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Untaroiu A, Reis LM, Higgins BP, Walesa A, Zacharias S, Nikezic D, Costakos DM, Carroll J, Semina EV. In Vivo Assessment of Retinal Phenotypes in Axenfeld-Rieger Syndrome. Invest Ophthalmol Vis Sci 2024; 65:20. [PMID: 38587439 PMCID: PMC11005067 DOI: 10.1167/iovs.65.4.20] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/22/2024] [Indexed: 04/09/2024] Open
Abstract
Purpose Axenfeld-Rieger syndrome (ARS) is characterized by ocular anomalies including posterior embryotoxon, iridocorneal adhesions, corectopia/iris hypoplasia, and developmental glaucoma. Although anterior segment defects and glaucoma contribute to decreased visual acuity, the role of potential posterior segment abnormalities has not been explored. We used high-resolution retinal imaging to test the hypothesis that individuals with ARS have posterior segment pathology. Methods Three individuals with FOXC1-ARS and 10 with PITX2-ARS completed slit-lamp and fundus photography, optical coherence tomography (OCT), OCT angiography, and adaptive optics scanning light ophthalmoscopy (AOSLO). Quantitative metrics were compared to previously published values for individuals with normal vision. Results All individuals demonstrated typical anterior segment phenotypes. Average ganglion cell and inner plexiform layer thickness was lower in PITX2-ARS, consistent with the glaucoma history in this group. A novel phenotype of foveal hypoplasia was noted in 40% of individuals with PITX2-ARS (but none with FOXC1-ARS). Moreover, the depth and volume of the foveal pit were significantly lower in PITX2-ARS compared to normal controls, even excluding individuals with foveal hypoplasia. Analysis of known foveal hypoplasia genes failed to identify an alternative explanation. Foveal cone density was decreased in one individual with foveal hypoplasia and normal in six without foveal hypoplasia. Two individuals (one from each group) demonstrated non-foveal retinal irregularities with regions of photoreceptor anomalies on OCT and AOSLO. Conclusions These findings implicate PITX2 in the development of the posterior segment, particularly the fovea, in humans. The identified posterior segment phenotypes may contribute to visual acuity deficits in individuals with PITX2-ARS.
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Affiliation(s)
- Ana Untaroiu
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Linda M. Reis
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Brian P. Higgins
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Ashleigh Walesa
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Serena Zacharias
- School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Danica Nikezic
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Deborah M. Costakos
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Joseph Carroll
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Elena V. Semina
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Department of Pediatrics and Children's Research Institute, Medical College of Wisconsin and Childrens Wisconsin, Milwaukee, Wisconsin, United States
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Ren X, Huang L, Cheng S, Wang J, Li N. Novel pathogenic variants of SLC38A8 gene and literature review. Eur J Ophthalmol 2024:11206721241242155. [PMID: 38515398 DOI: 10.1177/11206721241242155] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
PURPOSE This study aimed to analyze the clinical and genetic characteristics of 6 Chinese patients with foveal hypoplasia (FH) caused by the variants of solute carrier family 38 member 8 (SLC38A8), and to describe the genotype and phenotype of SLC38A8 variants from previous literature. METHODS All subjects underwent comprehensive ophthalmic examinations. Optical coherence tomography (OCT) was performed to evaluate the structural grade of FH. Pathogenic variants of SLC38A8 gene were identified using panel-based next-generation sequencing and direct Sanger sequencing techniques. Further, all previously reported cases of SLC38A8 variants were re-analyzed together with the novel ones identified in this study. RESULTS Nystagmus and FH were present in 6 patients with variants of SLC38A8 gene, accompanied by a normal anterior segment. Grade 4 FH was identified in 4 patients. A total of 12 variants of SLC38A8 gene were identified, including 9 novel variants. Systematical analysis revealed that half of the variants (30/60) were missense, the majority of which (23/30) were distributed in the transmembrane (TM) domains. Grade 4 FH was detected in the majority of patients (66%, 23/35). There was no statistical difference in the clinical features between the subgroups of patients with 0, 1 and 2 missense variants. CONCLUSION Severe arrest of foveal development was identified in patients with variants of SLC38A8. This study provides a brief summary of the clinical and genetic characteristics of the pathogenic SLC38A8 variants, which is helpful in the differentiation diagnosis of FH.
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Affiliation(s)
- Xiaofang Ren
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nanlishi Road, Xicheng District, Beijing, 100040, China
| | - Lijuan Huang
- Department of Ophthalmology, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, 362000, China
| | - Shan Cheng
- Department of Medical Genetics and Developmental Biology, School of Basic Medical Sciences, Capital Medical University, Beijing, 100069, China
| | - Jing Wang
- Department of Medical Genetics and Developmental Biology, School of Basic Medical Sciences, Capital Medical University, Beijing, 100069, China
| | - Ningdong Li
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nanlishi Road, Xicheng District, Beijing, 100040, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai, China
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Woertz EN, Ayala GD, Wynne N, Tarima S, Zacharias S, Brilliant MH, Dunn TM, Costakos D, Summers CG, Strul S, Drack AV, Carroll J. Quantitative Foveal Structural Metrics as Predictors of Visual Acuity in Human Albinism. Invest Ophthalmol Vis Sci 2024; 65:3. [PMID: 38441889 PMCID: PMC10916884 DOI: 10.1167/iovs.65.3.3] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 01/03/2024] [Indexed: 03/07/2024] Open
Abstract
Purpose To assess the degree to which quantitative foveal structural measurements account for variation in best-corrected visual acuity (BCVA) in human albinism. Methods BCVA was measured and spectral domain optical coherence tomography (SD-OCT) images were acquired for 74 individuals with albinism. Categorical foveal hypoplasia grades were assessed using the Leicester Grading System for Foveal Hypoplasia. Foveal anatomical specialization (foveal versus parafoveal value) was quantified for inner retinal layer (IRL) thickness, outer segment (OS) length, and outer nuclear layer (ONL) thickness. These metrics, participant sex, and age were used to build a multiple linear regression of BCVA. This combined linear model's predictive properties were compared to those of categorical foveal hypoplasia grading. Results The cohort included three participants with type 1a foveal hypoplasia, 23 participants with type 1b, 33 with type 2, ten with type 3, and five with type 4. BCVA ranged from 0.08 to 1.00 logMAR (mean ± SD: 0.53 ± 0.21). IRL ratio, OS ratio, and ONL ratio were measured in all participants and decreased with increasing severity of foveal hypoplasia. The best-fit combined linear model included all three quantitative metrics and participant age expressed as a binary variable (divided into 0-18 years and 19 years or older; adjusted R2 = 0.500). This model predicted BCVA more accurately than a categorical foveal hypoplasia model (adjusted R2 = 0.352). Conclusions A quantitative model of foveal specialization accounts for more variance in BCVA in albinism than categorical foveal hypoplasia grading. Other factors, such as optical aberrations and eye movements, may account for the remaining unexplained variance.
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Affiliation(s)
- Erica N. Woertz
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Gelique D. Ayala
- School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Niamh Wynne
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Sergey Tarima
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Serena Zacharias
- School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Murray H. Brilliant
- Center for Precision Medicine Research, Marshfield Clinic, Marshfield, Wisconsin, United States
| | - Taylor M. Dunn
- Department of Genetics, University of Alabama at Birmingham, Birmingham, Alabama, United States
- Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
| | - Deborah Costakos
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - C. Gail Summers
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, United States
| | - Sasha Strul
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, United States
| | - Arlene V. Drack
- Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
| | - Joseph Carroll
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
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Alarfaj G, Alhashim H, Alotaibi HM, Almubarak M, Alhamad J. Apparently X-linked Foveal Hypoplasia of Two Brothers: A Report of a Rare Case. Cureus 2024; 16:e53891. [PMID: 38465154 PMCID: PMC10924645 DOI: 10.7759/cureus.53891] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2024] [Indexed: 03/12/2024] Open
Abstract
Foveal hypoplasia is a retinal disorder characterized by the anatomic absence of the foveal pit. It might be isolated or associated with poor vision and several conditions such as albinism, aniridia, microphthalmos, congenital nystagmus, or other diseases. Genetic and non-genetic causes can play a role in foveal pit development. However, the exact mechanism that causes foveal pit absence has not been determined. This study reports a five-year-old boy who presented to the eye clinic with bilateral poor vision since birth. Optical coherence tomography (OCT) was performed and confirmed the absence of the foveal pit in both eyes. Diagnosis of foveal hypoplasia was made. The parents reported a positive family history of similar conditions, specifically, a paternal grandfather, a male paternal cousin, and a brother. To the best of our knowledge, this is the first reported case of foveal hypoplasia, with a positive family history in the male gender specifically. Thus, inheritance is presumed to be X-linked recessive. We acknowledge that further investigation by genetic testing would offer further insight into this case.
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Affiliation(s)
- Ghufran Alarfaj
- Ophthalmology, Dhahran Eye Specialist Hospital, Dhahran, SAU
| | - Hassan Alhashim
- Ophthalmology, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | | | - Mahdi Almubarak
- Ophthalmology, Dhahran Eye Specialist Hospital, Dhahran, SAU
| | - Jinan Alhamad
- Ophthalmology, Dhahran Eye Specialist Hospital, Dhahran, SAU
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Kessel L, Kjølholm CDB, Jordana JT. Does Foveal Hypoplasia Affect Emmetropization in Patients with Albinism? Children (Basel) 2023; 10:1910. [PMID: 38136112 PMCID: PMC10741917 DOI: 10.3390/children10121910] [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] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023]
Abstract
(1) Background: The aim of the study was to describe refractive development from early childhood to adulthood in Danish patients with albinism and to evaluate the effect of foveal developmental stage on refractive development; (2) Methods: Patients with a clinical diagnosis of ocular or oculocutaneous albinism were invited for a refractive evaluation and comprehensive phenotyping including macular optical coherence tomography (OCT) scans. Foveal hypoplasia was graded based on OCT from 0 (normal) to 4 (absence of any signs of foveal specialization). Medical files were reviewed for historical refractive values in individual patients; (3) Results: Hyperopia (spherical equivalent refraction (SEQ) of ≥+1 Diopter (D)) was common in both children (81.3%) and adults (67.1%). The lower prevalence of hyperopia in adults was predominantly explained by increasing astigmatism with age. Emmetropization (>2D change from before 3 years to adolescence) was seen in 22.2%. There was no influence on foveal hypoplasia grade on the degree of refractive errors throughout life; (4) Conclusions: We found that emmetropization was uncommon in Danish patients with albinism and that the degree of foveal developmental stage did not influence emmetropization or the distribution of refractive errors. High degrees of hyperopia and astigmatism were common. These results indicate that fear of impeding emmetropization should not refrain the clinician from providing adequate correction for refractive errors in young children with albinism.
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Affiliation(s)
- Line Kessel
- Department of Ophthalmology, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, Denmark; (C.D.B.K.); (J.T.J.)
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
| | | | - Joaquim Torner Jordana
- Department of Ophthalmology, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, Denmark; (C.D.B.K.); (J.T.J.)
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6
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Talsma HE, Kruijt CC, de Wit GC, Zwerver SHL, van Genderen MM. Nystagmus Characteristics in Albinism: Unveiling the Link to Foveal Hypoplasia and Visual Acuity. Invest Ophthalmol Vis Sci 2023; 64:30. [PMID: 38133506 PMCID: PMC10746925 DOI: 10.1167/iovs.64.15.30] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023] Open
Abstract
Purpose The purpose of this study was to describe the association among nystagmus characteristics, foveal hypoplasia, and visual acuity in patients with albinism. Methods We studied nystagmus recordings of 50 patients with albinism. The nystagmus waveform was decomposed into two types: dominantly pendular and dominantly jerk. We correlated the nystagmus type, amplitude, frequency, and percentage of low velocity (PLOV) to Snellen visual acuity and foveal hypoplasia grades. Results The grade of foveal hypoplasia and visual acuity showed a strong correlation (r = 0.87, P < 0.0001). Nystagmus type and PLOV had the strongest significant (P < 0.0001) correlation with visual acuity (r = 0.70 and r = -0.56, respectively) and with foveal hypoplasia (r = 0.76 and r = -0.60, respectively). Patients with pendular nystagmus type had the lowest PLOV, and the highest grade of foveal hypoplasia (P < 0.0001). Severe foveal hypoplasia (grade 4), was almost invariably associated with pendular nystagmus (86%). Conclusions Foveal hypoplasia grade 4 is associated with pendular nystagmus, lower PLOV, and worse visual acuity. Based on these results, nystagmus recordings at a young age may contribute to predicting visual outcomes.
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Affiliation(s)
- Herman E. Talsma
- Bartiméus Diagnostic Center for Complex Visual Disorders, Zeist, The Netherlands
| | - Charlotte C. Kruijt
- Bartiméus Diagnostic Center for Complex Visual Disorders, Zeist, The Netherlands
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Gerard C. de Wit
- Bartiméus Diagnostic Center for Complex Visual Disorders, Zeist, The Netherlands
| | - Stefan H. L. Zwerver
- Bartiméus Diagnostic Center for Complex Visual Disorders, Zeist, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands
| | - Maria M. van Genderen
- Bartiméus Diagnostic Center for Complex Visual Disorders, Zeist, The Netherlands
- Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands
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Shoji MK, Khodeiry MM, Sengillo JD, Mendoza C. Expanding the mutational spectrum of FHONDA syndrome. Ophthalmic Genet 2023; 44:602-605. [PMID: 36748941 DOI: 10.1080/13816810.2023.2175873] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/09/2023] [Accepted: 01/29/2023] [Indexed: 02/08/2023]
Abstract
AIM The aim of the study is to present a rare case of Foveal Hypoplasia, Optic Nerve Decussation defects, and Anterior segment dysgenesis (FHONDA) confirmed by genetic testing with two separate pathogenic mutations in the SLC38A8 gene. MATERIALS AND METHODS This was a case report. RESULTS A 3-month-old female presented to a neuro-ophthalmology clinic with nystagmus. Her past medical and family history was unremarkable. Her examination demonstrated horizontal pendular nystagmus and small optic nerves with foveal hypoplasia bilaterally. Neuroimaging was unremarkable. She underwent an examination under anesthesia and electroretinogram (ERG). Her anterior segment examination was normal, and dilated fundus examination demonstrated foveal hypoplasia with diffuse pigment granularity. The ERG was normal. Genetic testing revealed two mutations in the SLC38A8 gene, p.Glu233Lys:c.697 G>A (pathogenic) and p.Asp283Ala:c.848A>C (likely pathogenic) with positive parental segregation analysis. Therefore, she was diagnosed with FHONDA. CONCLUSIONS To our knowledge, this is the first report of a patient with FHONDA who is compound heterozygous for these two SLC38A8 mutations, which represents an expansion of the known mutational spectrum associated with this syndrome. Moreover, it may provide guidance into genetic counseling for patients and parents with these mutations.
