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Lee SJ, Emery D, Vukmanic E, Wang Y, Lu X, Wang W, Fortuny E, James R, Kaplan HJ, Liu Y, Du J, Dean DC. Metabolic transcriptomics dictate responses of cone photoreceptors to retinitis pigmentosa. Cell Rep 2023; 42:113054. [PMID: 37656622 PMCID: PMC10591869 DOI: 10.1016/j.celrep.2023.113054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/21/2023] [Accepted: 08/15/2023] [Indexed: 09/03/2023] Open
Abstract
Most mutations in retinitis pigmentosa (RP) arise in rod photoreceptors, but cone photoreceptors, responsible for high-resolution daylight and color vision, are subsequently affected, causing the most debilitating features of the disease. We used mass spectroscopy to follow 13C metabolites delivered to the outer retina and single-cell RNA sequencing to assess photoreceptor transcriptomes. The S cone metabolic transcriptome suggests engagement of the TCA cycle and ongoing response to ROS characteristic of oxidative phosphorylation, which we link to their histone modification transcriptome. Tumor necrosis factor (TNF) and its downstream effector RIP3, which drive ROS generation via mitochondrial dysfunction, are induced and activated as S cones undergo early apoptosis in RP. The long/medium-wavelength (L/M) cone transcriptome shows enhanced glycolytic capacity, which maintains their function as RP progresses. Then, as extracellular glucose eventually diminishes, L/M cones are sustained in long-term dormancy by lactate metabolism.
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Affiliation(s)
- Sang Joon Lee
- Department of Medicine, Brown Cancer Center, University of Louisville Health Sciences Center, Louisville, KY 40202, USA; Department of Ophthalmology, Kosin University College of Medicine, #262 Gamcheon-ro, Seo-gu, Busan 49267, Korea
| | - Douglas Emery
- Department of Medicine, Brown Cancer Center, University of Louisville Health Sciences Center, Louisville, KY 40202, USA
| | - Eric Vukmanic
- Department of Medicine, Brown Cancer Center, University of Louisville Health Sciences Center, Louisville, KY 40202, USA
| | - Yekai Wang
- Departments of Ophthalmology and Visual Sciences and Biochemistry and Molecular Medicine, West Virginia University, Morgantown, WV 26506, USA
| | - Xiaoqin Lu
- Department of Medicine, Brown Cancer Center, University of Louisville Health Sciences Center, Louisville, KY 40202, USA
| | - Wei Wang
- Department of Ophthalmology and Visual Sciences, University of Louisville Health Sciences Center, Louisville, KY 40202, USA
| | - Enzo Fortuny
- Department of Neurosurgery, University of Louisville Health Sciences Center, Louisville, KY 40202, USA
| | - Robert James
- Department of Neurosurgery, University of Louisville Health Sciences Center, Louisville, KY 40202, USA
| | - Henry J Kaplan
- Department of Ophthalmology, St. Louis University School of Medicine, St. Louis MO 63110, USA
| | - Yongqing Liu
- Department of Medicine, Brown Cancer Center, University of Louisville Health Sciences Center, Louisville, KY 40202, USA
| | - Jianhai Du
- Departments of Ophthalmology and Visual Sciences and Biochemistry and Molecular Medicine, West Virginia University, Morgantown, WV 26506, USA.
| | - Douglas C Dean
- Department of Medicine, Brown Cancer Center, University of Louisville Health Sciences Center, Louisville, KY 40202, USA.
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A Novel Autosomal Recessive Variant of the NRL Gene Causing Enhanced S-Cone Syndrome: A Morpho-Functional Analysis of Two Unrelated Pediatric Patients. Diagnostics (Basel) 2022; 12:diagnostics12092183. [PMID: 36140584 PMCID: PMC9497687 DOI: 10.3390/diagnostics12092183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
Enhanced S-cone syndrome (ESCS) is a rare autosomal recessive retinal degeneration mainly associated with pathogenic variations in the NR2E3 gene. Only a few pathogenic variations in the NRL gene associated with ESCS have been reported to date. Here, we describe the clinical and genetic findings of two unrelated pediatric patients with a novel frameshift homozygous variant in the NRL gene. Fundus examinations showed signs of peripheral degeneration in both patients, more severe in Proband 2, with relative sparing of the macular area. Spectral domain optical coherence tomography (SD-OCT) revealed a significant macular involvement with cysts in Proband 1, and minimal foveal alteration with peripheral retina involvement in Proband 2. Visual acuity was abnormal in both patients, but more severely affected in Proband 1 than Proband 2. The electroretinogram recordings showed reduced scotopic, mixed and single flash cone responses, with a typical supernormal S-cone response, meeting the criteria for a clinical diagnosis of ESCS in both patients. The present report expands the clinical and genetic spectrum of NRL-associated ESCS, and confirms the age-independent variability of phenotypic presentation already described in the NR2E3-associated ESCS.
