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Battista M, Coutinho CP, Berni A, Borrelli E, Galzignato A, Lari G, Checchin L, Pizza IC, Brotto L, Nucci P, Bandello F, Cascavilla ML, Barboni P. Sectorial Ganglion Cell Complex Thickness as Biomarker of Vision Outcome in Patients With Dominant Optic Atrophy. Invest Ophthalmol Vis Sci 2024; 65:24. [PMID: 38193759 PMCID: PMC10784844 DOI: 10.1167/iovs.65.1.24] [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: 09/07/2023] [Accepted: 12/04/2023] [Indexed: 01/10/2024] Open
Abstract
Purpose Dominant optic atrophy (DOA) is an inherited condition caused by autosomal dominant mutations involving the OPA-1 gene. The aim of this study was to assess the relationship between macular ganglion cell and inner plexiform layer (GC-IPL) thickness obtained from structural optical coherence tomography (OCT) and visual outcomes in DOA patients. Methods The study recruited 33 patients with confirmed OPA-1 heterozygous mutation and DOA. OCT scans were conducted to measure the GC-IPL thickness. The average and sectorial Early Treatment Diabetic Retinopathy Study (ETDRS) charts (six-sector macular analysis to enhance the topographical analysis) centered on the fovea were considered. Several regression analyses were carried out to investigate the associations between OCT metrics and final best-corrected visual acuity (BCVA) as the dependent variable. Results The mean BCVA was 0.43 ± 0.37 logMAR, and the average macular GC-IPL thickness was 43.65 ± 12.56 µm. All of the GC-IPL sectors were significantly reduced and correlated with BCVA. The univariate linear regression and the multivariate stepwise regression modeling showed that the strongest association with final BCVA was observed with the internal superior GC-IPL thickness. Dividing patients based on BCVA, we found a specific pattern. Specifically, in patients with BCVA ≤ 0.3 logMAR, the external superior and inferior sectors together with the internal superior were more significant; whereas, for BCVA > 0.3 logMAR, the external superior sector and internal superior sector were more significant. Conclusions The study identified OCT biomarkers associated with visual outcomes in DOA patients. Moreover, we assessed a specific OCT biomarker for DOA progression, ranging from patients in the early stages of disease with more preserved GC-IPL sectorial thickness to advanced stages with severe thinning.
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Affiliation(s)
- Marco Battista
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Alessandro Berni
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Enrico Borrelli
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Giorgio Lari
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Lisa Checchin
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Irene C. Pizza
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Luigi Brotto
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Paolo Nucci
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Francesco Bandello
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Maria Lucia Cascavilla
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Piero Barboni
- Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
- Studio Oculistico d'Azeglio, Bologna, Italy
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Wong DCS, Harvey JP, Jurkute N, Thomasy SM, Moosajee M, Yu-Wai-Man P, Gilhooley MJ. OPA1 Dominant Optic Atrophy: Pathogenesis and Therapeutic Targets. J Neuroophthalmol 2023; 43:464-474. [PMID: 37974363 PMCID: PMC10645107 DOI: 10.1097/wno.0000000000001830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Affiliation(s)
- David C. S. Wong
- Department of Clinical Neurosciences (DCSW, PY-W-M), John van Geest Center for Brain Repair, University of Cambridge, Cambridge, United Kingdom; Cambridge Eye Unit (DCSW, PY-W-M), Addenbrooke's Hospital, Cambridge, United Kingdom; UCL Institute of Ophthalmology (JPH, NJ, MM, PY-W-M, MJG), London, United Kingdom; Moorfields Eye Hospital NHS Foundation Trust (JPH, NJ, MM, PY-W-M, MJG), London, United Kingdom; Department of Ophthalmology and Vision Science (SMT), School of Medicine, U.C. Davis, Sacramento, California; Department of Surgical and Radiological Sciences (SMT), School of Veterinary Medicine, U.C. Davis, California; Great Ormond Street Hospital (MM), London, United Kingdom; and The Francis Crick Institute (MM), London, United Kingdom
| | - Joshua P. Harvey
- Department of Clinical Neurosciences (DCSW, PY-W-M), John van Geest Center for Brain Repair, University of Cambridge, Cambridge, United Kingdom; Cambridge Eye Unit (DCSW, PY-W-M), Addenbrooke's Hospital, Cambridge, United Kingdom; UCL Institute of Ophthalmology (JPH, NJ, MM, PY-W-M, MJG), London, United Kingdom; Moorfields Eye Hospital NHS Foundation Trust (JPH, NJ, MM, PY-W-M, MJG), London, United Kingdom; Department of Ophthalmology and Vision Science (SMT), School of Medicine, U.C. Davis, Sacramento, California; Department of Surgical and Radiological Sciences (SMT), School of Veterinary Medicine, U.C. Davis, California; Great Ormond Street Hospital (MM), London, United Kingdom; and The Francis Crick Institute (MM), London, United Kingdom
| | - Neringa Jurkute