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Affiliation(s)
- Marissa K Shoji
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA
| | | | - Jesse D Sengillo
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA
| | - Carlos Mendoza
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA
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8
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Guardia A, Fernández A, Seruggia D, Chotard V, Sánchez-Castillo C, Kutsyr O, Sánchez-Sáez X, Zurita E, Cantero M, Rebsam A, Cuenca N, Montoliu L. A Slc38a8 Mouse Model of FHONDA Syndrome Faithfully Recapitulates the Visual Deficits of Albinism Without Pigmentation Defects. Invest Ophthalmol Vis Sci 2023; 64:32. [PMID: 37862028 PMCID: PMC10599165 DOI: 10.1167/iovs.64.13.32] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/02/2023] [Indexed: 10/21/2023] Open
Abstract
Purpose We aimed to generate and phenotype a mouse model of foveal hypoplasia, optic nerve decussation defects, and anterior segment dysgenesis (FHONDA), a rare disease associated with mutations in Slc38a8 that causes severe visual alterations similar to albinism without affecting pigmentation. Methods The FHONDA mouse model was generated with clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 technology using an RNA guide targeting the Scl38a8 murine locus. The resulting mice were backcrossed to C57BL/6J. Melanin content was measured using spectrophotometry. Retinal cell architecture was analyzed through light and electron microscopy. Retinal projections to the brain were evaluated with anterograde labelling in embryos and adults. Visual function was assessed by electroretinography (ERG) and the optomotor test (OT). Results From numerous Slc38a8 mouse mutant alleles generated, we selected one that encodes a truncated protein (p.196Pro*, equivalent to p.199Pro* in the human protein) closely resembling a mutant allele described in patients (p.200Gln*). Slc38a8 mutant mice exhibit wild-type eye and coat pigmentation with comparable melanin content. Subcellular abnormalities were observed in retinal pigment epithelium cells of Slc38a8 mutant mice. Anterograde labeling experiments of retinal projections in embryos and adults showed a reduction of ipsilateral fibers. Functional visual analyses revealed a decreased ERG response in scotopic conditions and a reduction of visual acuity in mutant mice measured by OT. Conclusions Slc38a8 mutant mice recapitulate the phenotype of patients with FHONDA concerning their normal pigmentation and their abnormal visual system, in the latter being a hallmark of all types of albinism. These mice will be helpful in better understanding the pathophysiology of this genetic condition.
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Affiliation(s)
- Ana Guardia
- Department of Molecular and Cellular Biology, National Centre for Biotechnology (CNB-CSIC), Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER-ISCIII), Madrid, Spain
| | - Almudena Fernández
- Department of Molecular and Cellular Biology, National Centre for Biotechnology (CNB-CSIC), Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER-ISCIII), Madrid, Spain
| | - Davide Seruggia
- Department of Molecular and Cellular Biology, National Centre for Biotechnology (CNB-CSIC), Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER-ISCIII), Madrid, Spain
| | - Virginie Chotard
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Carla Sánchez-Castillo
- Department of Physiology, Genetics and Microbiology, University of Alicante, Alicante, Spain
| | - Oksana Kutsyr
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - Xavier Sánchez-Sáez
- Department of Physiology, Genetics and Microbiology, University of Alicante, Alicante, Spain
| | - Esther Zurita
- Department of Molecular and Cellular Biology, National Centre for Biotechnology (CNB-CSIC), Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER-ISCIII), Madrid, Spain
| | - Marta Cantero
- Department of Molecular and Cellular Biology, National Centre for Biotechnology (CNB-CSIC), Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER-ISCIII), Madrid, Spain
| | - Alexandra Rebsam
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Nicolás Cuenca
- Department of Physiology, Genetics and Microbiology, University of Alicante, Alicante, Spain
| | - Lluís Montoliu
- Department of Molecular and Cellular Biology, National Centre for Biotechnology (CNB-CSIC), Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER-ISCIII), Madrid, Spain
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9
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Seguy PH, Korobelnik JF, Delyfer MN, Michaud V, Arveiler B, Lasseaux E, Gattoussi S, Rougier MB, Trin K, Morice-Picard F, Ghomashchi N, Coste V. Ophthalmologic Phenotype-Genotype Correlations in Patients With Oculocutaneous Albinism Followed in a Reference Center. Invest Ophthalmol Vis Sci 2023; 64:26. [PMID: 37707835 PMCID: PMC10506686 DOI: 10.1167/iovs.64.12.26] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/27/2023] [Indexed: 09/15/2023] Open
Abstract
Purpose Albinism is a group of genetic disorders that includes several conditions related to a defect in melanin production. There is a broad phenotypic and genotypic variability between the different forms. The aim of this study was to assess the ophthalmologic characteristics according to patients' genotypes in a cohort followed in the Reference Center for oculocutaneous albinism (OCA) of Bordeaux University Hospital, France. Methods A retrospective observational study was conducted in a cohort of patients with OCA seen in consultation in the ophthalmology department between 2017 and 2021 in whom a genetic analysis was performed. Results In total, 127 patients with OCA were included in this study and matched with the results of the genetic analysis. In the population aged over 6 years, there was no statistical difference in binocular visual acuity between the OCA1, OCA2, and OCA4 forms (P = 0.27). There was difference in ametropia between the three forms (P = 0.003). A two-by-two comparison using the Bonferroni correction showed a significant difference in ametropia between the OCA2 and OCA4 forms (P = 0.007) and between the OCA1 and OCA2 forms (P = 0.0075). Regardless of the form, most patients (75.4%) had grade 4 foveal hypoplasia. There was no association between the grade of foveal hypoplasia and the gene involved (P = 0.87). Conclusions We described a genotype-phenotype correlation for the three most represented forms of albinism in our cohort. This study allowed assessing the degree of visual deficiency in young children with OCA.
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Affiliation(s)
| | - Jean-François Korobelnik
- Ophthalmology Department, CHU Bordeaux, Bordeaux, France
- Inserm, Bordeaux Population Health Research Center, Team LEHA, Université de Bordeaux, Bordeaux, France
| | - Marie-Noëlle Delyfer
- Ophthalmology Department, CHU Bordeaux, Bordeaux, France
- Inserm, Bordeaux Population Health Research Center, Team LEHA, Université de Bordeaux, Bordeaux, France
| | - Vincent Michaud
- Medical Genetics Department, CHU Bordeaux, Bordeaux, France
- INSERM U1211, Rare Diseases, Genetics and Metabolism, Université de Bordeaux, Bordeaux, France
| | - Benoit Arveiler
- Medical Genetics Department, CHU Bordeaux, Bordeaux, France
- INSERM U1211, Rare Diseases, Genetics and Metabolism, Université de Bordeaux, Bordeaux, France
| | | | | | | | - Kilian Trin
- Department of Pharmacology Medical, Bordeaux Regional Pharmacovigilance, Bordeaux University Hospital, Bordeaux, France
| | - Fanny Morice-Picard
- Department of Dermatology and Pediatric Dermatology, National Reference Centre for Rare Disorders, Hôpital des Enfants Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
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10
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Kavalaraki A, Paraskevopoulos K, Kavalaraki M, Karakosta C, Liaskou M. Foveal Hypoplasia in a Child With Tyrosinase-Positive Albinism. Cureus 2023; 15:e44558. [PMID: 37790023 PMCID: PMC10544804 DOI: 10.7759/cureus.44558] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2023] [Indexed: 10/05/2023] Open
Abstract
The purpose of this article is to report a case of bilateral foveal hypoplasia in an eight-year-old girl who presented to the ophthalmology department due to poor vision in both eyes. Clinical examination revealed bilateral nystagmus, decreased vision, as well as iris transillumination. Dilated fundus examination indicated the absence of light reflex around the foveal area and optical coherence tomography (OCT) imaging exhibited the absence of the fovea centralis depression. These findings, in addition to the patient's light-colored hair and skin complexion, raised suspicion for albinism. The patient was referred for genetic testing and the results confirmed the diagnosis of tyrosinase-positive oculocutaneous albinism (OCA2).
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Affiliation(s)
| | | | | | | | - Maria Liaskou
- Ophthalmology, Penteli General Children's Hospital, Athens, GRC
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11
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Matsushita I, Izumi H, Ueno S, Hayashi T, Fujinami K, Tsunoda K, Iwata T, Kiuchi Y, Kondo H. Functional Characteristics of Diverse PAX6 Mutations Associated with Isolated Foveal Hypoplasia. Genes (Basel) 2023; 14:1483. [PMID: 37510387 PMCID: PMC10379490 DOI: 10.3390/genes14071483] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
The human fovea is a specialized pit structure in the central retina. Foveal hypoplasia is a condition where the foveal pit does not fully develop, and it is associated with poor vision. Autosomal dominant isolated foveal hypoplasia (FVH1) is a rare condition of foveal hypoplasia (FH) that lacks any other ocular manifestations. FVH1 is associated with hypomorphic mutations in the PAX6 gene that encodes a sequence-specific DNA-binding transcription factor for morphogenesis and evolution of the eye. We report our findings in 17 patients with PAX6 mutations associated with FVH1 or FH with aniridia and corneal opacities. Patients with three mutations, p.V78E, p.V83F and p.R128H, in the C-terminal subdomain of the paired domain (CTS) consistently have severe FH. Luciferase assays for a single reporter containing a representative PAX6 binding site indicated that the transcriptional activities of these mutations were significantly reduced, comparable to that of the truncation mutation of p.G65Rfs*5. Patients with p.P20S in the N-terminal subdomain of the paired domain, and a patient with p.N365K in the proline-serine-threonine-rich domain (PSTD) had mild FH. A patient with p.Q255L in the homeodomain had severe FH. The P20S and Q255L mutants did not affect the transcriptional activity. Mutant N365K has a retained DNA-binding activity but a reduced transcriptional activity, due to a low PSTD transactivation. These findings demonstrated that mutations associated with FVH1 underlie a functional divergence between DNA-binding ability and transcriptional activity. We conclude that a wide range of mutations in the PAX6 gene is not limited to the CST region and are responsible for FVH1.
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Affiliation(s)
- Itsuka Matsushita
- Department of Ophthalmology, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan;
| | - Hiroto Izumi
- Department of Occupational Pneumology, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan;
| | - Shinji Ueno
- Department of Ophthalmology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan;
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Takaaki Hayashi
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo 105-8461, Japan;
| | - Kaoru Fujinami
- Department of Ophthalmology, National Hospital Organization Tokyo Medical Center, Tokyo 152-8902, Japan; (K.F.); (K.T.)
| | - Kazushige Tsunoda
- Department of Ophthalmology, National Hospital Organization Tokyo Medical Center, Tokyo 152-8902, Japan; (K.F.); (K.T.)
| | - Takeshi Iwata
- Division of Molecular and Cellular Biology, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo 152-8902, Japan;
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical and Health Sciences, Hiroshima 734-8551, Japan;
| | - Hiroyuki Kondo
- Department of Ophthalmology, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan;
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12
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Loftus SK, Gillis MF, Lundh L, Baxter LL, Wedel JC, Watkins-Chow DE, Donovan FX, Sergeev YV, Oetting WS, Pavan WJ, Adams DR. Haplotype-based analysis resolves missing heritability in oculocutaneous albinism type 1B. Am J Hum Genet 2023; 110:1123-1137. [PMID: 37327787 PMCID: PMC10357474 DOI: 10.1016/j.ajhg.2023.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 06/18/2023] Open
Abstract
Oculocutaneous albinism (OCA) is a rare disorder of pigment production. Affected individuals have variably decreased global pigmentation and visual-developmental changes that lead to low vision. OCA is notable for significant missing heritability, particularly among individuals with residual pigmentation. Tyrosinase (TYR) is the rate-limiting enzyme in melanin pigment biosynthesis and mutations that decrease enzyme function are one of the most common causes of OCA. We present the analysis of high-depth short-read TYR sequencing data for a cohort of 352 OCA probands, ∼50% of whom were previously sequenced without yielding a definitive diagnostic result. Our analysis identified 66 TYR single-nucleotide variants (SNVs) and small insertion/deletions (indels), 3 structural variants, and a rare haplotype comprised of two common frequency variants (p.Ser192Tyr and p.Arg402Gln) in cis-orientation, present in 149/352 OCA probands. We further describe a detailed analysis of the disease-causing haplotype, p.[Ser192Tyr; Arg402Gln] ("cis-YQ"). Haplotype analysis suggests that the cis-YQ allele arose by recombination and that multiple cis-YQ haplotypes are segregating in OCA-affected individuals and control populations. The cis-YQ allele is the most common disease-causing allele in our cohort, representing 19.1% (57/298) of TYR pathogenic alleles in individuals with type 1 (TYR-associated) OCA. Finally, among the 66 TYR variants, we found several additional alleles defined by a cis-oriented combination of minor, potentially hypomorph-producing alleles at common variant sites plus a second, rare pathogenic variant. Together, these results suggest that identification of phased variants for the full TYR locus are required for an exhaustive assessment for potentially disease-causing alleles.
