France
| | - Pascal Reynier
- Université Angers, MitoLab Team, UMR CNRS 6015 - INSERM U1083, Institut MitoVasc, SFR ICAT, Angers, France
- Département de Biochimie et Génétique, CHU d'Angers, Angers, France
| | | | - Guy Lenaers
- Université Angers, MitoLab Team, UMR CNRS 6015 - INSERM U1083, Institut MitoVasc, SFR ICAT, Angers, France
- Correspondence to: Guy Lenaers MitoLab Team, Mitochondrial Medicine Research Centre, MitoVasc Unit, Université d'Angers UMR CNRS 6015, INSERM U1083, CHU Bât IRIS/IBS, Rue des Capucins 49933 Angers cedex 9, France E-mail:
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12
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Müller PL, Maloca P, Webster A, Egan C, Tufail A. Structural Features Associated With the Development and Progression of RORA Secondary to Maternally Inherited Diabetes and Deafness. Am J Ophthalmol 2020; 218:136-47. [PMID: 32446735 DOI: 10.1016/j.ajo.2020.05.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 11/23/2022]
Abstract
PURPOSE To investigate the development and progression of retinal pigment epithelial and outer retinal atrophy (RORA) secondary to maternally inherited diabetes and deafness (MIDD). DESIGN Retrospective observational case series. METHODS Thirty-six eyes of 18 patients (age range, 22.4-71.6 years) with genetically proven MIDD and serial optical coherence tomography (OCT) images were included. As proposed reference standard to diagnose and stage atrophy, OCT images were longitudinally evaluated and analyzed for presence and precursors of RORA. RORA was defined as an area of (1) hypertransmission, (2) disruption of the retinal pigment epithelium, (3) photoreceptor degeneration, and (4) absence of other signs of a retinal pigment epithelial tear. RESULTS The majority of patients revealed areas of RORA in a circular area around the fovea of between 5° and 15° eccentricity. Over the observation time (range, 0.5-8.5 years), evidence for a consistent sequence of OCT features from earlier disease stages to the end stage of RORA could be found, starting with loss of ellipsoid zone and subretinal deposits, followed by loss of external limiting membrane and loss of retinal pigment epithelium with hypertransmission of OCT signal into the choroid, and leading to loss of the outer nuclear layer bordered by hyporeflective wedges. Outer retinal tabulations seemed to develop in regions of coalescent areas of RORA. CONCLUSIONS The development and progression of RORA could be tracked in MIDD patients using OCT images, allowing potential definition of novel surrogate markers. Similarities to OCT features in age-related macular degeneration, where mitochondrial dysfunction has been implicated in the pathogenesis, support wide-ranging benefits from proof-of-concept studies in MIDD.
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13
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Beykin G, Norcia AM, Srinivasan VJ, Dubra A, Goldberg JL. Discovery and clinical translation of novel glaucoma biomarkers. Prog Retin Eye Res 2020; 80:100875. [PMID: 32659431 DOI: 10.1016/j.preteyeres.2020.100875] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 06/01/2020] [Accepted: 06/04/2020] [Indexed: 12/16/2022]
Abstract
Glaucoma and other optic neuropathies are characterized by progressive dysfunction and loss of retinal ganglion cells and their axons. Given the high prevalence of glaucoma-related blindness and the availability of treatment options, improving the diagnosis and precise monitoring of progression in these conditions is paramount. Here we review recent progress in the development of novel biomarkers for glaucoma in the context of disease pathophysiology and we propose future steps for the field, including integration of exploratory biomarker outcomes into prospective therapeutic trials. We anticipate that, when validated, some of the novel glaucoma biomarkers discussed here will prove useful for clinical diagnosis and prediction of progression, as well as monitoring of clinical responses to standard and investigational therapies.