- Department of Clinical Neurosciences (DCSW, PY-W-M), John van Geest Center for Brain Repair, University of Cambridge, Cambridge, United Kingdom; Cambridge Eye Unit (DCSW, PY-W-M), Addenbrooke's Hospital, Cambridge, United Kingdom; UCL Institute of Ophthalmology (JPH, NJ, MM, PY-W-M, MJG), London, United Kingdom; Moorfields Eye Hospital NHS Foundation Trust (JPH, NJ, MM, PY-W-M, MJG), London, United Kingdom; Department of Ophthalmology and Vision Science (SMT), School of Medicine, U.C. Davis, Sacramento, California; Department of Surgical and Radiological Sciences (SMT), School of Veterinary Medicine, U.C. Davis, California; Great Ormond Street Hospital (MM), London, United Kingdom; and The Francis Crick Institute (MM), London, United Kingdom
| | - Sara M. Thomasy
- Department of Clinical Neurosciences (DCSW, PY-W-M), John van Geest Center for Brain Repair, University of Cambridge, Cambridge, United Kingdom; Cambridge Eye Unit (DCSW, PY-W-M), Addenbrooke's Hospital, Cambridge, United Kingdom; UCL Institute of Ophthalmology (JPH, NJ, MM, PY-W-M, MJG), London, United Kingdom; Moorfields Eye Hospital NHS Foundation Trust (JPH, NJ, MM, PY-W-M, MJG), London, United Kingdom; Department of Ophthalmology and Vision Science (SMT), School of Medicine, U.C. Davis, Sacramento, California; Department of Surgical and Radiological Sciences (SMT), School of Veterinary Medicine, U.C. Davis, California; Great Ormond Street Hospital (MM), London, United Kingdom; and The Francis Crick Institute (MM), London, United Kingdom
| | - Mariya Moosajee
- Department of Clinical Neurosciences (DCSW, PY-W-M), John van Geest Center for Brain Repair, University of Cambridge, Cambridge, United Kingdom; Cambridge Eye Unit (DCSW, PY-W-M), Addenbrooke's Hospital, Cambridge, United Kingdom; UCL Institute of Ophthalmology (JPH, NJ, MM, PY-W-M, MJG), London, United Kingdom; Moorfields Eye Hospital NHS Foundation Trust (JPH, NJ, MM, PY-W-M, MJG), London, United Kingdom; Department of Ophthalmology and Vision Science (SMT), School of Medicine, U.C. Davis, Sacramento, California; Department of Surgical and Radiological Sciences (SMT), School of Veterinary Medicine, U.C. Davis, California; Great Ormond Street Hospital (MM), London, United Kingdom; and The Francis Crick Institute (MM), London, United Kingdom
| | - Patrick Yu-Wai-Man
- Department of Clinical Neurosciences (DCSW, PY-W-M), John van Geest Center for Brain Repair, University of Cambridge, Cambridge, United Kingdom; Cambridge Eye Unit (DCSW, PY-W-M), Addenbrooke's Hospital, Cambridge, United Kingdom; UCL Institute of Ophthalmology (JPH, NJ, MM, PY-W-M, MJG), London, United Kingdom; Moorfields Eye Hospital NHS Foundation Trust (JPH, NJ, MM, PY-W-M, MJG), London, United Kingdom; Department of Ophthalmology and Vision Science (SMT), School of Medicine, U.C. Davis, Sacramento, California; Department of Surgical and Radiological Sciences (SMT), School of Veterinary Medicine, U.C. Davis, California; Great Ormond Street Hospital (MM), London, United Kingdom; and The Francis Crick Institute (MM), London, United Kingdom
| | - Michael J. Gilhooley
- Department of Clinical Neurosciences (DCSW, PY-W-M), John van Geest Center for Brain Repair, University of Cambridge, Cambridge, United Kingdom; Cambridge Eye Unit (DCSW, PY-W-M), Addenbrooke's Hospital, Cambridge, United Kingdom; UCL Institute of Ophthalmology (JPH, NJ, MM, PY-W-M, MJG), London, United Kingdom; Moorfields Eye Hospital NHS Foundation Trust (JPH, NJ, MM, PY-W-M, MJG), London, United Kingdom; Department of Ophthalmology and Vision Science (SMT), School of Medicine, U.C. Davis, Sacramento, California; Department of Surgical and Radiological Sciences (SMT), School of Veterinary Medicine, U.C. Davis, California; Great Ormond Street Hospital (MM), London, United Kingdom; and The Francis Crick Institute (MM), London, United Kingdom
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Newman NJ, Yu-Wai-Man P, Biousse V, Carelli V. Understanding the molecular basis and pathogenesis of hereditary optic neuropathies: towards improved diagnosis and management. Lancet Neurol 2023; 22:172-188. [PMID: 36155660 DOI: 10.1016/s1474-4422(22)00174-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 03/30/2022] [Accepted: 04/13/2022] [Indexed: 01/25/2023]
Abstract
Hereditary optic neuropathies result from defects in the human genome, both nuclear and mitochondrial. The two main and most recognised phenotypes are dominant optic atrophy and Leber hereditary optic neuropathy. Advances in modern molecular diagnosis have expanded our knowledge of genotypes and phenotypes of inherited disorders that affect the optic nerve, either alone or in combination, with various forms of neurological and systemic degeneration. A unifying feature in the pathophysiology of these disorders appears to involve mitochondrial dysfunction, suggesting that the retinal ganglion cells and their axons are especially susceptible to perturbations in mitochondrial homoeostasis. As we better understand the pathogenesis behind these genetic diseases, aetiologically targeted therapies are emerging and entering into clinical trials, including treatments aimed at halting the cascade of neurodegeneration, replacing or editing the defective genes or their protein products, and potentially regenerating damaged optic nerves, as well as preventing generational disease transmission.
