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Subirà O, Català-Mora J, Del Prado C, Díaz-Cascajosa J, Barraso Rodrigo M, Cobos E, Aguilera C, Esteve-Garcia A, García-Arumí J, Caminal JM. Optical coherence tomography biomarkers in MYO7A-inherited retinal dystrophy: longitudinal study in pediatric patients. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06545-3. [PMID: 38871877 DOI: 10.1007/s00417-024-06545-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 06/15/2024] Open
Abstract
PURPOSE This study aims to answer a key question: is MYO7A-inherited retinal dystrophy (MYO7A-IRD) a photoreceptor-first or retinal pigment epithelium-first disease? A second aim was to determine the most useful biomarkers to monitor disease progression in pediatric patients with Usher syndrome type 1B (USH1) secondary to MYO7A mutation. METHODS Fifty-two eyes from 26 patients with genetically-confirmed MYO7A-IRD underwent swept-source optical coherence tomography (SS-OCT). Structural abnormalities were evaluated and correlated with follow-up time and best corrected visual acuity (BCVA). All patients were evaluated at baseline and after ≥ 40 months of follow-up. RESULTS The mean (SD) patient age was 9.92 (± 4.1) years. Mean follow-up time was 43 (± 3.2) months. At the final evaluation, the most common qualitative abnormalities in the subfoveal area were alterations in the photoreceptor outer segments (76.9% of eyes) and in the interdigitation zone (IZ) (80.8%). The presence of cystoid macular edema at baseline was independently associated with worse BCVA at the final assessment (increase in LogMAR estimate = 0.142; t(45.00) = 2.78, p = 0.009). The mean width of the ellipsoid and interdigitation zones decreased significantly (by 668 μm and 278 μm, respectively; both p < 0.001). CONCLUSION This study shows that disruption of the photoreceptor outer segments and the IZ are the first alterations detected by SS-OCT in the early phases of MYO7A-IRD. These data highlight the potential value of measuring the width of the ellipsoid and IZ to evaluate disease progression. These findings also demonstrate the utility of monitoring for the emergence of cystic lesions as biomarkers of worse visual prognosis in patients with MYO7A-IRD.
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Affiliation(s)
- Olaia Subirà
- Ophthalmology Department, Hospital Universitari de Vall d'Hebron, Passeig de la Vall d'Hebron, 119, 08035, Barcelona, Spain.
| | - Jaume Català-Mora
- Ophthalmology Department, Hospital de Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Ophthalmology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
- Unitat de Distròfies Hereditàries de Retina, Hospital Sant Joan de Déu-Hospital Bellvitge, Barcelona, Spain
| | - Cristina Del Prado
- Ophthalmology Department, Hospital de Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Unitat de Distròfies Hereditàries de Retina, Hospital Sant Joan de Déu-Hospital Bellvitge, Barcelona, Spain
| | - Jesús Díaz-Cascajosa
- Ophthalmology Department, Hospital de Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Unitat de Distròfies Hereditàries de Retina, Hospital Sant Joan de Déu-Hospital Bellvitge, Barcelona, Spain
| | - Marina Barraso Rodrigo
- Ophthalmology Department, Hospital de Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Unitat de Distròfies Hereditàries de Retina, Hospital Sant Joan de Déu-Hospital Bellvitge, Barcelona, Spain
| | - Estefanía Cobos
- Ophthalmology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
- Unitat de Distròfies Hereditàries de Retina, Hospital Sant Joan de Déu-Hospital Bellvitge, Barcelona, Spain
| | - Cinthia Aguilera
- Laboratori Clínic Territorial Metropolitana Sud, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Clinical Genetics Unit, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Anna Esteve-Garcia
- Laboratori Clínic Territorial Metropolitana Sud, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Clinical Genetics Unit, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - José García-Arumí
- Ophthalmology Department, Hospital Universitari de Vall d'Hebron, Passeig de la Vall d'Hebron, 119, 08035, Barcelona, Spain
- Instituto de Microcirugía Ocular (IMO), Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Josep M Caminal
- Ophthalmology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
- Unitat de Distròfies Hereditàries de Retina, Hospital Sant Joan de Déu-Hospital Bellvitge, Barcelona, Spain
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Jolly JK, Rodda BM, Edwards TL, Ayton LN, Ruddle JB. Optical coherence tomography in children with inherited retinal disease. Clin Exp Optom 2024; 107:255-266. [PMID: 38252959 DOI: 10.1080/08164622.2023.2294807] [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: 02/13/2023] [Accepted: 12/06/2023] [Indexed: 01/24/2024] Open
Abstract
Recent advances have led to therapeutic options becoming available for people with inherited retinal disease. In particular, gene therapy has been shown to hold great promise for slowing vision loss from inherited retinal disease. Recent studies suggest that gene therapy is likely to be most effective when implemented early in the disease process, making consideration of paediatric populations important. It is therefore necessary to have a comprehensive understanding of retinal imaging in children with inherited retinal diseases, in order to monitor disease progression and to determine which early retinal biomarkers may be used as outcome measures in future clinical trials. In addition, as many optometrists will review children with an inherited retinal disease, an understanding of the expected imaging outcomes can improve clinical care. This review focuses on the most common imaging modality used in research assessment of paediatric inherited retinal diseases: optical coherence tomography. Optical coherence tomography findings can be used in both the clinical and research setting. In particular, the review discusses current knowledge of optical coherence tomography findings in eight paediatric inherited retinal diseases - Stargardt disease, Bests disease, Leber's congenital amaurosis, choroideremia, RPGR related retinitis pigmentosa, Usher syndrome, X-linked retinoschisis and, Batten disease.