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Affiliation(s)
- Stacie K Loftus
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA; Genetic Disease Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA.
| | - Meredith F Gillis
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Linnea Lundh
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Laura L Baxter
- Genetic Disease Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Julia C Wedel
- Genetic Disease Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Dawn E Watkins-Chow
- Genetic Disease Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Frank X Donovan
- Cancer Genomics Unit, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Yuri V Sergeev
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - William S Oetting
- Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN 55455, USA
| | - William J Pavan
- Genetic Disease Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - David R Adams
- Office of the Clinical Director, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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13
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Hallali G, Loudon SE, Robson AG, Mohand-Saïd S, Zanlonghi X, Sahel JA, Moore AT, Audo I. Extensive myelinated retinal nerve fibres and bilateral foveal hypoplasia: A specific clinical entity. Acta Ophthalmol 2023; 101:e261-e263. [PMID: 35929373 DOI: 10.1111/aos.15228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/24/2022] [Accepted: 07/26/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Gabriel Hallali
- CHNO des Quinze-Vingts, Ophthalmic pediatric unit, Paris, France.,Department of Ophthalmology, Hospital Fondation Adolphe de Rothschild, Paris, France
| | - Sjoukje E Loudon
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Anthony G Robson
- UCL Institute of Ophthalmology, University College London, London, UK.,Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Saddek Mohand-Saïd
- CHNO des Quinze-Vingts, Centre de Référence Maladies Rares REFERET and DHU Sight Restore, Paris, France
| | - Xavier Zanlonghi
- Laboratoire d'explorations fonctionnelles de la vision, Nantes, France
| | - José-Alain Sahel
- Department of Ophthalmology, Hospital Fondation Adolphe de Rothschild, Paris, France.,CHNO des Quinze-Vingts, Centre de Référence Maladies Rares REFERET and DHU Sight Restore, Paris, France.,CHNO des Quinze-Vingts, Ophthalmic pediatric unit, Paris, France.,Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France.,Department of Ophthalmology, University of Pittsburgh Medical School, Pittsburgh, Pennsylvania, USA
| | - Antony T Moore
- UCL Institute of Ophthalmology, University College London, London, UK.,Moorfields Eye Hospital NHS Foundation Trust, London, UK.,Department of Ophthalmology, UCSF School of Medicine, San Francisco, California, USA
| | - Isabelle Audo
- CHNO des Quinze-Vingts, Ophthalmic pediatric unit, Paris, France.,CHNO des Quinze-Vingts, Centre de Référence Maladies Rares REFERET and DHU Sight Restore, Paris, France.,Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
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14
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Moret E, Lejoyeux R, Bonnin S, Azar G, Guillaume J, Le Cossec C, Lafolie J, Alonso AS, Favard C, Meunier I, Vasseur V, Mauget-Faÿsse M. Atypical Foveal Hypoplasia in Best Disease. J Pers Med 2023; 13. [PMID: 36836571 DOI: 10.3390/jpm13020337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 02/17/2023] Open
Abstract
PURPOSE To determine the prevalence and characteristics of foveal hypoplasia (also called fovea plana) in patients with Best disease using spectral-domain (SD) optical coherence tomography (OCT) and OCT-angiography (OCT-A). DESIGN A retrospective observational study including patients diagnosed with Best disease. SUBJECTS AND PARTICIPANTS Fifty-nine eyes of thirty-two patients (fifteen females (46.9%) and seventeen males (53.1%), p = 0.9) diagnosed with Best disease were included. Patients' eyes were categorized into two groups: Eyes with a fovea plana appearance ('FP group') and eyes without fovea plana appearance ('no FP group'), based on the foveal appearance on B-scan SD-OCT. METHODS AND MAIN OUTCOME MEASURES Cross-sectional OCT images were assessed for the persistence of inner retinal layers (IRL) and OCT-A was analyzed for the presence of a foveal avascular zone (FAZ), the size of which was determined when applicable. RESULTS Overall, 16 eyes (27.1%) of 9 patients had a fovea plana appearance ('FP group') with the persistence of IRL, and 43 eyes (72.9%) of 23 patients did not have fovea plana appearance ('no FP group'). Among FP eyes, OCT-A performed in 13 eyes showed bridging vessels through the FAZ in 100% of eyes with OCT-A. Using Thomas classification, 14 out of the 16 eyes with fovea plana (87.5%) had atypical foveal hypoplasia, and the 2 others (12.5%) had a grade 1b fovea plana. CONCLUSION In our series, foveal hypoplasia was present in 27.1% of patients with Best disease. OCT-A showed bridging vessels through the FAZ in all eyes. These findings highlight the microvascular changes associated with Best disease, which can be an early sign of the disease in patients with a family history.
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15
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Lejoyeux R, Bonnin S, Guindolet D, Jacquiod B, Erol O, Le Mer Y, Jeguirim H, Mauget-Faÿsse M, Tadayoni R. Incidence and clinical significance of fovea plana in the French population with age-related cataract. Eur J Ophthalmol 2022:11206721221149067. [PMID: 36567486 DOI: 10.1177/11206721221149067] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Fovea plana is defined as an immature macula diagnosed by OCT, showing the unusual shunt of the inner retinal layers into the fovea. The incidence of fovea plana in the adult population remains to be determined. The aim of this study was to determine the incidence of fovea plana in the French population with age-related cataract. METHODS Consecutive patients who underwent cataract surgery in Rothschild Foundation Hospital, France, between January and March 2021, with preoperative analyzable OCT scans available, were retrospectively screened in order to determine the incidence of fovea plana in these population. Ophthalmological characteristics of patients were reported, and detailed. RESULT Fovea plana was encountered in 20 out of 204 patients during the 3 months corresponding to an incidence of 9.8%. One of those patients had stage 2 fovea plana. CONCLUSION Although fovea plana is defined as an immature macula, it is not rare in preoperative population. This macular aspect was not associated with poor visual acuity in our cohort.
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Affiliation(s)
- R Lejoyeux
- Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France
| | - S Bonnin
- Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France
| | - D Guindolet
- Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France
| | - B Jacquiod
- Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France
| | - O Erol
- Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France
| | - Y Le Mer
- Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France
| | - H Jeguirim
- Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France
| | - M Mauget-Faÿsse
- Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France
| | - R Tadayoni
- Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France
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16
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Mao J, Chen Y, Fang Y, Shao Y, Xiang Z, Li H, Zhao S, Chen Y, Shen L. Clinical characteristics and mutation spectrum in 33 Chinese families with familial exudative vitreoretinopathy. Ann Med 2022; 54:3286-3298. [PMID: 36411543 PMCID: PMC9704097 DOI: 10.1080/07853890.2022.2146744] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To explore the clinical manifestations and search for the variants of six related genes (LRP5, FZD4, TSPAN12, NDP, KIF11 and ZNF408) in Chinese patients with familial exudative vitreoretinopathy (FEVR), and investigate the correlation between the genetic variants and the clinical characteristics. PATIENTS AND METHODS Clinical data, including the retinal artery angle, acquired from wide-field fundus imaging, structural and microvascular features of the retina obtained from optical coherence tomography (OCT) and OCT angiography (OCTA) were collected from 33 pedigrees. Furthermore, mutation screening was performed. Variants filtering, bioinformatics analysis and Sanger sequencing were conducted to verify the variants. RESULTS Twenty-one variants were successfully detected in 16 of 33 families, of which 10 variants were newly identified. The proportion of variants in LRP5, FZD4, TSPAN12, NDP and KIF11 was 38.1% (8/21), 33.3% (7/21), 19.1% (4/21), 4.8% (1/21) and 4.8% (1/21), respectively. Three new variants were considered to be pathogenic or likely pathogenic. The FEVR group tended to exhibit a smaller retinal artery angle, higher incidence of foveal hypoplasia and lower vascular density compared to the control group. Patients who harboured variants of FZD4 exhibited greater severity of FEVR than those with LRP5 variants. However, those who harboured LRP5 variants tended to possess lower foveal vascular density. CONCLUSIONS Six known pathogenic genes were screened in 33 pedigrees with FEVR in our study, which revealed 10 novel variants. These findings enrich the clinical features and mutation spectrum in Chinese patients with FEVR, revealing the genotype-phenotype relationship, and contributing to the diagnosis and treatment of the disease.Key messagesWe identified 21 variants in 5 genes (LRP5, FZD4, TSPAN12, NDP and KIF11) associated with FEVR, 10 of which are novel (three were pathogenic or likely pathogenic).The proportion of variants was the highest for the LRP5 gene.FZD4 variants may be responsible for greater FEVR severity than LRP5 variants.
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Affiliation(s)
- Jianbo Mao
- Department of Ophthalmology, Center for Rehabilitation Medicine, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, PR China.,Department of Retina Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, PR China
| | - Yijing Chen
- Department of Retina Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, PR China
| | - Yuyan Fang
- Department of Retina Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, PR China
| | - Yirun Shao
- Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Ziyi Xiang
- Department of Retina Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, PR China
| | - Hanxiao Li
- Department of Retina Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, PR China
| | - Shixin Zhao
- Department of Retina Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, PR China
| | - Yiqi Chen
- Department of Ophthalmology, Center for Rehabilitation Medicine, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, PR China.,Department of Retina Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, PR China
| | - Lijun Shen
- Department of Ophthalmology, Center for Rehabilitation Medicine, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, PR China.,Department of Retina Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, PR China
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17
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Moreno-Artero E, Morice-Picard F, Lasseaux E, Robert MP, Coste V, Michaud V, Leclerc-Mercier S, Bremond-Gignac D, Arveiler B, Hadj-Rabia S. Oculo-Cutaneous Albinism Type 4 (OCA4): Phenotype-Genotype Correlation. Genes (Basel) 2022; 13. [PMID: 36553465 DOI: 10.3390/genes13122198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/04/2022] [Accepted: 11/15/2022] [Indexed: 11/25/2022] Open
Abstract
Albinism is a genetic disorder, present worldwide, caused by mutations in genes affecting melanin production or transport in the skin, hair and eyes. To date, mutations in at least 20 different genes have been identified. Oculo-cutaneous Albinism type IV (OCA4) is the most frequent form in Asia but has been reported in all populations, including Europeans. Little is known about the genotype-phenotype correlation. We identified two main phenotypes via the analysis of 30 OCA4 patients with a molecularly proven diagnosis. The first, found in 20 patients, is clinically indistinguishable from the classical OCA1 phenotype. The genotype-to-phenotype correlation suggests that this phenotype is associated with homozygous or compound heterozygous nonsense or deletion variants with frameshift leading to translation interruption in the SLC45A2 gene. The second phenotype, found in 10 patients, is characterized by very mild hypopigmentation of the hair (light brown or even dark hair) and skin that is similar to the general population. In this group, visual acuity is variable, but it can be subnormal, foveal hypoplasia can be low grade or even normal, and nystagmus may be lacking. These mild to moderate phenotypes are associated with at least one missense mutation in SLC45A2.
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18
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Muacevic A, Adler JR, Correia Barbosa R, Silva A, Teixeira C. Foveal Hypoplasia Related to Congenital Rubella. Cureus 2022; 14:e31766. [PMID: 36569709 PMCID: PMC9774997 DOI: 10.7759/cureus.31766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2022] [Indexed: 11/23/2022] Open
Abstract
Normal development of the fovea begins before midgestation and continues for several years after birth. Foveal hypoplasia is a condition in which the foveal pit and the foveal avascular zone do not fully develop. Several diseases are known to be associated with foveal hypoplasia; however, a direct association between foveal hypoplasia and congenital rubella has not been stated so far. This report describes a case of foveal hypoplasia detected during adulthood in a patient with known fetal exposure to maternal rubella infection and several ocular features of congenital rubella syndrome, including microphthalmia, congenital cataract, and pigmentary retinopathy. During follow-up, the visual acuity and ocular fundus changes remained stable.
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19
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Al-Nosairy KO, Quanz EV, Biermann J, Hoffmann MB. Optical Coherence Tomography as a Biomarker for Differential Diagnostics in Nystagmus: Ganglion Cell Layer Thickness Ratio. J Clin Med 2022; 11:jcm11174941. [PMID: 36078871 PMCID: PMC9456294 DOI: 10.3390/jcm11174941] [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: 07/07/2022] [Revised: 08/12/2022] [Accepted: 08/13/2022] [Indexed: 11/25/2022] Open
Abstract
In albinism, with the use of optical coherence tomography (OCT), a thinning of the macular ganglion cell layer was recently reported. As a consequence, the relevant OCT measure, i.e., a reduction of the temporal/nasal ganglion cell layer thickness quotient (GCLTQ), is a strong candidate for a novel biomarker of albinism. However, nystagmus is a common trait in albinism and is known as a potential confound of imaging techniques. Therefore, there is a need to determine the impact of nystagmus without albinism on the GCLTQ. In this bi-center study, the retinal GCLTQ was determined (OCT Spectralis, Heidelberg Engineering, Heidelberg, Germany) for healthy controls (n = 5, 10 eyes) vs. participants with nystagmus and albinism (Nalbinism, n = 8, 15 eyes), and with nystagmus of other origins (Nother, n = 11, 17 eyes). Macular OCT with 25 horizontal B scans 20 × 20° with 9 automated real time tracking (ART) frames centered on the retina was obtained for each group. From the sectoral GCLTs of the early treatment diabetic retinopathy study (ETDRS) circular thickness maps, i.e., 3 mm and 6 mm ETDRS rings, GCLTQ I and GCLTQ II were determined. Both GCLTQs were reduced in Nalbinism (GCLTQ I and II: 0.78 and 0.77, p < 0.001) compared to Nother (0.91 and 0.93) and healthy controls (0.89 and 0.95). The discrimination of Nalbinism from Nother via GCLTQ I and II had an area under the curve of 80 and 82% with an optimal cutoff point of 0.86 and 0.88, respectively. In conclusion, lower GCLTQ in Nalbinism appears as a distinguished feature in albinism-related nystagmus as opposed to other causes of nystagmus.
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Affiliation(s)
- Khaldoon O. Al-Nosairy
- Department of Ophthalmology, Faculty of Medicine, Otto-von-Guericke University, 39120 Magdeburg, Germany
| | - Elisabeth V. Quanz
- Department of Ophthalmology, Faculty of Medicine, Otto-von-Guericke University, 39120 Magdeburg, Germany
| | - Julia Biermann
- Department of Ophthalmology, University of Muenster Medical Centre, 48149 Muenster, Germany
| | - Michael B. Hoffmann
- Department of Ophthalmology, Faculty of Medicine, Otto-von-Guericke University, 39120 Magdeburg, Germany
- Center for Behavioral Brain Sciences, 39118 Magdeburg, Germany
- Correspondence:
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20
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Rocca C, Tiberi L, Bargiacchi S, Palazzo V, Landini S, Marziali E, Caputo R, Tinelli F, Marchi V, Benedetto A, Pagliazzi A, Bacci GM. Expanding the Spectrum of Oculocutaneous Albinism: Does Isolated Foveal Hypoplasia Really Exist? Int J Mol Sci 2022; 23:7825. [PMID: 35887175 DOI: 10.3390/ijms23147825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 05/14/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 02/05/2023] Open
Abstract
Oculocutaneous albinism is an autosomal recessive disorder characterized by the presence of typical ocular features, such as foveal hypoplasia, iris translucency, hypopigmented fundus oculi and reduced pigmentation of skin and hair. Albino patients can show significant clinical variability; some individuals can present with only mild depigmentation and subtle ocular changes. Here, we provide a retrospective review of the standardized clinical charts of patients firstly addressed for evaluation of foveal hypoplasia and slightly subnormal visual acuity, whose diagnosis of albinism was achieved only after extensive phenotypic and genotypic characterization. Our report corroborates the pathogenicity of the two common TYR polymorphisms p.(Arg402Gln) and p.(Ser192Tyr) when both are located in trans with a pathogenic TYR variant and aims to expand the phenotypic spectrum of albinism in order to increase the detection rate of the albino phenotype. Our data also suggest that isolated foveal hypoplasia should be considered a clinical sign instead of a definitive diagnosis of an isolated clinical entity, and we recommend deep phenotypic and molecular characterization in such patients to achieve a proper diagnosis.