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MESH Headings
- Humans
- Optic Nerve Diseases/diagnosis
- Optic Nerve Diseases/genetics
- Optic Nerve Diseases/therapy
- Optic Atrophy, Hereditary, Leber/diagnosis
- Optic Atrophy, Hereditary, Leber/genetics
- Optic Atrophy, Hereditary, Leber/therapy
- Optic Atrophy, Autosomal Dominant/diagnosis
- Optic Atrophy, Autosomal Dominant/genetics
- Optic Atrophy, Autosomal Dominant/therapy
- Optic Nerve
- Mitochondria/genetics
- Mitochondria/metabolism
- Mitochondria/pathology
- DNA, Mitochondrial/genetics
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Affiliation(s)
- Nancy J Newman
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA; Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA; Department of Neurological Surgery, Emory University School of Medicine, Atlanta, GA, USA.
| | - Patrick Yu-Wai-Man
- Cambridge Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK; MRC Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK; Cambridge Eye Unit, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK; Moorfields Eye Hospital, London, UK; UCL Institute of Ophthalmology, University College London, London, UK
| | - Valérie Biousse
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA; Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Valerio Carelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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Zehden JA, Raviskanthan S, Mortensen PW, Ferré M, Reynier P, Milea D, Lee AG. Dominant Optic Atrophy: How to Determine the Pathogenicity of Novel Variants? J Neuroophthalmol 2022; 42:149-153. [PMID: 34629404 DOI: 10.1097/wno.0000000000001352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Jason A Zehden
- Baylor College of Medicine (JZ), Houston, Texas, US; Department of Ophthalmology (SR, PWM, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; MITOVASC Institute (MF, PR, DM), CNRS 6015, INSERM U1083, University of Angers, France ; Singapore National Eye Center (DM), Singapore, Singapore ; Singapore Eye Research Institute (DM), Singapore, Singapore ; Duke-NUS Medical School (DM), Singapore, Singapore ; Copenhagen University Hospital Denmark (DM), Copenhagen, Denmark; Departments of Ophthalmology (AGL), Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New York; Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas; University of Texas MD Anderson Cancer Center (AGL), Houston, Texas; Texas A and M College of Medicine (AGL), Bryan, Texas; and Department of Ophthalmology (AGL), The University of Iowa Hospitals and Clinics, Iowa City, Iowa
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Barboni P, Amore G, Cascavilla ML, Battista M, Frontino G, Romagnoli M, Caporali L, Baldoli C, Gramegna LL, Sessagesimi E, Bonfanti R, Romagnoli A, Scotti R, Brambati M, Carbonelli M, Starace V, Fiorini C, Panebianco R, Parisi V, Tonon C, Bandello F, Carelli V, La Morgia C. The pattern of retinal ganglion cell loss in Wolfram syndrome is distinct from mitochondrial optic neuropathies. Am J Ophthalmol 2022; 241:206-216. [PMID: 35452662 DOI: 10.1016/j.ajo.2022.03.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 11/21/2021] [Revised: 03/13/2022] [Accepted: 03/16/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE To describe the clinical phenotype of a cohort of Wolfram syndrome (WS) patients, focusing on the pattern of optic atrophy correlated with brain MRI measurements, as compared to OPA1-associated mitochondrial optic neuropathy. DESIGN Retrospective, comparative cohort study METHODS: 25 WS patients and 33 age-matched patients affected by OPA1-related Dominant Optic Atrophy (DOA). Ophthalmological, neurological, endocrinological and MRI data from WS patients were retrospectively retrieved. Ophthalmological data were compared to OPA1-related DOA and further analyzed for age dependency dividing patients in age quartiles. In a subgroup of WS patients, we correlated the structural damage assessed by optical coherence tomography (OCT) with brain MRI morphological measurements. Visual acuity (VA), visual field mean defect (MD), retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness assessed by OCT, MRI morphological measurements of anterior and posterior visual pathways. RESULTS In our cohort optic atrophy was present in 100% of WS patients. VA, MD and RNFL thickness loss were worse in WS patients with a faster decline since early age as compared to DOA patients, who displayed a more stable visual function over the years. Conversely, GCL sectors were overall thinner in DOA patients since early age compared to WS, in which GCL thickness started to decline later in life. The neuroradiological sub-analysis on 11 WS patients exhibited bilateral thinning of the anterior optic pathway, especially prechiasmatic optic nerves and optic tracts. Optic tract thinning was significantly correlated with the GCL thickness but not with RNFL parameters. CONCLUSIONS Our results showed a generally more severe and diffuse degeneration of both anterior and posterior visual pathways in WS, with fast deterioration of visual function and structural OCT parameters since early age. The pattern observed at OCT suggests that retinal ganglion cells axonal degeneration (i.e. RNFL) precedes of about a decade the cellular body atrophy (i.e. GCL). This differs substantially from DOA, in which a more stable visual function is evident with predominant early loss of GCL, indirectly supporting the lack of a primary mitochondrial dysfunction in WS.