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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] [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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Haseoka T, Inagaki R, Kurata K, Arai S, Takagi Y, Suzuki H, Hikoya A, Nishimura K, Hotta Y, Sato M. Usefulness of handheld electroretinogram system for diagnosing blue-cone monochromatism in children. Jpn J Ophthalmol 2020; 65:23-29. [PMID: 33135089 DOI: 10.1007/s10384-020-00782-9] [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: 05/13/2020] [Accepted: 09/09/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To report the diagnosis of three childhood patients with blue-cone monochromatism (BCM) using S-cone electroretinograms (ERG) recorded with RETeval® Complete. STUDY DESIGN Prospective clinical study. METHODS We examined three boys initially suspected of having rod monochromatism. S-cone ERG was performed with red background and blue flashed light stimulation using two different intensities: 0.25 cd × s/m2 and 1 cd × s/m2. RESULTS Case 1 was a 12-year-old boy with a visual acuity of 0.1 OU. Case 2 was an 8-year-old boy with a visual acuity of 0.3 OD and 0.2 OS. Both cases showed a myopic fundus and nystagmus without any other ocular abnormalities. Case 3 was a 6-year-old boy with a visual acuity of 0.3 OD and 0.4 OS. He also showed myopic fundus changes, but nystagmus was not observed. Rod and maximal responses recorded with RETeval® were likely to be within normal range; however, cone responses were absent in all cases. S-cone ERGs showed positive responses at 40 ms with 0.25 cd × s/m2 intensity in Case 2, and at approximately 30-40 ms with 1.0 cd × s/m2 intensity in all three cases. These ERG findings led to a diagnosis of BCM. CONCLUSIONS S-cone ERG of RETeval® was helpful in diagnosing with minimal invasion BCM in childhood patients.
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Affiliation(s)
- Takashi Haseoka
- Department of Ophthalmology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu-shi, Higashi-ku, Shizuoka, 431-3192, Japan
| | - Risako Inagaki
- Department of Ophthalmology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu-shi, Higashi-ku, Shizuoka, 431-3192, Japan
| | - Kentaro Kurata
- Department of Ophthalmology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu-shi, Higashi-ku, Shizuoka, 431-3192, Japan
| | - Shinji Arai
- Department of Ophthalmology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu-shi, Higashi-ku, Shizuoka, 431-3192, Japan
| | - Yuri Takagi
- Department of Ophthalmology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu-shi, Higashi-ku, Shizuoka, 431-3192, Japan
| | - Hiroko Suzuki
- Department of Ophthalmology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu-shi, Higashi-ku, Shizuoka, 431-3192, Japan
| | - Akiko Hikoya
- Department of Ophthalmology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu-shi, Higashi-ku, Shizuoka, 431-3192, Japan
| | - Kasumi Nishimura
- Shizuoka Children's Hospital, Shizuoka, Japan
- Ueno Ganka Clinic Ophthalmology, Shizouka, Japan
| | - Yoshihiro Hotta
- Department of Ophthalmology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu-shi, Higashi-ku, Shizuoka, 431-3192, Japan
| | - Miho Sato
- Department of Ophthalmology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu-shi, Higashi-ku, Shizuoka, 431-3192, Japan.
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Perlman I, Kondo M, Chelva E, Robson AG, Holder GE. ISCEV extended protocol for the S-cone ERG. Doc Ophthalmol 2019; 140:95-101. [PMID: 31749034 DOI: 10.1007/s10633-019-09730-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 10/04/2019] [Indexed: 11/30/2022]
Abstract
The International Society for Clinical Electrophysiology of Vision (ISCEV) standard for full-field electroretinography (ERG) describes a minimum procedure for testing generalized retinal function but encourages more extensive testing. This extended protocol describes a method of assessing the function of the short-wavelength-sensitive cone (S-cone) retinal pathway, using a short-wavelength flash superimposed on a background that saturates the rods and adapts the L/M-cones to elicit a response, known as the S-cone ERG. Stimulus parameters such as the strength and luminance of the flash and background, respectively, and their spectral and temporal characteristics are specified. As a complement to the ISCEV standard, testing the S-cone ERG enables further characterization of light-adapted retinal function and may refine diagnosis of some retinal disorders. Typical applications are described including use in the diagnosis of rod monochromacy and S-cone monochromacy, identification and investigation of cone On-bipolar cell dysfunction and use of the technique to confirm the diagnosis of enhanced S-cone syndrome.
