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Li J, Hu YQ, Cheng HB, Wang T, Kuang LH, Huang T, Yan XH. RDH12-associated retinal degeneration caused by a homozygous pathogenic variant of 146C>T and literature review. Int J Ophthalmol 2024; 17:311-316. [PMID: 38371258 PMCID: PMC10827614 DOI: 10.18240/ijo.2024.02.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 12/01/2023] [Indexed: 02/20/2024] Open
Abstract
AIM To describe the clinical, electrophysiological, and genetic features of an unusual case with an RDH12 homozygous pathogenic variant and reviewed the characteristics of the patients reported with the same variant. METHODS The patient underwent a complete ophthalmologic examination including best-corrected visual acuity, anterior segment and dilated fundus, visual field, spectral-domain optical coherence tomography (OCT) and electroretinogram (ERG). The retinal disease panel genes were sequenced through chip capture high-throughput sequencing and Sanger sequencing was used to confirm the result. Then we reviewed the characteristics of the patients reported with the same variant. RESULTS A 30-year male presented with severe early retinal degeneration who complained night blindness, decreased visual acuity, vitreous floaters and amaurosis fugax. The best corrected vision was 0.04 OD and 0.12 OS, respectively. The fundus photo and OCT showed bilateral macular atrophy but larger areas of macular atrophy in the left eye. Autofluorescence shows bilateral symmetrical hypo-autofluorescence. ERG revealed that the amplitudes of a- and b-wave were severely decreased. Multifocal ERG showed decreased amplitudes in the local macular area. A homozygous missense variant c.146C>T (chr14:68191267) was found. The clinical characteristics of a total of 13 patients reported with the same pathologic variant varied. CONCLUSION An unusual patient with a homozygous pathogenic variant in the c.146C>T of RDH12 which causes late-onset and asymmetric retinal degeneration are reported. The clinical manifestations of the patient with multimodal retinal imaging and functional examinations have enriched our understanding of this disease.
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Affiliation(s)
- Jin Li
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, Guangdong Province, China
| | - Yi-Qun Hu
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, Guangdong Province, China
| | - Hong-Bo Cheng
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, Guangdong Province, China
| | - Ting Wang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, Guangdong Province, China
| | - Long-Hao Kuang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, Guangdong Province, China
| | - Tao Huang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, Guangdong Province, China
| | - Xiao-He Yan
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, Guangdong Province, China
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Daich Varela M, Moya R, Azevedo Souza Amaral R, Schlottmann PG, Álvarez Mendiara A, Francone A, Guazi Resende R, Capalbo L, Gelvez N, López G, Morales-Acevedo AM, Ossa RH, Arno G, Michaelides M, Tamayo ML, Ferraz Sallum JM. Clinical and Genetic Characterization of RDH12-Retinal Dystrophy in a South American Cohort. Ophthalmol Retina 2024; 8:163-173. [PMID: 37714431 DOI: 10.1016/j.oret.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/30/2023] [Accepted: 09/06/2023] [Indexed: 09/17/2023]
Abstract
PURPOSE To characterize the largest cohort of individuals with retinol dehydrogenase 12 (RDH12)-retinal dystrophy to date, and the first one from South America. DESIGN Retrospective multicenter international study. SUBJECTS Seventy-eight patients (66 families) with an inherited retinal dystrophy and biallelic variants in RDH12. METHODS Review of clinical notes, ophthalmic images, and molecular diagnosis. MAIN OUTCOME MEASURES Visual function, retinal imaging, and characteristics were evaluated and correlated. RESULTS Thirty-seven individuals self-identified as Latino (51%) and 34 as White (47%). Sixty-nine individuals (88%) had Leber congenital amaurosis (LCA)/early-onset severe retinal dystrophy. Macular and midperipheral atrophy were seen in all patients from 3 years of age. A novel retinal finding was a hyperautofluorescent ring in 2 young children with LCA. Thirty-nine patients (50%) had subsequent visits, with mean follow-up of 6.8 ± 7.3 (range, 0-29) years. Eight variants (21%) were previously unreported, and the most frequent variant was c.295C>A, p.Leu99Ile, present in 52 alleles of 32 probands. Individuals with LCA homozygous for p.Leu99Ile (31%) had a later age of onset, a slower rate of best-corrected visual acuity decrease, the largest percentage of patients with mild visual impairment, and were predicted to reach legal blindness at an older age than the rest of the cohort. CONCLUSIONS By describing the largest molecularly confirmed cohort to date, improved understanding of disease progression was possible. Our detailed characterization aims to support research and the development of novel therapies that may have the potential to reduce or prevent vision loss in individuals with RDH12-associated retinal dystrophy. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures.