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21
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Neveu MM, Padhy SK, Ramamurthy S, Takkar B, Jalali S, Cp D, Padhi TR, Robson AG. Ophthalmological Manifestations of Oculocutaneous and Ocular Albinism: Current Perspectives. Clin Ophthalmol 2022; 16:1569-1587. [PMID: 35637898 PMCID: PMC9148211 DOI: 10.2147/opth.s329282] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 02/07/2022] [Accepted: 04/14/2022] [Indexed: 11/23/2022] Open
Abstract
Albinism describes a heterogeneous group of genetically determined disorders characterized by disrupted synthesis of melanin and a range of developmental ocular abnormalities. The main ocular features common to both oculocutaneous albinism (OCA), and ocular albinism (OA) include reduced visual acuity, refractive errors, foveal hypoplasia, congenital nystagmus, iris and fundus hypopigmentation and visual pathway misrouting, but clinical signs vary and there is phenotypic overlap with other pathologies. This study reviews the prevalence, genetics and ocular manifestations of OCA and OA, including abnormal development of the optic chiasm. The role of visual electrophysiology in the detection of chiasmal dysfunction and visual pathway misrouting is emphasized, highlighting how age-associated changes in visual evoked potential (VEP) test results must be considered to enable accurate diagnosis, and illustrated further by the inclusion of novel VEP data in genetically confirmed cases. Differential diagnosis is considered in the context of suspected retinal and other disorders, including rare syndromes that may masquerade as albinism.
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Affiliation(s)
- Magella M Neveu
- Department Electrophysiology, Moorfields Eye Hospital, London, EC1V 2PD, UK.,Institute of Ophthalmology, University College London, London, UK
| | | | | | - Brijesh Takkar
- Anant Bajaj Retina Institute, LV Prasad Eye Institute, Hyderabad, India
| | - Subhadra Jalali
- Anant Bajaj Retina Institute, LV Prasad Eye Institute, Hyderabad, India
| | - Deepika Cp
- Anant Bajaj Retina Institute, LV Prasad Eye Institute, Hyderabad, India
| | - Tapas Ranjan Padhi
- Anant Bajaj Retina Institute, LV Prasad Eye Institute, Bhubaneswar, India
| | - Anthony G Robson
- Department Electrophysiology, Moorfields Eye Hospital, London, EC1V 2PD, UK.,Institute of Ophthalmology, University College London, London, UK
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22
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DARUICH ALEJANDRA, ROBERT MATTHIEUP, LEROY CAMILLE, DE VERGNES NATHALIE, BEUGNET CAROLINE, MALAN VALERIE, VALLEIX SOPHIE, BREMOND-GIGNAC DOMINIQUE. Foveal Hypoplasia Grading in 95 Cases of Congenital Aniridia: Correlation to Phenotype and PAX6 Genotype. Am J Ophthalmol 2022; 237:122-129. [PMID: 34942114 DOI: 10.1016/j.ajo.2021.12.007] [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: 09/16/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE To correlate the degree of foveal hypoplasia in congenital aniridia with visual acuity, iris phenotype, and PAX6 mutations. DESIGN Retrospective case series. METHODS Ninety-five consecutive patients with high-quality spectral-domain optical coherence tomography records and available genotype were included in a single referral center. Iris hypoplasia was classified as complete, presence of iris root or remnants, and mild atypical aniridia. Spectral-domain optical coherence tomography images were assessed to classify foveal hypoplasia as grade 1 to 4 and to determine mean thicknesses for retinal layers. For statistical analysis 1 eye for each patient was used and 1 member of the same family has been included (n = 76 eyes). RESULTS Most eyes (n= 158/169, 93.5%) showed variable degree of foveal hypoplasia. PAX6-positive patients presented higher degree of foveal hypoplasia than patients negative for PAX6 (P < .0001). PAX6 deletions, PAX6 variants subjected to nonsense-mediated decay and C-terminal extension variants were mostly associated with grade 3 or 4 foveal hypoplasia. Deletions restricted to the 3' flanking regulatory regions of PAX6 were associated with grade 1 or 2 foveal hypoplasia (P < .0001). Best-corrected visual acuity was higher and foveal outer retinal layers were thicker in patients with deletions in the 3' regulatory region of PAX6 (P = .001 and P < .0001). Patients with missense mutations presented with variable degree of foveal hypoplasia. The degree of foveal hypoplasia was most frequently correlated with the severity of iris defects, with 95% of eyes with complete aniridia presenting grade 3 or 4 foveal hypoplasia (P = .005). However, among eyes with mild iris phenotype, 70% (n=9/13) showed severe foveal hypoplasia. CONCLUSIONS All types of PAX6 variants, even those associated with mild iris defects, may be at risk for severe foveal hypoplasia with poor visual prognosis, except for deletions restricted to the 3' regulatory PAX6 regions.
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23
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Asano M, Yokoyama K, Oku K, Matsushita I, Kimoto K, Kubota T, Kondo H. Severe foveal hypoplasia and macular degeneration in Stickler syndrome caused by missense mutation in COL2A1 gene. Ophthalmic Genet 2022; 43:508-512. [PMID: 35473494 DOI: 10.1080/13816810.2022.2068044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The aim is to determine the retinal changes in patients with Stickler syndrome caused by a p.R565C missense mutation of the COL2A1 gene. METHODS We reviewed the clinical records of 10 eyes of six patients from two families with the Stickler syndrome. The members of both families were heterozygous for the p.R565C mutation. The clinical features including the visual acuity, fundus appearances, fundus autofluorescence (FAF), optical coherence tomographic (OCT) images, and electroretinograms were examined. RESULTS Myopia of -12 diopters (D) to -24 D with an average of -16.8 D was observed in 9 eyes of the 5 patients. The FAF images showed different degrees of hyper and hypoautofluorescent patterns in the macula in all but the two youngest patients (7 of 9 eyes, 78%). The OCT images showed the absence of a foveal pit and destruction of the outer retinal layers in the macular area in all patients. The ellipsoid zone (EZ) in the macular region was disrupted in eight eyes (80%) of which seven were fovea sparing. CONCLUSION Two families with Stickler syndrome with the p.R565C mutation showed more severe foveal hypoplasia, macular degeneration, and extensive retinal degeneration. A correlation of the OCT and FAF images with the genotype is helpful in determining the prognosis of Stickler syndrome.
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Affiliation(s)
- Mamika Asano
- Department of Ophthalmology, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | | | - Kazuma Oku
- Department of Ophthalmology, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Itsuka Matsushita
- Department of Ophthalmology, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kenichi Kimoto
- Department of Ophthalmology, Oita University, Oita, Japan
| | | | - Hiroyuki Kondo
- Department of Ophthalmology, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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24
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Abstract
PURPOSE To investigate foveal photoreceptor configuration in Alport syndrome, a rare inherited disease characterized by Collagen IV dysfunction. METHODS Adaptive optics scanning laser ophthalmoscope (AOSLO) in vivo imaging of the foveal center and quantitative analysis of cone photoreceptor topography in a 17-year-old male patient with Alport syndrome presenting absence of a foveal avascular zone (FAZ) and foveal hypoplasia in both eyes. RESULTS Cone density analysis based on AOSLO images revealed an unusual linear cone topography profile displaying supernormal densities within the fovea (z-scores up to + 3.57 and + 2.97 in right and left eyes, respectively). CONCLUSION Foveal hypoplasia has previously been associated with normal or reduced cone density. Our observation is the first case of disease-related supernormal cone density within the foveola, shedding light upon the role of Collagen IV in foveal maturation.
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Affiliation(s)
- Julius Ameln
- Department of Ophthalmology, 39062University of Bonn, Bonn, Germany
| | - Jenny L Reiniger
- Department of Ophthalmology, 39062University of Bonn, Bonn, Germany
| | - Kristina Hess
- Department of Ophthalmology, 39062University of Bonn, Bonn, Germany.,Division of Epidemiology and Clinical Research, 35034National Eye Institute, National Institute of Health, Bethesda, MD, USA
| | - Frank G Holz
- Department of Ophthalmology, 39062University of Bonn, Bonn, Germany
| | - Wolf M Harmening
- Department of Ophthalmology, 39062University of Bonn, Bonn, Germany
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25
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Czeszyk A, Hautz W, Jaworski M, Bulsiewicz D, Czech-Kowalska J. Morphology and Vessel Density of the Macula in Preterm Children Using Optical Coherence Tomography Angiography. J Clin Med 2022; 11:1337. [PMID: 35268428 PMCID: PMC8911277 DOI: 10.3390/jcm11051337] [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: 01/12/2022] [Revised: 02/20/2022] [Accepted: 02/24/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Retinal morphology changes may be associated with prematurity and can lead to visual impairment. Optical coherence tomography angiography may contribute to understanding the pathomechanism of structural and vascular retinal impairment in premature children. The aim of this study was to assess an influence of prematurity, neonatal clinical characteristics, and a history of retinopathy of prematurity (ROP) on the morphology and retinal vascularity of macula in children. Methods: A case−control study of 123 preterm children and 86 full-term children was performed. The age of the subjects was 10.45 years (IQR: 8.12−12.77), while the age of the control group was 11.78 years (IQR: 8.81−13.79). Optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA, angio-OCT) were performed using RTVueXR Avanti (Optovue, Fremont, CA, USA). Ganglion cell complex (GCC), foveal thickness (FT), parafoveal thickness (PFT), size of foveal avascular zone (FAZ) in superficial plexus, superficial capillary vessel density (sVD), deep capillary vessel density (dVD), central choroidal thickness (CCT), and presence of macular hypoplasia were analyzed. The association between OCT/angio-OCT results and clinical characteristics including the degree of ROP and therapy requirements was assessed in preterm infants. Results: Foveal morphology was affected in preterm children with high incidence of foveal hypoplasia (24.77%). GCC was thinner in preterm children compared to controls: avgGG 93 μm vs. 100 μm, p < 0.001. No associations between GCC and gestational age (R = −0.085; p = 0.228) and birth weight (R = −0.054; p = 0.446) were found. FAZ in preterm group was smaller than in controls (0.13 ± 0.09 vs. 0.22 ± 0.09; p < 0.001). FAZ area correlated with gestational age (R = 0.456; p < 0.001) and birth weight (R = 0.472; p < 0.001). Deep vessel density in the fovea was higher in preterm children than in control group (p < 0.001). PFT was significantly lower in preterm children compared to control group. However, increased thickness in the fovea was noted in preterm children (p < 0.001). FT was inversely correlated with gestational age (R = −0.562; p < 0.001) and birth weight (R = −0.508, p < 0.001). CCT was lower in preterm children (312 μm vs. 337.5 μm, p < 0.001) Parameters of GCC and FT were higher in patients with ROP required treatment compared to patients without ROP and spontaneously regressed retinopathy. FAZ was smaller in patients with retinopathy than in preterm children without ROP. Conclusion: Prematurity has a significant negative impact on GCC, macular morphology, and vascularization. In premature children, decreased FAZ, increased FT, and vessel density were strongly associated with gestational age, birth weight, Apgar score, ROP stage, and treatment requirement. Optical coherence tomography angiography is a useful tool for detecting retinal changes in premature children.
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Affiliation(s)
- Agnieszka Czeszyk
- Department of Ophthalmology, Children’s Memorial Health Institute, 04-730 Warsaw, Poland;
| | - Wojciech Hautz
- Department of Ophthalmology, Children’s Memorial Health Institute, 04-730 Warsaw, Poland;
| | - Maciej Jaworski
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland;
| | - Dorota Bulsiewicz
- Department of Neonatology and Neonatal Intensive Care, Children’s Memorial Health Institute, 04-730 Warsaw, Poland; (D.B.); (J.C.-K.)
| | - Justyna Czech-Kowalska
- Department of Neonatology and Neonatal Intensive Care, Children’s Memorial Health Institute, 04-730 Warsaw, Poland; (D.B.); (J.C.-K.)
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26
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Kruijt CC, Gradstein L, Bergen AA, Florijn RJ, Arveiler B, Lasseaux E, Zanlonghi X, Bagdonaite-Bejarano L, Fulton AB, Yahalom C, Blumenfeld A, Perez Y, Birk OS, de Wit GC, Schalij-Delfos NE, van Genderen MM. The Phenotypic and Mutational Spectrum of the FHONDA Syndrome and Oculocutaneous Albinism: Similarities and Differences. Invest Ophthalmol Vis Sci 2022; 63:19. [PMID: 35029636 PMCID: PMC8762694 DOI: 10.1167/iovs.63.1.19] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Purpose The purpose of this study was to further expand the mutational spectrum of the Foveal Hypoplasia, Optic Nerve Decussation defect, and Anterior segment abnormalities (FHONDA syndrome), to describe the phenotypic spectrum, and to compare it to albinism. Subjects and Methods We retrospectively collected molecular, ophthalmic, and electrophysiological data of 28 patients molecularly confirmed with FHONDA from the Netherlands (9), Israel (13), France (2), and the United States of America (4). We compared the data to that of 133 Dutch patients with the 3 most common types of albinism in the Netherlands: oculocutaneous albinism type 1 (49), type 2 (41), and ocular albinism (43). Results Patients with FHONDA had a total of 15 different mutations in SLC38A8, of which 6 were novel. Excluding missing data, all patients had moderate to severe visual impairment (median visual acuity [VA] = 0.7 logMAR, interquartile range [IQR] = 0.6-0.8), nystagmus (28/28), and grade 4 foveal hypoplasia (17/17). Misrouting was present in all nine tested patients. None of the patients had any signs of hypopigmentation of skin and hair. VA in albinism was better (median = 0.5 logMAR, IQR = 0.3-0.7, P 0.006) and the phenotypes were more variable: 14 of 132 without nystagmus, foveal hypoplasia grades 1 to 4, and misrouting absent in 16 of 74. Conclusions Compared to albinism, the FHONDA syndrome appears to have a more narrow phenotypic spectrum, consisting of nonprogressive moderately to severely reduced VA, nystagmus, severe foveal hypoplasia, and misrouting. The co-occurrence of nystagmus, foveal hypoplasia, and misrouting in the absence of hypopigmentation implies that these abnormalities are not caused by lack of melanin, which has important implications for understanding the pathogenesis of these features.