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Affiliation(s)
- Ido Perlman
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. .,Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
| | - Mineo Kondo
- Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Enid Chelva
- Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Anthony G Robson
- Moorfield Eye Hospital and Institute of Ophthalmology, University College London, London, UK
| | - Graham E Holder
- National University of Singapore, Singapore, Singapore.,UCL Institute of Ophthalmology, London, UK
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Mowat FM, Wise E, Oh A, Foster ML, Kremers J. In vivo electroretinographic differentiation of rod, short-wavelength and long/medium-wavelength cone responses in dogs using silent substitution stimuli. Exp Eye Res 2019; 185:107673. [PMID: 31128103 DOI: 10.1016/j.exer.2019.05.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 05/20/2019] [Accepted: 05/21/2019] [Indexed: 02/05/2023]
Abstract
The canine species has dichromatic color vision comprising short-wavelength (S-) and long/medium (L/M-) wavelength-sensitive cones with peak spectral sensitivity of 429-435 nm and 555 nm respectively. Although differentiation of rod- and cone-mediated responses by electroretinogram (ERG) in dogs is commonly performed, and standards have been developed based on standards for human observers, methods to differentiate S- and L/M-cone responses in dogs have not been described. We developed flicker protocols derived from previously published rod and cone spectral sensitivities. We used a double silent substitution paradigm to isolate responses from each of the 3 photoreceptor subclasses. ERG responses were measured to sine-wave modulation of photoreceptor excitation at different temporal frequencies (between 4 and 56 Hz) and mean luminance (between 3.25 and 130 cd/m2) on 6 different normal dogs (3 adult female, and 3 adult male beagles) and one female beagle dog with suspected hereditary congenital stationary night blindness (CSNB). Peak rod driven response amplitudes were achieved with low frequency (4 Hz, maximal range 4-12 Hz) and low mean luminance (3.25 cd/m2). In contrast, peak L/M-cone driven response amplitudes were achieved with high frequency (32 Hz, maximal range 28-44 Hz) and high mean luminance (32.5-130 cd/m2). Maximal S-cone driven responses were obtained with low frequency stimuli (4 Hz, maximal range 4-12 Hz) and 32.5-130 cd/m2 mean luminance. The dog with CSNB had reduced rod- and S-cone-driven responses, but normal/supernormal L/M cone-driven responses. We have developed methods to differentiate rod, S- and L/M-cone function in dogs using silent substitution methods. The influence of temporal frequency and mean luminance on the ERGs originating in each photoreceptor type can now be studied independently. Dogs and humans have similar L/M cone responses, whereas mice have significantly different L/M responses. This work will facilitate a greater understanding of canine retinal electrophysiology and will complement the study of canine models of human hereditary photoreceptor disorders.
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Affiliation(s)
- Freya M Mowat
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.
| | - Elisabeth Wise
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Annie Oh
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Melanie L Foster
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Jan Kremers
- University Hospital Erlangen, Erlangen, Germany
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Campi I, Cammarata G, Bianchi Marzoli S, Beck-Peccoz P, Santarsiero D, Dazzi D, Bottari de Castello A, Taroni EG, Viola F, Mian C, Watutantrige-Fernando S, Pelusi C, Muzza M, Maffini MA, Persani L. Retinal Photoreceptor Functions Are Compromised in Patients With Resistance to Thyroid Hormone Syndrome (RTHβ). J Clin Endocrinol Metab 2017; 102:2620-2627. [PMID: 28379567 DOI: 10.1210/jc.2016-3671] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 03/27/2017] [Indexed: 01/29/2023]
Abstract
CONTEXT In animal models, disruption of thyroid hormone (TH) receptor-β (TRβ) reduces the long/medium wavelength (L/M) and increases the short-wavelength (S) cones. Retinal photoreceptor (RP) functions are unknown in patients with resistance to TH syndrome (RTHβ) with dominant-negative TRβ mutations. OBJECTIVE To investigate RP functions in RTHβ. DESIGN, SETTING, AND PARTICIPANTS Case-control study involving 27 RTHβ patients and 31 age/sex-matched controls, conducted in two tertiary referral centers in Italy. MAIN OUTCOME MEASURES Color vision sensitivity assessed by Farnsworth; central macular thickness (CMT) of the outer retinal layer measured by spectral-domain optical coherence tomography; and retinal function tested by full-field electroretinogram (ERG) and S-cone ERG. RESULTS Color sensitivity was worse in RTHβ patients than controls (P = 0.002). CMT was overlapping between the study groups but directly correlated with sex hormone-binding globuline levels in RTHβ. We found a significant reduction in amplitude of the cone (P = 0.024) and of the rod response (P = 0.006) in the ERG of RTHβ patients compared with controls. The response of the L/M cones measured by a specialized ERG test was lower in RTHβ than controls (P = 0.027), whereas no differences were found in the S-cone response. No correlations were found between TH levels, total error score, or electrophysiological results. Furthermore, no differences were found between patients with maternal or de novo/paternal inheritance. CONCLUSIONS We report, to our knowledge, the first in vivo evidence of functional defects of RP in RTHβ. These changes occur independently of endogenous TH levels or the prenatal exposure to high or normal maternal TH.
