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Sisera L, Hanson JVM, Füglistaler J, Jeltsch BM, Patzelt S, Wehrle FM, Hagmann CF, Fauchère JC, Heyard R, Gerth-Kahlert C. The effect of high-dose erythropoietin perinatally on retinal function in school-aged children born extremely or very preterm. Am J Ophthalmol 2024:S0002-9394(24)00290-3. [PMID: 38996833 DOI: 10.1016/j.ajo.2024.06.027] [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: 01/20/2024] [Revised: 06/19/2024] [Accepted: 06/21/2024] [Indexed: 07/14/2024]
Abstract
PURPOSE To investigate the long-term effects of high-dose recombinant human erythropoietin (rhEPO) administered during the perinatal period on retinal and visual function in children born extremely or very preterm. DESIGN Randomized, double-blind clinical trial follow-up plus cohort study. METHODS Setting: Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland. STUDY POPULATION extremely or very preterm-born children aged 7-15 years, previously randomized to receive either high-dose rhEPO or placebo in the perinatal period. INCLUSION CRITERIA participation in an ongoing neuropediatric study (EpoKids), written informed consent (IC). EXCLUSION CRITERIA previous ocular trauma or surgery; retinal or developmental disease unrelated to prematurity. Healthy control (HC) children of comparable age were recruited. INCLUSION CRITERIA term birth, IC. EXCLUSION CRITERIA any ocular/visual abnormality, high refractive error. Intervention status (rhEPO/placebo) was unknown to examiners and subjects at examination, with examiners unblinded only after completion of all analyses. OBSERVATION PROCEDURES Electroretinography (ERG) was performed with the RETeval device (LKC Technologies, Inc., Gaithersburg MD). Ophthalmological and orthoptic examinations excluded comorbidity in the prematurely born cohort and ocular diseases in the HC group. MAIN OUTCOME MEASURES Scotopic and photopic ERG response amplitudes and peak times (6 amplitudes; 6 peak times). Secondary outcomes were habitual visual acuity and color discrimination performance (for descriptive summary only). RESULTS No differences in ERG parameters between EPO (n=52; 104 eyes) and placebo (n=35; 70 eyes) subgroups were observed (all corrected p>0.05). Two cone system-mediated peak times were slightly slower in the placebo than HC (n=52; 104 eyes) subgroup (coefficient/95% confidence interval (CI) = 0.53/0.21 to 0.85 and 0.36/0.13 to 0.60; p = 0.012 and 0.022); a predominantly rod system-mediated peak time was slightly faster in the EPO than the HC subgroup (coefficient/95% CI = -4.33/-6.88 to -1.78; p = 0.011). Secondary outcomes were comparable across subgroups. CONCLUSIONS Administration of high-dose rhEPO to infants born extremely or very preterm during the perinatal period has no measurable effects on retinal function in childhood compared to placebo. Premature birth may cause small, likely clinically insignificant effects on retinal function in childhood, which may be partially mitigated by administration of rhEPO during the perinatal period.
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Affiliation(s)
- Lorena Sisera
- Department of Ophthalmology, University Hospital Zurich and University of Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland
| | - James V M Hanson
- Department of Ophthalmology, University Hospital Zurich and University of Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland
| | - Jonas Füglistaler
- Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
| | - Brida M Jeltsch
- Department of Ophthalmology, University Hospital Zurich and University of Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland
| | - Sarah Patzelt
- Department of Ophthalmology, University Hospital Zurich and University of Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland
| | - Flavia M Wehrle
- Department of Neonatology and Pediatric Intensive Care, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Cornelia F Hagmann
- Department of Neonatology and Pediatric Intensive Care, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Jean-Claude Fauchère
- Department of Neonatology, University Hospital Zurich and University of Zurich, Frauenklinikstrasse 10, 8091 Zurich, Switzerland
| | - Rachel Heyard
- Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
| | - Christina Gerth-Kahlert
- Department of Ophthalmology, University Hospital Zurich and University of Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland.