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Affiliation(s)
- Piero Barboni
- From the Department of Ophthalmology (P.B., M.L.C., M.Ba., M.Br., V.S., F.B.), University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy; Studio Oculistico d'Azeglio (P.B.), Bologna, Italy.
| | - Giulia Amore
- Dipartimento di Scienze Biomediche e Neuromotorie (G.A., L.L.G., E.S., M.C., C.T., V.C.), Università di Bologna, Bologna, Italy
| | - Maria Lucia Cascavilla
- From the Department of Ophthalmology (P.B., M.L.C., M.Ba., M.Br., V.S., F.B.), University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Marco Battista
- From the Department of Ophthalmology (P.B., M.L.C., M.Ba., M.Br., V.S., F.B.), University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Giulio Frontino
- Department of Pediatrics (G.F., R.B., A.R.), IRCCS San Raffaele Hospital, Milan, Italy; Diabetes Research Institute (G.F., R.B., A.R.), IRCCS San Raffaele Hospital, Milan, Italy
| | - Martina Romagnoli
- IRCCS Istituto delle Scienze Neurologiche di Bologna (M.R., L.C., C.F., V.C., C.L.M.), Programma di Neurogenetica, Bologna, Italy
| | - Leonardo Caporali
- IRCCS Istituto delle Scienze Neurologiche di Bologna (M.R., L.C., C.F., V.C., C.L.M.), Programma di Neurogenetica, Bologna, Italy
| | - Cristina Baldoli
- Neuroradiology Unit (C.B., R.S.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura Ludovica Gramegna
- Dipartimento di Scienze Biomediche e Neuromotorie (G.A., L.L.G., E.S., M.C., C.T., V.C.), Università di Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna (L.L.G., E.S., C.T.), Functional and Molecular Neuroimaging Unit, Bologna, Italy
| | - Elisa Sessagesimi
- Dipartimento di Scienze Biomediche e Neuromotorie (G.A., L.L.G., E.S., M.C., C.T., V.C.), Università di Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna (L.L.G., E.S., C.T.), Functional and Molecular Neuroimaging Unit, Bologna, Italy
| | - Riccardo Bonfanti
- Department of Pediatrics (G.F., R.B., A.R.), IRCCS San Raffaele Hospital, Milan, Italy; Diabetes Research Institute (G.F., R.B., A.R.), IRCCS San Raffaele Hospital, Milan, Italy
| | - Andrea Romagnoli
- Department of Pediatrics (G.F., R.B., A.R.), IRCCS San Raffaele Hospital, Milan, Italy; Diabetes Research Institute (G.F., R.B., A.R.), IRCCS San Raffaele Hospital, Milan, Italy
| | - Roberta Scotti
- Neuroradiology Unit (C.B., R.S.), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Brambati
- From the Department of Ophthalmology (P.B., M.L.C., M.Ba., M.Br., V.S., F.B.), University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Michele Carbonelli
- Dipartimento di Scienze Biomediche e Neuromotorie (G.A., L.L.G., E.S., M.C., C.T., V.C.), Università di Bologna, Bologna, Italy
| | - Vincenzo Starace
- From the Department of Ophthalmology (P.B., M.L.C., M.Ba., M.Br., V.S., F.B.), University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Claudio Fiorini
- IRCCS Istituto delle Scienze Neurologiche di Bologna (M.R., L.C., C.F., V.C., C.L.M.), Programma di Neurogenetica, Bologna, Italy
| | - Roberta Panebianco
- Department of Ophthalmology (R.P.), University of Catania, Catania, Italy
| | | | - Caterina Tonon
- Dipartimento di Scienze Biomediche e Neuromotorie (G.A., L.L.G., E.S., M.C., C.T., V.C.), Università di Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna (L.L.G., E.S., C.T.), Functional and Molecular Neuroimaging Unit, Bologna, Italy
| | - Francesco Bandello
- From the Department of Ophthalmology (P.B., M.L.C., M.Ba., M.Br., V.S., F.B.), University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Valerio Carelli
- Dipartimento di Scienze Biomediche e Neuromotorie (G.A., L.L.G., E.S., M.C., C.T., V.C.), Università di Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna (M.R., L.C., C.F., V.C., C.L.M.), Programma di Neurogenetica, Bologna, Italy
| | - Chiara La Morgia
- IRCCS Istituto delle Scienze Neurologiche di Bologna (M.R., L.C., C.F., V.C., C.L.M.), Programma di Neurogenetica, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna (C.L.M.), UOC Clinica Neurologica, Bologna, Italy
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Harvey JP, Sladen PE, Yu-Wai-Man P, Cheetham ME. Induced Pluripotent Stem Cells for Inherited Optic Neuropathies-Disease Modeling and Therapeutic Development. J Neuroophthalmol 2022; 42:35-44. [PMID: 34629400 DOI: 10.1097/wno.0000000000001375] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Inherited optic neuropathies (IONs) cause progressive irreversible visual loss in children and young adults. There are limited disease-modifying treatments, and most patients progress to become severely visually impaired, fulfilling the legal criteria for blind registration. The seminal discovery of the technique for reprogramming somatic nondividing cells into induced pluripotent stem cells (iPSCs) has opened several exciting opportunities in the field of ION research and treatment. EVIDENCE ACQUISITION A systematic review of the literature was conducted with PubMed using the following search terms: autosomal dominant optic atrophy, ADOA, dominant optic atrophy, DOA, Leber hereditary optic neuropathy, LHON, optic atrophy, induced pluripotent stem cell, iPSC, iPSC derived, iPS, stem cell, retinal ganglion cell, and RGC. Clinical trials were identified on the ClinicalTrials.gov website. RESULTS This review article is focused on disease modeling and the therapeutic strategies being explored with iPSC technologies for the 2 most common IONs, namely, dominant optic atrophy and Leber hereditary optic neuropathy. The rationale and translational advances for cell-based and gene-based therapies are explored, as well as opportunities for neuroprotection and drug screening. CONCLUSIONS iPSCs offer an elegant, patient-focused solution to the investigation of the genetic defects and disease mechanisms underpinning IONs. Furthermore, this group of disorders is uniquely amenable to both the disease modeling capability and the therapeutic potential that iPSCs offer. This fast-moving area will remain at the forefront of both basic and translational ION research in the coming years, with the potential to accelerate the development of effective therapies for patients affected with these blinding diseases.
