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Georgiou M, Robson AG, Fujinami K, de Guimarães TAC, Fujinami-Yokokawa Y, Daich Varela M, Pontikos N, Kalitzeos A, Mahroo OA, Webster AR, Michaelides M. Phenotyping and genotyping inherited retinal diseases: Molecular genetics, clinical and imaging features, and therapeutics of macular dystrophies, cone and cone-rod dystrophies, rod-cone dystrophies, Leber congenital amaurosis, and cone dysfunction syndromes. Prog Retin Eye Res 2024; 100:101244. [PMID: 38278208 DOI: 10.1016/j.preteyeres.2024.101244] [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: 10/26/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 01/28/2024]
Abstract
Inherited retinal diseases (IRD) are a leading cause of blindness in the working age population and in children. The scope of this review is to familiarise clinicians and scientists with the current landscape of molecular genetics, clinical phenotype, retinal imaging and therapeutic prospects/completed trials in IRD. Herein we present in a comprehensive and concise manner: (i) macular dystrophies (Stargardt disease (ABCA4), X-linked retinoschisis (RS1), Best disease (BEST1), PRPH2-associated pattern dystrophy, Sorsby fundus dystrophy (TIMP3), and autosomal dominant drusen (EFEMP1)), (ii) cone and cone-rod dystrophies (GUCA1A, PRPH2, ABCA4, KCNV2 and RPGR), (iii) predominant rod or rod-cone dystrophies (retinitis pigmentosa, enhanced S-Cone syndrome (NR2E3), Bietti crystalline corneoretinal dystrophy (CYP4V2)), (iv) Leber congenital amaurosis/early-onset severe retinal dystrophy (GUCY2D, CEP290, CRB1, RDH12, RPE65, TULP1, AIPL1 and NMNAT1), (v) cone dysfunction syndromes (achromatopsia (CNGA3, CNGB3, PDE6C, PDE6H, GNAT2, ATF6), X-linked cone dysfunction with myopia and dichromacy (Bornholm Eye disease; OPN1LW/OPN1MW array), oligocone trichromacy, and blue-cone monochromatism (OPN1LW/OPN1MW array)). Whilst we use the aforementioned classical phenotypic groupings, a key feature of IRD is that it is characterised by tremendous heterogeneity and variable expressivity, with several of the above genes associated with a range of phenotypes.
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Affiliation(s)
- Michalis Georgiou
- Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, University College London, London, United Kingdom; Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | - Anthony G Robson
- Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, University College London, London, United Kingdom.
| | - Kaoru Fujinami
- Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, University College London, London, United Kingdom; Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
| | - Thales A C de Guimarães
- Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, University College London, London, United Kingdom.
| | - Yu Fujinami-Yokokawa
- UCL Institute of Ophthalmology, University College London, London, United Kingdom; Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan; Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan.
| | - Malena Daich Varela
- Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, University College London, London, United Kingdom.
| | - Nikolas Pontikos
- Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, University College London, London, United Kingdom.
| | - Angelos Kalitzeos
- Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, University College London, London, United Kingdom.
| | - Omar A Mahroo
- Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, University College London, London, United Kingdom; Section of Ophthalmology, King s College London, St Thomas Hospital Campus, London, United Kingdom; Physiology, Development and Neuroscience, University of Cambridge, Downing Street, Cambridge, United Kingdom; Department of Translational Ophthalmology, Wills Eye Hospital, Philadelphia, PA, USA.
| | - Andrew R Webster
- 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.
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Ribarich N, Rivolta MC, Sacconi R, Querques G. Novel IMPG2 variant causing adult macular vitelliform dystrophy: A case report. Eur J Ophthalmol 2024; 34:NP1-NP4. [PMID: 37661650 DOI: 10.1177/11206721231199850] [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] [Indexed: 09/05/2023]
Abstract
INTRODUCTION Adult-onset vitelliform macular dystrophy (AVMD) is an inherited maculopathy characterized by metamorphopsias and decrease in visual acuity occurring between the fourth and the sixth decade. It is characterized by an 'egg yolk' macular lesion eventually evolving towards foveal atrophy and fibrosis. It is usually an autosomal dominant inherited disorder with variable penetrance, mainly related to variants in BEST1, PRPH2, IMPG1, and IMPG2 genes. CASE DESCRIPTION A 47-year-old woman complaining of "wavy" vision was referred to our clinic. Her past medical history and reported family history did not reveal any ocular disease. Complete ophthalmological evaluation was performed. Funduscopic examination and multimodal imaging revealed a round vitelliform lesion in both eyes, leading to a diagnosis of AVMD. Genetic analysis revealed a novel, likely pathogenetic, heterozygous c.478G > T (p.Glu160Ter), (NM_016247) variant in the IMPG2 gene. DISCUSSION Our patient exhibits a novel pathogenetic variant in a gene associated with AVMD. Heterozygous variants in the IMPG2 gene have been reported in multiple individuals with vitelliform macular dystrophy, with an autosomal dominant mode of inheritance. Genetic screening is essential to characterize patients, to predict vision loss in patients with a positive family history and to characterize eligible patients for new potential emerging therapies. Genotype-phenotype correlation studies are needed to have a clearer picture of pathogenetic mechanisms. Our study characterizes the phenotype related to a novel IMPG2 pathogenic variant through multimodal imaging.
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Affiliation(s)
- Nicolò Ribarich
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | | | - Riccardo Sacconi
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Giuseppe Querques
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
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Williams BN, Draper A, Lang PF, Lewis TR, Smith AL, Mayerl SJ, Rougié M, Simon JM, Arshavsky VY, Greenwald SH, Gamm DM, Pinilla I, Philpot BD. Heterogeneity in the progression of retinal pathologies in mice harboring patient mimicking Impg2 mutations. Hum Mol Genet 2024; 33:448-464. [PMID: 37975905 PMCID: PMC10877459 DOI: 10.1093/hmg/ddad199] [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: 06/02/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023] Open
Abstract
Biallelic mutations in interphotoreceptor matrix proteoglycan 2 (IMPG2) in humans cause retinitis pigmentosa (RP) with early macular involvement, albeit the disease progression varies widely due to genetic heterogeneity and IMPG2 mutation type. There are currently no treatments for IMPG2-RP. To aid preclinical studies toward eventual treatments, there is a need to better understand the progression of disease pathology in appropriate animal models. Toward this goal, we developed mouse models with patient mimicking homozygous frameshift (T807Ter) or missense (Y250C) Impg2 mutations, as well as mice with a homozygous frameshift mutation (Q244Ter) designed to completely prevent IMPG2 protein expression, and characterized the trajectory of their retinal pathologies across postnatal development until late adulthood. We found that the Impg2T807Ter/T807Ter and Impg2Q244Ter/Q244Ter mice exhibited early onset gliosis, impaired photoreceptor outer segment maintenance, appearance of subretinal deposits near the optic disc, disruption of the outer retina, and neurosensorial detachment, whereas the Impg2Y250C/Y250C mice exhibited minimal retinal pathology. These results demonstrate the importance of mutation type in disease progression in IMPG2-RP and provide a toolkit and preclinical data for advancing therapeutic approaches.
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Affiliation(s)
- Brittany N Williams
- Neuroscience Center, University of North Carolina, Chapel Hill, NC 27599, United States
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC 27599, United States
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC 27599, United States
| | - Adam Draper
- Neuroscience Center, University of North Carolina, Chapel Hill, NC 27599, United States
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC 27599, United States
| | - Patrick F Lang
- Neuroscience Center, University of North Carolina, Chapel Hill, NC 27599, United States
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC 27599, United States
| | - Tylor R Lewis
- Department of Ophthalmology, Duke University, Durham, NC 27705, United States
| | - Audrey L Smith
- Neuroscience Center, University of North Carolina, Chapel Hill, NC 27599, United States
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC 27599, United States
| | - Steven J Mayerl
- Department of Ophthalmology and Visual Sciences, McPherson Eye Research Institute, University of Wisconsin-Madison, Madison, WI 53705, United States
| | - Marie Rougié
- Neuroscience Center, University of North Carolina, Chapel Hill, NC 27599, United States
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC 27599, United States
| | - Jeremy M Simon
- Neuroscience Center, University of North Carolina, Chapel Hill, NC 27599, United States
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC 27599, United States
| | - Vadim Y Arshavsky
- Department of Ophthalmology, Duke University, Durham, NC 27705, United States
| | | | - David M Gamm
- Department of Ophthalmology and Visual Sciences, McPherson Eye Research Institute, University of Wisconsin-Madison, Madison, WI 53705, United States
| | - Isabel Pinilla
- Department of Ophthalmology, Lozano Blesa University Hospital, Zaragoza 50009, Spain
- Aragón Health Research Institute (IIS Aragón), Zaragoza 50009, Spain
- Department of Surgery, University of Zaragoza, Zaragoza 50009, Spain
| | - Benjamin D Philpot
- Neuroscience Center, University of North Carolina, Chapel Hill, NC 27599, United States
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC 27599, United States
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC 27599, United States
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Birtel J, Caswell R, De Silva SR, Herrmann P, Rehman S, Lotery AJ, Mahroo OA, Michaelides M, Webster AR, MacLaren RE, Charbel Issa P. IMPG2-Related Maculopathy. Am J Ophthalmol 2024; 258:32-42. [PMID: 37806544 DOI: 10.1016/j.ajo.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 10/01/2023] [Accepted: 10/01/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE To investigate the phenotype, variability, and penetrance of IMPG2-related maculopathy. DESIGN Retrospective observational case series. METHODS Clinical evaluation, multimodal retinal imaging, genetic testing, and molecular modeling. RESULTS A total of 25 individuals with a mono-allelic IMPG2 variant were included, 5 of whom were relatives of patients with IMPG2-associated retinitis pigmentosa. A distinct maculopathy was present in 17 individuals (median age, 52 years; range, 20-72 years), and included foveal elevation with or without subretinal vitelliform material or focal atrophy of the retinal pigment epithelium. Best-corrected visual acuity (BCVA) was ≥20/50 in the better eye (n = 15), and 5 patients were asymptomatic. Longitudinal observation (n = 8, up to 19 years) demonstrated stable maculopathy (n = 3), partial/complete resorption (n = 4) or increase (n = 1) of the subretinal material, with overall stable vision (n = 6). No manifest maculopathy was observed in 8 individuals (median age, 58 years; range, 43-83 years; BCVA ≥20/25), all were identified through segregation analysis. All 8 individuals were asymptomatic, with minimal foveal changes observed on optical coherence tomography in 3 cases. A total of 18 different variants were detected, 11 of them truncating. Molecular modeling of 5 missense variants [c.727G>C, c.1124C>A, c.2816T>A, c.3047T>C, and c.3193G>A] supported the hypothesis that these have a loss-of-function effect. CONCLUSIONS Mono-allelic IMPG2 variants may result in haploinsufficiency manifesting as a maculopathy with variable penetrance and expressivity. Family members of patients with IMPG2-related retinitis pigmentosa may present with vitelliform lesions. The maculopathy often remains limited to the fovea and is usually associated with moderate visual impairment.
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Affiliation(s)
- Johannes Birtel
- From the Oxford Eye Hospital (J.B., S.R.D.S., S.R., R.E.M., P.C.I.), Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom; Nuffield Laboratory of Ophthalmology (J.B., S.R.D.S., S.R., R.E.M., P.C.I.), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Department of Ophthalmology (J.B.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Ophthalmology (J.B., P.H.), University of Bonn, Bonn, Germany
| | - Richard Caswell
- Exeter Genomics Laboratory (R.C.), Royal Devon University Healthcare NHS Foundation Trust, Exeter, United Kingdom
| | - Samantha R De Silva
- From the Oxford Eye Hospital (J.B., S.R.D.S., S.R., R.E.M., P.C.I.), Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom; Nuffield Laboratory of Ophthalmology (J.B., S.R.D.S., S.R., R.E.M., P.C.I.), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Moorfields Eye Hospital NHS Foundation Trust (S.R.D.S., O.A.M., M.M., A.R.W.), London, United Kingdom; UCL Institute of Ophthalmology (S.R.D.S., O.A.M., M.M., A.R.W.), University College London, London, United Kingdom
| | - Philipp Herrmann
- Department of Ophthalmology (J.B., P.H.), University of Bonn, Bonn, Germany
| | - Salwah Rehman
- From the Oxford Eye Hospital (J.B., S.R.D.S., S.R., R.E.M., P.C.I.), Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom; Nuffield Laboratory of Ophthalmology (J.B., S.R.D.S., S.R., R.E.M., P.C.I.), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Andrew J Lotery
- Clinical Neurosciences (A.J.L.), Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; Southampton Eye Unit (A.J.L.), University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Omar A Mahroo
- Moorfields Eye Hospital NHS Foundation Trust (S.R.D.S., O.A.M., M.M., A.R.W.), London, United Kingdom; UCL Institute of Ophthalmology (S.R.D.S., O.A.M., M.M., A.R.W.), University College London, London, United Kingdom
| | - Michel Michaelides
- Moorfields Eye Hospital NHS Foundation Trust (S.R.D.S., O.A.M., M.M., A.R.W.), London, United Kingdom; UCL Institute of Ophthalmology (S.R.D.S., O.A.M., M.M., A.R.W.), University College London, London, United Kingdom
| | - Andrew R Webster
- Moorfields Eye Hospital NHS Foundation Trust (S.R.D.S., O.A.M., M.M., A.R.W.), London, United Kingdom; UCL Institute of Ophthalmology (S.R.D.S., O.A.M., M.M., A.R.W.), University College London, London, United Kingdom
| | - Robert E MacLaren
- From the Oxford Eye Hospital (J.B., S.R.D.S., S.R., R.E.M., P.C.I.), Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom; Nuffield Laboratory of Ophthalmology (J.B., S.R.D.S., S.R., R.E.M., P.C.I.), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Peter Charbel Issa
- From the Oxford Eye Hospital (J.B., S.R.D.S., S.R., R.E.M., P.C.I.), Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom; Nuffield Laboratory of Ophthalmology (J.B., S.R.D.S., S.R., R.E.M., P.C.I.), Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
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Heath Jeffery RC, Chen FK. Macular neovascularization in inherited retinal diseases: A review. Surv Ophthalmol 2024; 69:1-23. [PMID: 37544613 DOI: 10.1016/j.survophthal.2023.07.007] [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: 03/03/2023] [Revised: 07/25/2023] [Accepted: 07/31/2023] [Indexed: 08/08/2023]
Abstract
Inherited retinal diseases (IRDs) are the most common cause of blindness in working-age adults. Macular neovascularization (MNV) may be a presenting feature or occurs as a late-stage complication in several IRDs. We performed an extensive literature review on MNV associated with IRDs. MNV is a well-known complication of Sorsby fundus dystrophy and pseudoxanthoma elasticum. Those with late-onset Stargardt disease may masquerade as exudative age-related macular degeneration (AMD) when MNV is the presenting feature. Peripherinopathies may develop MNV that responds well to a short course of anti-vascular endothelial growth factor (anti-VEGF) therapy, while bestrophinopathies tend to develop MNV in the early stages of the disease without vision loss. Enhanced S-cone syndrome manifests type 3 MNV that typically regresses into a subfoveal fibrotic nodule. MNV is only a rare complication in choroideraemia and rod-cone dystrophies. Most IRD-related MNVs exhibit a favorable visual prognosis requiring less intensive regimens of anti-vascular endothelial growth factor therapy compared to age-related macular degeneration. We discuss the role of key imaging modalities in the diagnosis of MNV across a wide spectrum of IRDs and highlight the gaps in our knowledge with respect to the natural history and prognosis to pave the way for future directions of research.