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Affiliation(s)
- Gala Beykin
- Spencer Center for Vision Research at Stanford University, 2370 Watson Ct, Palo Alto, CA, 94303, USA.
| | - Anthony M Norcia
- Department of Psychology, Stanford University, 290 Jane Stanford Way, Stanford, CA, 94305, USA.
| | - Vivek J Srinivasan
- Department of Biomedical Engineering, University of California, Davis, One Shields Ave, Davis, CA, 95616, USA; Department of Ophthalmology and Vision Science, University of California Davis School of Medicine, 4610 X St, Sacramento, CA, 96817, USA.
| | - Alfredo Dubra
- Spencer Center for Vision Research at Stanford University, 2370 Watson Ct, Palo Alto, CA, 94303, USA.
| | - Jeffrey L Goldberg
- Spencer Center for Vision Research at Stanford University, 2370 Watson Ct, Palo Alto, CA, 94303, USA.
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14
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Mohammadzadeh V, Fatehi N, Yarmohammadi A, Lee JW, Sharifipour F, Daneshvar R, Caprioli J, Nouri-Mahdavi K. Macular imaging with optical coherence tomography in glaucoma. Surv Ophthalmol 2020; 65:597-638. [PMID: 32199939 DOI: 10.1016/j.survophthal.2020.03.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 02/07/2023]
Abstract
With the advent of spectral-domain optical coherence tomography, imaging of the posterior segment of the eye can be carried out rapidly at multiple anatomical locations, including the optic nerve head, circumpapillary retinal nerve fiber layer, and macula. There is now ample evidence to support the role of spectral-domain optical coherence tomography imaging of the macula for detection of early glaucoma. Macular spectral-domain optical coherence tomography measurements demonstrate high reproducibility, and evidence on its utility for detection of glaucoma progression is accumulating. We present a comprehensive review of macular spectral-domain optical coherence tomography imaging emerging as an essential diagnostic tool in glaucoma.
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Affiliation(s)
- Vahid Mohammadzadeh
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| | - Nima Fatehi
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA; Saint Mary Medical Center - Dignity Health, Long Beach, California, USA
| | - Adeleh Yarmohammadi
- Shiley Eye Institute, University of California, San Diego, La Jolla, California, United States
| | - Ji Woong Lee
- Department of Ophthalmology, Pusan National University College of Medicine, Busan, Korea
| | - Farideh Sharifipour
- Department of Ophthalmology, Shahid Beheshti university of Medical Sciences, Tehran, Iran
| | - Ramin Daneshvar
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Joseph Caprioli
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| | - Kouros Nouri-Mahdavi
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA.
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15
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Krylova TD, Sheremet NL, Tabakov VY, Lyamzaev KG, Itkis YS, Tsygankova PG, Andreeva NA, Shmelkova MS, Nevinitsyna TA, Kadyshev VV, Zakharova EY. Three rare pathogenic mtDNA substitutions in LHON patients with low heteroplasmy. Mitochondrion 2019; 50:139-144. [PMID: 31669237 DOI: 10.1016/j.mito.2019.10.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 09/25/2019] [Accepted: 10/02/2019] [Indexed: 10/25/2022]
Abstract
In this article we present clinical, molecular and biochemical investigations of three patients with LHON caused by rare point substitutions in mtDNA. One patient harbours the known mtDNA mutation (m.13513 G>A), the others have new variants (m.13379 A>G in MT-ND5 gene and m.14597 A>G in MT-ND6 gene, which has never been previously associated with LHON). NGS analysis of a whole mtDNA derived from patient's blood revealed a low mutation load (24%, 47%, 23% respectively). Our data, including family segregation analysis, measurement of reactive oxygen species (ROS) production and cytotoxic effect of paraquat and high-resolution respirometry, showed that nucleotide variant m.14597 A>G can be classified as pathogenic mutation.