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Affiliation(s)
- Joshua Paul Harvey
- UCL Institute of Ophthalmology (JPH, PES, PY-W-M, MC), London, United Kingdom; Moorfields Eye Hospital NHS Foundation Trust (JPH, PY-W-M), London, United Kingdom; Department of Clinical Neurosciences (PY-W-M), Cambridge Centre for Brain Repair, University of Cambridge, Cambridge, United Kingdom; and Department of Clinical Neurosciences (PY-W-M), John van Geest Centre for Brain Repair and MRC Mitochondrial Biology Unit, University of Cambridge, Cambridge, United Kingdom
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Lin CW, Huang CW, Luo AC, Chou YT, Huang YS, Chen PL, Chen TC. Genetic Spectrum and Characteristics of Hereditary Optic Neuropathy in Taiwan. Genes (Basel) 2021; 12:genes12091378. [PMID: 34573359 PMCID: PMC8467776 DOI: 10.3390/genes12091378] [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: 06/28/2021] [Revised: 07/20/2021] [Accepted: 08/30/2021] [Indexed: 12/30/2022] Open
Abstract
Hereditary optic neuropathy (HON) is a group of genetically heterogeneous diseases that cause optic nerve atrophy and lead to substantial visual impairment. HON may present with optic nerve atrophy only or in association with various systemic abnormalities. Although a genetic survey is indispensable for diagnosing HON, conventional sequencing techniques could render its diagnosis challenging. In this study, we attempted to explore the genetic background of patients with HON in Taiwan through capture-based next-generation sequencing targeting 52 HON-related genes. In total, 57 patients from 48 families were recruited, with 6 patients diagnosed as having Leber hereditary optic neuropathy through initial screening for three common variants (m.3460G>A, m.11778G>A, m.14484T>C). Disease-causing genotypes were identified in 14 (33.3%) probands, and OPA1 variants were the most prevalent cause of autosomal HON. Exposure to medications such as ethambutol could trigger an attack of autosomal dominant optic atrophy. WFS1 variants were identified in three probands with variable clinical features in our cohort. Hearing impairment could occur in patients with OPA1 or WFS1 variants. This is the first comprehensive study investigating the genetic characteristics of HON in Taiwan, especially for autosomal HON. Our results could provide useful information for clinical diagnosis and genetic counseling in this field.
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MESH Headings
- Adolescent
- Adult
- Aged
- Child
- Child, Preschool
- DNA Mutational Analysis/statistics & numerical data
- Female
- GTP Phosphohydrolases/genetics
- Genetic Counseling
- Genetic Testing/statistics & numerical data
- Humans
- Male
- Membrane Proteins/genetics
- Middle Aged
- Mutation
- Optic Atrophy, Autosomal Dominant/diagnosis
- Optic Atrophy, Autosomal Dominant/epidemiology
- Optic Atrophy, Autosomal Dominant/genetics
- Optic Atrophy, Hereditary, Leber/diagnosis
- Optic Atrophy, Hereditary, Leber/epidemiology
- Optic Atrophy, Hereditary, Leber/genetics
- Taiwan/epidemiology
- Young Adult
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Affiliation(s)
- Chao-Wen Lin
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan; (C.-W.L.); (C.-W.H.); (Y.-S.H.)
| | - Ching-Wen Huang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan; (C.-W.L.); (C.-W.H.); (Y.-S.H.)
| | - Allen Chilun Luo
- Department of Medical Genetics, National Taiwan University Hospital, Taipei 100, Taiwan; (A.C.L.); (Y.-T.C.)
| | - Yuh-Tsyr Chou
- Department of Medical Genetics, National Taiwan University Hospital, Taipei 100, Taiwan; (A.C.L.); (Y.-T.C.)
| | - Yu-Shu Huang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan; (C.-W.L.); (C.-W.H.); (Y.-S.H.)
| | - Pei-Lung Chen
- Department of Medical Genetics, National Taiwan University Hospital, Taipei 100, Taiwan; (A.C.L.); (Y.-T.C.)
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan
- Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei 100, Taiwan
- Correspondence: (P.-L.C.); (T.-C.C.); Tel.: +886-2-23123456 (ext. 71942) (P.-L.C.); +886-2-23123456 (ext. 63783) (T.-C.C.); Fax: +886-2-23934420 (T.-C.C.)
| | - Ta-Ching Chen
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan; (C.-W.L.); (C.-W.H.); (Y.-S.H.)
- Correspondence: (P.-L.C.); (T.-C.C.); Tel.: +886-2-23123456 (ext. 71942) (P.-L.C.); +886-2-23123456 (ext. 63783) (T.-C.C.); Fax: +886-2-23934420 (T.-C.C.)
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Pilz YL, Bass SJ, Sherman J. A Review of Mitochondrial Optic Neuropathies: From Inherited to Acquired Forms. J Optom 2017; 10:205-214. [PMID: 28040497 PMCID: PMC5595256 DOI: 10.1016/j.optom.2016.09.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 09/02/2016] [Accepted: 09/22/2016] [Indexed: 05/28/2023]
Abstract
In recent years, the term mitochondrial optic neuropathy (MON) has increasingly been used within the literature to describe a group of optic neuropathies that exhibit mitochondrial dysfunction in retinal ganglion cells (RGCs). Interestingly, MONs include genetic aetiologies, such as Leber hereditary optic neuropathy (LHON) and dominant optic atrophy (DOA), as well as acquired aetiologies resulting from drugs, nutritional deficiencies, and mixed aetiologies. Regardless of an inherited or acquired cause, patients exhibit the same clinical manifestations with selective loss of the RGCs due to mitochondrial dysfunction. Various novel therapies are being explored to reverse or limit damage to the RGCs. Here we review the pathophysiology, clinical manifestations, differential diagnosis, current treatment, and promising therapeutic targets of MON.