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Affiliation(s)
- Rachael C Heath Jeffery
- Centre for Ophthalmology and Visual Science (Lions Eye Institute), The University of Western Australia, Nedlands, WA, Australia; Royal Victorian Eye and Ear Hospital (Centre for Eye Research Australia), East Melbourne, VIC, Australia
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science (Lions Eye Institute), The University of Western Australia, Nedlands, WA, Australia; Royal Victorian Eye and Ear Hospital (Centre for Eye Research Australia), East Melbourne, VIC, Australia; Ophthalmology, Department of Surgery, The University of Melbourne, East Melbourne, VIC, Australia; Department of Ophthalmology, Royal Perth Hospital, Perth, WA, Australia.
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Castellini ME, Spagnolli G, Poggi L, Biasini E, Casarosa S, Messina A. Identification of the zebrafish homologues of IMPG2, a retinal proteoglycan. Cell Tissue Res 2023; 394:93-105. [PMID: 37470839 PMCID: PMC10558372 DOI: 10.1007/s00441-023-03808-z] [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: 03/06/2023] [Accepted: 07/05/2023] [Indexed: 07/21/2023]
Abstract
Photoreceptor outer segments are surrounded by a carbohydrate-rich matrix, the interphotoreceptor matrix, necessary for physiological retinal function. Few roles for molecules characterizing the interphotoreceptor matrix have been clearly defined. Recent studies have found the presence of nonsense mutations in the interphotoreceptor matrix proteoglycan 2 (IMPG2) gene in patients affected by retinal dystrophies. IMPG2 encodes for a proteoglycan synthesized by photoreceptors and secreted in the interphotoreceptor matrix. Little is known about the structure and function of this protein, we thus decided to characterize zebrafish impg2. In zebrafish there are two Impg2 proteins, Impg2a and Impg2b. We generated a phylogenetic tree based on IMPG2 protein sequence similarity among vertebrates, showing a significant similarity between humans and teleosts. The human and zebrafish proteins share conserved domains, as also shown by homology models. Expression analyses of impg2a and impg2b show a continued expression in the photoreceptor layer starting from developmental stages and continuing through adulthood. Between 1 and 6 months post-fertilization, there is a significant shift of Impg2 expression toward the outer segment region, suggesting an increase in secretion. This raises intriguing hypotheses about its possible role(s) during retinal maturation, laying the groundwork for the generation of most needed models for the study of IMPG2-related inherited retinal dystrophies.
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Affiliation(s)
- M E Castellini
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Via Sommarive, 9, 38123, Povo, TN, Italy
| | - G Spagnolli
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Via Sommarive, 9, 38123, Povo, TN, Italy
- Sibylla Biotech S.R.L, Piazzetta Chiavica 2 - 37121, Verona, VR, Italy
| | - L Poggi
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Via Sommarive, 9, 38123, Povo, TN, Italy
- Centre for Medical Sciences (CISMed), University of Trento, Via S. Maria Maddalena, 1, 38122, Trento, TN, Italy
| | - E Biasini
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Via Sommarive, 9, 38123, Povo, TN, Italy
- Centre for Medical Sciences (CISMed), University of Trento, Via S. Maria Maddalena, 1, 38122, Trento, TN, Italy
| | - S Casarosa
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Via Sommarive, 9, 38123, Povo, TN, Italy.
- Centre for Medical Sciences (CISMed), University of Trento, Via S. Maria Maddalena, 1, 38122, Trento, TN, Italy.
| | - A Messina
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Via Sommarive, 9, 38123, Povo, TN, Italy
- Centre for Mind/Brain Sciences (CIMeC), University of Trento, Piazza Manifattura 1, 38068, Rovereto, TN, Italy
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Nipp GE, Lee T, Sarici K, Malek G, Hadziahmetovic M. Adult-onset foveomacular vitelliform dystrophy: epidemiology, pathophysiology, imaging, and prognosis. FRONTIERS IN OPHTHALMOLOGY 2023; 3:1237788. [PMID: 38983024 PMCID: PMC11182240 DOI: 10.3389/fopht.2023.1237788] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 07/25/2023] [Indexed: 07/11/2024]
Abstract
Adult-onset foveomacular dystrophy (AOFVD) is a retinal pattern dystrophy that may affect up to 1 in 7,400 individuals. There is much that is unknown regarding this disease's epidemiology, risk factors for development, and rate of progression through its four stages. Advancements in retinal imaging over the past 15 years have enabled improved characterization of the different stages of AOFVD. These imaging advancements also offer new ways of differentiating AOFVD from phenotypically similar retinal diseases like age-related macular degeneration and Best disease. This review synthesizes the most recent discoveries regarding imaging correlates within AOFVD as well as risk factors for the development of AOFVD, complications of AOFVD, and treatment options. Our aim is to provide ophthalmologists a succinct resource so that they may offer clarity, guidance, and appropriate monitoring and treatments for their patients with suspected AOFVD.
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Affiliation(s)
- Grace E Nipp
- School of Medicine, Duke University, Durham, NC, United States
| | - Terry Lee
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, United States
| | - Kubra Sarici
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, United States
| | - Goldis Malek
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, United States
- Department of Pathology, Duke University Medical Center, Durham, NC, United States
| | - Majda Hadziahmetovic
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, United States
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Shmueli O, Lender R, Shwartz Y, Chowers I, Tiosano L. The pseudohypopyon stage in adult-onset foveomacular vitelliform dystrophy. Int Ophthalmol 2023:10.1007/s10792-023-02710-5. [PMID: 37067692 DOI: 10.1007/s10792-023-02710-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/09/2023] [Indexed: 04/18/2023]
Abstract
PURPOSE To gain insight into the pathogenesis of adult-onset foveomacular vitelliform dystrophy (AFVD) via assessment of its pseudohypopyon stage (PHS). METHODS Retrospectively, data were collected in a tertiary center from established cohorts of a genetically evaluated AFVD and best vitelliform macular dystrophy (BVMD) eyes in the pseudohypopyon stage. Best-corrected visual acuity (BCVA, LogMAR), lesion characterization, including lesion dimensions, liquefaction areas and patterns (altitudinal or lateral), and ellipsoid zone integrity were analyzed from spectral-domain optical coherence tomography images. RESULTS Out of 167 eyes of 90 AFVD patients and 56 eyes of 28 BVMD patients, 8 eyes of six AFVD patients and five eyes of four BVMD patients were at the PHS were included. The mean LogMAR BCVA ± SD was 0.21 ± 0.20 and 0.41 ± 0.10 in AFVD and BVMD diseases, respectively (p = 0.13). Seven AFVD eyes (87.5%) demonstrated lateral liquefaction, while all BVMD eyes demonstrated an altitudinal pattern (p = 0.005). Maximal horizontal lesion diameters were 1.41 ± 0.46 mm and 2.64 ± 0.77 mm in AFVD and BVMD, respectively (p = 0.02). AFVD patients were older (69 ± 14) than BVMD patients (22 ± 13; p = 0.009). CONCLUSION The pseudohypopyon stage in AFVD is often characterized by a lateral liquefaction pattern, unlike the altitudinal pattern characterizing BVMD. Age, lesion size, or pathogenesis pathways may underline the different pseudohypopyon stage patterns in AFVD and BVMD.
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Affiliation(s)
- Or Shmueli
- Department of Ophthalmology, Faculty of Medicine, Hadassah-Hebrew University Medical Center, Ein-Karem, 91120, Jerusalem, Israel
| | - Rivkah Lender
- Department of Ophthalmology, Faculty of Medicine, Hadassah-Hebrew University Medical Center, Ein-Karem, 91120, Jerusalem, Israel
| | - Yahel Shwartz
- Department of Ophthalmology, Faculty of Medicine, Hadassah-Hebrew University Medical Center, Ein-Karem, 91120, Jerusalem, Israel
| | - Itay Chowers
- Department of Ophthalmology, Faculty of Medicine, Hadassah-Hebrew University Medical Center, Ein-Karem, 91120, Jerusalem, Israel
| | - Liran Tiosano
- Department of Ophthalmology, Faculty of Medicine, Hadassah-Hebrew University Medical Center, Ein-Karem, 91120, Jerusalem, Israel.
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Sharkova M, Chow E, Erickson T, Hocking JC. The morphological and functional diversity of apical microvilli. J Anat 2023; 242:327-353. [PMID: 36281951 PMCID: PMC9919547 DOI: 10.1111/joa.13781] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/03/2022] [Accepted: 10/05/2022] [Indexed: 11/30/2022] Open
Abstract
Sensory neurons use specialized apical processes to perceive external stimuli and monitor internal body conditions. The apical apparatus can include cilia, microvilli, or both, and is adapted for the functions of the particular cell type. Photoreceptors detect light through a large, modified cilium (outer segment), that is supported by a surrounding ring of microvilli-like calyceal processes (CPs). Although first reported 150 years ago, CPs remain poorly understood. As a basis for future study, we therefore conducted a review of existing literature about sensory cell microvilli, which can act either as the primary sensory detector or as support for a cilia-based detector. While all microvilli are finger-like cellular protrusions with an actin core, the processes vary across cell types in size, number, arrangement, dynamics, and function. We summarize the current state of knowledge about CPs and the characteristics of the microvilli found on inner ear hair cells (stereocilia) and cerebral spinal fluid-contacting neurons, with comparisons to the brush border of the intestinal and renal epithelia. The structure, stability, and dynamics of the actin core are regulated by a complement of actin-binding proteins, which includes both common components and unique features when compared across cell types. Further, microvilli are often supported by lateral links, a glycocalyx, and a defined extracellular matrix, each adapted to the function and environment of the cell. Our comparison of microvillar features will inform further research into how CPs support photoreceptor function, and also provide a general basis for investigations into the structure and functions of apical microvilli found on sensory neurons.
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Affiliation(s)
- Maria Sharkova
- Department of Cell Biology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Erica Chow
- Department of Cell Biology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Timothy Erickson
- Department of Biology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Jennifer C Hocking
- Department of Cell Biology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.,Division of Anatomy, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.,Department of Medical Genetics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.,Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
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10
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Xu R, Wang Y, Du J, Salido EM. Retinal Metabolic Profile on IMPG2 Deficiency Mice with Subretinal Lesions. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1415:457-463. [PMID: 37440072 DOI: 10.1007/978-3-031-27681-1_67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
The interphotoreceptor matrix (IPM) is the extracellular matrix between the photoreceptors and the retinal pigment epithelium (RPE). The IPM has two proteoglycans: the IPM proteoglycans 1 and 2 (IMPG1 and IMPG2, respectively). Patients with mutations on IMPG2 develop subretinal vitelliform lesions that affect vision. We previously created an IMPG2 knockout (KO) mice model that generates subretinal lesions similar to those found in humans. These subretinal lesions in IMPG2 KO mice retinas are, in part, composed of mislocalized IMPG1. In addition, IMPG2 KO mice show microscopic IMPG1 material accumulation between the RPE and the photoreceptor outer segments. In this work we discuss the possibility that material accumulation on IMPG2 KO mice retinas affects photoreceptor metabolism. To further investigate this idea, we used targeted metabolomics to profile retinal metabolome on IMPG2 KO mice. The metabolite set enrichment analysis showed reduced glutamate metabolism, urea cycle, and galactose metabolism suggesting affected energy metabolism in mice retinas of IMPG2 KO mice with subretinal lesion.
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Affiliation(s)
- Rong Xu
- Departments of Biochemistry and molecular medicine, and Ophthalmology and Visual Sciences, West Virginia University, Morgantown, WV, USA
| | - Yekai Wang
- Departments of Biochemistry and molecular medicine, and Ophthalmology and Visual Sciences, West Virginia University, Morgantown, WV, USA
| | - Jianhai Du
- Departments of Biochemistry and molecular medicine, and Ophthalmology and Visual Sciences, West Virginia University, Morgantown, WV, USA
| | - Ezequiel M Salido
- Departments of Biochemistry and molecular medicine, and Ophthalmology and Visual Sciences, West Virginia University, Morgantown, WV, USA.