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Affiliation(s)
- Tatiana D Krylova
- Department of Inborn Errors of Metabolism, FSBI 'Research Centre for Medical Genetics', Moscow, Russia.
| | | | - Vyacheslav Yu Tabakov
- Common Use Center "Biobank", FSBI 'Research Centre for Medical Genetics', Moscow, Russia
| | - Konstantin G Lyamzaev
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Faculty of Bioengineering and Bioinformatics, Moscow, Russia
| | - Yulia S Itkis
- Department of Inborn Errors of Metabolism, FSBI 'Research Centre for Medical Genetics', Moscow, Russia
| | - Polina G Tsygankova
- Department of Inborn Errors of Metabolism, FSBI 'Research Centre for Medical Genetics', Moscow, Russia
| | | | | | | | - Vitaly V Kadyshev
- Department of Epidemiology Genetics, FSBI 'Research Centre for Medical Genetics', Moscow, Russia
| | - Ekaterina Yu Zakharova
- Department of Inborn Errors of Metabolism, FSBI 'Research Centre for Medical Genetics', Moscow, Russia
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16
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Affiliation(s)
- Brad Fortune
- Discoveries in Sight Research Laboratories, Devers Eye Institute and Legacy Research Institute, Legacy Health, Portland, Oregon, United States
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17
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Yu AK, Datta S, McMackin MZ, Cortopassi GA. Rescue of cell death and inflammation of a mouse model of complex 1-mediated vision loss by repurposed drug molecules. Hum Mol Genet 2018; 26:4929-4936. [PMID: 29040550 DOI: 10.1093/hmg/ddx373] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 09/28/2017] [Indexed: 11/14/2022] Open
Abstract
Inherited mitochondrial optic neuropathies, such as Leber's hereditary optic neuropathy (LHON) and Autosomal dominant optic atrophy (ADOA) are caused by mutant mitochondrial proteins that lead to defects in mitochondrial complex 1-driven ATP synthesis, and cause specific retinal ganglion cell (RGC) loss. Complex 1 defects also occur in patients with primary open angle glaucoma (POAG), in which there is specific RGC loss. The treatment of mitochondrial optic neuropathy in the US is only supportive. The Ndufs4 knockout (Ndufs4 KO) mouse is a mitochondrial complex 1-deficient model that leads to RGC loss and rapid vision loss and allows for streamlined testing of potential therapeutics. Preceding RGC loss in the Ndufs4 KO is the loss of starburst amacrine cells, which may be an important target in the mechanism of complex 1-deficient vision loss. Papaverine and zolpidem were recently shown to be protective of bioenergetic loss in cell models of optic neuropathy. Treatment of Ndufs4 KO mice with papaverine, zolpidem, and rapamycin-suppressed inflammation, prevented cell death, and protected from vision loss. Thus, in the Ndufs4 KO mouse model of mitochondrial optic neuropathy, papaverine and zolpidem provided significant protection from multiple pathophysiological features, and as approved drugs in wide human use could be considered for the novel indication of human optic neuropathy.