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MESH Headings
- DNA, Mitochondrial
- Diagnosis, Differential
- Humans
- Mitochondrial Diseases/diagnosis
- Mitochondrial Diseases/genetics
- Mitochondrial Diseases/physiopathology
- Mitochondrial Diseases/therapy
- Optic Atrophy, Autosomal Dominant/diagnosis
- Optic Atrophy, Autosomal Dominant/genetics
- Optic Atrophy, Autosomal Dominant/physiopathology
- Optic Atrophy, Autosomal Dominant/therapy
- Optic Atrophy, Hereditary, Leber/diagnosis
- Optic Atrophy, Hereditary, Leber/genetics
- Optic Atrophy, Hereditary, Leber/physiopathology
- Optic Atrophy, Hereditary, Leber/therapy
- Optic Nerve Diseases/diagnosis
- Optic Nerve Diseases/genetics
- Optic Nerve Diseases/physiopathology
- Optic Nerve Diseases/therapy
- Retinal Ganglion Cells/pathology
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Affiliation(s)
- Yasmine L Pilz
- State University New York, College of Optometry, New York, USA.
| | - Sherry J Bass
- State University New York, College of Optometry, New York, USA
| | - Jerome Sherman
- State University New York, College of Optometry, New York, USA
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Affiliation(s)
- Cecilia Rönnbäck
- Department of Ophthalmology, Glostrup Hospital, Glostrup, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Dan Milea
- Department of Ophthalmology, Glostrup Hospital, Glostrup, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Michael Larsen
- Department of Ophthalmology, Glostrup Hospital, Glostrup, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; National Eye Clinic, Kennedy Center, Glostrup, Denmark
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10
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Avetisov SÉ, Sheremet NL, Vorob'eva OK, Eliseeva ÉG, Chukhrova AL, Loginova AN, Khanakova NA, Poliakov AV. [Clinical and molecular genetic analysis of hereditary optic neuropathies]. Vestn Oftalmol 2013; 129:8-13. [PMID: 23808173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
DNA samples of 50 patients with optic neuropathy (ON) associated with congenital cataract were studied to find 3 major mt-DNA mutations (m.11778G>A, m.3460G>A, m.14484T>C), mutations in "hot" regions of OPA 1 gene (exons 8, 14, 15, 16, 18, 27, 28) and in the entire coding sequence of OPA3 gene for molecular genetic confirmation of diagnosis of hereditary Leber and autosomal dominant ON. Primary mutations of mtDNA responsible for hereditary Leber ON were found in 16 patients (32%). Pathogenic mutations of OPAl gene (c.869G>A and c. 2850delT) were identified in 2 patients (4%), these mutations were not found in the literature. OPA3 gene mutations were not revealed.
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MESH Headings
- Adolescent
- Adult
- Aged
- DNA Mutational Analysis
- DNA, Mitochondrial/genetics
- Female
- Genes, Mitochondrial
- Genetic Association Studies
- Genetic Testing/methods
- Humans
- Male
- Middle Aged
- Mutation
- Ophthalmoscopy/methods
- Optic Atrophy, Autosomal Dominant/diagnosis
- Optic Atrophy, Autosomal Dominant/genetics
- Optic Atrophy, Autosomal Dominant/physiopathology
- Optic Atrophy, Hereditary, Leber/diagnosis
- Optic Atrophy, Hereditary, Leber/genetics
- Optic Atrophy, Hereditary, Leber/physiopathology
- Pedigree
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11
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Abstract
Leber hereditary optic neuropathy (LHON) and autosomal dominant optic atrophy (DOA) are the two most common inherited optic neuropathies and they result in significant visual morbidity among young adults. Both disorders are the result of mitochondrial dysfunction: LHON from primary mitochondrial DNA (mtDNA) mutations affecting the respiratory chain complexes; and the majority of DOA families have mutations in the OPA1 gene, which codes for an inner mitochondrial membrane protein critical for mtDNA maintenance and oxidative phosphorylation. Additional genetic and environmental factors modulate the penetrance of LHON, and the same is likely to be the case for DOA which has a markedly variable clinical phenotype. The selective vulnerability of retinal ganglion cells (RGCs) is a key pathological feature and understanding the fundamental mechanisms that underlie RGC loss in these disorders is a prerequisite for the development of effective therapeutic strategies which are currently limited.