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11
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Georgiou M, Chauhan MZ, Michaelides M, Uwaydat SH. IMPG2-associated unilateral adult onset vitelliform macular dystrophy. Am J Ophthalmol Case Rep 2022; 28:101699. [PMID: 36118280 PMCID: PMC9471960 DOI: 10.1016/j.ajoc.2022.101699] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/13/2022] [Accepted: 09/01/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose To present a case of unilateral IMPG2-associated adult onset vitelliform macular dystrophy (AVMD). Observations A 68 year-old female presented with best corrected visual acuity (BCVA) of 20/20 and 20/40 for the right and left eye respectively. The patient had a left subfoveal yellow lesion on dilated fundus examination. Optical coherence tomography showed hyper-reflective material accumulation below the fovea in the left eye only. The patient was followed for 10 years with stable BCVA, and evolution of the subretinal vitelliform lesion to a “vitelliruptive” stage. The right eye did not develop vitelliform lesion. Genetic testing identified a heterozygous likely disease-causing variant in IMPG2; c.3423–7_3423-4del. Conclusions and importance This is the first report of unilateral AVMD associated with IMPG2, expanding the phenotypic spectrum of IMPG2 retinopathy. We provide further evidence that IMPG2 variants can cause both autosomal recessive rod-cone dystrophy and autosomal dominant AVMD, with implications for patient counselling.
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Affiliation(s)
- Michalis Georgiou
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, EC1V 2PD, UK
- UCL Institute of Ophthalmology, University College London, 11-43 Bath Street, London, EC1V 9EL, UK
| | - Muhammad Z. Chauhan
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Michel Michaelides
- Moorfields Eye Hospital NHS Foundation Trust, City Road, London, EC1V 2PD, UK
- UCL Institute of Ophthalmology, University College London, 11-43 Bath Street, London, EC1V 9EL, UK
| | - Sami H. Uwaydat
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Corresponding author. Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, 4105 Outpatient Circle, Little Rock, AR, 72205, USA.
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12
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Mayerl SJ, Bajgai S, Ludwig AL, Jager LD, Williams BN, Bacig C, Stoddard C, Sinha D, Philpot BD, Gamm DM. Human retinal organoids harboring IMPG2 mutations exhibit a photoreceptor outer segment phenotype that models advanced retinitis pigmentosa. Stem Cell Reports 2022; 17:2409-2420. [PMID: 36206764 PMCID: PMC9669399 DOI: 10.1016/j.stemcr.2022.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 11/05/2022] Open
Abstract
Interphotoreceptor matrix proteoglycan 2 (IMPG2) mutations cause a severe form of early-onset retinitis pigmentosa (RP) with macular involvement. IMPG2 is expressed by photoreceptors and incorporated into the matrix that surrounds the inner and outer segments (OS) of rods and cones, but the mechanism of IMPG2-RP remains unclear. Loss of Impg2 function in mice produces a mild, late-onset photoreceptor phenotype without the characteristic OS loss that occurs in human patients. We generated retinal organoids (ROs) from patient-derived induced pluripotent stem (iPS) cells and gene-edited embryonic stem cells to model human IMPG2-RP in vitro. All ROs harboring IMPG2 mutations lacked an OS layer, in contrast to isogenic controls. Subsequent protein analyses revealed that this phenotype arises due to a loss of IMPG2 expression or its inability to undergo normal post-translational modifications. We hypothesized that loss of IMPG2 function destabilizes the interphotoreceptor matrix and renders the OS vulnerable to physical stressors, which is accentuated in the tissue culture environment. In support of this mechanism, transplantation of IMPG2 mutant ROs into the protected subretinal space of immunocompromised rodents restored OS production. Beyond providing a robust platform to study IMPG2-RP, this human RO model system may serve a broader role in honing strategies to treat advanced photoreceptor-based diseases.
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Affiliation(s)
- Steven J Mayerl
- Cellular and Molecular Pathology University of Wisconsin-Madison, Madison, WI, USA; McPherson Eye Research Institute, University of Wisconsin-Madison, Madison, WI, USA; Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Simona Bajgai
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Allison L Ludwig
- McPherson Eye Research Institute, University of Wisconsin-Madison, Madison, WI, USA; Waisman Center, University of Wisconsin-Madison, Madison, WI, USA; Comparative Biomedical Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Lindsey D Jager
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Brittany N Williams
- Department of Cell Biology & Physiology, University of North Carolina, Chapel Hill, NC, USA; Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC, USA; Neuroscience Center, University of North Carolina, Chapel Hill, NC, USA
| | - Cole Bacig
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Christopher Stoddard
- Department of Genetics and Genome Sciences, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Divya Sinha
- McPherson Eye Research Institute, University of Wisconsin-Madison, Madison, WI, USA; Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Benjamin D Philpot
- Department of Cell Biology & Physiology, University of North Carolina, Chapel Hill, NC, USA; Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC, USA; Neuroscience Center, University of North Carolina, Chapel Hill, NC, USA
| | - David M Gamm
- Cellular and Molecular Pathology University of Wisconsin-Madison, Madison, WI, USA; McPherson Eye Research Institute, University of Wisconsin-Madison, Madison, WI, USA; Waisman Center, University of Wisconsin-Madison, Madison, WI, USA; Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, USA.
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13
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Mitchell B, Coulter C, Geldenhuys WJ, Rhodes S, Salido EM. Interphotoreceptor matrix proteoglycans IMPG1 and IMPG2 proteolyze in the SEA domain and reveal localization mutual dependency. Sci Rep 2022; 12:15535. [PMID: 36109576 PMCID: PMC9478142 DOI: 10.1038/s41598-022-19910-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/06/2022] [Indexed: 11/08/2022] Open
Abstract
The interphotoreceptor matrix (IPM) is a specialized extracellular mesh of molecules surrounding the inner and outer segments of photoreceptor neurons. Interphotoreceptor matrix proteoglycan 1 and 2 (IMPG1 and IMPG2) are major components of the IPM. Both proteoglycans possess SEA (sperm protein, enterokinase and agrin) domains, which may support proteolysis. Interestingly, mutations in the SEA domains of IMPG1 and IMPG2 are associated with vision disease in humans. However, if SEA domains in IMPG molecules undergo proteolysis, and how this contributes to vision pathology is unknown. Therefore, we investigated SEA-mediated proteolysis of IMPG1 and IMPG2 and its significance to IPM physiology. Immunoblot analysis confirmed proteolysis of IMPG1 and IMPG2 in the retinas of wildtype mice. Point mutations mimicking human mutations in the SEA domain of IMPG1 that are associated with vision disease inhibited proteolysis. These findings demonstrate that proteolysis is part of the maturation of IMPG1 and IMPG2, in which deficits are associated with vision diseases. Further, immunohistochemical assays showed that proteolysis of IMPG2 generated two subunits, a membrane-attached peptide and an extracellular peptide. Notably, the extracellular portion of IMPG2 trafficked from the IPM around the inner segment toward the outer segment IPM by an IMPG1-dependent mechanism. This result provides the first evidence of a trafficking system that shuttles IMPG1 and IMPG2 from the inner to outer IPM in a co-dependent manner. In addition, these results suggest an interaction between IMPG1-IMPG2 and propose that mutations affecting one IMPG could affect the localization of the normal IMPG partner, contributing to the disease mechanism of vision diseases associated with defective IMPG molecules.
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Affiliation(s)
- Benjamin Mitchell
- Department of Ophthalmology and Visual Sciences, West Virginia University, Morgantown, WV, USA
| | - Chloe Coulter
- Undergraduate Program in Biochemistry, West Virginia University, Morgantown, WV, USA
| | - Werner J Geldenhuys
- Department of Neuroscience, School of Medicine, West Virginia University, Morgantown, WV, USA
- Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - Scott Rhodes
- Department of Ophthalmology and Visual Sciences, West Virginia University, Morgantown, WV, USA
- Department of Biochemistry and Molecular Medicine, West Virginia University, Morgantown, WV, USA
| | - Ezequiel M Salido
- Department of Ophthalmology and Visual Sciences, West Virginia University, Morgantown, WV, USA.
- Department of Biochemistry and Molecular Medicine, West Virginia University, Morgantown, WV, USA.
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14
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Lee W, Su PY, Zernant J, Nagasaki T, Tsang SH, Allikmets R. Longitudinal Analysis of a Resolving Foveomacular Vitelliform Lesion in ABCA4 Disease. Ophthalmol Retina 2022; 6:847-860. [PMID: 35413457 PMCID: PMC9464664 DOI: 10.1016/j.oret.2022.04.005] [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: 02/01/2022] [Revised: 03/27/2022] [Accepted: 04/05/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe the longitudinal progression and phenotypic association of bilateral foveomacular vitelliform lesions in the setting of ABCA4 disease. DESIGN Case report and cross-sectional cohort study. PARTICIPANTS Nineteen patients with confirmed ABCA4 disease exhibiting an optical gap phenotype. METHODS Multimodal retinal imaging across multiple visits included autofluorescence imaging, spectral-domain OCT (SD-OCT), and OCT angiography. Electro-oculogram (EOG) and full-field electroretinogram testing results were analyzed. Exome sequencing was performed for diagnostic confirmation and the verification of other variations. MAIN OUTCOME MEASURES Light-peak-to-dark-trough ratio (Arden ratio) on EOG; thickness and en face maps of various retinal layers on SD-OCT; area measurements on 488- and 787-nm autofluorescence images; and the presence of variation in vitelliform-associated genes identified using exome sequencing. RESULTS A 25-year-old White man presented with bilateral central vision loss due to foveal lesions consisting of vitelliform fluid. The result of EOG testing was inconsistent with bestrophinopathy (Arden ratio = 1.62), and no generalized rod or cone dysfunction was detected on full-field electroretinogram. Exome sequencing identified the pathogenic variants c.5882G>A (p.(Gly1961Glu)) and c.4139C>T (p.(Pro1380Leu)) in ABCA4 and no other vitelliform-associated genes. Significant thinning and abnormal reflectivity of photoreceptor-attributable layers as well as near-infrared autofluorescence abnormalities were found in lesion-adjacent areas. Complete resorption of the vitelliform fluid occurred after 30 months, after which the optical gap lesions exhibited an enlarged and "cavitated" appearance. Phenotypic screening for additional cases from a large ABCA4 disease database (n = 602) identified 18 additional patients at various stages of optical gap lesion formation, most of whom harbored the c.5882G>A (p.(Gly1961Glu)) variant (P < 0.001), although none had apparent vitelliform fluid. At least 5 of the 18 (31.6%) patients exhibited optical gap lesions with the distinct "cavitated" appearance, whereas the lesions remained unperturbed in the other patients over the course of examination. CONCLUSIONS Foveomacular vitelliform deposition is a mechanistically congruent but rare manifestation of ABCA4 disease. Specifically, this disease phenotype may be clinically associated with the c.5882G>A (p.(Gly1961Glu)) allele and optical gap lesions.
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Affiliation(s)
- Winston Lee
- Department of Genetics & Development, Columbia University, New York, New York; Department of Ophthalmology, Columbia University, New York, New York
| | - Pei-Yin Su
- Department of Ophthalmology, Columbia University, New York, New York
| | - Jana Zernant
- Department of Ophthalmology, Columbia University, New York, New York
| | - Takayuki Nagasaki
- Department of Ophthalmology, Columbia University, New York, New York
| | - Stephen H Tsang
- Department of Genetics & Development, Columbia University, New York, New York; Department of Pathology & Cell Biology, Columbia University, New York, New York
| | - Rando Allikmets
- Department of Genetics & Development, Columbia University, New York, New York; Department of Pathology & Cell Biology, Columbia University, New York, New York.
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15
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SPACR Encoded by IMPG1 Is Essential for Photoreceptor Survival by Interplaying between the Interphotoreceptor Matrix and the Retinal Pigment Epithelium. Genes (Basel) 2022; 13:genes13091508. [PMID: 36140676 PMCID: PMC9498744 DOI: 10.3390/genes13091508] [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: 07/29/2022] [Revised: 08/18/2022] [Accepted: 08/21/2022] [Indexed: 11/20/2022] Open
Abstract
Several pathogenic variants have been reported in the IMPG1 gene associated with the inherited retinal disorders vitelliform macular dystrophy (VMD) and retinitis pigmentosa (RP). IMPG1 and its paralog IMPG2 encode for two proteoglycans, SPACR and SPACRCAN, respectively, which are the main components of the interphotoreceptor matrix (IPM), the extracellular matrix surrounding the photoreceptor cells. To determine the role of SPACR in the pathological mechanisms leading to RP and VMD, we generated a knockout mouse model lacking Impg1, the mouse ortholog. Impg1-deficient mice show abnormal accumulation of autofluorescent deposits visible by fundus imaging and spectral-domain optical coherence tomography (SD-OCT) and attenuated electroretinogram responses from 9 months of age. Furthermore, SD-OCT of Impg1−/− mice shows a degeneration of the photoreceptor layer, and transmission electron microscopy shows a disruption of the IPM and the retinal pigment epithelial cells. The decrease in the concentration of the chromophore 11-cis-retinal supports this loss of photoreceptors. In conclusion, our results demonstrate the essential role of SPACR in maintaining photoreceptors. Impg1−/− mice provide a novel model for mechanistic investigations and the development of therapies for VMD and RP caused by IMPG1 pathogenic variants.
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16
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Liu T, Aguilera N, Bower AJ, Li J, Ullah E, Dubra A, Cukras C, Brooks BP, Jeffrey BG, Hufnagel RB, Huryn LA, Zein WM, Tam J. Photoreceptor and Retinal Pigment Epithelium Relationships in Eyes With Vitelliform Macular Dystrophy Revealed by Multimodal Adaptive Optics Imaging. Invest Ophthalmol Vis Sci 2022; 63:27. [PMID: 35900727 PMCID: PMC9344216 DOI: 10.1167/iovs.63.8.27] [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] [Indexed: 11/24/2022] Open
Abstract
Purpose To assess the structure of cone photoreceptors and retinal pigment epithelial (RPE) cells in vitelliform macular dystrophy (VMD) arising from various genetic etiologies. Methods Multimodal adaptive optics (AO) imaging was performed in 11 patients with VMD using a custom-assembled instrument. Non-confocal split detection and AO-enhanced indocyanine green were used to visualize the cone photoreceptor and RPE mosaics, respectively. Cone and RPE densities were measured and compared across BEST1-, PRPH2-, IMPG1-, and IMPG2-related VMD. Results Within macular lesions associated with VMD, both cone and RPE densities were reduced below normal, to 37% of normal cone density (eccentricity 0.2 mm) and to 8.4% of normal RPE density (eccentricity 0.5 mm). Outside of lesions, cone and RPE densities were slightly reduced (both to 92% of normal values), but with high degree of variability in the individual measurements. Comparison of juxtalesional cone and RPE measurements (<1 mm from the lesion edge) revealed significant differences in RPE density across the four genes (P < 0.05). Overall, cones were affected to a greater extent than RPE in patients with IMPG1 and IMPG2 pathogenic variants, but RPE was affected more than cones in BEST1 and PRPH2 VMD. This trend was observed even in contralateral eyes from a subset of five patients who presented with macular lesions in only one eye. Conclusions Assessment of cones and RPE in retinal locations outside of the macular lesions reveals a pattern of cone and RPE disruption that appears to be gene dependent in VMD. These findings provide insight into the cellular pathogenesis of disease in VMD.