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Affiliation(s)
- Alfred K Yu
- Department of Molecular Biosciences, University of California Davis, School of Veterinary Medicine, Davis, CA 95616, USA
| | - Sandipan Datta
- Department of Molecular Biosciences, University of California Davis, School of Veterinary Medicine, Davis, CA 95616, USA
| | - Marissa Z McMackin
- Department of Molecular Biosciences, University of California Davis, School of Veterinary Medicine, Davis, CA 95616, USA
| | - Gino A Cortopassi
- Department of Molecular Biosciences, University of California Davis, School of Veterinary Medicine, Davis, CA 95616, USA
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18
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de Araújo RB, Oyamada MK, Zacharias LC, Cunha LP, Preti RC, Monteiro MLR. Morphological and Functional Inner and Outer Retinal Layer Abnormalities in Eyes with Permanent Temporal Hemianopia from Chiasmal Compression. Front Neurol 2017; 8:619. [PMID: 29255441 PMCID: PMC5723053 DOI: 10.3389/fneur.2017.00619] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 11/06/2017] [Indexed: 12/24/2022] Open
Abstract
Purpose The aims of this study are to compare optical coherence tomography (OCT)-measured macular retinal layers in eyes with permanent temporal hemianopia from chiasmal compression and control eyes; to compare regular and slow-flash multifocal electroretinography (mfERG) in patients and controls; and to assess the correlation between OCT, mfERG, and central visual field (SAP) data. Methods Forty-three eyes of 30 patients with permanent temporal hemianopia due to pituitary tumors who were previously submitted to chiasm decompression and 37 healthy eyes of 19 controls were submitted to macular spectral domain OCT, mfERG, and 10-2 SAP testing. After segmentation, the thickness of the macular retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer, and photoreceptor layer (PRL) was measured. Amplitudes and oscillatory potentials (OPs) were measured on regular and slow-flash mfERG, respectively, and expressed as the mean values per quadrant and hemifield. Results RNFL, GCL, and IPL thickness measurements were significantly reduced in all quadrants, whereas INL, OPL, and PRL thicknesses were significantly increased in the nasal quadrants in patients compared to those in controls. Significant correlations between OCT and 10-2 SAP measurements were positive for the RNFL, GCL, and IPL and negative for the INL, OPL, and PRL. OPs and mfERG N1 amplitudes were significantly reduced in the nasal hemiretina of patients. Significant correlations were found between OP and mfERG amplitudes for inner and outer nasal hemiretina OCT measurements, respectively. Conclusion Patients with permanent temporal hemianopia from previously treated chiasmal compression demonstrated significant thinning of the RNFL, GCL, IPL, and thickening of the INL, OPL, and PRL associated with reduced OP and mfERG N1 amplitudes, suggesting that axonal injury to the inner retina leads to secondary damage to the outer retina in this condition.
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Affiliation(s)
- Rafael B de Araújo
- Laboratory of Investigation in Ophthalmology (LIM 33), Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
| | - Maria K Oyamada
- Laboratory of Investigation in Ophthalmology (LIM 33), Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
| | - Leandro C Zacharias
- Laboratory of Investigation in Ophthalmology (LIM 33), Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
| | - Leonardo P Cunha
- Department of Ophtalmology, School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Rony C Preti
- Laboratory of Investigation in Ophthalmology (LIM 33), Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
| | - Mário L R Monteiro
- Laboratory of Investigation in Ophthalmology (LIM 33), Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
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Govetto A, Su D, Farajzadeh M, Megerdichian A, Platner E, Ducournau Y, Virgili G, Hubschman JP. Microcystoid Macular Changes in Association With Idiopathic Epiretinal Membranes in Eyes With and Without Glaucoma: Clinical Insights. Am J Ophthalmol 2017; 181:156-165. [PMID: 28673749 DOI: 10.1016/j.ajo.2017.06.023] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/21/2017] [Accepted: 06/23/2017] [Indexed: 01/09/2023]
Abstract
PURPOSE To describe the clinical and surgical significance of microcystoid macular changes in the inner nuclear layer in patients with idiopathic epiretinal membranes, with and without glaucomatous optic neuropathy. DESIGN Retrospective case series. METHODS Clinical charts and spectral-domain optical coherence tomography images of 264 eyes of 234 consecutive patients diagnosed with idiopathic epiretinal membranes were reviewed and analyzed. Surgical data were analyzed in a subgroup of eyes with microcystoid macular changes treated with pars plana vitrectomy and epiretinal and internal limiting membrane peel. In surgical cases, postoperative functional and anatomic results at 1 and 6 months were compared between glaucomatous and nonglaucomatous eyes. Associations of microcystoid macular changes with visual acuity and other morphometric parameters were assessed by means of linear or multiple logistic regressions. RESULTS Microcystoid macular changes in the inner nuclear layer were diagnosed in 52 out of 264 eyes with epiretinal membranes (19.7%), of which 28 (55.0%) had concomitant glaucoma. The likelihood to develop microcystoid macular changes increased at advanced glaucoma and epiretinal membrane stages. The morphology of microcystoid macular changes was similar between glaucomatous and nonglaucomatous eyes. Forty-four out of 52 eyes (84.6%) with microcystoid macular changes, of which 20 were with glaucoma and 24 without glaucoma, underwent surgery with pars plana vitrectomy and epiretinal and internal limiting membrane peel. At 1 and 6 months after surgery the mean number of microcysts decreased significantly from baseline in nonglaucomatous eyes (P = .003 and P = .002, respectively) and remained unchanged in glaucomatous eyes (P = .400 and P = .700, respectively). CONCLUSIONS This study reports a high frequency of microcystoid macular changes in the inner nuclear layer in eyes with concomitant epiretinal membrane and glaucomatous optic neuropathy. In glaucomatous eyes, pars plana vitrectomy with epiretinal and internal limiting membrane peel was ineffective in the treatment of microcystoid macular changes.
