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Yahya F, Escher P, Rivolta C, Scholl HP, Roulez F. SPATA7-Associated Juvenile Retinitis Pigmentosa in Two Brothers from a Consanguineous Iraqi Family in Switzerland. Klin Monbl Augenheilkd 2023; 240:544-548. [PMID: 37164434 DOI: 10.1055/a-2009-0498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- Faady Yahya
- Department of Ophthalmology, University of Basel, Basel, Switzerland
- University Hospital Basel Eye Clinic, Basel, Switzerland
| | - Pascal Escher
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - Carlo Rivolta
- Department of Ophthalmology, University of Basel, Basel, Switzerland
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
- Department of Genetics and Genome Biology, University of Leicester, Leicester, UK
| | - Hendrik Pn Scholl
- Department of Ophthalmology, University of Basel, Basel, Switzerland
- University Hospital Basel Eye Clinic, Basel, Switzerland
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
| | - Francoise Roulez
- Department of Ophthalmology, University of Basel, Basel, Switzerland
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Fischer MD, Ochakovski GA, Beier B, Seitz IP, Vaheb Y, Kortuem C, Reichel FFL, Kuehlewein L, Kahle NA, Peters T, Girach A, Zrenner E, Ueffing M, MacLaren RE, Bartz-Schmidt KU, Wilhelm B. Efficacy and Safety of Retinal Gene Therapy Using Adeno-Associated Virus Vector for Patients With Choroideremia: A Randomized Clinical Trial. JAMA Ophthalmol 2019; 137:1247-1254. [PMID: 31465092 DOI: 10.1001/jamaophthalmol.2019.3278] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Importance Choroideremia (CHM) is a rare, degenerative, genetic retinal disorder resulting from mutation of the CHM gene, leading to an absence of functional ras-associated binding escort protein 1 (REP1). There is currently no approved treatment for CHM. Objective To assess the safety and efficacy of retinal gene therapy with an adeno-associated virus vector (AAV2) designed to deliver a functional version of the CHM gene (AAV2-REP1) for treatment of patients with choroideremia. Design, Setting, and Participants Tübingen Choroideremia Gene Therapy (THOR) was a single-center, phase 2, open-label randomized clinical trial. Data were collected from January 11, 2016, to February 26, 2018. Twenty-four-month data are reported for 6 men with a molecularly confirmed diagnosis of CHM. Intention-to-treat analysis was used. Interventions Patients received AAV2-REP1 by a single, 0.1-mL subretinal injection of 1011 genome particles during vitrectomy into 1 eye randomly assigned to receive treatment. Main Outcomes and Measures Primary end point was change in best-corrected visual acuity (BCVA) on the Early Treatment Diabetic Retinopathy Study chart from baseline to month 24 in the treated eye vs the control eye. Secondary end points included microperimetry variables, change in fundus autofluorescence, and spectral-domain optical coherence tomographic evaluations from baseline to month 24 in the treated eye vs the control eye. Results On enrollment, the mean (SD) age of the 6 men included in the study was 54.9 (4.1) years. The mean (SD) BCVA score was 60.3 (13.4) (approximately 20/63 Snellen equivalent) in the study eyes and 69.3 (20.6) (approximately 20/40 Snellen equivalent) in the control eyes. At 24 months, the BCVA change was 3.7 (7.5) in the treated eyes and 0.0 (5.1) in the control eyes (difference, 3.7; 95% CI, -7.2 to 14.5; P = .43). Mean change in retinal sensitivity was 10.3 (5.5) dB in the treated eyes and 9.7 (4.9) dB in the control eyes (difference, 0.6; 95% CI, -10.2 to 11.4; P = .74). A total of 28 adverse events were reported; all were consistent with the surgical procedure (eg, conjunctival hyperemia, foreign body sensation), and none were regarded as severe. Conclusions and Relevance Among 6 participants, gene therapy with AAV2-REP1 was associated with maintenance or improvement of visual acuity, although no significant difference was found from control eyes. All safety issues were associated with the surgical procedure and none were judged severe. Continued investigations could more precisely define the efficacy and safety of gene therapy with AAV2-REP1 in CHM. Trial Registration ClinicalTrials.gov identifier: NCT02671539.