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Affiliation(s)
- Tao Liu
- National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States.,https://orcid.org/0000-0001-9864-3896
| | - Nancy Aguilera
- National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States.,https://orcid.org/0000-0003-0863-596X
| | - Andrew J Bower
- National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States.,https://orcid.org/0000-0003-1645-5950
| | - Joanne Li
- National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States.,https://orcid.org/0000-0003-2845-2490
| | - Ehsan Ullah
- National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States.,https://orcid.org/0000-0003-0107-6608
| | - Alfredo Dubra
- Department of Ophthalmology, Stanford University, Palo Alto, California, United States.,https://orcid.org/0000-0002-6506-9020
| | - Catherine Cukras
- National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States
| | - Brian P Brooks
- National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States.,https://orcid.org/0000-0002-1916-7551
| | - Brett G Jeffrey
- National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States.,https://orcid.org/0000-0001-9549-0644
| | - Robert B Hufnagel
- National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States.,https://orcid.org/0000-0003-3015-3545
| | - Laryssa A Huryn
- National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States.,https://orcid.org/0000-0002-0309-9419
| | - Wadih M Zein
- National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States.,https://orcid.org/0000-0002-3771-6120
| | - Johnny Tam
- National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States.,https://orcid.org/0000-0003-2300-0567
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17
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Vázquez-Domínguez I, Li CHZ, Fadaie Z, Haer-Wigman L, Cremers FPM, Garanto A, Hoyng CB, Roosing S. Identification of a Complex Allele in IMPG2 as a Cause of Adult-Onset Vitelliform Macular Dystrophy. Invest Ophthalmol Vis Sci 2022; 63:27. [PMID: 35608844 PMCID: PMC9150824 DOI: 10.1167/iovs.63.5.27] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Purpose Inherited retinal diseases are a group of clinically and genetically heterogeneous disorders with approximately 270 genes involved. IMPG2 is associated with adult-onset vitelliform macular dystrophy. Here, we investigated two unrelated patients with vitelliform macular dystrophy to identify the underlying genetic cause. Methods Whole-exome sequencing identified a putative causal complex allele consisting of c.3023-15T>A and c.3023G>A (p.(Gly1008Asp)) in IMPG2 in both individuals. To assess its effect, in vitro splice assays in HEK293T and further characterization in patient-derived photoreceptor precursor cells (PPCs) were conducted. Results The results of the midigene splice assays in HEK293T showed that the complex allele causes a variety of splicing defects ranging from a small deletion to (multiple-)exon skipping. This finding was further validated using patient-derived PPCs that showed a significant increase of out-of-frame transcripts lacking one or multiple exons compared to control-derived PPCs. Overall, control PPCs consistently showed low levels of aberrantly spliced IMPG2 transcripts that were highly elevated in patient-derived PPCs. These differences were even more obvious upon inhibition of nonsense-mediated decay with cycloheximide. Conclusions We report a heterozygous complex allele in IMPG2 causative for adult-onset vitelliform macular dystrophy in two unrelated individuals with mild visual loss and bilateral vitelliform lesions. The predicted causal missense mutation c.3023G>A, located in the consensus splice acceptor site, enhances the splicing effect of the upstream variant c.3023-15T>A, leading to the generation of aberrant transcripts that decrease the full-length IMPG2 levels. These results suggest a haploinsufficiency mechanism of action and highlight the complementarity of using different models to functionally assesses splicing defects.
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Affiliation(s)
- Irene Vázquez-Domínguez
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Catherina H Z Li
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.,Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Zeinab Fadaie
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Lonneke Haer-Wigman
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Frans P M Cremers
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Alejandro Garanto
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands.,Department of Pediatrics, Amalia Children's Hospital and Radboud Institute of Molecular Life Sciences (RIMLS), Radboud University Medical Center, Nijmegen, the Netherlands
| | - Carel B Hoyng
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.,Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Susanne Roosing
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
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18
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Chatterjee S, Gupta S, Chaudhry VN, Chaudhry P, Mukherjee A, Mutsuddi M. Whole exome sequencing identifies a novel splice-site mutation in IMPG2 gene causing Stargardt-like juvenile macular dystrophy in a north Indian family. Gene 2022; 816:146158. [PMID: 34990796 DOI: 10.1016/j.gene.2021.146158] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/10/2021] [Indexed: 12/01/2022]
Abstract
We report on the genetic analysis of a north Indian family affected with Stargardt-like juvenile macular dystrophy. Considering an autosomal recessive inheritance of macular dystrophy in the recruited family, whole exome sequencing was employed in two affected siblings and their mother. We have identified a novel splice-site variant NC_000003.11(NM_016247.3):c.1239 + 1G > T, co-segregating in the affected siblings, in the Interphotoreceptor Matrix Proteoglycan 2 (IMPG2) gene. The identified variant is present immediately after exon 11, and is predicted to disrupt the wild-type donor splice-site of IMPG2 transcripts. We confirmed the splice-site changes in the IMPG2 transcripts using minigene functional assay. Although a number of studies on IMPG2 have demonstrated its involvement in retinitis pigmentosa and vitelliform macular dystrophy, this is the first report of a splice-site variant in IMPG2 that is responsible for Stargardt-like juvenile macular dystrophy.
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Affiliation(s)
- Souradip Chatterjee
- Department of Molecular and Human Genetics, Institute of Science, Banaras Hindu University, Varanasi 221005, India
| | - Shashank Gupta
- Department of Molecular and Human Genetics, Institute of Science, Banaras Hindu University, Varanasi 221005, India
| | | | | | - Ashim Mukherjee
- Department of Molecular and Human Genetics, Institute of Science, Banaras Hindu University, Varanasi 221005, India
| | - Mousumi Mutsuddi
- Department of Molecular and Human Genetics, Institute of Science, Banaras Hindu University, Varanasi 221005, India.
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19
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Gupta MP, Brodie SE, Freund KB. UNUSUAL EARLY-ONSET VITELLIFORM DYSTROPHY POSSIBLY LINKED TO THE INTERPHOTORECEPTOR MATRIX PROTEOGLYCAN-1 P.LEU154PRO MUTATION. Retin Cases Brief Rep 2021; 15:527-531. [PMID: 30688845 DOI: 10.1097/icb.0000000000000843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE To describe a case of symptomatic outer retinal disruption in a patient heterozygous for the p.Leu154Pro interphotoreceptor matrix proteoglycan-1 (IMPG1) mutation implicated in adult-onset foveomacular vitelliform dystrophy. METHODS Observational case report. RESULTS We describe a case of a 25-year-old female patient with symptomatic scotoma and vision decrease who exhibited bilateral small foveal yellow spots. Optical coherence tomography revealed disorganization and decreased reflectance of the foveal ellipsoid and interdigitation zones in the left eye more than in the right eye. Fundus autofluorescence imaging showed minimal findings, and dye angiography was unrevealing. Multifocal electroretinogram revealed slightly decreased retinal sensitivity in the central retina of the left eye. Genetic testing identified a heterozygous p.Leu154Pro mutation in the IMPG1 gene. CONCLUSION The p.Leu154Pro IMPG1 mutation may cause symptomatic outer retinal disturbance in the heterozygous state. Further studies are necessary.
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Affiliation(s)
- Mrinali P Gupta
- Department of Ophthalmology, Weill Cornell Medical College, New York, New York
| | - Scott E Brodie
- Department of Ophthalmology, NYU School of Medicine, New York, New York
| | - K Bailey Freund
- Vitreous Retina Macual Consultants of New York, New York, New York; and
- LuEster T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, New York
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20
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Xu H, Qu C, Gan L, Sun K, Tan J, Liu X, Jiang Z, Tian W, Liu W, Zhang S, Yang Y, Jiang L, Zhu X, Zhang L. Deletion of the Impg2 gene causes the degeneration of rod and cone cells in mice. Hum Mol Genet 2021; 29:1624-1634. [PMID: 32242237 DOI: 10.1093/hmg/ddaa062] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/18/2020] [Accepted: 03/30/2020] [Indexed: 11/14/2022] Open
Abstract
Variants in interphotoreceptor matrix proteoglycans (IMPG2) have been reported in retinitis pigmentosa (RP) and vitelliform macular dystrophy (VMD) patients. However, the underlying molecular mechanisms remain elusive due to a lack of suitable disease models. We developed two independent Impg2 knockout (KO) mouse models using the CRISPR/Cas9 technique to assess the in vivo functions of Impg2 in the retina. Impg2 ablation in mice recapitulated the RP phenotypes of patients, including an attenuated electroretinogram (ERG) response and the progressive degeneration of photoreceptors. The histopathological examination of Impg2-KO mice revealed irregularly arranged rod cells and mislocalized rhodopsin protein in the inner segment at 6 months of age. In addition to the pathological changes in rod cells, cone cells were also affected in KO retinas. KO retinas exhibited progressive cone cell death and impaired cone cell elongation. Further immunoblotting analysis revealed increased levels of endoplasmic reticulum (ER) stress-related proteins, including C/EBP homologous protein (CHOP), immunoglobulin heavy-chain-binding protein (BIP) and protein disulfide isomerase (PDI), in Impg2-KO mouse retinas. Increased gliosis and apoptotic cell death were also observed in the KO retinas. As autophagy is closely associated with ER stress, we then checked whether autophagy was disturbed in Impg2-KO mouse retinas. The results showed that autophagy was impaired in KO retinas, as revealed by the increased accumulation of SQSTM1 and other proteins involved in autophagy. Our results demonstrate the essential roles of Impg2 in the retina, and this study provides novel models for mechanistic investigations and development of therapies for RP caused by IMPG2 mutations.
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Affiliation(s)
- Huijuan Xu
- The Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan, China.,Chengdu Institute of Biology, Sichuan Translational Medicine Research Hospital, Chinese Academy of Sciences, Chengdu 610072, Sichuan, China.,Department of Laboratory Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan China
| | - Chao Qu
- The Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan, China.,Department of Ophthalmology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan China
| | - Li Gan
- The Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan, China
| | - Kuanxiang Sun
- The Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan, China
| | - Junkai Tan
- Xiamen Eye Center, Xiamen University, Xiamen 361005, China
| | - Xuyang Liu
- Xiamen Eye Center, Xiamen University, Xiamen 361005, China
| | - Zhilin Jiang
- The Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan, China.,Department of Ophthalmology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan China
| | - Wanli Tian
- The Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan, China
| | - Wenjing Liu
- The Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan, China
| | - Shanshan Zhang
- The Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan, China
| | - Yeming Yang
- The Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan, China
| | - Li Jiang
- The Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan, China.,Department of Ophthalmology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan China
| | - Xianjun Zhu
- The Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan, China.,Chengdu Institute of Biology, Sichuan Translational Medicine Research Hospital, Chinese Academy of Sciences, Chengdu 610072, Sichuan, China.,Department of Laboratory Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan China.,Research Unit for Blindness Prevention of Chinese Academy of medical Sciences (2019RU026), Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan, China.,Department of Ophthalmology, First People's Hospital of Shangqiu, Shangqiu 476000, Henan, China
| | - Lin Zhang
- The Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan, China.,Research Unit for Blindness Prevention of Chinese Academy of medical Sciences (2019RU026), Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan, China
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21
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Olivier G, Corton M, Intartaglia D, Verbakel SK, Sergouniotis PI, Le Meur G, Dhaenens CM, Naacke H, Avila-Fernández A, Hoyng CB, Klevering J, Bocquet B, Roubertie A, Sénéchal A, Banfi S, Muller A, Hamel CL, Black GC, Conte I, Roosing S, Zanlonghi X, Ayuso C, Meunier I, Manes G. Pathogenic variants in IMPG1 cause autosomal dominant and autosomal recessive retinitis pigmentosa. J Med Genet 2021; 58:570-578. [PMID: 32817297 DOI: 10.1136/jmedgenet-2020-107150] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/09/2020] [Accepted: 06/24/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Inherited retinal disorders are a clinically and genetically heterogeneous group of conditions and a major cause of visual impairment. Common disease subtypes include vitelliform macular dystrophy (VMD) and retinitis pigmentosa (RP). Despite the identification of over 90 genes associated with RP, conventional genetic testing fails to detect a molecular diagnosis in about one third of patients with RP. METHODS Exome sequencing was carried out for identifying the disease-causing gene in a family with autosomal dominant RP. Gene panel testing and exome sequencing were performed in 596 RP and VMD families to identified additional IMPG1 variants. In vivo analysis in the medaka fish system by knockdown assays was performed to screen IMPG1 possible pathogenic role. RESULTS Exome sequencing of a family with RP revealed a splice variant in IMPG1. Subsequently, the same variant was identified in individuals from two families with either RP or VMD. A retrospective study of patients with RP or VMD revealed eight additional families with different missense or nonsense variants in IMPG1. In addition, the clinical diagnosis of the IMPG1 retinopathy-associated variant, originally described as benign concentric annular macular dystrophy, was also revised to RP with early macular involvement. Using morpholino-mediated ablation of Impg1 and its paralog Impg2 in medaka fish, we confirmed a phenotype consistent with that observed in the families, including a decreased length of rod and cone photoreceptor outer segments. CONCLUSION This study discusses a previously unreported association between monoallelic or biallelic IMPG1 variants and RP. Notably, similar observations have been reported for IMPG2.