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Affiliation(s)
- Charlotte C Kruijt
- Bartiméus Diagnostic Center for Complex Visual Disorders, Zeist, The Netherlands.,Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Libe Gradstein
- Department of Ophthalmology, Soroka Medical Center and Clalit Health Services, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Arthur A Bergen
- Department of Human Genetics, Amsterdam University Medical Center, Location AMC, Amsterdam, The Netherlands.,The Netherlands Institute for Neurosciences (NIN-KNAW), Amsterdam, The Netherlands.,Department of Ophthalmology, Academic Medical Center, Amsterdam, The Netherlands
| | - Ralph J Florijn
- Department of Human Genetics, Amsterdam University Medical Center, Location AMC, Amsterdam, The Netherlands
| | - Benoit Arveiler
- Maladies Rares: Génétique et Métabolisme (MRGM), Inserm U1211, University of Bordeaux, Bordeaux, France.,Department of Medical Genetics, CHU Bordeaux, Bordeaux, France
| | | | - Xavier Zanlonghi
- Centre de Compétence Maladie Rares, Clinique Pluridisciplinaire Jules Verne, Nantes, France
| | | | - Anne B Fulton
- Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
| | - Claudia Yahalom
- Faculty of Medicine, Hebrew University of Jerusalem, Israel; Department of Ophthalmology, Hadassah Medical Center, Jerusalem, Israel
| | - Anat Blumenfeld
- Faculty of Medicine, Hebrew University of Jerusalem, Israel; Department of Ophthalmology, Hadassah Medical Center, Jerusalem, Israel
| | - Yonatan Perez
- The Morris Kahn Laboratory of Human Genetics, National Institute for Biotechnology in the Negev and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Ohad S Birk
- The Morris Kahn Laboratory of Human Genetics, National Institute for Biotechnology in the Negev and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.,Genetics Institute, Soroka Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Gerard C de Wit
- Bartiméus Diagnostic Center for Complex Visual Disorders, Zeist, The Netherlands
| | | | - Maria M van Genderen
- Bartiméus Diagnostic Center for Complex Visual Disorders, Zeist, The Netherlands.,Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands
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27
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Hansen MM, Bach Holm D, Kessel L. Associations between visual function and ultrastructure of the macula and optic disc after childhood cataract surgery. Acta Ophthalmol 2021; 100:640-647. [PMID: 34786847 DOI: 10.1111/aos.15065] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/01/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate the association between visual function and ultrastructural characteristics of the retina and optic disc in children operated for cataract and factors influencing this relationship. METHODS We included 56 children aged 7-18 years who had been operated for bilateral or unilateral cataract. Three-dimensional swept source OCT scans of the macula and the optic disc were obtained using the Triton OCT (Topcon, Corporation, Tokyo, Japan). Best corrected distance visual acuity was measured using the HOTV 3 Meter visual chart. Contrast vision was evaluated using the Freiburg Visual Acuity Contrast Test (FrACT). Healthy fellow eyes of the unilateral group were used as control eyes. RESULTS We did not find any associations between visual acuity or contrast sensitivity and structural retinal parameters. Shorter axial length, the presence of glaucoma and pseudophakia (opposed to aphakia) were all significant predictors of greater mean macular thickness in a multiple regression analysis, (p = 0.039). Two children had foveal hypoplasia, and one child had a right eye with a thin, disorganized retina. CONCLUSIONS Children with pseudophakia have a thicker macula but this does not seem to be related to visual function. Obtaining high quality OCT scans of the macula and optic disc in severely visually impaired children with glaucoma and/or nystagmus is challenging. We found structural macular changes which contributed to poor vision but most eyes with very reduced vision were difficult to image, and the prevalence of structural changes may be underestimated.
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Affiliation(s)
| | - Daniella Bach Holm
- Department of Ophthalmology Rigshospitalet‐Glostrup Glostrup Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Line Kessel
- Department of Ophthalmology Rigshospitalet‐Glostrup Glostrup Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
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28
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Ansari D, Borkar PP, Davis PL, Collison FT, Wynne N, Zangler N, Fishman GA, Carroll J, Yao X, Grassi MA. Pathognomonic macular ripples are revealed by polarized infrared retinal imaging. Exp Biol Med (Maywood) 2021; 246:2202-2206. [PMID: 34233520 PMCID: PMC8718259 DOI: 10.1177/15353702211021089] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/10/2021] [Indexed: 01/21/2023] Open
Abstract
A pathognomonic macular ripple sign has been reported with scanning laser ophthalmoscopy images in patients with foveal hypoplasia, though the optical basis of this sign is presently unknown. Here we present a case series of seven individuals with foveal hypoplasia (based on spectral domain optical coherence tomography). Each patient underwent infrared scanning laser ophthalmoscopy retinal imaging in both eyes, acquired with and without a polarization filter and assessment for a ripple-like effect in the fovea. On imaging, macular ripples were present in all eyes with foveal hypoplasia when using a polarization filter, but not when imaged without the filter. We conclude that the macular ripple sign is an imaging artifact attributable to the unique pattern of phase retardation of the Henle fiber layer in the setting of foveal hypoplasia. By utilizing a polarization filter with retinal photography, this feature can be exploited to promptly identify foveal hypoplasia in settings where OCT is not possible due to nystagmus.
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Affiliation(s)
- Darius Ansari
- Department of Ophthalmology, University of Illinois at Chicago College of Medicine, Chicago, IL 60612, USA
| | - Poulami P Borkar
- Department of Ophthalmology, University of Illinois at Chicago College of Medicine, Chicago, IL 60612, USA
| | | | - Frederick T Collison
- The Pangere Center for Inherited Retinal Diseases, The Chicago Lighthouse, Chicago, IL 60608, USA
- Chicago College of Optometry, Midwestern University, Downers Grove, IL 60515, USA
| | - Niamh Wynne
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | | | - Gerald A Fishman
- Department of Ophthalmology, University of Illinois at Chicago College of Medicine, Chicago, IL 60612, USA
- The Pangere Center for Inherited Retinal Diseases, The Chicago Lighthouse, Chicago, IL 60608, USA
| | - Joseph Carroll
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Xincheng Yao
- Department of Ophthalmology, University of Illinois at Chicago College of Medicine, Chicago, IL 60612, USA
- Department of Bioengineering, University of Illinois at Chicago College of Engineering, Chicago, IL 60607, USA
| | - Michael A Grassi
- Department of Ophthalmology, University of Illinois at Chicago College of Medicine, Chicago, IL 60612, USA
- Grassi Retina, Naperville, IL 60564, USA
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29
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Patterson EJ, Langlo CS, Georgiou M, Kalitzeos A, Pennesi ME, Neitz J, Hardcastle AJ, Neitz M, Michaelides M, Carroll J. Comparing Retinal Structure in Patients with Achromatopsia and Blue Cone Monochromacy Using OCT. Ophthalmol Sci 2021; 1:100047. [PMID: 36186895 PMCID: PMC9521040 DOI: 10.1016/j.xops.2021.100047] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/01/2021] [Accepted: 07/20/2021] [Indexed: 01/12/2023]
Abstract
Purpose To compare foveal hypoplasia and the appearance of the ellipsoid zone (EZ) at the fovea in patients with genetically confirmed achromatopsia (ACHM) and blue cone monochromacy (BCM). Design Retrospective, multi-center observational study. Subjects Molecularly confirmed patients with ACHM (n = 89) and BCM (n = 33). Methods We analyzed high-resolution spectral domain optical coherence tomography (SD-OCT) images of the macula from aforementioned patients with BCM. Three observers independently graded SD-OCT images for foveal hypoplasia (i.e. retention of one or more inner retinal layers at the fovea) and four observers judged the integrity of the EZ at the fovea, based on an established grading scheme. These measures were compared with previously published data from the ACHM patients. Main Outcome Measures Presence of foveal hypoplasia and EZ grade. Results Foveal hypoplasia was significantly more prevalent in ACHM than in BCM (p<0.001). In addition, we observed a significant difference in the distribution of EZ grades between ACHM and BCM, with grade II EZ being by far the most common phenotype in BCM (61% of patients). In contrast, ACHM patients had a relatively equal prevalence of EZ grades I, II, and IV. Interestingly, grade IV EZ was 2.6 times more prevalent in ACHM compared to BCM, while grade V EZ (macular atrophy) was present in 3% of both the ACHM and BCM cohorts. Conclusions The higher incidence of foveal hypoplasia in ACHM than BCM supports a role for cone activity in foveal development. Although there are differences in EZ grades between these conditions, the degree of overlap suggests EZ grade is not sufficient for definitive diagnosis, in contrast to previous reports. Analysis of additional OCT features in similar cohorts may reveal differences with greater diagnostic value. Finally, the extent to which foveal hypoplasia or EZ grade is prognostic for therapeutic potential in either group remains to be seen, but motivates further study.
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Key Words
- achromatopsia
- blue cone monochromacy
- cone
- ellipsoid zone
- fovea
- foveal hypoplasia
- hyper-reflective band
- imaging
- oct
- photoreceptor
- sd-oct
- x-linked cone dysfunction
- achm, achromatopsia
- bcm, blue cone monochromacy
- elm, external limiting membrane
- erg, electroretinography
- ez, ellipsoid zone
- lcr, locus control region
- lrp, longitudinal reflectivity profile
- npv, negative predictive value
- ppv, positive predictive value
- sd-oct, spectral-domain oct
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Affiliation(s)
- Emily J. Patterson
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- Moorfields Eye Hospital, London, United Kingdom
| | | | - Michalis Georgiou
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- Moorfields Eye Hospital, London, United Kingdom
| | - Angelos Kalitzeos
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- Moorfields Eye Hospital, London, United Kingdom
| | - Mark E. Pennesi
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
| | - Jay Neitz
- Ophthalmology, University of Washington, Seattle, Washington
| | - Alison J. Hardcastle
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- Moorfields Eye Hospital, London, United Kingdom
| | - Maureen Neitz
- Ophthalmology, University of Washington, Seattle, Washington
| | - Michel Michaelides
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- Moorfields Eye Hospital, London, United Kingdom
| | - Joseph Carroll
- Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
- Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin
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30
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Tekavčič Pompe M, Vrabič N, Volk M, Meglič A, Jarc-Vidmar M, Peterlin B, Hawlina M, Fakin A. Disease Progression in CNGA3 and CNGB3 Retinopathy; Characteristics of Slovenian Cohort and Proposed OCT Staging Based on Pooled Data from 126 Patients from 7 Studies. Curr Issues Mol Biol 2021; 43:941-957. [PMID: 34449556 PMCID: PMC8929018 DOI: 10.3390/cimb43020067] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/02/2021] [Accepted: 08/05/2021] [Indexed: 11/20/2022] Open
Abstract
Achromatopsia has been proposed to be a morphologically predominately stable retinopathy with rare reports of progression of structural changes in the macula. A five-grade system of optical coherence tomography (OCT) features has been used for the classification of structural macular changes. However, their association with age remains questionable. We characterized the Slovenian cohort of 12 patients with pathogenic variants in CNGA3 or CNGB3 who had been followed up with OCT for up to 9 years. Based on observed structural changes in association with age, the following four-stage classification of retinal morphological changes was proposed: (I) preserved inner segment ellipsoid band (Ise), (II) disrupted ISe, (III) ISe loss and (IV) ISe and RPE loss. Data from six previously published studies reporting OCT morphology in CNGA3 and CNGB3 patients were additionally collected, forming the largest CNGA3/CNGB3 cohort to date, comprising 126 patients aged 1–71 years. Multiple regression analysis showed a significant correlation of OCT stage with age (p < 0.001) and no correlation with gene (p > 0.05). The median ages of patients with stages I–IV were 12 years, 23 years, 27 years and 48 years, respectively, and no patient older than 50 years had continuous ISe. Our findings suggest that achromatopsia presents with slowly but steadily progressive structural changes of the macular outer retinal layers. However, whether morphological changes in time follow the proposed four-stage linear pattern needs to be confirmed in a long-term study.
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Affiliation(s)
- Manca Tekavčič Pompe
- Eye Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (M.T.P.); (N.V.); (A.M.); (M.J.-V.); (M.H.)
| | - Nika Vrabič
- Eye Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (M.T.P.); (N.V.); (A.M.); (M.J.-V.); (M.H.)
| | - Marija Volk
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (M.V.); (B.P.)
| | - Andrej Meglič
- Eye Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (M.T.P.); (N.V.); (A.M.); (M.J.-V.); (M.H.)
| | - Martina Jarc-Vidmar
- Eye Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (M.T.P.); (N.V.); (A.M.); (M.J.-V.); (M.H.)
| | - Borut Peterlin
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (M.V.); (B.P.)
| | - Marko Hawlina
- Eye Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (M.T.P.); (N.V.); (A.M.); (M.J.-V.); (M.H.)
| | - Ana Fakin
- Eye Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (M.T.P.); (N.V.); (A.M.); (M.J.-V.); (M.H.)
- Correspondence:
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Iarossi G, Coppè AM, Passarelli C, Maltese PE, Sinibaldi L, Cappelli A, Cetola S, Novelli A, Buzzonetti L. Blue Cone Monochromatism with Foveal Hypoplasia Caused by the Concomitant Effect of Variants in OPN1LW/OPN1MW and GPR143 Genes. Int J Mol Sci 2021; 22:ijms22168617. [PMID: 34445325 PMCID: PMC8395340 DOI: 10.3390/ijms22168617] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/04/2021] [Accepted: 08/04/2021] [Indexed: 12/11/2022] Open
Abstract
Blue cone monochromatism (BCM) is an X-linked recessive cone dysfunction disorder caused by mutations in the OPN1LW/OPN1MW gene cluster, encoding long (L)- and middle (M)-wavelength-sensitive cone opsins. Here, we report on the unusual clinical presentation of BCM caused by a novel mutation in the OPN1LW gene in a young man. We describe in detail the phenotype of the proband, and the subclinical morpho-functional anomalies shown by his carrier mother. At a clinical level, the extensive functional evaluation demonstrated in the proband the M/L cone affection and the sparing of S-cone function, distinctive findings of BCM. Interestingly, spectral-domain optical coherence tomography showed the presence of foveal hypoplasia with focal irregularities of the ellipsoid layer in the foveal area, reported to be associated with some cases of cone-rod dystrophy and achromatopsia. At a molecular level, we identified the novel mutation c.427T > C p.(Ser143Pro) in the OPN1LW gene and the common missense mutation c.607T > C (p.Cys203Arg) in the OPN1MW gene. In addition, we discovered the c.768-2_769delAGTT splicing variant in the GPR143 gene. To our knowledge, this is the first case of foveal hypoplasia in a BCM patient and of mild clinical affection in a female carrier caused by the concomitant effect of variants in OPN1LW/OPN1MW and GPR143 genes, thus as the result of the simultaneous action of two independent genetic defects.