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Affiliation(s)
- M Dominik Fischer
- University Eye Hospital, University of Tübingen, Tübingen, Germany.,Institute for Ophthalmic Research, Centre for Ophthalmology, University of Tübingen, Tübingen, Germany.,STZ eyetrial at the Centre for Ophthalmology, University Hospital Tübingen, Tübingen, Tübingen, Germany.,Nuffield Laboratory of Ophthalmology, University of Oxford, Oxford, United Kingdom
| | - G Alex Ochakovski
- University Eye Hospital, University of Tübingen, Tübingen, Germany.,Institute for Ophthalmic Research, Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
| | - Benjamin Beier
- STZ eyetrial at the Centre for Ophthalmology, University Hospital Tübingen, Tübingen, Tübingen, Germany
| | - Immanuel P Seitz
- University Eye Hospital, University of Tübingen, Tübingen, Germany.,Institute for Ophthalmic Research, Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
| | - Yousof Vaheb
- University Eye Hospital, University of Tübingen, Tübingen, Germany
| | | | - Felix F L Reichel
- University Eye Hospital, University of Tübingen, Tübingen, Germany.,Institute for Ophthalmic Research, Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
| | - Laura Kuehlewein
- University Eye Hospital, University of Tübingen, Tübingen, Germany
| | - Nadine A Kahle
- STZ eyetrial at the Centre for Ophthalmology, University Hospital Tübingen, Tübingen, Tübingen, Germany
| | - Tobias Peters
- STZ eyetrial at the Centre for Ophthalmology, University Hospital Tübingen, Tübingen, Tübingen, Germany
| | - Aniz Girach
- Nightstar Therapeutics, London, United Kingdom
| | - Eberhart Zrenner
- University Eye Hospital, University of Tübingen, Tübingen, Germany.,Institute for Ophthalmic Research, Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
| | - Marius Ueffing
- Institute for Ophthalmic Research, Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
| | - Robert E MacLaren
- Nuffield Laboratory of Ophthalmology, University of Oxford, Oxford, United Kingdom.,Nightstar Therapeutics, London, United Kingdom.,Oxford Eye Hospital, Oxford University Hospitals National Health Service Foundation Trust, Oxford, United Kingdom.,Moorfields Eye Hospital National Health Service Foundation Trust, London, United Kingdom
| | | | - Barbara Wilhelm
- STZ eyetrial at the Centre for Ophthalmology, University Hospital Tübingen, Tübingen, Tübingen, Germany
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Islamaj E, Jordaan-Kuip CP, Vermeer KA, Lemij HG, de Waard PWT. Motility Changes and Diplopia After Baerveldt Glaucoma Drainage Device Implantation or After Trabeculectomy. Transl Vis Sci Technol 2018; 7:7. [PMID: 30221073 PMCID: PMC6136847 DOI: 10.1167/tvst.7.5.7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 07/30/2018] [Indexed: 12/11/2022] Open
Abstract
Purpose The purpose of this study was to quantify any diplopia and motility changes after the implantation of a Baerveldt glaucoma implant (BGI) or after trabeculectomy (TE). Methods We analyzed 51 patients with a BGI and 52 patients with a TE from a prospective cohort study. To quantify any diplopia, we asked patients about the presence of diplopia at 1 year after surgery. To quantify any ocular motility changes, we measured ductions in eight gaze directions, the patients' ocular alignment and their fusion range before and 1 year after surgery. Results In the BGI group, 14 patients (28%) experienced diplopia compared with one patient (2%) in the TE group (P < 0.001). Duction changes were more commonly observed in the BGI group (35%) than in the TE group (19%). In the BGI group, ductions were mostly restricted in elevation (13%; P < 0.001), in abduction (13%), in elevation in 25° adduction (13%; P = 0.044), and in elevation in 25° abduction (25%; P < 0.001). In 32% of the patients, their near horizontal ocular alignment shifted, notably in exodirection (P = 0.04). The fusion range decreased significantly in the horizontal direction (−12.6° ± 10.3°, mean ± standard deviation; P = 0.01). Conclusions BGI surgery was significantly associated with postoperative diplopia and impaired eye motility (reduced ductions), mostly present in abduction, elevation, elevation in 25° adduction, and elevation in 25° abduction. Even without impaired ductions, diplopia could come about. Translational Relevance By studying diplopia across glaucoma patients prospectively with diplopia questionnaires and extensive orthoptic measurements, we gain better insight into its occurrence.
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Affiliation(s)
- Esma Islamaj
- Rotterdam Ophthalmic Institute, Rotterdam Eye Hospital, Schiedamse Vest 160d 3011BH Rotterdam, The Netherlands
| | - Caroline P Jordaan-Kuip
- Rotterdam Ophthalmic Institute, Rotterdam Eye Hospital, Schiedamse Vest 160d 3011BH Rotterdam, The Netherlands
| | - Koen A Vermeer
- Rotterdam Ophthalmic Institute, Rotterdam Eye Hospital, Schiedamse Vest 160d 3011BH Rotterdam, The Netherlands
| | - Hans G Lemij
- Rotterdam Eye Hospital, Glaucoma Department, Schiedamse Vest 180 3011BH Rotterdam, The Netherlands
| | - Peter W T de Waard
- Rotterdam Eye Hospital, Glaucoma Department, Schiedamse Vest 180 3011BH Rotterdam, The Netherlands
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