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Affiliation(s)
- Guillaume Olivier
- Institute for Neurosciences of Montpellier, University of Montpellier, Montpellier, France
- Institute for Neurosciences of Montpellier, INSERM U1051, Montpellier, France
| | - Marta Corton
- Department of Genetics & Genomics, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM)-Center for Biomedical Network Research on Rare Diseases-(CIBERER), Madrid, Spain
| | - Daniela Intartaglia
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Telethon Institute of Genetics and Medicine, Pozzuoli (NA), and Medical Genetics, Naples, Italy
| | - Sanne K Verbakel
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Panagiotis I Sergouniotis
- Manchester Royal Eye Hospital, Manchester Academic Health Science Centre, Central Manchester NHS Foundation Trust, Manchester Royal Eye Hospital, Manchester, M13 9WL, UK
| | - Guylène Le Meur
- Service Ophtalmologie, CHU Nantes, Nantes Université, Nantes, France
| | - Claire-Marie Dhaenens
- University Lille-Nord de France, INSERM U837, Lille, France
- Lille Neuroscience & Cognition, LilNCog, Lille, France
| | - Hélène Naacke
- Service d'ophtalmologie, Clinique Saint Joseph, Angouleme, Nouvelle Aquitaine, France
| | - Almudena Avila-Fernández
- Department of Genetics & Genomics, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM)-Center for Biomedical Network Research on Rare Diseases-(CIBERER), Madrid, Spain
| | - Carel B Hoyng
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jeroen Klevering
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Béatrice Bocquet
- Institute for Neurosciences of Montpellier, University of Montpellier, Montpellier, France
- Institute for Neurosciences of Montpellier, INSERM U1051, Montpellier, France
| | - Agathe Roubertie
- Département de Neuropédiatrie, CHU Montpellier, Hôpital Gui de Chauliac, Montpellier, Hérault, France
- Institute for Neurosciences of Montpellier, INSERM U1051, Montpellier, Hérault, France
| | - Audrey Sénéchal
- Institute for Neurosciences of Montpellier, University of Montpellier, Montpellier, France
- Institute for Neurosciences of Montpellier, INSERM U1051, Montpellier, France
| | - Sandro Banfi
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Telethon Institute of Genetics and Medicine, Naples, Italy
| | - Agnès Muller
- Institute for Neurosciences of Montpellier, University of Montpellier, Montpellier, France
- Institute for Neurosciences of Montpellier, INSERM U1051, Montpellier, France
| | - Christian L Hamel
- Service d'ophtalmologie, Hôpital Gui de Chauliac, CHU Montpellier, Montpellier, France
| | - Graeme C Black
- Department of Genetic Medicine, University of Manchester, Manchester, UK
| | - Ivan Conte
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Telethon Institute of Genetics and Medicine, Pozzuoli (NA), and Medical Genetics, Naples, Italy
- Department of Biology, University of Naples Federico II, Napoli, Campania, Italy
| | - Susanne Roosing
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Xavier Zanlonghi
- Institut Ophtalmologique de l'Ouest, Eye Clinic Jules Verne, Nantes, France
| | - Carmen Ayuso
- Department of Genetics & Genomics, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz University Hospital, Universidad Autónoma de Madrid (IIS-FJD, UAM)-Center for Biomedical Network Research on Rare Diseases-(CIBERER), Madrid, Spain
- Department of Genetics & Genomics, Centro de Investigacion Biomedica en Red (CIBER) de Enfermedades Raras, ISCIII, Madrid, Spain
| | - Isabelle Meunier
- Institute for Neurosciences of Montpellier, University of Montpellier, Montpellier, France
- National Centre in Rare Diseases, Genetics of Sensory Diseases, CHU Montpellier, Montpellier, Languedoc-Roussillon, France
| | - Gaël Manes
- Institute for Neurosciences of Montpellier, University of Montpellier, Montpellier, France
- Institute for Neurosciences of Montpellier, INSERM U1051, Montpellier, France
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22
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Sodi A, Mucciolo DP, Giorgio D, Passerini I, Pacini B, Bruschi M, Verdina T, Virgili G, Giansanti F, Murro V. Clinical and molecular findings in patients with pattern dystrophy. Ophthalmic Genet 2021; 42:577-587. [PMID: 34240658 DOI: 10.1080/13816810.2021.1938140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Purposes: To study the clinical and genetic background of a series of Italian patients affected by pattern dystrophy (PD).Methods: We reviewed patients with a clinical diagnosis of PD examined at the Eye Clinic in Florence from 2012 to 2019. We took into consideration patients with a standard ophthalmological examination, personal and familial ophthalmological history, fundus imaging, and molecular genetic analysis of genes PRPH2 and BEST1. We labelled patients with BEST1 and PRPH2 mutations as m-PD group (mutated) whereas patients with no mutations in these 2 genes as nm-PD group (non-mutated).Results: Seventy-seven PD patients were assessed (average age 59.7 ± 14.2, range 31-88 years). Fifty patients were placed in the nm-PD group and 27 in the m-PD. Pathogenic BEST1 and PRPH2 mutations were detected in 7% and 22% of PD patients, respectively. In total, we reported 1 BEST1 and 8 PRPH2 novel mutations. Ten patients were characterized by drusen in the nm-PD group whereas in no patients in the m-PD group drusen were detected at the fundus.Conclusions: An important proportion of patients affected by PD showed BEST1 or PRPH2 mutations. Patients affected by drusen represent a different sub-phenotype. Genetic examination is recommended for a correct clinical management.
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Affiliation(s)
- Andrea Sodi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Dario Pasquale Mucciolo
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy.,Ophthalmology Unit, San Jacopo Hospital, Pistoia, Italy
| | - Dario Giorgio
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Ilaria Passerini
- Department of Genetic Diagnosis, Careggi Teaching Hospital, Florence, Italy
| | - Bianca Pacini
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Mario Bruschi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Tommaso Verdina
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - Gianni Virgili
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy.,IRCCS Fondazione G. B. Bietti, Roma, Italy
| | - Fabrizio Giansanti
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Vittoria Murro
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
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23
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Shah SM, Schimmenti LA, Marmorstein AD, Bakri SJ. ADULT-ONSET VITELLIFORM MACULAR DYSTROPHY SECONDARY TO A NOVEL IMPG2 GENE VARIANT. Retin Cases Brief Rep 2021; 15:356-358. [PMID: 30300315 DOI: 10.1097/icb.0000000000000824] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE To report a case of adult-onset vitelliform macular dystrophy in a patient who was found to have a previously unreported variant of the IMPG2 gene. METHODS Case report. RESULTS A 65-year-old white woman with no significant medical or ocular history presented with a complaint of persistent wavy vision for 10 months. On funduscopic examination, bilateral vitelliform lesions of approximately 1 mm in the right eye and 0.5 mm in the left eye were evident, with no choroidal neovascularization in either eye. The patient was diagnosed with adult-onset vitelliform macular dystrophy. Genetic testing revealed a single likely pathogenic variant of the IMPG2 gene that may explain the examination findings. CONCLUSION Adult-onset vitelliform macular dystrophy is a common and relatively benign condition occurring in approximately 1 in 8,000 individuals. Although vitelliform lesions can be a manifestation of systemic diseases or be idiopathic, in a minority of patients, genetic predisposition may play a role. Mutations in four particular genes BEST1, PRPH2, IMPG1, and IMPG2 have been associated with some cases of adult-onset vitelliform macular dystrophy, with this particular gene variant of IMPG2 being previously unreported.
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Affiliation(s)
- Saumya M Shah
- Mayo Clinic School of Medicine, Rochester, Minnesota
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24
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Differential diagnosis algorithms of сentral serous chorioretinopathy and adult-onset vitelliform dystrophies. OPHTHALMOLOGY JOURNAL 2020. [DOI: 10.17816/ov60596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Purpose.To optimize the differential diagnosis of chronic central serous chorioretinopathy (CSCR) and of adult-onset vitelliform dystrophies (VD). Research objectives. On the multimodal diagnosis basis, to investigate signs characteristic for VD and chronic CSCR using mathematic modeling, to elaborate algorithms of their differential diagnosis in settings of differently equipped clinics.
Materials and methods.61 patient (90 eyes) with long-term neuroepithelial detachments (NEDs) were included in the study. In all patients, the disease history was collected, including the family history; all patients underwent a standard ophthalmologic examination: visual acuity testing including best corrected visual acuity (BCVA), biomicroophthalmoscopy, fundus photography, spectral domain optical coherence tomography (SD-OCT) and optical coherence tomography angiography (OCT-A), short-wavelength autofluorescence (SW-AF), fluorescein angiography (FA), indocyanine green angiography (ICGA). Patients were divided into two groups: with vitelliform dystrophies 30 patients (30 eyes), and with CSCR 31 patients (31 eyes). To estimate the probability of disease detection, binary logistic regression method was used.
Results.Diagnostic predictors found in both groups were scrutinized; mathematical models for estimating the probability of disease detection were obtained. Differential diagnostics algorithms have been developed taking into account the resulting formulas for calculating the probability of disease detection, including criteria of different examination combinations: SD-OCT (area under ROC curve 0.946); BAF (area under ROC curve 0.955), SD-OCT and SW-AF (area under ROC curve 0.980); SW-AF, FA and ICGA (area under ROC curve 0.989).
Conclusion.The obtained models make it possible to carry out differential diagnosis of vitelliform dystrophies and chronic CSCR in settings of differently equipped clinics.
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25
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Çavdarli C, Çavdarlı B, Alp MN. Investigating the role of BEST1 and PRPH2 variants in the molecular aetiology of adult-onset vitelliform macular dystrophies. Ophthalmic Genet 2020; 41:585-590. [PMID: 32942919 DOI: 10.1080/13816810.2020.1821385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objective: To determine the clinical relevance and frequency of BEST1 and PRPH2 mutations in a clinically diagnosed adult-onset vitelliform macular dystrophy (AVMD) group with Caucasian ethnicity. Methods: The study comprised 24 patients who had been diagnosed with AVMD via indirect fundus ophthalmoscopy and presented with a dome-shaped appearance between the retinal pigment epithelium and photoreceptors on their spectral-domain optical coherence tomography. They had lesion hyper- autofluorescence on their fundus autofluorescence images and were also investigated for BEST1 and PRPH2 mutations for a probable molecular aetiology. Results: No pathogenic or likely pathogenic mutation was detected in the BEST1 and PRPH2 genes of any of the clinically diagnosed AVDM patients. A heterozygous NM_000322.5:c.938C>T (p.Pro313Leu) variant of the PRPH2 gene was detected in 2 non-consanguineous patients. According to current guidelines, this variant was classified as a 'variant of uncertain significance'. Conclusion: In conclusion, AVMD is a genotypic and phenotypic heterogeneous disease. The genetic aetiology could not be explained by sequencing BEST1 and PRPH2 genes in the AVMD patients; however, the variant of PRPH2 could be a cause of predisposition relevant to the phenotype.
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Affiliation(s)
- Cemal Çavdarli
- Department of Ophthalmology, University of Health Sciences, Ankara Numune Training and Research Hospital , Ankara, Turkey
| | - Büşranur Çavdarlı
- Department of Medical Genetics, University of Health Sciences, Ankara Numune Training and Research Hospital , Ankara, Turkey
| | - Mehmet Numan Alp
- Department of Ophthalmology, University of Health Sciences, Ankara Numune Training and Research Hospital , Ankara, Turkey
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26
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Aardema ML, Stiassny MLJ, Alter SE. Genomic Analysis of the Only Blind Cichlid Reveals Extensive Inactivation in Eye and Pigment Formation Genes. Genome Biol Evol 2020; 12:1392-1406. [PMID: 32653909 PMCID: PMC7502198 DOI: 10.1093/gbe/evaa144] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2020] [Indexed: 12/21/2022] Open
Abstract
Trait loss represents an intriguing evolutionary problem, particularly when it occurs across independent lineages. Fishes in light-poor environments often evolve “troglomorphic” traits, including reduction or loss of both pigment and eyes. Here, we investigate the genomic basis of trait loss in a blind and depigmented African cichlid, Lamprologus lethops, and explore evolutionary forces (selection and drift) that may have contributed to these losses. This species, the only known blind cichlid, is endemic to the lower Congo River. Available evidence suggests that it inhabits deep, low-light habitats. Using genome sequencing, we show that genes related to eye formation and pigmentation, as well as other traits associated with troglomorphism, accumulated inactivating mutations rapidly after speciation. A number of the genes affected in L. lethops are also implicated in troglomorphic phenotypes in Mexican cavefish (Astyanax mexicanus) and other species. Analysis of heterozygosity patterns across the genome indicates that L. lethops underwent a significant population bottleneck roughly 1 Ma, after which effective population sizes remained low. Branch-length tests on a subset of genes with inactivating mutations show little evidence of directional selection; however, low overall heterozygosity may reduce statistical power to detect such signals. Overall, genome-wide patterns suggest that accelerated genetic drift from a severe bottleneck, perhaps aided by directional selection for the loss of physiologically expensive traits, caused inactivating mutations to fix rapidly in this species.