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Affiliation(s)
- Andrea Govetto
- Retina Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
| | - Daniel Su
- Retina Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
| | - Matthew Farajzadeh
- Retina Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
| | - Alin Megerdichian
- Retina Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
| | - Eva Platner
- Retina Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
| | - Yvette Ducournau
- Pathological Anatomy and Cytology Department, Nantes University Hospital, Nantes, France
| | - Gianni Virgili
- Department of Opthalmology, Careggi University Hospital, Florence, Italy
| | - Jean Pierre Hubschman
- Retina Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California.
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Cesareo M, Ciuffoletti E, Martucci A, Sebastiani J, Sorge RP, Lamantea E, Garavaglia B, Ricci F, Cusumano A, Nucci C, Brancati F. Assessment of the retinal posterior pole in dominant optic atrophy by spectral-domain optical coherence tomography and microperimetry. PLoS One 2017; 12:e0174560. [PMID: 28358911 DOI: 10.1371/journal.pone.0174560] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 03/11/2017] [Indexed: 11/24/2022] Open
Abstract
Background To assess posterior pole (PP) retinal structure in patients with genetically confirmed autosomal dominant optic atrophy (ADOA) using new spectral domain optical coherence tomography (SD-OCT) segmentation technology. To analyze retinal PP thickness in relation to retinal sensitivity data from microperimetry (MP) in ADOA patients. Methods and findings This prospective cross-sectional study included 11 patients with ADOA and 11 age-matched healthy subjects. All participants underwent both a “Posterior Pole” and “peripapillary RNFL (pRNFL)” scanning protocol using SD-OCT. Functional mapping of the PP was also performed using MP. A customized program was implemented in order to achieve accurate superimposition of MP sensitivity map onto SD-OCT map. The thickness of the PP different retinal layers and pRNFL was obtained and measured for each eye. Mean retinal sensitivity values and fixation stability were obtained and compared between ADOA patients and healthy subjects. Correlation analysis was performed on a point-to-point basis to evaluate the association between mean thickness and retinal sensitivity of each retinal layer. Total retinal thickness (TRT), Retinal Nerve Fiber Layer (RNFL), Ganglion Cell Layer (GCL), Inner Plexiform Layer (IPL), Inner Nuclear Layer (INL) and Inner Retinal Layers (IRL) at the posterior pole as well as pRNFL were significantly thinner in ADOA patients (P < 0.0001). On the contrary, the Outer Plexiform Layer (OPL) and the Outer Nuclear Layer (ONL) were significantly thicker in the ADOA group (P < 0.001). No significant differences were found in Retinal Pigment Epithelium (RPE) and Outer Retinal Layers (ORL) thickness between ADOA and controls. The average PP retinal sensitivity was significantly reduced in ADOA patients compared with controls (P < 0.001), as measured by microperimeter Nidek MP-1 (MP1). Fixation stability was significantly worse in the ADOA group (P = 0.01). The most severe sensitivity defects in ADOA patients were found at the level of the papillo-macular bundle (PMB). Conclusions Inner retinal layers showed pathological changes in ADOA patients. In addition, the whole retinal PP (not only the PMB) was significantly altered in ADOA, both in terms of retinal thickness and sensitivity.