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Affiliation(s)
- Giancarlo Iarossi
- Department of Ophthalmology, Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (A.M.C.); (A.C.); (L.B.)
- Correspondence: (G.I.); (P.E.M.); Tel.: +39-06-6859-3362 (G.I.); +39-04-6442-0795 (P.E.M.)
| | - Andrea Maria Coppè
- Department of Ophthalmology, Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (A.M.C.); (A.C.); (L.B.)
| | - Chiara Passarelli
- Translational Cytogenomics Research Unit, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (C.P.); (L.S.); (S.C.); (A.N.)
| | - Paolo Enrico Maltese
- MAGI’S Lab s.r.l., 38068 Rovereto, Italy
- Correspondence: (G.I.); (P.E.M.); Tel.: +39-06-6859-3362 (G.I.); +39-04-6442-0795 (P.E.M.)
| | - Lorenzo Sinibaldi
- Translational Cytogenomics Research Unit, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (C.P.); (L.S.); (S.C.); (A.N.)
- Rare Disease and Medical Genetics, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy
| | - Alessandro Cappelli
- Department of Ophthalmology, Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (A.M.C.); (A.C.); (L.B.)
| | - Sarah Cetola
- Translational Cytogenomics Research Unit, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (C.P.); (L.S.); (S.C.); (A.N.)
| | - Antonio Novelli
- Translational Cytogenomics Research Unit, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (C.P.); (L.S.); (S.C.); (A.N.)
| | - Luca Buzzonetti
- Department of Ophthalmology, Bambino Gesù Children’s Hospital, 00165 Rome, Italy; (A.M.C.); (A.C.); (L.B.)
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Abstract
PURPOSE To report on the reliability of optical coherence tomography angiography (OCTA) to diagnose fovea plana. METHODS A retrospective, cross-sectional, case-control study included patients with foveal persistence of the inner retinal layers, confirmed by spectral domain OCT, and superficial capillary plexus (SCP) and deep capillary plexus foveal vascularization confirmed by OCTA. A healthy control group was selected. The best-corrected visual acuity was obtained. Spectral-domain OCT was used for measuring the outer nuclear layer thickness, and OCTA determined the foveal avascular zone, SCP, and deep capillary plexus vascular density. RESULTS Optical coherence tomography angiography reliability, based on all parameters, reached 97%, whereas based only on SCP vascular density 91%. The plana group (n = 57) differed significantly from the control group (n = 28) in terms of foveal avascular zone, SCP, and deep capillary plexus foveal vascular density (P < 0.005). Subjects with SCP foveal vascular density >30% or foveal avascular zone <0.1 mm2 had fovea plana. The best-corrected visual acuity of the plana group had no correlation with OCTA quantitative parameters (Pearson |r|<0.18, Spearman |r|<0.44). CONCLUSION Optical coherence tomography angiography has a high accuracy in diagnosing fovea plana, as its characteristics differ significantly from the normal population. The lack of correlation between the best-corrected visual acuity and OCTA parameters implies that reduced the best-corrected visual acuity is likely to result from coexistent diseases rather than from the foveal structure.
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Affiliation(s)
| | - Helena Cilliers
- Health and Community Services, Jersey General Hospital, Gloucester Street, St Helier, Jersey
| | | | - Aude Ambresin
- RétinElysée, Lausanne, Switzerland
- Department of Ophthalmology, Clinique de Montchoisi Centre C, Lausanne, Switzerland; and
- University of Lausanne (UNIL), Faculty of Biology and Medicine, Lausanne, Switzerland
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Chan HW, Schiff ER, Tailor VK, Malka S, Neveu MM, Theodorou M, Moosajee M. Prospective Study of the Phenotypic and Mutational Spectrum of Ocular Albinism and Oculocutaneous Albinism. Genes (Basel) 2021; 12. [PMID: 33808351 DOI: 10.3390/genes12040508] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 02/01/2021] [Revised: 03/15/2021] [Accepted: 03/26/2021] [Indexed: 02/07/2023] Open
Abstract
Albinism encompasses a group of hereditary disorders characterized by reduced or absent ocular pigment and variable skin and/or hair involvement, with syndromic forms such as Hermansky-Pudlak syndrome and Chédiak-Higashi syndrome. Autosomal recessive oculocutaneous albinism (OCA) is phenotypically and genetically heterogenous (associated with seven genes). X-linked ocular albinism (OA) is associated with only one gene, GPR143. We report the clinical and genetic outcomes of 44 patients, from 40 unrelated families of diverse ethnicities, with query albinism presenting to the ocular genetics service at Moorfields Eye Hospital NHS Foundation Trust between November 2017 and October 2019. Thirty-six were children (≤ 16 years) with a median age of 31 months (range 2-186), and eight adults with a median age of 33 years (range 17-39); 52.3% (n = 23) were male. Genetic testing using whole genome sequencing (WGS, n = 9) or a targeted gene panel (n = 31) gave an overall diagnostic rate of 42.5% (44.4% (4/9) with WGS and 41.9% (13/31) with panel testing). Seventeen families had confirmed mutations in TYR (n = 9), OCA2, (n = 4), HPS1 (n = 1), HPS3 (n = 1), HPS6 (n = 1), and GPR143 (n = 1). Molecular diagnosis of albinism remains challenging due to factors such as missing heritability. Differential diagnoses must include SLC38A8-associated foveal hypoplasia and syndromic forms of albinism.
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Abstract
PURPOSE To describe the appearance of concentric, fingerprint-like waves within the Henle fiber layer (HFL) using en face optical coherence tomography in patients with tractional pathologies of the retina. METHODS Retrospective analysis of six eyes of six patients imaged by optical coherence tomography with volumetric slabs positioned at the level of the HFL. RESULTS Optical coherence tomography data from six patients with tractional vitreoretinal pathology were reviewed. Concentric, fingerprint-like microwaves were visualized through en face optical coherence tomography in all six study eyes at the level of the HFL. This finding resembled the finding of HFL waves previously noted histopathologically from force exerted on this layer. CONCLUSION In retinal pathologies in which specific physical forces act on the retina, volumetric optical coherence tomography may permit visualization of en face concentric, fingerprint-like hyperreflective rings within the HFL. This "fingerprint sign" may represent a biomechanical consequence of traction on the retina and allow clinical decision making based on improved recognition of the existence of such traction.
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Affiliation(s)
- Shane M. Griffin
- Casey Eye Institute, Oregon Health & Science University, Portland, OR
| | - H. Richard McDonald
- West Coast Retina Medical Group, San Francisco, CA
- Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA
| | - Robert N. Johnson
- West Coast Retina Medical Group, San Francisco, CA
- Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA
| | - J. Michael Jumper
- West Coast Retina Medical Group, San Francisco, CA
- Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA
| | - Arthur D. Fu
- West Coast Retina Medical Group, San Francisco, CA
- Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA
| | - Emmett T. Cunningham
- West Coast Retina Medical Group, San Francisco, CA
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA
- Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA
- The Francis I Proctor Foundation, UCSF School of Medicine, San Francisco, CA
| | - Kiang Lee
- Casey Eye Institute, Oregon Health & Science University, Portland, OR
| | - Caleb C. Ng
- West Coast Retina Medical Group, San Francisco, CA
- Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA
| | - Brandon J. Lujan
- Casey Eye Institute, Oregon Health & Science University, Portland, OR
- West Coast Retina Medical Group, San Francisco, CA
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Schiff ER, Tailor VK, Chan HW, Theodorou M, Webster AR, Moosajee M. Novel Biallelic Variants and Phenotypic Features in Patients with SLC38A8-Related Foveal Hypoplasia. Int J Mol Sci 2021; 22:ijms22031130. [PMID: 33498813 PMCID: PMC7866073 DOI: 10.3390/ijms22031130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/17/2021] [Accepted: 01/21/2021] [Indexed: 12/19/2022] Open
Abstract
Biallelic pathogenic variants in solute carrier family 38 member 8, SLC38A8, cause a pan-ocular autosomal recessive condition known as foveal hypoplasia 2, FVH2, characterised by foveal hypoplasia, nystagmus and optic nerve chiasmal misrouting. Patients are often clinically diagnosed with ocular albinism, but foveal hypoplasia can occur in several other ocular disorders. Here we describe nine patients from seven families who had molecularly confirmed biallelic recessive variants in SLC38A8 identified through whole genome sequencing or targeted gene panel testing. We identified four novel sequence variants (p.(Tyr88*), p.(Trp145*), p.(Glu233Gly) and c.632+1G>A). All patients presented with foveal hypoplasia, nystagmus and reduced visual acuity; however, one patient did not exhibit any signs of chiasmal misrouting, and three patients had features of anterior segment dysgenesis. We highlight these findings in the context of 30 other families reported to date. This study reinforces the importance of obtaining a molecular diagnosis in patients whose phenotype overlap with other inherited ocular conditions, in order to support genetic counselling, clinical prognosis and family planning. We expand the spectrum of SLC38A8 mutations which will be relevant for treatment through future genetic-based therapies.
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Affiliation(s)
- Elena R. Schiff
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK; (E.R.S.); (V.K.T.); (H.W.C.); (M.T.); (A.R.W.)
- Institute of Ophthalmology, University College London, London EC1V 9EL, UK
| | - Vijay K. Tailor
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK; (E.R.S.); (V.K.T.); (H.W.C.); (M.T.); (A.R.W.)
- Department of Experimental Psychology, University College London, London WC1H 0AP, UK
| | - Hwei Wuen Chan
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK; (E.R.S.); (V.K.T.); (H.W.C.); (M.T.); (A.R.W.)
- Institute of Ophthalmology, University College London, London EC1V 9EL, UK
- Department of Ophthalmology, National University Hospital, Singapore S118177, Singapore
| | - Maria Theodorou
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK; (E.R.S.); (V.K.T.); (H.W.C.); (M.T.); (A.R.W.)
| | - Andrew R. Webster
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK; (E.R.S.); (V.K.T.); (H.W.C.); (M.T.); (A.R.W.)
- Institute of Ophthalmology, University College London, London EC1V 9EL, UK
| | - Mariya Moosajee
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK; (E.R.S.); (V.K.T.); (H.W.C.); (M.T.); (A.R.W.)
- Institute of Ophthalmology, University College London, London EC1V 9EL, UK
- Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK
- The Francis Crick Institute, London NW1 1AT, UK
- Correspondence:
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Pillay E, Naidoo T, Asmal K, Maliwa L, Mchunua S, van Staden DB, Rampersad N. Characterization of Retinal Thickness in Individuals with Albinism: Baseline Data for a Black South African Population. Clin Optom (Auckl) 2021; 13:15-22. [PMID: 33505177 PMCID: PMC7829131 DOI: 10.2147/opto.s273141] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/03/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The central retina is responsible for several visual functions and continues to develop postnatally. In albinism, which is a genetic disorder characterized by impaired melanin biosynthesis, the development of the central retina is prematurely arrested and results in foveal hypoplasia. Retinal thickness measurements can be determined non-invasively using optical coherence tomography systems. This article reports on the retinal thickness measurements of individuals with albinism in South Africa to aid in the assessment and management of affected individuals. METHODS The study used a comparative research design and included 60 individuals (30 albinism and 30 controls) aged from 10 to 30 years who accessed the eye clinic at a tertiary institution in KwaZulu-Natal, South Africa. The Optovue iVue100 optical coherence tomographer was used to measure retinal thickness in the nine Early Treatment Diabetic Retinopathy Study (ETDRS) sectors including the central foveal, parafoveal and perifoveal regions. Study data were analysed using descriptive and inferential statistics. RESULTS The mean central foveal thickness was significantly higher in individuals with albinism compared with controls (289 µm versus 239 µm, p < 0.001). In contrast, control participants showed thicker retinal thickness measurements in the other ETDRS sectors (p < 0.001). The nasal and temporal quadrants were thickest and thinnest, respectively, in the parafoveal and perifoveal regions for the albinism and control groups. CONCLUSION Individuals with albinism, aged from 10 to 30 years, have higher central foveal thickness but thinner retinal thickness measurements in the parafoveal and perifoveal regions. Optometric personnel should consider these measurements when assessing individuals with albinism with foveal retinal diseases.
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Affiliation(s)
- Ethan Pillay
- Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, DurbanX54001, South Africa
| | - Thiroshnee Naidoo
- Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, DurbanX54001, South Africa
| | - Khadija Asmal
- Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, DurbanX54001, South Africa
| | - Lilitha Maliwa
- Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, DurbanX54001, South Africa
| | - Sinenhlanhla Mchunua
- Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, DurbanX54001, South Africa
| | - Diane Beverly van Staden
- Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, DurbanX54001, South Africa
| | - Nishanee Rampersad
- Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, DurbanX54001, South Africa
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37
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Değirmenci C, Afrashi F, Nalçacı S, Furundaoturan O. Multimodal Imaging of Isolated Foveal Hypoplasia: A Case Report. Turk J Ophthalmol 2020; 50:321-323. [PMID: 33342204 PMCID: PMC7610051 DOI: 10.4274/tjo.galenos.2020.58638] [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] [Indexed: 12/01/2022] Open
Abstract
Fovea hipoplazisi, normal foveanın gelişmemesi ile karakterizedir. İzole veya başka oküler durumlarda sekonder olarak gelişebilmektedir. Optik koherens tomografi (OKT), floresein anjiyografi, fundus otofloresans ve OKT anjiyografi tanıda kullanılabilir. Bu olgu sunumunda multimodal görüntüleme ile tanı konulan, foveal hipoplazili bir hastayı sunmaktayız.