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Affiliation(s)
- Matthew L Aardema
- Department of Biology, Montclair State University.,Sackler Institute for Comparative Genomics, American Museum of Natural History, New York, New York
| | - Melanie L J Stiassny
- Department of Ichthyology, American Museum of Natural History, New York, New York
| | - S Elizabeth Alter
- Department of Ichthyology, American Museum of Natural History, New York, New York.,The Graduate Center, City University of New York.,Department of Biology, York College/The City University of New York
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27
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Xuan Y, Zhang Y, Zong Y, Wang M, Li L, Ye X, Liu W, Chen J, Sun X, Zhang Y, Chen Y. The Clinical Features and Genetic Spectrum of a Large Cohort of Chinese Patients With Vitelliform Macular Dystrophies. Am J Ophthalmol 2020; 216:69-79. [PMID: 32278767 DOI: 10.1016/j.ajo.2020.03.047] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/18/2020] [Accepted: 03/31/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE To provide the clinical and genetic characteristics of a large cohort of Chinese patients with vitelliform macular dystrophies. DESIGN Cross-sectional study. METHODS One hundred and thirty-four unrelated Chinese patients diagnosed with Best vitelliform macular dystrophy (BVMD), autosomal recessive bestrophinopathy (ARB), or adult vitelliform macular dystrophy (AVMD) were enrolled. Detailed ophthalmic examinations and genetic testing on vitelliform macular dystrophy-related genes were performed. Genotype and phenotype association were analyzed among different diagnostic groups. RESULTS In total, 87 BVMD, 30 AVMD, and 17 ARB patients were enrolled in this study. Genetic analysis identified 37 BEST1 mutations in 53 patients with BVMD and ARB. Of these, 5 variants (c.254A>C, c.291C>G, c.722C>G, c.848_850del, c.1740-2A>C) were novel. The variant c.898G>A was a hotspot mutation, which was identified in 13 patients with BVMD and 1 patient with ARB. There were significant differences of ocular biometric parameters among patients with homozygous or compound heterozygous mutations, heterozygous mutations, and those without mutations of BEST1. Homozygous or compound heterozygous patients had shortest axial length (AL), shallowest anterior chamber depth (ACD), and highest intraocular pressure (IOP); patients without mutations had longest AL, deepest ACD, and lowest IOP; and heterozygous patients were in between. Moreover, 7 patients harboring heterozygous mutations in BEST1 and 3 patients without BEST1 mutations showed similar clinical appearance to ARB in our cohort. CONCLUSIONS This is the largest sample size study of Chinese vitelliform macular dystrophy patients. Our results indicated that assessment of angle-closure risk is a necessary consideration for all types of BEST1-related vitelliform macular dystrophies. The study expanded both the clinical and genetic findings of 3 common types of vitelliform macular dystrophies in a Chinese population.
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Affiliation(s)
- Yi Xuan
- Department of Ophthalmology & Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Youjia Zhang
- Department of Ophthalmology & Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Yuan Zong
- Department of Ophthalmology & Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia, Fudan University, Chinese Academy of Medical Sciences, Shanghai, China
| | - Min Wang
- Department of Ophthalmology & Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Lei Li
- Department of Ophthalmology & Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Xiaofeng Ye
- Department of Ophthalmology & Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Wei Liu
- Department of Ophthalmology & Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Junyi Chen
- Department of Ophthalmology & Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia, Fudan University, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xinghuai Sun
- Department of Ophthalmology & Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China; State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia, Fudan University, Chinese Academy of Medical Sciences, Shanghai, China
| | - Yongjin Zhang
- Department of Ophthalmology & Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Yuhong Chen
- Department of Ophthalmology & Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia, Fudan University, Chinese Academy of Medical Sciences, Shanghai, China.
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Proteoglycan IMPG2 Shapes the Interphotoreceptor Matrix and Modulates Vision. J Neurosci 2020; 40:4059-4072. [PMID: 32265257 DOI: 10.1523/jneurosci.2994-19.2020] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/29/2020] [Accepted: 03/19/2020] [Indexed: 12/13/2022] Open
Abstract
Photoreceptor neurons are surrounded by an extracellular matrix, called the interphotoreceptor matrix (IPM). Activities crucial to vision occur within the IPM, including trafficking of nutrients and metabolites, retinal attachment, and interactions needed for normal outer segment phagocytosis. The IPM includes the following two unique proteoglycans: IPM proteoglycan 1 (IMPG1) and IMPG2. Patients with mutations in IMPG1/IMPG2 develop visual deficits with subretinal material accumulation, highlighting the critical role of the IPM in vision. To determine the role of these proteoglycans in retinal physiology and the pathologic mechanisms that lead to vision loss, we generated mouse models lacking IMPG1/IMPG2. In normal retina, IMPG1 and IMPG2 occupy distinct IPM compartments, represent the main source of chondroitin sulfate and are fundamental for the constitution of the cone-specific glycocalyx stained by the PNA (peanut agglutinin) lectin marker. No evident morphologic or functional deficits were found in mice lacking IMPG1. In the absence of IMPG2, IMPG1 abnormally accumulated at the subretinal space need, likely leading to the formation of subretinal lesions and reduced visual function. Interestingly, mice lacking both IMPG1 and IMPG2, regardless of sex, showed normal retinal structure and function, demonstrating that the aberrant IMPG1 distribution is the main cause of the visual alterations observed in the absence of IMPG2. In conclusion, our results show the dependence of secreted proteoglycans such as IMPG1 on the extracellular environment to properly integrate into the matrix, demonstrate the role of IMPG2 in shaping the IPM, and shed light on the potential mechanisms leading to the development of subretinal lesions and vision loss.SIGNIFICANCE STATEMENT The photoreceptors are specialized neurons that drive phototransduction in the mammalian retina. These cells are organized and surrounded by an extracellular matrix, the interphotoreceptor matrix (IPM). Mutations in IPM proteoglycans are associated with blindness in humans. Our studies show that two specific proteoglycans of the IPM, IPM proteoglycan 1 (IMPG1) and IMPG2, form a dynamic structure with distinct localization and dependency. When IMPG2 is absent, IMPG1 cannot integrate into the IPM, leading to abnormal proteoglycan accumulation and visual deficits. This work adds a new layer of understanding to IPM physiology and describes the pathologic events following deficits in proteoglycans, providing novel possibilities for visual restoration in patients with IMPG-related pathologies.
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Yata N, Yasukawa T, Kawamura M, Hirano Y, Ogura Y. Macular hole and serous pigment epithelial detachment in bilateral acquired vitelliform lesions. Am J Ophthalmol Case Rep 2020; 18:100628. [PMID: 32140615 PMCID: PMC7049591 DOI: 10.1016/j.ajoc.2020.100628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 11/16/2019] [Accepted: 02/21/2020] [Indexed: 11/30/2022] Open
Abstract
Purpose Acquired vitelliform lesions (AVLs) are associated with age-related macular degeneration and other variable macular disorders. AVLs often lead to outer retinal atrophy, sometimes accompanying a macular hole and choroidal neovascularization. The purpose of this study was to report a rare case with bilateral AVLs, in which one eye had accompanied a macular hole and the second eye a serous pigment epithelial detachment (sPED). Observations A 66-year-old woman complained of bilateral metamorphopsia. AVLs were observed in the right eye and a flat sPED in the left eye. The best-corrected visual acuity (BCVA) was 20/17 in both eyes. Fluorescein angiography revealed local leakage in the right eye and pattern dystrophy-like hypofluorescence in both eyes. The sPED progressed with AVLs in the left eye and was treated with a combination therapy of intravitreal aflibercept, a sub-Tenon's injection of triamcinolone acetonide, and photodynamic therapy (IVA/STTA/PDT), which successfully flattened the sPED and sustained good vision for 4 years. The right eye was treated with intravitreal ranibizumab and tissue plasminogen activator, which enhanced absorption of the vitelliform material. However, 14 months later, a macular hole with typical metamorphopsia formed above a subretinal fibrotic scar at the vitelliruptive stage. Although pars plana vitrectomy closed the macular hole, enlargement of the outer retinal atrophy worsened the BCVA to 20/100. Conclusions and importance We successfully treated one eye with a sPED with AVLs using the combination therapy of IVA/STTA/PDT, while the second eye with a macular hole secondary to AVLs ultimately developed outer retinal atrophy with visual loss.
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Affiliation(s)
- Nana Yata
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Tsutomu Yasukawa
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Mihoko Kawamura
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yoshio Hirano
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yuichiro Ogura
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Yuan X, Lan G, Li L, He H, Wang J, Hu S. Differential gene expression profiling of the goose pineal gland. Br Poult Sci 2020; 61:200-208. [PMID: 31830828 DOI: 10.1080/00071668.2019.1698014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
1. The present study was conducted to obtain a better understanding of the molecular mechanisms underlying broodiness in a commercial breed, Tianfu geese, as little is known about the role of the pineal gland in this period. The aim was to identify genes which are differentially expressed in the pineal gland between the laying and broodiness periods by performing a transcriptome screen.2. After sequencing cDNA derived from the pineal gland and annotation of the results, a sequencing depth of 14.82 and 18.17 million mapped tags was obtained during the laying and broodiness periods, respectively, and a total of 120 differentially expressed genes were identified. Of these, 32 genes showing up-regulated expression and 88 genes showing down-regulated expression were identified in broodiness period vs. laying period libraries.3. Gene ontology (GO) analyses showed that these genes were related to the visual process, phototransduction, and lipoprotein metabolism. Kyoto Encyclopaedia of Genes and Genome (KEGG) analyses showed that phototransduction and tryptophan metabolism pathways exhibited the largest enrichment factors. The reliability of the RNA sequence data was confirmed by quantitative real-time PCR analysis of five genes, and the results were mostly consistent with those from the high-throughput RNA sequencing.4. The goose transcriptome and the identification of differentially expressed genes provided comprehensive gene expression information that enables a better understanding of the molecular mechanisms underlying the broodiness period of geese.
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Affiliation(s)
- X Yuan
- Institute of Animal Genetics and Breeding, College of Animal Science and Technology, Sichuan Agricultural University, Ya'an, Sichuan, P.R.China.,Animal husbandry and veterinary medicine, Chengdu Agriculture College, Wenjiang, Sichuan, P.R.China
| | - G Lan
- Institute of Animal Genetics and Breeding, College of Animal Science and Technology, Sichuan Agricultural University, Ya'an, Sichuan, P.R.China
| | - L Li
- Institute of Animal Genetics and Breeding, College of Animal Science and Technology, Sichuan Agricultural University, Ya'an, Sichuan, P.R.China
| | - H He
- Institute of Animal Genetics and Breeding, College of Animal Science and Technology, Sichuan Agricultural University, Ya'an, Sichuan, P.R.China
| | - J Wang
- Institute of Animal Genetics and Breeding, College of Animal Science and Technology, Sichuan Agricultural University, Ya'an, Sichuan, P.R.China
| | - S Hu
- Institute of Animal Genetics and Breeding, College of Animal Science and Technology, Sichuan Agricultural University, Ya'an, Sichuan, P.R.China
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Rahman N, Georgiou M, Khan KN, Michaelides M. Macular dystrophies: clinical and imaging features, molecular genetics and therapeutic options. Br J Ophthalmol 2019; 104:451-460. [PMID: 31704701 PMCID: PMC7147237 DOI: 10.1136/bjophthalmol-2019-315086] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/24/2019] [Accepted: 10/21/2019] [Indexed: 11/03/2022]
Abstract
Macular dystrophies (MDs) consist of a heterogeneous group of disorders that are characterised by bilateral symmetrical central visual loss. Advances in genetic testing over the last decade have led to improved knowledge of the underlying molecular basis. The developments in high-resolution multimodal retinal imaging have also transformed our ability to make accurate and more timely diagnoses and more sensitive quantitative assessment of disease progression, and allowed the design of optimised clinical trial endpoints for novel therapeutic interventions. The aim of this review was to provide an update on MDs, including Stargardt disease, Best disease, X-linked r etinoschisis, pattern dystrophy, Sorsby fundus dystrophy and autosomal dominant drusen. It highlights the range of innovations in retinal imaging, genotype-phenotype and structure-function associations, animal models of disease and the multiple treatment strategies that are currently in clinical trial or planned in the near future, which are anticipated to lead to significant changes in the management of patients with MDs.
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Affiliation(s)
| | - Michalis Georgiou
- Moorfields Eye Hospital, London, UK.,Institute of Ophthalmology, UCL, London, UK
| | - Kamron N Khan
- Ophthalmology Department, St James's University Hospital, Leeds, UK
| | - Michel Michaelides
- Moorfields Eye Hospital, London, UK .,Institute of Ophthalmology, UCL, London, UK
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Datta P, Hendrickson B, Brendalen S, Ruffcorn A, Seo S. The myosin-tail homology domain of centrosomal protein 290 is essential for protein confinement between the inner and outer segments in photoreceptors. J Biol Chem 2019; 294:19119-19136. [PMID: 31694913 DOI: 10.1074/jbc.ra119.009712] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/30/2019] [Indexed: 12/13/2022] Open
Abstract
Mutations in the centrosomal protein 290 (CEP290) gene cause various ciliopathies involving retinal degeneration. CEP290 proteins localize to the ciliary transition zone and are thought to act as a gatekeeper that controls ciliary protein trafficking. However, precise roles of CEP290 in photoreceptors and pathomechanisms of retinal degeneration in CEP290-associated ciliopathies are not sufficiently understood. Using conditional Cep290 mutant mice, in which the C-terminal myosin-tail homology domain of CEP290 is disrupted after the connecting cilium is assembled, we show that this domain is essential for protein confinement between the inner and the outer segments. Upon disruption of the myosin-tail homology domain, inner segment plasma membrane proteins, including syntaxin 3 (STX3), synaptosome-associated protein 25 (SNAP25), and interphotoreceptor matrix proteoglycan 2 (IMPG2), rapidly accumulated in the outer segment. In contrast, localization of endomembrane proteins was not altered. Trafficking and confinement of most outer segment-resident proteins appeared to be unaffected or only minimally affected in Cep290 mutant mice. One notable exception was rhodopsin (RHO), which severely mislocalized to inner segments during the initial stage of degeneration. Similar mislocalization phenotypes were observed in Cep290rd16 mice. These results suggest that a failure of protein confinement at the connecting cilium and consequent accumulation of inner segment membrane proteins in the outer segment, along with insufficient RHO delivery, is part of the disease mechanisms that cause retinal degeneration in CEP290-associated ciliopathies. Our study provides insights into the pathomechanisms of retinal degenerations associated with compromised ciliary gates.