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Yu-Wai-Man P, Votruba M, Burté F, La Morgia C, Barboni P, Carelli V. A neurodegenerative perspective on mitochondrial optic neuropathies. Acta Neuropathol 2016; 132:789-806. [PMID: 27696015 DOI: 10.1007/s00401-016-1625-2] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 09/24/2016] [Accepted: 09/25/2016] [Indexed: 12/15/2022]
Abstract
Mitochondrial optic neuropathies constitute an important cause of chronic visual morbidity and registrable blindness in both the paediatric and adult population. It is a genetically heterogeneous group of disorders caused by both mitochondrial DNA (mtDNA) mutations and a growing list of nuclear genetic defects that invariably affect a critical component of the mitochondrial machinery. The two classical paradigms are Leber hereditary optic neuropathy (LHON), which is a primary mtDNA disorder, and autosomal dominant optic atrophy (DOA) secondary to pathogenic mutations within the nuclear gene OPA1 that encodes for a mitochondrial inner membrane protein. The defining neuropathological feature is the preferential loss of retinal ganglion cells (RGCs) within the inner retina but, rather strikingly, the smaller calibre RGCs that constitute the papillomacular bundle are particularly vulnerable, whereas melanopsin-containing RGCs are relatively spared. Although the majority of patients with LHON and DOA will present with isolated optic nerve involvement, some individuals will also develop additional neurological complications pointing towards a greater vulnerability of the central nervous system (CNS) in susceptible mutation carriers. These so-called “plus” phenotypes are mechanistically important as they put the loss of RGCs within the broader perspective of neuronal loss and mitochondrial dysfunction, highlighting common pathways that could be modulated to halt progressive neurodegeneration in other related CNS disorders. The management of patients with mitochondrial optic neuropathies still remains largely supportive, but the development of effective disease-modifying treatments is now within tantalising reach helped by major advances in drug discovery and delivery, and targeted genetic manipulation.
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Lam BL, Burke SP, Wang MX, Nadayil GA, Rosa PR, Gregori G, Feuer WJ, Cuprill-Nilson S, Vandenbroucke R, Zhang X, Guy J. Macular Retinal Sublayer Thicknesses in G11778A Leber Hereditary Optic Neuropathy. Ophthalmic Surg Lasers Imaging Retina 2016; 47:802-10. [DOI: 10.3928/23258160-20160901-02] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 06/08/2016] [Indexed: 11/20/2022]
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Barboni P, Savini G, Carelli V, Balducci N, La Morgia C, Bandello F, Sadun AA. Re: Pilat et al.: High-resolution imaging of the optic nerve and retina in optic nerve hypoplasia (Ophthalmology 2015;122:1330-9). Ophthalmology 2016; 123:e19-20. [PMID: 26902567 DOI: 10.1016/j.ophtha.2015.09.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 09/04/2015] [Indexed: 11/17/2022] Open
Affiliation(s)
- Piero Barboni
- Scientific Institute San Raffaele, Milan, Italy; Studio Oculistico d'Azeglio, Bologna, Italy.
| | | | - Valerio Carelli
- IRCCS, Institute of Neurological Sciences of Bologna, Ospedale Bellaria, Bologna, Italy; Unit of Neurology, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | | | - Chiara La Morgia
- IRCCS, Institute of Neurological Sciences of Bologna, Ospedale Bellaria, Bologna, Italy; Unit of Neurology, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | | | - Alfredo A Sadun
- Doheny Eye Institute, University of California Los Angeles, Los Angeles, California
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