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MESH Headings
- DNA, Mitochondrial
- Female
- GTP Phosphohydrolases/genetics
- Humans
- Male
- Optic Atrophy, Autosomal Dominant/diagnosis
- Optic Atrophy, Autosomal Dominant/epidemiology
- Optic Atrophy, Autosomal Dominant/genetics
- Optic Atrophy, Autosomal Dominant/pathology
- Optic Atrophy, Hereditary, Leber/diagnosis
- Optic Atrophy, Hereditary, Leber/epidemiology
- Optic Atrophy, Hereditary, Leber/genetics
- Optic Atrophy, Hereditary, Leber/pathology
- Point Mutation
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Affiliation(s)
- P Yu-Wai-Man
- Mitochondrial Research Group, The Medical School, Newcastle University, Newcastle upon Tyne, UK
- Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - P G Griffiths
- Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - G Hudson
- Mitochondrial Research Group, The Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - P F Chinnery
- Mitochondrial Research Group, The Medical School, Newcastle University, Newcastle upon Tyne, UK
- Institute of Human Genetics, Newcastle University, Newcastle upon Tyne, NE1 3BZ, UK
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12
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Leo-Kottler B, Jägle H, Küpker T, Schimpf S. [How to distinguish between autosomal dominant optic atrophy and Leber's hereditary optic neuropathy]. Ophthalmologe 2008; 104:1060-5. [PMID: 17899121 DOI: 10.1007/s00347-007-1577-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Patients with long-lasting bilateral optic atrophy showed typical clinical features of autosomal dominant optic atrophy (ADOA). Molecular genetic analysis identified them as atypical cases of Leber's hereditary optic neuropathy (LHON). METHOD Three patients with bilateral optic atrophy and central scotomas of their visual fields were clinically diagnosed with ADOA. Samples of lymphocytic genomic DNA were amplified with polymerase chain reaction, and analysis of the coding exons including the flanking intron/UTR sequences of the OPA-1 gene was performed. However, no ADOA-associated mutations were found. We therefore analysed the total lymphocyte mitochondrial DNA for all common LHON mutations in these patients. RESULTS Three patients from three unrelated pedigrees (two men, one woman) who were clinically diagnosed as suffering from ADOA did not harbor any typical mutation of the OPA-1 gene. However, analysis of their mitochondrial DNA showed that they harbored the 3460, 11778, and 14484 LHON mutations. The patients were identified as atypical cases of LHON. The pedigrees of the patients fulfilled the criteria for both dominant and mitochondrial-maternal transmission in all cases. The clinical picture of LHON differed remarkably from the classic course of LHON. CONCLUSIONS To identify atypical LHON patients with bilateral optic atrophy and central scotomas in the visual field and to distinguish them from ADOA patients, careful molecular genetic analysis is necessary. In these rare cases, only double examinations of both the genomic and the mitochondrial DNA will allow these patients to be adequately advised.
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Affiliation(s)
- B Leo-Kottler
- Universitätsaugenklinik, Schleichstrasse 12-16, 72076 Tübingen.
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Ban Y, Yoshida Y, Kawasaki S, Mochida C. A novel mutation of the OPA1 gene in a Japanese patient with autosomal dominant optic atrophy. Graefes Arch Clin Exp Ophthalmol 2007; 245:1581-3. [PMID: 17579882 DOI: 10.1007/s00417-007-0598-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2006] [Revised: 02/20/2007] [Accepted: 04/12/2007] [Indexed: 11/29/2022] Open
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14
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Eiberg H, Hansen L, Kjer B, Hansen T, Pedersen O, Bille M, Rosenberg T, Tranebjaerg L. Autosomal dominant optic atrophy associated with hearing impairment and impaired glucose regulation caused by a missense mutation in the WFS1 gene. J Med Genet 2006; 43:435-40. [PMID: 16648378 PMCID: PMC2649014 DOI: 10.1136/jmg.2005.034892] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Autosomal dominant optic atrophy (ADOA) is genetically heterogeneous, with OPA1 on 3q28 being the most prevalently mutated gene. Additional loci are OPA3, OPA4, and OPA5, located at 19q13.2, 18q12.2, and 22q12.1-q13.1, respectively. Mutations in the WFS1 gene, at 4p16.3, are associated with either optic atrophy (OA) as part of the autosomal recessive Wolfram syndrome or with autosomal dominant progressive low frequency sensorineural hearing loss (LFSNHL) without any ophthalmological abnormalities. Linkage and sequence mutation analyses of the ADOA candidate genes OPA1, OPA3, OPA4, and OPA5, including the genes WFS1, GJB2, and GJB6 associated with recessive inherited OA or dominant LFSNHL, were performed. We identified one novel WFS1 missense mutation E864K, c.2590G-->A in exon 8 that co-segregates with ADOA combined with hearing impairment and impaired glucose regulation. This is the first example of autosomal dominant optic atrophy and hearing loss associated with a WFS1 mutation, supporting the notion that mutations in WFS1 as well as in OPA1 may lead to ADOA combined with impaired hearing.
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Affiliation(s)
- H Eiberg
- Department of Medical Biochemistry and Genetics, Panum Institute, University of Copenhagen, DK-2200 Copenhagen N, Denmark.
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Walters JW, Gaume A, Pate L. Short wavelength-automated perimetry compared with standard achromatic perimetry in autosomal dominant optic atrophy. Br J Ophthalmol 2006; 90:1267-70. [PMID: 16837542 PMCID: PMC1857431 DOI: 10.1136/bjo.2006.097196] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Autosomal dominant optic atrophy (ADOA, Kjer-type) is a heterogeneous, non-inflammatory degeneration of retinal ganglion cells. The diagnosis of ADOA can be challenging owing to its insidious onset and large variability in phenotypic expression, both within and between individual pedigrees. The earliest literature reports relatively mild centrocaecal scatomas to white targets in ADOA, but extensive and dense peripheral field loss to coloured targets, especially blue, with Bjerrum perimetry. The phrase "inverted peripheral visual fields to coloured targets" has been used to describe this phenomenon. METHODS Humphrey standard achromatic perimetry (SAP) and short wavelength-automated perimetry (SWAP) were carried out on five patients with ADOA. RESULTS Regardless of wide variations in patient age, visual acuity, disc appearance and colour vision, the SWAP mean deviation (MD) was between 10 and 20 times more depressed than the SAP MD. The actual differences ranged from 9.38 to 13.78 dB. CONCLUSIONS These data are consistent with the original reports suggesting that, early in this disease process, the blue-target deficits are typically peripheral and that this difference between SAP and SWAP perimetry may be a robust indicator of ADOA in both early and late stages of this disease.