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Affiliation(s)
- Poppy Datta
- Department of Ophthalmology and Visual Sciences, University of Iowa College of Medicine, Iowa City, Iowa 52242.,Institute for Vision Research, University of Iowa, Iowa City, Iowa 52242
| | - Brandon Hendrickson
- Department of Ophthalmology and Visual Sciences, University of Iowa College of Medicine, Iowa City, Iowa 52242.,Institute for Vision Research, University of Iowa, Iowa City, Iowa 52242
| | - Sarah Brendalen
- Department of Ophthalmology and Visual Sciences, University of Iowa College of Medicine, Iowa City, Iowa 52242.,Institute for Vision Research, University of Iowa, Iowa City, Iowa 52242
| | - Avri Ruffcorn
- Department of Ophthalmology and Visual Sciences, University of Iowa College of Medicine, Iowa City, Iowa 52242.,Institute for Vision Research, University of Iowa, Iowa City, Iowa 52242
| | - Seongjin Seo
- Department of Ophthalmology and Visual Sciences, University of Iowa College of Medicine, Iowa City, Iowa 52242 .,Institute for Vision Research, University of Iowa, Iowa City, Iowa 52242
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Khan AO, Al Teneiji AM. Homozygous and heterozygous retinal phenotypes in families harbouring IMPG2 mutations. Ophthalmic Genet 2019; 40:247-251. [PMID: 31264916 DOI: 10.1080/13816810.2019.1627467] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: Biallelic mutations in interphotoreceptor matrix proteoglycan 2 (IMPG2) have been shown to underlie recessive childhood-onset rod-cone dystrophy with early macular involvement in several families. In other families, heterozygous IMPG2 mutations have been associated with dominant vitelliform macular dystrophy. To date, the retinal phenotype of heterozygotes from families with recessive IMPG2-related retinal dystrophy has not been assessed. This study documents the genotypes and phenotypes observed in both homozygotes and available heterozygotes from additional families with IMPG2-related recessive rod-cone dystrophy. Methods: Retrospective case series (2016-2018). Results: Four families were identified. All were first-cousin marriages and had no known relation to each other. Individuals with biallelic pathogenic variants (7 individuals) had childhood-onset rod-cone dystrophy. Families 1 and 2 harboured the same novel homozygous mutation c.189dup;p.Gln64Thrfs*9 (5 individuals, 4-17 years old). Family 3 harboured the novel homozygous mutation c.533 + 4_533 + 7del;p.? (1 individual, 17 years old), and Family 4 harboured the previously reported homozygous mutation c.3262C>T;p.Arg1088* (1 individual, 45 years old). The 3 available carriers were genetically confirmed (both parents from Family 1 and the father from Family 3) and had macular focal retinal pigment epithelium thickening by optical coherence tomography (OCT). The father from Family 3 also had unilateral sectoral pigmentary retinopathy. Conclusions: Childhood-onset recessive rod-cone dystrophy with early macular involvement should prompt examination of the parents for macular focal retinal pigment epithelium thickening on OCT. If present the possibility of biallelic IMPG2 mutations in the proband should be considered. Young affected relatives of the proband can show multimodal imaging abnormalities before they are overtly symptomatic.
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Affiliation(s)
- Arif O Khan
- a Eye Institute , Cleveland Clinic Abu Dhabi , Abu Dhabi , United Arab Emirates.,b Department of Ophthalmology , Cleveland Clinic Lerner College of Medicine of Case Western University , Cleveland , Ohio , USA
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Hanif AM, Yan J, Jain N. Pattern Dystrophy: An Imprecise Diagnosis in the Age of Precision Medicine. Int Ophthalmol Clin 2019; 59:173-194. [PMID: 30585925 DOI: 10.1097/iio.0000000000000262] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Sisk RA, Hufnagel RB, Laham A, Wohler ES, Sobreira N, Ahmed ZM. Peripheral Cone Dystrophy: Expanded Clinical Spectrum, Multimodal and Ultrawide-Field Imaging, and Genomic Analysis. J Ophthalmol 2018; 2018:2984934. [PMID: 30116628 PMCID: PMC6079493 DOI: 10.1155/2018/2984934] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 04/19/2018] [Accepted: 05/02/2018] [Indexed: 12/30/2022] Open
Abstract
PURPOSE To present new clinical features, multimodal and ultrawide-field imaging characteristics of peripheral cone dystrophy (PCD), and results of laboratory and genetic investigation to decipher the etiology. METHODS Retrospective observational case-series. RESULTS Three patients with PCD presented with bilateral paracentral scotomas and a mean visual acuity of 20/25. All exhibited confluent macular hyperautofluorescence with a central bull's eye lesion. Spectral-domain optical coherence tomography revealed loss of outer retinal elements, particularly the inner segment ellipsoid band and external limiting membrane, within the area of macular hyperautofluorescence. This area corresponded with a lightened fundus appearance and variable retinal pigment epithelium (RPE) abnormalities. Full field and multifocal electroretinography distinguished PCD from other photoreceptor dystrophies. Ultrawide-field imaging revealed irregular peripheral retinal lesions in a distribution greater nasally than temporally and not contiguous with the macular lesion. Functional and anatomic testing remained stable over a mean follow-up of 3 years. Laboratory investigation for causes of uveitis was negative. Whole exome sequencing identified rare variants in genes associated with macular or cone dystrophy or degeneration. CONCLUSIONS In contrast to the original description, the funduscopic and fluorescein angiographic appearance of PCD is abnormal, although the defects are subtle. Peripheral lesions may be observed in some patients. Bilateral, symmetric, macular hyperautofluorescence associated with outer retinal atrophy that spares the fovea is a characteristic of PCD. Pathogenic variants in the same gene were not shared across the cohort, suggesting genetic heterogeneity. Further evaluation is warranted.
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Affiliation(s)
- Robert A. Sisk
- Department of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Cincinnati Eye Institute, Cincinnati, OH, USA
- Division of Pediatric Ophthalmology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Robert B. Hufnagel
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Ailee Laham
- Department of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Elizabeth S. Wohler
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nara Sobreira
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Zubair M. Ahmed
- Department of Otorhinolaryngology, School of Medicine, University of Maryland, Baltimore, MD, USA
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SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY FEATURES IN DIFFERENT STAGES OF BEST VITELLIFORM MACULAR DYSTROPHY. Retina 2018; 38:1041-1046. [PMID: 28376040 DOI: 10.1097/iae.0000000000001634] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE To provide a systematic classification of findings regarding the different stages of vitelliform macular dystrophy on spectral domain optical coherence tomography (SD-OCT). METHODS Ninety-four eyes of 47 patients were recruited in a prospective cross-sectional study. All patients underwent a complete ophthalmologic examination, including best-corrected visual acuity using Early Treatment Diabetic Retinopathy Study (ETDRS) charts, biomicroscopy, and SD-OCT. The findings assessed included vitelliform material, neurosensory detachment, status of external limiting membrane, ellipsoid zone and retinal pigment epithelium, choroidal excavation, foveal cavitation, choroidal neovascularization, vitreomacular traction, and macular hole. The primary outcome measure was the identification of SD-OCT findings in each vitelliform macular dystrophy stage. Secondary outcomes included the correlations between SD-OCT features and visual acuity changes. RESULTS The outer retinal layers (external limiting membrane, ellipsoid zone, and retinal pigment epithelium) were found to be more commonly disrupted in Stages 2 to 4 (range: 86%-100%), whereas their absence was more typical of Stage 5 (71%-86%). Vitelliform material was found in 100% of Stages 2 and 3, 93% of Stage 4, and interestingly in 43% of Stage 5. Eyes characterized by vitelliform material showed a greater correlation with higher best-corrected visual acuity than eyes without it (0.35 logarithm of the minimum angle of resolution vs. 0.80 ± 0.36 logarithm of the minimum angle of resolution, approximately 20/45 and 20/125 Snellen equivalent, respectively) (t = 3.726, P < 0.05). Moreover, its absence was associated with a best-corrected visual acuity of 0.5 logarithm of the minimum angle of resolution or worse (approximately 20/63 Snellen equivalent; P < 0.05). Subretinal fluid was more common in Stages 3 and 4 (72.7% and 75%, respectively) than Stages 2 and 5 (P = 0.004). Eyes with subretinal fluid were significantly associated with a visual acuity of 0.2 logarithm of the minimum angle of resolution or worse (approximately 20/32 Snellen equivalent; P = 0.04). CONCLUSION Spectral domain optical coherence tomography assessment primarily indicates an outer retinal layer disruption in Stages 2 to 4, along with the presence of vitelliform material extending into the more advanced clinical stages too. Eyes characterized by the persistence of vitelliform material show better best-corrected visual acuity. Future investigations based on a longitudinal follow-up are warranted to correlate SD-OCT modifications with functional responses to identify SD-OCT indicators for prognostic and therapeutic purposes.
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Abeshi A, Coppola P, Beccari T, Dundar M, Di Nicola M, Viola F, Colombo L, Bertelli M. Genetic testing for pattern dystrophies. EUROBIOTECH JOURNAL 2017. [DOI: 10.24190/issn2564-615x/2017/s1.27] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Abstract
We studied the scientific literature and disease guidelines in order to summarize the clinical utility of the genetic test for pattern dystrophies. Pattern dystrophies are mostly inherited in an autosomal dominant manner (autosomal recessive transmission is rare). The overall prevalence is currently unknown. Pattern dystrophies are caused by variations in the BEST1, IMPG1, IMPG2, OTX2, PRPH2 and CTNNA1 genes. Clinical diagnosis is based on clinical findings, ophthalmological examination, optical coherence tomography, electrooculography and electroretinography. The genetic test is useful for confirming diagnosis and for differential diagnosis, couple risk assessment and access to clinical trials.
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Affiliation(s)
- Andi Abeshi
- MAGI Balkans, Tirana , Albania
- MAGI’S Lab, Rovereto , Italy
| | | | - Tommaso Beccari
- Department of Pharmaceutical Sciences, University of Perugia, Perugia , Italy
| | - Munis Dundar
- Department of Medical Genetics, Erciyes University Medical School, Kayseri , Turkey
| | - Maura Di Nicola
- Department of Clinical Sciences and Community Health, University of Milan, Ophthalmological Unit, IRCCS-Cà Granda Foundation-Ospedale Maggiore Policlinico, Milan , Italy
| | - Francesco Viola
- Department of Clinical Sciences and Community Health, University of Milan, Ophthalmological Unit, IRCCS-Cà Granda Foundation-Ospedale Maggiore Policlinico, Milan , Italy
| | - Leonardo Colombo
- Department of Ophthalmology, ASST Santi Paolo e Carlo, University of Milan, Milan , Italy
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Adult-Onset Vitelliform Macular Dystrophy caused by BEST1 p.Ile38Ser Mutation is a Mild Form of Best Vitelliform Macular Dystrophy. Sci Rep 2017; 7:9146. [PMID: 28831140 PMCID: PMC5567297 DOI: 10.1038/s41598-017-09629-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 07/20/2017] [Indexed: 01/08/2023] Open
Abstract
Adult-onset vitelliform macular dystrophy (AVMD) is a common and benign macular degeneration which can be caused by BEST1 mutation. Here, we investigated the clinical characteristics associated with a newly identified BEST1 mutation, p.Ile38Ser and confirmed the associated physiological functional defects. The 51-year-old patient presented bilateral small subretinal yellow deposits. Consistent with AVMD, the corresponding lesions showed hyperautofluorescence, late staining in fluorescein angiography, and subretinal hyper-reflective materials in spectral-domain optical coherence tomography. Genetic analysis demonstrated that the patient presented with a heterozygous p.Ile38Ser BEST1 mutation. Surface biotinylation and patch clamp experiments were performed in transfected HEK293T cells. Although, the identified BEST1 mutant maintains normal membrane expression, p.Ile38Ser mutant showed significantly smaller currents than wild type (WT). However, it showed larger currents than other BEST1 mutants, p.Trp93Cys, causing autosomal dominant best vitelliform macular dystrophy (BVMD), and p.Ala195Val, causing autosomal recessive bestrophinopathy (ARB). The cells expressing both WT and each BEST1 mutant showed that the functional defect of p.Ile38ser was milder than that of p.Trp93Cys, whereas combination of p.Ala195Val with WT showed good current. We identified and described the phenotype and in vitro functions of a novel BEST1 mutation causing AVMD. AVMD induced by p.Ile38Ser BEST1 mutation is a mild form of BVMD.
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Brandl C, Schulz HL, Charbel Issa P, Birtel J, Bergholz R, Lange C, Dahlke C, Zobor D, Weber BHF, Stöhr H. Mutations in the Genes for Interphotoreceptor Matrix Proteoglycans, IMPG1 and IMPG2, in Patients with Vitelliform Macular Lesions. Genes (Basel) 2017. [PMID: 28644393 PMCID: PMC5541303 DOI: 10.3390/genes8070170] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
A significant portion of patients diagnosed with vitelliform macular dystrophy (VMD) do not carry causative mutations in the classic VMD genes BEST1 or PRPH2. We therefore performed a mutational screen in a cohort of 106 BEST1/PRPH2-negative VMD patients in two genes encoding secreted interphotoreceptor matrix proteoglycans-1 and -2 (IMPG1 and IMPG2). We identified two novel mutations in IMPG1 in two simplex VMD cases with disease onset in their early childhood, a heterozygous p.(Leu238Pro) missense mutation and a homozygous c.807 + 5G > A splice site mutation. The latter induced partial skipping of exon 7 of IMPG1 in an in vitro splicing assay. Furthermore, we found heterozygous mutations including three stop [p.(Glu226*), p.(Ser522*), p.(Gln856*)] and five missense mutations [p.(Ala243Pro), p.(Gly1008Asp), p.(Phe1016Ser), p.(Tyr1042Cys), p.(Cys1077Phe)] in the IMPG2 gene, one of them, p.(Cys1077Phe), previously associated with VMD. Asymptomatic carriers of the p.(Ala243Pro) and p.(Cys1077Phe) mutations show subtle foveal irregularities that could characterize a subclinical stage of disease. Taken together, our results provide further evidence for an involvement of dominant and recessive mutations in IMPG1 and IMPG2 in VMD pathology. There is a remarkable similarity in the clinical appearance of mutation carriers, presenting with bilateral, central, dome-shaped foveal accumulation of yellowish material with preserved integrity of the retinal pigment epithelium (RPE). Clinical symptoms tend to be more severe for IMPG1 mutations.