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Affiliation(s)
- Cumali Değirmenci
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Filiz Afrashi
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Serhad Nalçacı
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Onur Furundaoturan
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
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Godinho G, Madeira C, Grangeia A, Neves-Cardoso P, Santos-Silva R, Brandão E, Carneiro Â, Falcão-Reis F, Estrela-Silva S. A novel MFRP gene variant in a family with posterior microphthalmos, retinitis pigmentosa, foveoschisis, and foveal hypoplasia. Ophthalmic Genet 2020; 41:474-479. [PMID: 32703043 DOI: 10.1080/13816810.2020.1795888] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND To characterize the phenotype and genotype of a syndrome associating posterior microphthalmos (PM), retinitis pigmentosa (RP), foveoschisis, and foveal hypoplasia (FH) in a consanguineous Portuguese family. MATERIALS AND METHODS Three siblings were studied and underwent comprehensive eye examinations for best-corrected visual acuity, axial length, refractive error, B-mode ultrasound, electroretinography, retinography, fluorescein angiography (FA), kinetic visual field (VF), and optical coherence tomography (OCT). Molecular analysis was performed by Sanger sequencing of the entire coding region of the MFRP gene. RESULTS All members presented nyctalopia, decreased visual acuity, and constriction of the VF, as well as bilateral shortening of the posterior ocular segment and normal anterior segment dimensions. The fundoscopy and ERG results were compatible with RP. Macular OCT analysis revealed schisis of the outer retinal layer, FH, as well as retinal and choroidal folds. We identified a homozygous mutation in intron 9 of the membrane frizzled-related protein (MFRP) gene (c.1124 + 1 G > A). CONCLUSIONS Our study shows a family with PM and RP due to a mutation in the MFRP gene. The relationship has previously been proven, but this specific mutation has never been described. These gene mutations show wide phenotypic variability, being evident in the presence of foveoschisis, retinal and choroidal folds, and FH, other than PM and RP.
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Affiliation(s)
- Gonçalo Godinho
- Department of Ophthalmology, Centro Hospitalar e Universitário São João , Porto, Portugal
| | - Carolina Madeira
- Department of Ophthalmology, Centro Hospitalar e Universitário São João , Porto, Portugal
| | - Ana Grangeia
- Department of Genetic, Centro Hospitalar e Universitário São João , Porto, Portugal
| | - Pedro Neves-Cardoso
- Department of Ophthalmology, Centro Hospitalar e Universitário São João , Porto, Portugal
| | - Renato Santos-Silva
- Department of Ophthalmology, Centro Hospitalar e Universitário São João , Porto, Portugal.,Department of Surgery and Physiology, Faculty of Medicine, University of Porto , Porto, Portugal
| | - Elisete Brandão
- Department of Ophthalmology, Centro Hospitalar e Universitário São João , Porto, Portugal
| | - Ângela Carneiro
- Department of Ophthalmology, Centro Hospitalar e Universitário São João , Porto, Portugal.,Department of Surgery and Physiology, Faculty of Medicine, University of Porto , Porto, Portugal
| | - Fernando Falcão-Reis
- Department of Ophthalmology, Centro Hospitalar e Universitário São João , Porto, Portugal.,Department of Surgery and Physiology, Faculty of Medicine, University of Porto , Porto, Portugal
| | - Sérgio Estrela-Silva
- Department of Ophthalmology, Centro Hospitalar e Universitário São João , Porto, Portugal.,Department of Surgery and Physiology, Faculty of Medicine, University of Porto , Porto, Portugal
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Falcone MM, Patel NA, Yannuzzi NA, Acon D, Negron CI, McKeown C, Berrocal AM. Bilateral atypical lamellar holes in a patient with oculocutaneous albinism. Ophthalmic Genet 2020; 41:448-450. [PMID: 32543925 DOI: 10.1080/13816810.2020.1765397] [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] [Indexed: 10/24/2022]
Abstract
BACKGROUND Albinism can present with a wide range of ophthalmic findings and variable expressivity. With the use of optical coherence tomography, there has been increasing awareness of the variability of macular findings in this condition. MATERIALS AND METHODS Case report. RESULTS We present a case of oculocutaneous albinism with bilateral atypical lamellar holes which may represent part of the spectrum of retinal abnormalities in this condition. CONCLUSION Optical coherence tomography can be helpful in diagnosing albinism. Variable expressivity leads to a range of macular pathology in albinism which may include atypical lamellar holes as described in this patient.
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Affiliation(s)
- Michelle M Falcone
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami , Miami, FL, USA
| | - Nimesh A Patel
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami , Miami, FL, USA
| | - Nicolas A Yannuzzi
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami , Miami, FL, USA
| | - Dhariana Acon
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami , Miami, FL, USA
| | - Catherin I Negron
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami , Miami, FL, USA
| | - Craig McKeown
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami , Miami, FL, USA
| | - Audina M Berrocal
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami , Miami, FL, USA
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40
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Abstract
Septo-optic dysplasia (SOD) is characterized by optic nerve hypoplasia, pituitary gland hypoplasia, and midline abnormalities of the brain. The phenotype of SOD is highly heterogeneous, and the existence of at least two features is considered sufficient for diagnosis. Fovea plana is the absence of a foveal pit in the central fovea, and despite being a developmental abnormality of the fovea, good visual acuity may be retained in some individuals. In this case, a 12-year-old female presented to the ophthalmology clinic with the complaint of blurred vision in her right eye. In dilated fundus examination, optic disc hypoplasia and no foveal light reflex were seen. Magnetic resonance imaging and optical coherence tomography revealed optic nerve, brain midline, and foveal abnormalities. The patient was diagnosed as having SOD with optic nerve hypoplasia and septum pellucidum agenesis, and fovea plana. Both SOD and fovea plana are rare conditions, and there are several reports in the literature that separately describe their clinical features. The most important aspect of this case report is to reveal the unusual co-existence of SOD and fovea plana in a young patient.
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Affiliation(s)
- Ali Keles
- Department of Ophthalmology, Cizre State Hospital, Sirnak, Turkey
| | - Cagri Ilhan
- Department of Ophthalmology, Hatay State Hospital, Hatay, Antakya, Turkey
| | - Mehmet Yasin Teke
- University of Health Sciences, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Kemal Tekin
- Department of Ophthalmology, Ercis State Hospital, Van, Turkey
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41
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Mayer AK, Mahajnah M, Thomas MG, Cohen Y, Habib A, Schulze M, Maconachie GDE, AlMoallem B, De Baere E, Lorenz B, Traboulsi EI, Kohl S, Azem A, Bauer P, Gottlob I, Sharkia R, Wissinger B. Homozygous stop mutation in AHR causes autosomal recessive foveal hypoplasia and infantile nystagmus. Brain 2020; 142:1528-1534. [PMID: 31009037 DOI: 10.1093/brain/awz098] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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: 07/27/2018] [Revised: 02/04/2019] [Accepted: 02/16/2019] [Indexed: 01/27/2023] Open
Abstract
Herein we present a consanguineous family with three children affected by foveal hypoplasia with infantile nystagmus, following an autosomal recessive mode of inheritance. The patients showed normal electroretinography responses, no signs of albinism, and no anterior segment or brain abnormalities. Upon whole exome sequencing, we identified a homozygous mutation (c.1861C>T;p.Q621*) in the aryl hydrocarbon receptor (AHR) gene that perfectly co-segregated with the disease in the larger family. AHR is a ligand-activated transcription factor that has been intensively studied in xenobiotic-induced toxicity. Further, it has been shown to play a physiological role under normal cellular conditions, such as in immunity, inflammatory response and neurogenesis. Notably, knockout of the Ahr gene in mouse impairs optic nerve myelin sheath formation and results in oculomotor deficits sharing many features with our patients: the eye movement disorder in Ahr-/- mice appears early in development and presents as conjugate horizontal pendular nystagmus. We therefore propose AHR to be a novel disease gene for a new, recessively inherited disorder in humans, characterized by infantile nystagmus and foveal hypoplasia.
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Affiliation(s)
- Anja K Mayer
- Molecular Genetics Laboratory, Institute for Ophthalmic Research, University of Tuebingen, Tuebingen, Germany
| | - Muhammad Mahajnah
- Child Neurology and Development Center, Hillel-Yaffe Medical Center, Hadera, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Mervyn G Thomas
- Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Yuval Cohen
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.,Ophthalmology Department, Hillel Yaffe Medical Center, Hadera, Israel
| | - Adib Habib
- Pediatric Department, St. Vincent French Hospital, Nazareth, Israel
| | - Martin Schulze
- Institute of Medical Genetics and Applied Genomics, University of Tuebingen, Tuebingen, Germany
| | - Gail D E Maconachie
- Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Basamat AlMoallem
- Center for Medical Genetics Ghent, Ghent University and Ghent University Hospital, Ghent, Belgium.,Department of Ophthalmology, King Abdul-Aziz University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Elfride De Baere
- Center for Medical Genetics Ghent, Ghent University and Ghent University Hospital, Ghent, Belgium
| | - Birgit Lorenz
- Department of Ophthalmology, Justus Liebig University Giessen, Giessen, Germany
| | | | - Susanne Kohl
- Molecular Genetics Laboratory, Institute for Ophthalmic Research, University of Tuebingen, Tuebingen, Germany
| | - Abdussalam Azem
- Department of Biochemistry and Molecular Biology, Tel Aviv University, Tel Aviv, Israel
| | - Peter Bauer
- Institute of Medical Genetics and Applied Genomics, University of Tuebingen, Tuebingen, Germany
| | - Irene Gottlob
- Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Rajech Sharkia
- The Triangle Regional Research and Development Center, Kfar Qari', Israel.,Beit-Berl Academic College, Beit-Berl, Israel
| | - Bernd Wissinger
- Molecular Genetics Laboratory, Institute for Ophthalmic Research, University of Tuebingen, Tuebingen, Germany
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Hess K, Pfau M, Wintergerst MWM, Loeffler KU, Holz FG, Herrmann P. Phenotypic Spectrum of the Foveal Configuration and Foveal Avascular Zone in Patients With Alport Syndrome. Invest Ophthalmol Vis Sci 2020; 61:5. [PMID: 32031577 PMCID: PMC7324255 DOI: 10.1167/iovs.61.2.5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 11/11/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate characteristics of the foveal pit and the foveal avascular zone (FAZ) in patients with Alport syndrome (AS), a rare monogenetic disease due to mutations in genes encoding for collagen type IV. Methods Twenty-eight eyes of nine patients with AS, and five autosomal-recessive carriers and 15 eyes from 15 age-similar healthy control subjects were examined using optical coherence tomography (OCT) and OCT-angiography (OCT-A). Foveal configuration and FAZ measures including the FAZ area, circularity, and vessel density in the central 1° and 3° were correlated. Results Foveal hypoplasia was found in 10 eyes from seven patients with either genotype. In contrast, a staircase foveopathy was found in seven eyes of four X-linked AS patients. The average FAZ area did not differ significantly between AS patients and control subjects (mean ± SD 0.24 ± 0.24 mm2 vs. 0.21 ± 0.09 mm2; P = 0.64). Five eyes showed absence or severe anomalies of the FAZ with crossing macular capillaries that was linked to the degree of foveal hypoplasia on OCT images leading to a significant inverse correlation of FAZ area and foveal thickness (r = -0.88; P < 0.001). In contrary, female patients with X-linked mutations exhibited a significantly greater FAZ area (0.48 ± 0.30 mm2 vs. 0.21 ± 0.09 mm2; P = 0.007), in line with OCT findings of a staircase foveopathy. Conclusions The foveal phenotypic spectrum in AS ranges from foveal hypoplasia and absence of a FAZ to staircase foveopathy with an enlarged FAZ. Because the development of the FAZ and foveal pit are closely related, these findings suggest an important role for collagen type IV in foveal development and maturation.
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Affiliation(s)
- Kristina Hess
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
- Center for Rare Diseases Bonn (ZSEB), University Hospital of Bonn, Bonn, Germany
| | - Maximilian Pfau
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
- GRADE Reading Center, Bonn, Germany
| | | | - Karin U. Loeffler
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Frank G. Holz
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
- Center for Rare Diseases Bonn (ZSEB), University Hospital of Bonn, Bonn, Germany
- GRADE Reading Center, Bonn, Germany
| | - Philipp Herrmann
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
- Center for Rare Diseases Bonn (ZSEB), University Hospital of Bonn, Bonn, Germany
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Abstract
Purpose: To describe Optical Coherence Tomography (OCT) findings of the macula in patients with nystagmus, mainly the relationship between spectral-domain OCT (SD-OCT) images and nystagmus in macular dysplasia.Methods: In this study, 17 cases (29 eyes) with congenital macular abnormalities in patients with albinism, macular heterotopias, congenital aniridia, foveal hypoplasia, congenital macular coloboma, and congenital retinoschisis were retrospectively analyzed. Patients underwent multimodal retinal imaging examinations including ultra-widefield fundus imaging, SD-OCT, autofluorescence, and visual field. When the pit was not clearly presented, SD-OCT imaging was centered at the expected foveal center.Results: In cases of oculocutaneous albinism SD-OCT showed the absence of the foveal pit and increased foveal thickness, with nystagmus. Their fundus revealed a lack of pigment in retinal pigment epithelium with visible large choroidal vessels. SD-OCT in congenital aniridia showed a planar fovea in the macula with the lack of a foveal pit and nystagmus. SD-OCT showed the absence of a foveal pit in foveal hypoplasia with nystagmus. In cases of monocular macular heterotopia, no nystagmus was found; the fellow eye had good vision and the macular morphology was usually normal. Nystagmus was not found in patients with congenital macular coloboma and congenital retinoschisis in this study.Conclusion: SD-OCT plays an important role in the diagnosis and prognosis of macular dysplasia in patients with nystagmus. Absence of a normal foveal pit is an OCT-imaging characteristic of macular dysplasia associated with nystagmus.