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Affiliation(s)
- Malena Daich Varela
- Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, University College London, London, United Kingdom.
| | - Rene Moya
- Departamento de Retina y Departamento de Genética Ocular, Hospital del Salvador, Universidad de Chile, Santiago, Chile
| | - Rebeca Azevedo Souza Amaral
- Ophthalmology Department, Federal University of São Paulo (UNIFESP), São Paulo, Brazil; Instituto de Genética Ocular, São Paulo, Brazil
| | | | | | | | | | | | - Nancy Gelvez
- Instituto de Genética Humana, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Greizy López
- Instituto de Genética Humana, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Rafael H Ossa
- Instituto de Genética Humana, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Gavin Arno
- Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Michel Michaelides
- Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Martha L Tamayo
- Instituto de Genética Humana, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Juliana Maria Ferraz Sallum
- Ophthalmology Department, Federal University of São Paulo (UNIFESP), São Paulo, Brazil; Instituto de Genética Ocular, São Paulo, Brazil
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Daich Varela M, Michaelides M. RDH12 retinopathy: clinical features, biology, genetics and future directions. Ophthalmic Genet 2022; 43:1-6. [PMID: 35491887 PMCID: PMC10479312 DOI: 10.1080/13816810.2022.2062392] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/14/2022] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
Abstract
Retinol dehydrogenase 12 (RDH12) is a small gene located on chromosome 14, encoding an enzyme capable of metabolizing retinoids. It is primarily located in photoreceptor inner segments and thereby is believed to have an important role in clearing excessive retinal and other toxic aldehydes produced by light exposure. Clinical features: RDH12-associated retinopathy has wide phenotypic variability; including early-onset severe retinal dystrophy/Leber Congenital Amaurosis (EOSRD/LCA; most frequent presentation), retinitis pigmentosa, cone-rod dystrophy, and macular dystrophy. It can be inherited in an autosomal recessive and dominant fashion. RDH12-EOSRD/LCA's key features are early visual impairment, petal-shaped, coloboma-like macular atrophy with variegated watercolour-like pattern, peripapillary sparing, and often dense bone spicule pigmentation. Future directions: There is currently no treatment available for RDH12-retinopathy. However, extensive preclinical investigations and an ongoing prospective natural history study are preparing the necessary foundation to design and establish forthcoming clinical trials. Herein, we will concisely review pathophysiology, molecular genetics, clinical features, and discuss therapeutic approaches.