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Affiliation(s)
- J W Walters
- College of Optometry, University of Houston, J Davis Armistead Building, Houston, TX 77204-6052, USA.
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Newman NJ. Hereditary optic neuropathies: from the mitochondria to the optic nerve. Am J Ophthalmol 2005; 140:517-23. [PMID: 16083845 DOI: 10.1016/j.ajo.2005.03.017] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2004] [Revised: 03/01/2005] [Accepted: 03/02/2005] [Indexed: 12/22/2022]
Abstract
PURPOSE To review our current knowledge of inherited optic neuropathies. DESIGN Perspective. METHODS Literature review. RESULTS The hereditary optic neuropathies consist of a group of disorders in which optic nerve dysfunction figures solely or prominently and direct inheritance is clinically or genetically proven. The most common of these disorders are autosomal dominant optic atrophy (Kjers' disease) and maternally-inherited Leber's hereditary optic neuropathy. Other inherited neurologic and systemic syndromic diseases will frequently manifest optic neuropathy. A selective vulnerability of the optic nerve to perturbations in mitochondrial function may underlie a final common pathway among these disorders. CONCLUSIONS The ophthalmologist should be familiar with the clinical characteristics and diagnosis of the hereditary optic neuropathies. Recent advances in our understanding of the underlying pathophysiology of the inherited optic neuropathies may provide insight into their treatment and the treatment of acquired optic nerve disorders.
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Affiliation(s)
- Nancy J Newman
- Department of Ophthalmology, Emory University School of Medicine, Emory Eye Center, 1365-B Clifton Road NE, Atlanta, GA 30322, USA.
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Puomila A, Huoponen K, Mäntyjärvi M, Hämäläinen P, Paananen R, Sankila EM, Savontaus ML, Somer M, Nikoskelainen E. Dominant optic atrophy: correlation between clinical and molecular genetic studies. ACTA ACUST UNITED AC 2005; 83:337-46. [PMID: 15948788 DOI: 10.1111/j.1600-0420.2005.00448.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To assess the clinical picture and molecular genetics of 14 Finnish families with dominant optic atrophy (DOA). METHODS The clinical status of family members was based on the assessment of visual acuity, colour vision, visual fields and optic nerve appearance; 31 individuals were affected, two suspect and 21 unaffected. A total of 30 coding exons and exon- intron boundaries of the OPA1 gene were sequenced in order to detect mutations. RESULTS Half the patients were diagnosed at the age of < or = 20 years. Ten out of 20 affected individuals followed up for > or = 6 years had a progressive disease and 10 had a stable disease. According to WHO criteria, 36% of the affected patients were visually handicapped. Eight OPA1 pathogenic mutations, all but one novel, and 18 neutral polymorphisms were detected. CONCLUSION The most sensitive indicators of DOA were optic disc pallor and dyschromatopsia. With molecular genetic analysis, asymptomatic mutation carriers and DOA cases with a mild clinical outcome were ascertained. No mutational hotspot or Finnish major mutation in the OPA1 gene could be demonstrated as most families carried a unique mutation. No obvious genotype- phenotype correlation could be detected. Detailed clinical assessment and exclusion of non-DOA families prior to mutation screening are necessary for obtaining a high mutation detection rate.
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Affiliation(s)
- Anu Puomila
- Department of Medical Genetics, University of Turku, Turku, Finland.
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Abstract
Dominant optic atrophy is the most common heredodegenerative optic neuropathy. Typically, patients present with slowly progressive, bilaterally decreased central visual acuity. Subtle central or cecocentral visual field defect and normal peripheral isopters are demonstrated with perimetry. A defect in blue-yellow discrimination (tritan error axis) is the most common type of dyschromatopsia, however protan and deutan axes may be superimposed. A characteristic optic disk appearance includes temporal disk pallor with excavation. An autosomal dominant inheritance pattern can often be elicited from the family history.
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Affiliation(s)
- Lawrence M Buono
- Neuro-Ophthalmology Service, Wills Eye Hospital/Thomas Jefferson Medical College, Philadelphia, Pennsylvania 19107, USA
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Abstract
PURPOSE To report a novel mutation of the OPA1 gene in a Japanese family with optic atrophy type 1 (OPA1) and to describe the clinical features of this family. METHODS Standard ocular examinations were performed on the proband and his two affected sons. The DNA sequence of all exons and splice sites of the OPA1 gene was determined to detect mutations. RESULTS The proband and his sons had a heterozygous mutation of the OPA1 gene in the third nucleotide of intron 12 (IVS12+3A-->T). Clinically, each patient had reduced visual acuity (onset within the first 6 years of life) and optic nerve pallor. The proband showed bilateral central scotomas and generalized dyschroatopsia. This is the first report of OPA1 gene mutation in Japanese patients with familial optic atrophy. CONCLUSIONS A mutation of the OPA1 gene was detected in a Japanese family with OPA1, which follows the same pattern as reported in Western countries. It is suggested that mutations of the OPA1 gene contribute to the development of optic nerve atrophy regardless of ethnic groups. Screening for the OPA1 gene mutation will be useful for diagnosis of OPA1 in Japanese patients.
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Affiliation(s)
- Satoko Shimizu
- Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan
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