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Affiliation(s)
- Caroline Brandl
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg, 93053 Regensburg, Germany;
- Institut für Humangenetik, Universität Regensburg, 93053 Regensburg, Germany; (H.L.S.); (B.H.F.W.)
- Lehrstuhl für Genetische Epidemiologie, Universität Regensburg, 93053 Regensburg, Germany
| | - Heidi L. Schulz
- Institut für Humangenetik, Universität Regensburg, 93053 Regensburg, Germany; (H.L.S.); (B.H.F.W.)
| | - Peter Charbel Issa
- Department of Ophthalmology, University of Bonn, 53113 Bonn, Germany;
- Oxford Eye Hospital, OUH NHS Foundation Trust and the Nuffield Laboratory of Ophthalmology, Department of Clinical Neurosciences, University of Oxford, Oxford OX1 3BD, UK
| | - Johannes Birtel
- Department of Ophthalmology, University of Bonn, 53113 Bonn, Germany;
| | - Richard Bergholz
- Klinik für Augenheilkunde, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany;
| | - Clemens Lange
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert Ludwigs Universität Freiburg, 79085 Freiburg, Germany;
| | - Claudia Dahlke
- Klinik für Augenheilkunde, Universitätsklinikum Köln, 50937 Köln, Germany;
| | - Ditta Zobor
- Forschungsinstitut für Augenheilkunde, Universitätsklinikum Tübingen, 72076 Tübingen, Germany;
| | - Bernhard H. F. Weber
- Institut für Humangenetik, Universität Regensburg, 93053 Regensburg, Germany; (H.L.S.); (B.H.F.W.)
| | - Heidi Stöhr
- Institut für Humangenetik, Universität Regensburg, 93053 Regensburg, Germany; (H.L.S.); (B.H.F.W.)
- Correspondence: ; Tel.: +49-941-944-5424
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Guziewicz KE, Sinha D, Gómez NM, Zorych K, Dutrow EV, Dhingra A, Mullins RF, Stone EM, Gamm DM, Boesze-Battaglia K, Aguirre GD. Bestrophinopathy: An RPE-photoreceptor interface disease. Prog Retin Eye Res 2017; 58:70-88. [PMID: 28111324 PMCID: PMC5441932 DOI: 10.1016/j.preteyeres.2017.01.005] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 01/16/2017] [Accepted: 01/18/2017] [Indexed: 11/17/2022]
Abstract
Bestrophinopathies, one of the most common forms of inherited macular degenerations, are caused by mutations in the BEST1 gene expressed in the retinal pigment epithelium (RPE). Both human and canine BEST1-linked maculopathies are characterized by abnormal accumulation of autofluorescent material within RPE cells and bilateral macular or multifocal lesions; however, the specific mechanism leading to the formation of these lesions remains unclear. We now provide an overview of the current state of knowledge on the molecular pathology of bestrophinopathies, and explore factors promoting formation of RPE-neuroretinal separations, using the first spontaneous animal model of BEST1-associated retinopathies, canine Best (cBest). Here, we characterize the nature of the autofluorescent RPE cell inclusions and report matching spectral signatures of RPE-associated fluorophores between human and canine retinae, indicating an analogous composition of endogenous RPE deposits in Best Vitelliform Macular Dystrophy (BVMD) patients and its canine disease model. This study also exposes a range of biochemical and structural abnormalities at the RPE-photoreceptor interface related to the impaired cone-associated microvillar ensheathment and compromised insoluble interphotoreceptor matrix (IPM), the major pathological culprits responsible for weakening of the RPE-neuroretina interactions, and consequently, formation of vitelliform lesions. These salient alterations detected at the RPE apical domain in cBest as well as in BVMD- and ARB-hiPSC-RPE model systems provide novel insights into the pathological mechanism of BEST1-linked disorders that will allow for development of critical outcome measures guiding therapeutic strategies for bestrophinopathies.
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Affiliation(s)
- Karina E Guziewicz
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, PA 19104, USA.
| | - Divya Sinha
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA; McPherson Eye Research Institute, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Néstor M Gómez
- Department of Anatomy & Cell Biology, School of Dental Medicine, University of Pennsylvania, PA 19104, USA
| | - Kathryn Zorych
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, PA 19104, USA
| | - Emily V Dutrow
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, PA 19104, USA
| | - Anuradha Dhingra
- Department of Biochemistry, School of Dental Medicine, University of Pennsylvania, PA 19104, USA
| | - Robert F Mullins
- Department of Ophthalmology & Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Edwin M Stone
- Department of Ophthalmology & Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - David M Gamm
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA; McPherson Eye Research Institute, University of Wisconsin-Madison, Madison, WI 53705, USA; Department of Ophthalmology & Visual Sciences, University of Wisconsin-Madison, Madison, WI 53705, USA
| | | | - Gustavo D Aguirre
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, PA 19104, USA
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Johnson AA, Guziewicz KE, Lee CJ, Kalathur RC, Pulido JS, Marmorstein LY, Marmorstein AD. Bestrophin 1 and retinal disease. Prog Retin Eye Res 2017; 58:45-69. [PMID: 28153808 DOI: 10.1016/j.preteyeres.2017.01.006] [Citation(s) in RCA: 141] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 01/23/2017] [Accepted: 01/25/2017] [Indexed: 12/18/2022]
Abstract
Mutations in the gene BEST1 are causally associated with as many as five clinically distinct retinal degenerative diseases, which are collectively referred to as the "bestrophinopathies". These five associated diseases are: Best vitelliform macular dystrophy, autosomal recessive bestrophinopathy, adult-onset vitelliform macular dystrophy, autosomal dominant vitreoretinochoroidopathy, and retinitis pigmentosa. The most common of these is Best vitelliform macular dystrophy. Bestrophin 1 (Best1), the protein encoded by the gene BEST1, has been the subject of a great deal of research since it was first identified nearly two decades ago. Today we know that Best1 functions as both a pentameric anion channel and a regulator of intracellular Ca2+ signaling. Best1 is an integral membrane protein which, within the eye, is uniquely expressed in the retinal pigment epithelium where it predominantly localizes to the basolateral plasma membrane. Within the brain, Best1 expression has been documented in both glial cells and astrocytes where it functions in both tonic GABA release and glutamate transport. The crystal structure of Best1 has revealed critical information about how Best1 functions as an ion channel and how Ca2+ regulates that function. Studies using animal models have led to critical insights into the physiological roles of Best1 and advances in stem cell technology have allowed for the development of patient-derived, "disease in a dish" models. In this article we review our knowledge of Best1 and discuss prospects for near-term clinical trials to test therapies for the bestrophinopathies, a currently incurable and untreatable set of diseases.
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Affiliation(s)
- Adiv A Johnson
- Department of Ophthalmology, Mayo Clinic, Rochester, MN, USA; Nikon Instruments, Melville, NY, USA
| | - Karina E Guziewicz
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - C Justin Lee
- Center for Neuroscience and Functional Connectomics, Brain Science Institute, Korea Institute of Science and Technology, Seoul, South Korea
| | - Ravi C Kalathur
- New York Structural Biology Center, New York Consortium on Membrane Protein Structure, New York, NY, USA
| | - Jose S Pulido
- Department of Ophthalmology, Mayo Clinic, Rochester, MN, USA
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Clinical Characteristics, Choroidal Neovascularization, and Predictors of Visual Outcomes in Acquired Vitelliform Lesions. Am J Ophthalmol 2016; 172:28-38. [PMID: 27640006 DOI: 10.1016/j.ajo.2016.09.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 09/07/2016] [Accepted: 09/07/2016] [Indexed: 01/29/2023]
Abstract
PURPOSE To quantify the temporal properties of the acquired vitelliform lesion (AVL) life cycle, define the clinical characteristics of choroidal neovascularization (NV) in this setting, and determine the predictors of long-term visual outcomes. DESIGN Retrospective cohort study. METHODS Clinical and imaging data from 199 eyes of 124 consecutive patients with AVLs associated with age-related macular degeneration (AMD) and adult-onset foveomacular vitelliform dystrophy (AOFVD) were analyzed. Volumetric calculations of vitelliform material were determined using spectral-domain optical coherence tomography and the temporal properties of the AVL life cycle were quantified. The clinical characteristics of NV were assessed, as were the predictors of final best-corrected visual acuity (BCVA) and change in BCVA. RESULTS Mean age was 79.2 ± 12.1 years. AVLs grew and collapsed at approximately the same rate (P = .275). Fifteen eyes (7.5%) developed NV, of which all were type 1. In 13 of these eyes, NV occurred during the collapse phase of the AVL life cycle, after the peak AVL volume was reached. The risk of NV (P = .006) and the decline in BCVA (P = .001) were both significantly greater among eyes with AMD. Foveal atrophy was the characteristic most significantly associated with final BCVA and change in BCVA from baseline (both P < .0005). The development of NV was not predictive of long-term visual outcomes (all P = .216). CONCLUSIONS Complications associated with AVLs typically occur during the collapse phase of the AVL life cycle. Visual outcomes and risk of NV are related to the underlying disease associated with AVLs.
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Liu J, Zhang Y, Xuan Y, Liu W, Wang M. Novel BEST1 Mutations and Special Clinical Features of Best Vitelliform Macular Dystrophy. Ophthalmic Res 2016; 56:178-185. [DOI: 10.1159/000444681] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 02/07/2016] [Indexed: 11/19/2022]
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Prevalence of reticular pseudodrusen in newly presenting adult onset foveomacular vitelliform dystrophy. Eye (Lond) 2016; 30:817-24. [PMID: 27034200 DOI: 10.1038/eye.2016.46] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 01/21/2016] [Indexed: 11/08/2022] Open
Abstract
PurposeTo report the association and prevalence of reticular pseudodrusen (RPD) in eyes with newly presenting adult onset foveomacular vitelliform dystrophy (AFVD). To compare the strength of association with other pathologies resulting from dysfunction of the choroid-Bruch's membrane-retinal pigment epithelium (RPE) complex, including eyes with geographic atrophy (GA) and angioid streaks.MethodsRetrospective single-centre review of all consecutive newly presenting AFVD. Multimodal imaging with spectral domain optical coherence tomography, fundus photographs, red-free/blue light images, and fundus fluorescein angiograms were graded for the presence of RPD. For comparison, all consecutive newly presenting cases of GA and eyes with angioid streaks were studied.ResultsFifteen (15) patients were identified with AFVD (mean age of 77.3 years; 73.3% female). Mean age of patients with AFVD and RPD was 80.5 years (SD 3.7), whereas that of patients with AFVD without RPD was 75.1 years (SD 7.0). This age difference did not reach statistical significance, P=0.1. Six (40%) had identifiable RPD; being a bilateral finding in 100% of patients. No males with AFVD and RPD were identified. A total of 92 eyes presented with GA. Twenty-three (23) of these (25.0%) had RPD. Twelve (12) patients presented with identifiable angioid streaks, with 4 (36.4%) having RPD.ConclusionRPD are a frequent finding in eyes with newly presenting AFVD; not being restricted to AMD, but a finding common among diseases where pathophysiological mechanisms involve damage to Bruch's membrane and the RPE, whether genetic or degenerative. Our study supports the concept that they occur with high but variable frequencies in eyes with various pathologies.
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Katagiri S, Hayashi T, Ohkuma Y, Sekiryu T, Takeuchi T, Gekka T, Kondo M, Iwata T, Tsuneoka H. Mutation analysis of BEST1 in Japanese patients with Best's vitelliform macular dystrophy. Br J Ophthalmol 2015. [PMID: 26201355 DOI: 10.1136/bjophthalmol-2015-306830] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To describe the clinical and genetic features of Japanese patients with Best's vitelliform macular dystrophy (BVMD). PATIENTS AND METHODS This study examined 22 patients, including 16 probands from 16 families with BVMD. Comprehensive ophthalmic examinations were performed, including dilated funduscopy, full-field electroretinography (ERG) and electro-oculography (EOG). BEST1 mutation analysis was performed by Sanger sequencing. RESULTS All 16 probands exhibited characteristic BVMD fundus appearances, abnormal EOG, and normal ERG responses with the exception of one diabetic retinopathy proband. Genetic analysis identified 12 BEST1 variants in 13 probands (81%). Of these, 10 variants (p.T2A, p.R25W, p.F80L, p.V81M, p.A195V, p.R218H, p.G222E, p.V242M, p.D304del and p.E306D) have been previously reported in BVMD, while two variants (p.S7N and p.P346H) were novel, putative disease-causing variants. Single BEST1 variants were found in 12 probands. The one proband with compound heterozygous variants (p.S7N and p.R218H) exhibited typical BVMD phenotypes (pseudohypopyon stage and vitelliruptive stage in the right and left eyes, respectively). CONCLUSIONS Twelve different variants, two of which (p.S7N and p.P346H) were novel, were identified in the 13 Japanese families with BVMD. Compound heterozygous variants were found in one proband exhibiting a typical BVMD phenotype. Our results suggest that BEST1 variants do play a large role in Japanese patients with BVMD.
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Affiliation(s)
- Satoshi Katagiri
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Takaaki Hayashi
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Yasuhiro Ohkuma
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Tetsuju Sekiryu
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tomokazu Takeuchi
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Tamaki Gekka
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Mineo Kondo
- Department of Ophthalmology, Mie University School of Medicine, Mie, Japan
| | - Takeshi Iwata
- Division of Molecular and Cellular Biology, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Hiroshi Tsuneoka
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
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Adult-onset foveomacular vitelliform dystrophy: A fresh perspective. Prog Retin Eye Res 2015; 47:64-85. [DOI: 10.1016/j.preteyeres.2015.02.001] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 02/01/2015] [Accepted: 02/04/2015] [Indexed: 01/06/2023]
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Schatz P, Sharon D, Al-Hamdani S, Andréasson S, Larsen M. Retinal structure in young patients aged 10 years or less with Best vitelliform macular dystrophy. Graefes Arch Clin Exp Ophthalmol 2015; 254:215-21. [DOI: 10.1007/s00417-015-3025-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 04/08/2015] [Accepted: 04/20/2015] [Indexed: 11/30/2022] Open
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