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Affiliation(s)
- Fu-Bin Wang
- Department of retinal diseases, Shanghai Bright Eye Hospital
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Casas-Llera P, Siverio A, Esquivel G, Bautista C, Alió JL. Spectral-domain optical coherence tomography foveal morphology as a prognostic factor for vision performance in congenital aniridia. Eur J Ophthalmol 2018; 30:58-65. [PMID: 30556423 DOI: 10.1177/1120672118818352] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Patients with congenital aniridia usually have some degree of foveal hypoplasia, thus representing a limiting factor in the final visual acuity achieved by these patients. The purpose of this study was to analyze whether the foveal morphology assessed by spectral-domain optical coherence tomography may serve as a prognostic indicator for best-corrected visual acuity in congenital aniridia patients. METHODS Observational two-center study performed between January 2012 and March 2017 in the pediatric ophthalmology department at Vissum Alicante and Vissum Madrid, Spain. A total of 31 eyes from 19 patients with congenital aniridia were included. After a complete ophthalmological examination, a high-resolution spectral-domain optical coherence tomography with a three-dimensional scan program macular protocol was used. A morphological grading system of foveal hypoplasia was used varying from grade 1 in which there is a presence of a shallow foveal pit, extrusion of inner retinal layers, outer nuclear layer widening, and a presence of outer segment lengthening to grade 4 in which none of these processes occur. RESULTS No correlation between central, mid-peripheral, and peripheral macular thickness and logMAR best-corrected visual acuity was found. The presence of outer segment lengthening was associated with better best-corrected visual acuity with a median best-corrected visual acuity, 0.30 logMAR, whereas the absence of this morphologic feature was associated with poorer VA with a median best-corrected visual acuity of 0.61 logMAR (p < 0.001). CONCLUSION Foveal hypoplasia morphology can predict the best-corrected visual acuity. Specifically, the morphologic optical coherence tomography feature that is related to a better best-corrected visual acuity in congenital aniridia patients is the presence of outer segment lengthening.
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Affiliation(s)
| | | | | | | | - Jorge L Alió
- VISSUM Alicante, Alicante, Spain.,Miguel Hernández University, Elche, Spain
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Monfermé S, Lasseaux E, Duncombe-Poulet C, Hamel C, Defoort-Dhellemmes S, Drumare I, Zanlonghi X, Dollfus H, Perdomo Y, Bonneau D, Korobelnik JF, Plaisant C, Michaud V, Pennamen P, Rooryck-Thambo C, Morice-Picard F, Paya C, Arveiler B. Mild form of oculocutaneous albinism type 1: phenotypic analysis of compound heterozygous patients with the R402Q variant of the TYR gene. Br J Ophthalmol 2018; 103:1239-1247. [PMID: 30472657 DOI: 10.1136/bjophthalmol-2018-312729] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 09/17/2018] [Revised: 10/23/2018] [Accepted: 11/08/2018] [Indexed: 11/03/2022]
Abstract
AIM Oculocutaneous albinism type 1 (OCA1) is due to TYR mutations. c.1205G>A/p.Arg402Gln (R402Q) is a thermosensitive variant of the TYR gene that has been reported to be responsible for mild forms of OCA1. The aim of our study was to define the phenotype associated with this variant. METHODS In our retrospective series, among 268 patients diagnosed with OCA1, 122 (45.5%) harboured one pathogenic variant of TYR, and the R402Q variant ensured to be in trans by segregation analysis in 69 patients (25.7%), constituting the 'R402Q-OCA1' group. 146 patients harboured two pathogenic variants of the TYR gene other than R402Q. Clinical records were available for 119 of them, constituting the 'Classical-OCA1' group. RESULTS Most R402Q-OCA1 patients presented with white or yellow-white hair at birth (71.43%), blond hair later (46.97%), a light phototype but with residual pigmentation (69.64%), and blue eyes (76.56%). Their pigmentation was significantly higher than in the classical-OCA1 group. All patients from the R402Q-OCA1 group presented with ocular features of albinism. However the prevalence of photophobia (78.13%) and iris transillumination (83.87%) and the severity scores of iris transillumination, retinal hypopigmentation and foveal hypoplasia were lower in the R402Q-OCA1 group. Visual acuity was higher in the R402Q-OCA1 group (0.38±0.21 logarithm of the minimum angle of resolution vs 0.76±0.24). Investigations concerning a possible additive effect of the c.575C>A/p.Ser192 (S192Y) variant of TYR in cis with R402Q, suggested by others, showed no significant impact on the phenotype. CONCLUSION The R402Q variant leads to variable but generally mild forms of albinism whose less typical presentation may lead to underdiagnosis.
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Affiliation(s)
| | - Eulalie Lasseaux
- Service de génétique médicale, CHU de Bordeaux, Bordeaux, France
| | | | - Christian Hamel
- Service d'ophtalmologie, Equipe maladies sensorielles génétiques, CHU de Montpellier, Montpellier, France
| | | | - Isabelle Drumare
- Service d'exploration de la vision et neuro-ophtalmologie, CHRU de Lille, Lille, France
| | | | - Hélène Dollfus
- Centre des affections rares en génétique ophtalmologique, CHU de Strasbourg, Strasbourg, France
| | - Yaurama Perdomo
- Centre des affections rares en génétique ophtalmologique, CHU de Strasbourg, Strasbourg, France
| | | | | | - Claudio Plaisant
- Service de génétique médicale, CHU de Bordeaux, Bordeaux, France
| | - Vincent Michaud
- Service de génétique médicale, CHU de Bordeaux, Bordeaux, France
| | - Perrine Pennamen
- Service de génétique médicale, CHU de Bordeaux, Bordeaux, France.,INSERM U1211, Maladies Rares, Génétique et Métabolisme, Université de Bordeaux, Bordeaux, France
| | - Caroline Rooryck-Thambo
- Service de génétique médicale, CHU de Bordeaux, Bordeaux, France.,INSERM U1211, Maladies Rares, Génétique et Métabolisme, Université de Bordeaux, Bordeaux, France
| | - Fanny Morice-Picard
- Service de dermatologie, Unité de dermato-pédiatrie du CHU de Bordeaux, Bordeaux, France
| | - Clement Paya
- Centre d'ophtalmologie du Palais Gallien, Bordeaux, France
| | - Benoit Arveiler
- Service de génétique médicale, CHU de Bordeaux, Bordeaux, France.,INSERM U1211, Maladies Rares, Génétique et Métabolisme, Université de Bordeaux, Bordeaux, France
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Mansour AM, Chhablani J, Arevalo JF, Wu L, Sharma R, Sinawat S, Sujirakul T, Assi A, Vélez-Vázquez WM, Mansour MA, Kayikcioglu O, Kucukerdonmez C, Kal A. Retinal detachment in albinism. Clin Ophthalmol 2018; 12:651-656. [PMID: 29670325 PMCID: PMC5896647 DOI: 10.2147/opth.s158785] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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] [Indexed: 11/29/2022] Open
Abstract
Purpose To report the visual and anatomic outcomes of albino retinal detachment (ARD) repair. Methods Collaborative retrospective analysis of ARD. Outcome measures were number of surgical interventions, final retinal reattachment, and best corrected visual acuity (BCVA) at last follow-up. Results Seventeen eyes of 16 patients (12 males; mean age =37.8 years) had the following complications at presentation: macula off (14), total (7) or inferior detachment (5), proliferative vitreoretinopathy (5), detectable break (16), lattice (5), horseshoe tears (9), and giant tear or dialysis (4). Mean number of interventions was 1.8 (range =1–5) and included cryopexy (15) with scleral buckle (11), and/or vitrectomy (8). Mean initial BCVA was counting finger (CF) 1 m and at last follow-up (mean 77 months) CF4m with mean improvement of 4.5 lines (early treatment diabetic retinopathy study) (P=0.05). Intraoperative choroidal hemorrhage occurred in three eyes. The retina was finally attached in 14 eyes, with residual inferior detachment in three eyes with silicone oil in situ. Silicone oil was kept in six of seven eyes because of residual inferior detachment (3) and removal of silicone oil, which led to redetachment (1) or fear of redetachment (2). Conclusion Repair of ARD may require several interventions, with the need to keep silicone oil in several cases due to nystagmus and reduced melanin pigment.
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Affiliation(s)
- Ahmad M Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon.,Department of Ophthalmology, Rafic Hariri University Hospital, Beirut, Lebanon
| | - Jay Chhablani
- L.V. Prasad Eye Institute, Banjara Hills, Hyderabad, India
| | - J Fernando Arevalo
- Department of Ophthalmology, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.,Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lihteh Wu
- Asociados de Macula Vitreo y Retina de Costa Rica, San José, Costa Rica
| | - Ravi Sharma
- L.V. Prasad Eye Institute, Banjara Hills, Hyderabad, India
| | - Suthasinee Sinawat
- Department of Ophthalmology, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
| | - Tharikarn Sujirakul
- Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | | | - Mohamad A Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
| | | | | | - Ali Kal
- Department of Ophthalmology, Baskent University, Konya, Turkey
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Abstract
Foveal hypoplasia is a retinal disorder in which there is a lack of full development of the morphology of the fovea. The optical coherence tomography (OCT) and functional findings are presented in relation to the underlying genetic and developmental conditions. Recent advancements of high-resolution OCT imaging have unveiled characteristics of foveal hypoplasia that were not detected by conventional imaging methods. An absence of a foveal pit does not necessarily imply poor visual acuity, and the maturation of the cone photoreceptors is important for the visual acuity. Regardless of the degree of the development of the inner retinal layers, the visual acuity can be preserved as in diseases such as Stickler syndrome that is a newly identified retinal disorder associated with foveal hypoplasia.
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Affiliation(s)
- Hiroyuki Kondo
- Department of Ophthalmology, University of Occupational and Environmental Health, Kitakyushu, Japan
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48
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Borruat FX, Holder GE, Bremner F. Inner Retinal Dysfunction in the Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay. Front Neurol 2017; 8:523. [PMID: 29075231 PMCID: PMC5643501 DOI: 10.3389/fneur.2017.00523] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 06/19/2017] [Accepted: 09/20/2017] [Indexed: 11/25/2022] Open
Abstract
The autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is associated with structural retinal abnormalities either directly visible on funduscopy or revealed by optical coherence tomography (OCT). Most patients with ARSACS have a whitish peripapillary appearance corresponding to a thickening of the peripapillary retinal nerve fiber layer. OCT has also shown an absence of the physiological foveal depression. Abnormal electroretinography (ERG) has previously been reported in only two cases, without further details. This report describes a patient with ARSACS in whom careful full-field ERG revealed dysfunction of the retinal On− bipolar cells with sparing of photoreceptor function. This is the first report of inner retinal dysfunction in ARSACS.
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Affiliation(s)
| | - Graham E Holder
- Moorfields Eye Hospital, London, United Kingdom.,University College London Institute of Ophthalmology, London, United Kingdom
| | - Fion Bremner
- The National Hospital for Neurology and Neurosurgery, London, United Kingdom
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49
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Toral MA, Velez G, Boudreault K, Schaefer KA, Xu Y, Saffra N, Bassuk AG, Tsang SH, Mahajan VB. Structural modeling of a novel SLC38A8 mutation that causes foveal hypoplasia. Mol Genet Genomic Med 2017; 5:202-209. [PMID: 28546991 PMCID: PMC5441399 DOI: 10.1002/mgg3.266] [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: 09/14/2016] [Revised: 11/07/2016] [Accepted: 11/13/2016] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Foveal hypoplasia (FH) in the absence of albinism, aniridia, microphthalmia, or achromatopsia is exceedingly rare, and the molecular basis for the disorder remains unknown. FH is characterized by the absence of both the retinal foveal pit and avascular zone, but with preserved retinal architecture. SLC38A8 encodes a sodium-coupled neutral amino acid transporter with a preference for glutamate as a substrate. SLC38A8 has been linked to FH. Here, we describe a novel mutation to SLC38A8 which causes FH, and report the novel use of OCT-angiography to improve the precision of FH diagnosis. More so, we used computational modeling to explore possible functional effects of known SLC38A8 mutations. METHODS Fundus autofluorescence, SD-OCT, and OCT-angiography were used to make the clinical diagnosis. Whole-exome sequencing led to the identification of a novel disease-causing variant in SLC38A8. Computational modeling approaches were used to visualize known SLC38A8 mutations, as well as to predict mutation effects on transporter structure and function. RESULTS We identified a novel point mutation in SLC38A8 that causes FH. A conclusive diagnosis was made using OCT-angiography, which more clearly revealed retinal vasculature penetrating into the foveal region. Structural modeling of the channel showed the mutation was near previously published mutations, clustered on an extracellular loop. Our modeling also predicted that the mutation destabilizes the protein by altering the electrostatic potential within the channel pore. CONCLUSION Our results demonstrate a novel use for OCT-angiography in confirming FH, and also uncover genotype-phenotype correlations of FH-linked SLC38A8 mutations.
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Affiliation(s)
- Marcus A Toral
- Omics LaboratoryUniversity of IowaIowa CityIowa.,Department of Ophthalmology and Visual SciencesUniversity of IowaIowa CityIowa.,Medical Scientist Training ProgramUniversity of IowaIowa CityIowa
| | - Gabriel Velez
- Omics LaboratoryUniversity of IowaIowa CityIowa.,Department of Ophthalmology and Visual SciencesUniversity of IowaIowa CityIowa.,Medical Scientist Training ProgramUniversity of IowaIowa CityIowa
| | | | - Kellie A Schaefer
- Omics LaboratoryUniversity of IowaIowa CityIowa.,Department of Ophthalmology and Visual SciencesUniversity of IowaIowa CityIowa
| | - Yu Xu
- Department of OphthalmologyUniversity of MontrealMontrealQuebecCanada
| | - Norman Saffra
- Department of OphthalmologyMaimonides Medical CenterBrooklynNew York
| | | | - Stephen H Tsang
- The Barbara & Donald Jonas Laboratory of Regenerative Medicine and Bernard & Shirlee Brown Glaucoma LaboratoryDepartments of Ophthalmology, Pathology & Cell BiologyCollege of Physicians & SurgeonsColumbia UniversityNew York CityNew York.,Edward S. Harkness Eye InstituteNew York-Presbyterian HospitalNew York CityNew York
| | - Vinit B Mahajan
- Omics LaboratoryUniversity of IowaIowa CityIowa.,Department of Ophthalmology and Visual SciencesUniversity of IowaIowa CityIowa
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50
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Nambiar S, Ramasubramanian S, Swaminathan M. Brown's syndrome with ocular albinism: Case report of a rare presentation and literature review. Oman J Ophthalmol 2015; 8:117-9. [PMID: 26622141 PMCID: PMC4640037 DOI: 10.4103/0974-620x.159264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We report a rare case of Brown's syndrome associated with ocular albinism in a 10-year-old boy. This report highlights the importance of further analysis of cases of Brown's syndrome and throws some light on the etiology and association of this rare condition.
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Affiliation(s)
- Soumya Nambiar
- Department of Pediatric Ophthalmology, Medical Research Foundation, Chennai, Tamil Nadu, India
| | | | - Meenakshi Swaminathan
- Department of Pediatric Ophthalmology, Medical Research Foundation, Chennai, Tamil Nadu, India
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