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Affiliation(s)
- Irene Campi
- Division of Endocrine and Metabolic Diseases, Laboratory of Endocrine and Metabolic Research, Istituto Di Ricovero e Cura a Carattere Scientifico, Istituto Auxologico Italiano, 20149 Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Gabriella Cammarata
- Neuro-Ophthalmology Service, Electrophysiology Laboratory, Department of Ophthalmology, Istituto Di Ricovero e Cura a Carattere Scientifico, Istituto Auxologico Italiano, 20149 Milan, Italy
| | - Stefania Bianchi Marzoli
- Neuro-Ophthalmology Service, Electrophysiology Laboratory, Department of Ophthalmology, Istituto Di Ricovero e Cura a Carattere Scientifico, Istituto Auxologico Italiano, 20149 Milan, Italy
| | - Paolo Beck-Peccoz
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Diletta Santarsiero
- Neuro-Ophthalmology Service, Electrophysiology Laboratory, Department of Ophthalmology, Istituto Di Ricovero e Cura a Carattere Scientifico, Istituto Auxologico Italiano, 20149 Milan, Italy
| | - Davide Dazzi
- Division of Internal Medicine, Ospedale Vaio, 43036 Fidenza, Parma, Italy
| | | | - Elena Giuliana Taroni
- Ophthalmology Unit, Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico Ca' Granda, 20122 Milan, Italy
| | - Francesco Viola
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Ophthalmology Unit, Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico Ca' Granda, 20122 Milan, Italy
| | - Caterina Mian
- Department of Medicine, Endocrinology Unit-University of Padua, 35128 Padova, Italy
| | | | - Carla Pelusi
- Department of Medical and Surgical Sciences, Division of Endocrinology, University of Bologna, Sant'Orsola-Malpighi Hospital, 40138 Bologna, Italy
| | - Marina Muzza
- Endocrine Unit, Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico Ca' Granda, 20122 Milan, Italy
| | - Maria Antonia Maffini
- Endocrine Unit, Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico Ca' Granda, 20122 Milan, Italy
| | - Luca Persani
- Division of Endocrine and Metabolic Diseases, Laboratory of Endocrine and Metabolic Research, Istituto Di Ricovero e Cura a Carattere Scientifico, Istituto Auxologico Italiano, 20149 Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
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Sustar M, Perovšek D, Cima I, Stirn-Kranjc B, Hawlina M, Brecelj J. Electroretinography and optical coherence tomography reveal abnormal post-photoreceptoral activity and altered retinal lamination in patients with enhanced S-cone syndrome. Doc Ophthalmol 2015; 130:165-77. [PMID: 25663266 DOI: 10.1007/s10633-015-9487-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 01/26/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE To compare functional abnormalities of enhanced S-cone syndrome (ESCS), as examined using standard and extended electroretinography (ERG), with structural findings and retinal architecture obtained by spectral domain optical coherence tomography (SD-OCT). METHODS Four patients with ESCS underwent standard full-field and multifocal ERGs, with extended S-cone and ON/OFF ERG protocols also performed. SD-OCT was also carried out, and longitudinal reflectivity profiles (LRPs) were calculated for the perifoveolar retina. RESULTS All four patients exhibited pathognomonic full-field ERG findings for ESCS, with delayed responses of similar waveforms to the same intensity flash under both scotopic and photopic conditions. The amplitudes of the full-field ERGs showed considerable variation between patients, which were not related to the extent of the visual field defects. Multifocal ERGs reflected preserved central function in eyes with good visual acuity (Snellen visual acuity >0.7). The ERGs to S-cone-specific stimulation confirmed the expected predominant activity of the S-cone system in all four patients. The ON/OFF ERG recordings revealed abnormal presence of both ON-response and OFF-response activities in three patients; the remaining patient showed only OFF-response activity. SD-OCT showed a significantly thickened outer nuclear layer in all four patients, as obtained by LRP analysis. Furthermore, in the patient with selective preservation of the OFF-response activity, LRP showed reduced numbers of hyper-reflectivity sub-peaks in the inner plexiform layer. CONCLUSION Patients with ESCS show characteristic full-field ERG waveform abnormality, predominance of S-cone ERG activity, and thickening of the outer nuclear layer on SD-OCT. Moreover, they can also show abnormal post-photoreceptor connectivity through S-cone-related OFF-bipolar cell activity.