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Affiliation(s)
- Jasleen K Jolly
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK
- Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Brent M Rodda
- Department of Optometry and Vision Sciences, The University of Melbourne, Carlton, Victoria, Australia
| | - Thomas L Edwards
- Ophthalmology, Department of Surgery, The University of Melbourne, East Melbourne, Victoria, Australia
- Centre for Eye Research Australia, The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Lauren N Ayton
- Department of Optometry and Vision Sciences, The University of Melbourne, Carlton, Victoria, Australia
- Ophthalmology, Department of Surgery, The University of Melbourne, East Melbourne, Victoria, Australia
- Centre for Eye Research Australia, The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Jonathan B Ruddle
- Centre for Eye Research Australia, The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- Department of Ophthalmology, Royal Children's Hospital, Parkville, Victoria, Australia
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Cuzzuol BR, Apolonio JS, da Silva Júnior RT, de Carvalho LS, Santos LKDS, Malheiro LH, Silva Luz M, Calmon MS, Crivellaro HDL, Lemos FFB, Freire de Melo F. Usher syndrome: Genetic diagnosis and current therapeutic approaches. World J Otorhinolaryngol 2024; 11:1-17. [DOI: 10.5319/wjo.v11.i1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/21/2023] [Accepted: 01/05/2024] [Indexed: 01/17/2024] Open
Abstract
Usher Syndrome (USH) is the most common deaf-blind syndrome, affecting approximately 1 in 6000 people in the deaf population. This genetic condition is characterized by a combination of hearing loss (HL), retinitis pigmentosa, and, in some cases, vestibular areflexia. Among the subtypes of USH, USH type 1 is considered the most severe form, presenting profound bilateral congenital deafness, vestibular areflexia, and early onset RP. USH type 2 is the most common form, exhibiting congenital moderate to severe HL for low frequencies and severe to profound HL for high frequencies. Conversely, type 3 is the rarest, initially manifesting mild symptoms during childhood that become more prominent in the first decades of life. The dual impact of USH on both visual and auditory senses significantly impairs patients’ quality of life, restricting their daily activities and interactions with society. To date, 9 genes have been confirmed so far for USH: MYO7A, USH1C, CDH23, PCDH15, USH1G, USH2A, ADGRV1, WHRN and CLRN1. These genes are inherited in an autosomal recessive manner and encode proteins expressed in the inner ear and retina, leading to functional loss. Although non-genetic methods can assist in patient triage and disease extension evaluation, genetic and molecular tests play a pivotal role in providing genetic counseling, enabling appropriate gene therapy, and facilitating timely cochlear implantation (CI). The CRISPR/Cas9 system and viral-based gene replacement therapy have recently emerged as highly promising techniques for treating USH. Regarding drug therapy, PTC-124 and Nb54 have been identified as promising drug interventions for genetic HL in USH. Simultaneously, CI has proven to be critical in the restoration of hearing. This review aims to summarize the genetic and molecular diagnosis of USH and highlight the importance of early diagnosis in guiding appropriate treatment strategies and improving patient prognosis.
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Affiliation(s)
- Beatriz Rocha Cuzzuol
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Jonathan Santos Apolonio
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | | | - Lorena Sousa de Carvalho
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Luana Kauany de Sá Santos
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Luciano Hasimoto Malheiro
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Marcel Silva Luz
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Mariana Santos Calmon
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Henrique de Lima Crivellaro
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Fabian Fellipe Bueno Lemos
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Fabrício Freire de Melo
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
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Ben-Avi R, Rivera A, Hendler K, Sharon D, Banin E, Khateb S, Yahalom C. Prevalence and associated factors of cystoid macular edema in children with early onset inherited retinal dystrophies. Eur J Ophthalmol 2022; 33:11206721221136318. [PMID: 36317312 PMCID: PMC9999276 DOI: 10.1177/11206721221136318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 10/06/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE To assess the prevalence of Cystoid macular edema (CME) in children with early onset retinal dystrophies (EORD) and to evaluate if there are associated factors and/or response to early treatment. METHODS Consecutive, retrospective case series. Medical records of patients, 18 years or younger, diagnosed with EORD were included in the study. Optic coherence tomography (OCT) scans, clinical and genetic characteristics as well as other associated factors were analyzed. Main outcome was the presence of CME on OCT scans. RESULTS One hundred and two children with EORD (aged 1-18 years, mean 9.7 ± 4.2) were recruited. OCT was performed in 60/102 and among them, 19/60 had CME (31.7%). The disease-causing gene was identified in 13 children with CME; autosomal-recessive inheritance was found in 88.3% of those with an identified genotype. Children with Usher syndrome had CME in 44.4% of the cases. Early treatment of CME resulted in variable response. CONCLUSIONS Our results show that 31.7% of children with EORD who underwent OCT have macular edema. CME prevalence was found to be relatively higher in children with Usher syndrome. Autosomal recessive was the most prevalent inheritance identified in the EORD group as well as in the CME group. Additional prospective research is needed to assess the efficacy of early CME treatment in pediatric EORD patients.