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Affiliation(s)
- Malena Daich Varela
- UCL Institute of Ophthalmology, University College London, London, UK
- Moorfields Eye Hospital, London, UK
| | - Michel Michaelides
- UCL Institute of Ophthalmology, University College London, London, UK
- Moorfields Eye Hospital, London, UK
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Associations Between Fundus Types and Clinical Manifestations in Patients with RDH12 Gene Mutations. Brain Topogr 2022; 35:525-535. [PMID: 35006499 DOI: 10.1007/s10548-021-00885-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/27/2021] [Indexed: 12/27/2022]
Abstract
To study the associations between RDH12 gene mutations, fundus types, and clinical manifestations. In total, 46 patients with inherited eye diseases caused by RDH12 gene mutations were included in this study. High-throughput chip capture sequencing, Sanger sequencing, and gene panel detection were used to determine that RDH12 was the pathogenic gene. All patients underwent the following detailed ophthalmic examinations: visual acuity, visual field, intraocular pressure, fundus photography, electroretinography, and optical coherence tomography (OCT). Statistical analysis was used to evaluate the clinical phenotype. A total of 32 mutations were identified in 46 patients. The most common mutations were c.437T > A, c.184C > T, and c.524C > T; the corresponding amino acid changes were p.Val146Asp, p.Arg62Ter, and p.Ser175Leu. Of the 46 patients, retinitis pigmentosa (RP) was found in 31 (68.9%); leber congenital amaurosis (LVA) was found in 11 (24.4%); early onset of severe retinal dystrophy (EOSRD) was found in one (2.2%); cone rod dystrophy (CORD) was found in one (2.2%); and Stargardt disease was found in one (2.2%). There was a significant difference in best-corrected visual acuity among patients based on fundus type (p = 0.0124). Linear trend analysis showed that best-corrected visual acuity gradually decreased as the fundus type increased in severity. In addition, there was a significant difference in the incidence of night blindness among patients with different fundus types (p = 0.0429): types I and IV fundi were associated with the highest incidences of night blindness. RDH12 gene mutation can cause serious inherited retinal diseases, which primarily include RP and LCA. Combined with clinical symptoms and fundus types, the progression of the disease can be characterized and used to guide genetic diagnosis and gene therapy.
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Bian J, Chen H, Sun J, Cao Y, An J, Pan Q, Qi M. Gene Therapy for Rdh12-Associated Retinal Diseases Helps to Delay Retinal Degeneration and Vision Loss. DRUG DESIGN DEVELOPMENT AND THERAPY 2021; 15:3581-3591. [PMID: 34429587 PMCID: PMC8380142 DOI: 10.2147/dddt.s305378] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/04/2021] [Indexed: 12/15/2022]
Abstract
Purpose The aim of study was to establish Rdh12-associated inherited retinal disease (Rdh12-IRD) mouse model and to identify the best timepoint for gene therapy. Methods We induced retinal degeneration in Rdh12-/- mice using a bright light. We clarified the establishment of Rdh12-IRD mouse model by analyzing the thickness of retinal layers and electroretinography (ERG). Rdh12-IRD mice received a subretinal injection of adeno-associated virus 2/8-packaged Rdh12 cDNA for treatment. We evaluated the visual function and retinal structure in the treated and untreated eyes to identify the best timepoint for gene therapy. Results Rdh12-IRD mice showed significant differences in ERG amplitudes and photoreceptor survival compared to Rdh12+/+ mice. Preventive gene therapy not only maintained normal visual function but also prevented photoreceptor loss. Salvage gene therapy could not reverse the retinal degeneration phenotype of Rdh12-IRD mice, but it could slow down the loss of visual function. Conclusion The light-induced retinal degeneration in our Rdh12-/- mice indicated that a defect in Rdh12 alone was sufficient to cause visual dysfunction and photoreceptor degeneration, which reproduced the phenotypes observed in RDH12-IRD patients. This model is suitable for gene therapy studies. Early treatment of the primary Rdh12 defect helps to delay the later onset of photoreceptor degeneration and maintains visual function in Rdh12-IRD mice.