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Affiliation(s)
- M Sustar
- Eye Hospital, University Medical Centre, Grablovičeva 46, 1000, Ljubljana, Slovenia,
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Electroretinographic characteristics in children with infantile nystagmus syndrome and early-onset retinal dystrophies. Eur J Ophthalmol 2014; 25:33-42. [PMID: 25096283 DOI: 10.5301/ejo.5000493] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE To differentiate early-onset retinal dystrophies on the basis of electroretinogram (ERG) characteristics in children with infantile nystagmus syndrome (INS). METHODS Thirty-seven children with INS and early-onset retinal dystrophies were included, with diagnosis according to clinical and ERG findings. Three ERG protocols were used according to the child's age and 17 children were followed with 2 protocols: 27 (mean 2.1 years) were recorded with skin electrodes to flash stimulation, 16 (mean 6.5 years) with skin electrodes to full-field stimulation, and 11 (mean 12.2 years) with HK electrodes to full-field stimulation. The ERGs were compared to those of age-matched controls, with differences significant if p<0.05. RESULTS Clinical and electrophysiologic findings were in agreement across all of the children. In nine children with Leber congenital amaurosis, the scotopic and photopic ERGs were not recordable under all protocols. Six children with congenital stationary night blindness (CSNB) had electronegative scotopic ERG under all protocols, those with complete CSNB had absent rod ERG, and those with incomplete CSNB had reduced rod ERG. Eight children with achromatopsia had nonrecordable photopic and subnormal scotopic ERG under all protocols. The implicit times of the scotopic b-waves were prolonged. One child had blue-cone monochromatism and reduced photopic and normal S-cone ERG. Six children with cone-rod dystrophy without systemic disorder, and seven children with systemic disorder, had affected photopic and scotopic ERGs under all protocols. CONCLUSIONS In children with INS, some early-onset retinal dystrophies can be differentiated through ERGs, also with skin electrodes.
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Topical dorzolamide treatment of macular cysts in the enhanced S-cone syndrome patient. Doc Ophthalmol 2013; 126:241-6. [PMID: 23292616 PMCID: PMC3664744 DOI: 10.1007/s10633-012-9371-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 12/21/2012] [Indexed: 11/05/2022]
Abstract
Purpose The purpose of the study was to evaluate the efficacy of a topical form of a carbonic anhydrase inhibitor (dorzolamide) on the foveal function and thickness in the eye of a patient with enhanced S-cone syndrome (ESCS) associated with macular cysts. Methods Twenty-eight-year-old Polish man with ESCS and macular cysts appearance in the right eye was treated 3 times daily with 2.0 % dorzolamide drops for the period time equal to 6 months. Monthly controls included: best corrected distance visual acuity (BCDVA-logMAR), foveal thickness (optical coherence tomography, OCT) and foveal function (multi-focal electroretinography, mfERG). Results Before treatment, BCDVA in the right eye was equal to 0.26 logMAR, improved to 0.1 logMAR during the first 3 months and remained stable for the next 3 months. After 6 months, foveal thickness decreased (from 482 to 224 μm) and foveal function improved (the amplitude of P1-wave density increased from 34.8 to 107.3 nV/deg2) and was between the ranges of normal values. Implicit time of P1-wave remained prolonged. Conclusions The results of our short-term study suggest potential efficacy of topical dorzolamide treatment in ESCS patients with macular cysts.
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