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Affiliation(s)
- Ravid Ben-Avi
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Ophthalmology, Hadassah Medical Center, Jerusalem, Israel
| | - Antonio Rivera
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Ophthalmology, Hadassah Medical Center, Jerusalem, Israel
| | - Karen Hendler
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Ophthalmology, Hadassah Medical Center, Jerusalem, Israel
| | - Dror Sharon
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Ophthalmology, Hadassah Medical Center, Jerusalem, Israel
| | - Eyal Banin
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Ophthalmology, Hadassah Medical Center, Jerusalem, Israel
| | - Samer Khateb
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Ophthalmology, Hadassah Medical Center, Jerusalem, Israel
| | - Claudia Yahalom
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Dinculescu A, Link BA, Saperstein DA. Retinal Gene Therapy for Usher Syndrome: Current Developments, Challenges, and Perspectives. Int Ophthalmol Clin 2021; 61:109-124. [PMID: 34584048 PMCID: PMC8478317 DOI: 10.1097/iio.0000000000000378] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Calabro KR, Boye SL, Choudhury S, Fajardo D, Peterson JJ, Li W, Crosson SM, Kim MJ, Ding D, Salvi R, Someya S, Boye SE. A Novel Mouse Model of MYO7A USH1B Reveals Auditory and Visual System Haploinsufficiencies. Front Neurosci 2019; 13:1255. [PMID: 31824252 PMCID: PMC6883748 DOI: 10.3389/fnins.2019.01255] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 11/05/2019] [Indexed: 12/20/2022] Open
Abstract
Usher’s syndrome is the most common combined blindness–deafness disorder with USH1B, caused by mutations in MYO7A, resulting in the most severe phenotype. The existence of numerous, naturally occurring shaker1 mice harboring variable MYO7A mutations on different genetic backgrounds has complicated the characterization of MYO7A knockout (KO) and heterozygote mice. We generated a novel MYO7A KO mouse (Myo7a–/–) that is easily genotyped, maintained, and confirmed to be null for MYO7A in both the eye and inner ear. Like USH1B patients, Myo7a–/– mice are profoundly deaf, and display near complete loss of inner and outer cochlear hair cells (HCs). No gross structural changes were observed in vestibular HCs. Myo7a–/– mice exhibited modest declines in retinal function but, unlike patients, no loss of retinal structure. We attribute the latter to differential expression of MYO7A in mouse vs. primate retina. Interestingly, heterozygous Myo7a+/– mice had reduced numbers of cochlear HCs and concomitant reductions in auditory function relative to Myo7a+/+ controls. Notably, this is the first report that loss of a single Myo7a allele significantly alters auditory structure and function and suggests that audiological characterization of USH1B carriers is warranted. Maintenance of vestibular HCs in Myo7a–/– mice suggests that gene replacement could be used to correct the vestibular dysfunction in USH1B patients. While Myo7a–/– mice do not exhibit sufficiently robust retinal phenotypes to be used as a therapeutic outcome measure, they can be used to assess expression of vectored MYO7A on a null background and generate valuable pre-clinical data toward the treatment of USH1B.
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Affiliation(s)
- Kaitlyn R Calabro
- Department of Ophthalmology, University of Florida, Gainesville, FL, United States
| | - Sanford L Boye
- Department of Pediatrics, University of Florida, Gainesville, FL, United States
| | - Shreyasi Choudhury
- Department of Ophthalmology, University of Florida, Gainesville, FL, United States
| | - Diego Fajardo
- Department of Ophthalmology, University of Florida, Gainesville, FL, United States
| | - James J Peterson
- Department of Ophthalmology, University of Florida, Gainesville, FL, United States
| | - Wei Li
- Department of Ophthalmology, University of Florida, Gainesville, FL, United States
| | - Sean M Crosson
- Department of Ophthalmology, University of Florida, Gainesville, FL, United States
| | - Mi-Jung Kim
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States
| | - Dalian Ding
- Department of Communicative Disorders and Sciences, The State University of New York at Buffalo, Buffalo NY, United States
| | - Richard Salvi
- Department of Communicative Disorders and Sciences, The State University of New York at Buffalo, Buffalo NY, United States
| | - Shinichi Someya
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States
| | - Shannon E Boye
- Department of Ophthalmology, University of Florida, Gainesville, FL, United States
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