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Affiliation(s)
- Jiaxin Bian
- Department of Cell Biology and Medical Genetics, School of Medicine Zhejiang University, Hangzhou, 310000, People's Republic of China.,Center for Precision Medicine, Zhejiang-California International NanoSystems Institute, Hangzhou, 310000, People's Republic of China
| | - Hongyu Chen
- Department of Cell Biology and Medical Genetics, School of Medicine Zhejiang University, Hangzhou, 310000, People's Republic of China.,Center for Precision Medicine, Zhejiang-California International NanoSystems Institute, Hangzhou, 310000, People's Republic of China
| | - Junhui Sun
- Department of Cell Biology and Medical Genetics, School of Medicine Zhejiang University, Hangzhou, 310000, People's Republic of China.,Center for Precision Medicine, Zhejiang-California International NanoSystems Institute, Hangzhou, 310000, People's Republic of China
| | - Yuqing Cao
- School of Optometry and Ophthalmology Wenzhou Medical College, Wenzhou, People's Republic of China
| | - Jianhong An
- School of Optometry and Ophthalmology Wenzhou Medical College, Wenzhou, People's Republic of China
| | - Qing Pan
- Department of Ophthalmology, Zhejiang University Medical School First Affiliated Hospital, Hangzhou, 310000, People's Republic of China
| | - Ming Qi
- Department of Cell Biology and Medical Genetics, School of Medicine Zhejiang University, Hangzhou, 310000, People's Republic of China.,Center for Precision Medicine, Zhejiang-California International NanoSystems Institute, Hangzhou, 310000, People's Republic of China.,Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Department of Laboratory Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, 310000, People's Republic of China.,DIAN Diagnostics, Hangzhou, 310000, People's Republic of China.,Department of Pathology and Laboratory of Medicine, University of Rochester Medical Centre, Rochester, NY, 14609, USA.,HVP-China, Hangzhou, 310000, People's Republic of China
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Zhu L, Ouyang W, Zhang M, Wang H, Li S, Meng X, Yin ZQ. Molecular genetics with clinical characteristics of Leber congenital amaurosis in the Han population of western China. Ophthalmic Genet 2021; 42:392-401. [PMID: 33970760 DOI: 10.1080/13816810.2021.1904417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Purpose: Leber congenital amaurosis (LCA) is one of the earliest inherited retinal dystrophies (IRD) that leads to blindness. To date, there have been 25 LCA-associated genes reported in China as well as other countries. The current study aimed to present the dominant molecular genetics and clinical features of LCA in the Han population of western China.Methods: Our study comprised 37 patients with strictly defined Leber congenital amaurosis in a cohort of IRD (2009-2019). The mutations were detected by targeted next-generation sequencing (NGS), Sanger sequencing, and segregation analysis. The patients underwent comprehensive clinical examinations, analysis of phenotypes and genotypes.Results: Out of the 37 patients, 34 harbored known LCA genes; the detection rate of mutations was 91.9%. Forty-seven different alleles incorporated 21 novel mutations; 8 were known LCA-associated genes. The three most frequently mutated genes included CRB1 (27.0%), RDH12 (24.3%), and RPGRIP1 (18.9%). The CRB1-associated LCA showed a pigmented fundus; the RDH12-associated LCA featured macular atrophy. Our results revealed that CRB1 and RPGRIP1 genes occupied a greater proportion in the western Chinese population. The proportion of these two genes was similar in other regions of China as well. The difference existed in a larger proportion of RDH12-associated LCA in the western Chinese population.Conclusions: The new findings in our study group polished the spectrum of the novel mutations and phenotypes of LCA with regional and ethnic variations. This comprehensive database can provide essential information for gene therapies.
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Affiliation(s)
- Luyao Zhu
- Southwest Hospital/Southwest Eye Hospital, Army Medical University, Chongqing, China.,Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Army Medical University, Chongqing, China
| | - Wangbin Ouyang
- Southwest Hospital/Southwest Eye Hospital, Army Medical University, Chongqing, China.,Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Army Medical University, Chongqing, China
| | - Minfang Zhang
- Southwest Hospital/Southwest Eye Hospital, Army Medical University, Chongqing, China.,Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Army Medical University, Chongqing, China
| | - Hao Wang
- Southwest Hospital/Southwest Eye Hospital, Army Medical University, Chongqing, China.,Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Army Medical University, Chongqing, China
| | - Shiying Li
- Southwest Hospital/Southwest Eye Hospital, Army Medical University, Chongqing, China.,Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Army Medical University, Chongqing, China
| | - Xiaohong Meng
- Southwest Hospital/Southwest Eye Hospital, Army Medical University, Chongqing, China.,Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Army Medical University, Chongqing, China
| | - Zheng Qin Yin
- Southwest Hospital/Southwest Eye Hospital, Army Medical University, Chongqing, China.,Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Army Medical University, Chongqing, China
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