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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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Artemiev D, Todorova MG. A Case of Congenital Stationary Night Blindness in a Healthy Female Infant: Emphasis on Electroretinography. Klin Monbl Augenheilkd 2024; 241:529-532. [PMID: 38653284 DOI: 10.1055/a-2211-9248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Affiliation(s)
- Dmitri Artemiev
- Department of Ophthalmology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Margarita G Todorova
- Department of Ophthalmology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- Department of Ophthalmology, University Hospital Basel, Basel, Switzerland
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Tan JK, Arno G, Josifova D, Mohamed MD, Mahroo OA. Unusual OCT findings in a patient with CABP4-associated cone-rod synaptic disorder. Doc Ophthalmol 2024; 148:115-120. [PMID: 38206458 PMCID: PMC10954985 DOI: 10.1007/s10633-023-09961-8] [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: 08/25/2023] [Accepted: 12/06/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE Bi-allelic variants in CABP4 are associated with congenital cone-rod synaptic disorder, which has also been classified, electrophysiologically, as incomplete congenital stationary night blindness (iCSNB). We describe clinical findings in a patient who demonstrated an unusual macular optical coherence tomography (OCT) phenotype, not previously reported in this condition. METHODS Our patient underwent multimodal retinal imaging, international standard full-field ERG testing and whole genome sequencing. RESULTS The patient was a 60-year-old woman with non-progressive visual impairment since birth, nystagmus and preference for dim lighting. Clinical fundus examination was unremarkable. OCT imaging revealed a hypo-reflective zone under an elevated fovea in both eyes. ERGs showed an electronegative DA10 response, with severely abnormal light-adapted responses. Whole genome sequencing revealed homozygosity for a known pathogenic variant in CABP4. No variants were found in other genes that could explain the patient's phenotype. CONCLUSIONS OCT findings of foveal elevation and an underlying hypo-reflective zone are novel in this condition. Whilst the clinical history was similar to achromatopsia and other cone dysfunction syndromes, ERG findings suggested disease associated with CACNA1F or CABP4. As CACNA1F is X-linked, CABP4 was more likely, and confirmed on genetic testing. The patient saw better in dim light, confirming that night blindness is not a feature of CABP4-associated disease. Our case highlights the value of ERGs in discriminating between causes of cone dysfunction, and extends the range of retinal imaging phenotypes reported in this disorder.
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Affiliation(s)
- Jit Kai Tan
- Department of Ophthalmology, Guy's & St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, England
- Institute of Ophthalmology, University College London, Bath Street, London, England
| | - Gavin Arno
- Institute of Ophthalmology, University College London, Bath Street, London, England
- Retinal and Genetics Services, Moorfields Eye Hospital, City Road, London, England
| | - Dragana Josifova
- Department of Genetics, Guy's & St Thomas' NHS Foundation Trust, Guy's Hospital, London, England
| | - Moin D Mohamed
- Department of Ophthalmology, Guy's & St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, England
| | - Omar A Mahroo
- Department of Ophthalmology, Guy's & St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, England.
- Institute of Ophthalmology, University College London, Bath Street, London, England.
- Retinal and Genetics Services, Moorfields Eye Hospital, City Road, London, England.
- Section of Ophthalmology, King's College London, St Thomas' Hospital Campus, Westminster Bridge Road, London, England.
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Katta M, de Guimaraes TAC, Fujinami-Yokokawa Y, Fujinami K, Georgiou M, Mahroo OA, Webster AR, Michaelides M. Congenital Stationary Night Blindness Structure, Function and Genotype-Phenotype Correlations in a Cohort of 122 Patients. Ophthalmol Retina 2024:S2468-6530(24)00121-0. [PMID: 38522615 DOI: 10.1016/j.oret.2024.03.017] [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: 02/02/2024] [Revised: 03/04/2024] [Accepted: 03/18/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVE To examine the molecular causes of Schubert-Bornschein (S-B) congenital stationary night blindness (CSNB), clinically characterize in detail, and assess genotype-phenotype correlations for retinal function and structure. DESIGN Retrospective, longitudinal, single-center case series. PARTICIPANTS One hundred twenty-two patients with S-B CSNB attending Moorfields Eye Hospital, United Kingdom. METHODS All case notes, results of molecular genetic testing, and OCT were reviewed. MAIN OUTCOME MEASURES Molecular genetics, presenting complaints, rates of nystagmus, nyctalopia, photophobia, strabismus, color vision defects and spherical equivalent refraction (SER). Retinal thickness, outer nuclear layer (ONL) thickness, and ganglion cell layer + inner plexiform layer (GCL+IPL) thickness from OCT imaging. RESULTS X-linked (CACNA1F and NYX) and autosomal recessive (TRPM1, GRM6, GPR179 and CABP4) genotypes were identified. The mean (± standard deviation) reported age of onset was 4.94 ± 8.99 years. Over the follow-up period, 95.9% of patients reported reduced visual acuity (VA), half had nystagmus, and 64.7% reported nyctalopia. Incomplete CSNB (iCSNB) patients more frequently had nystagmus and photophobia. Nyctalopia was similar for iCSNB and complete CSNB (cCSNB). Color vision data were limited but more defects were found in iCSNB. None of these clinical differences met statistical significance. There was no significant difference between groups in VA, with a mean of 0.46 logarithm of the minimum angle of resolution, and VA remained stable over the course of follow-up. Complete congenital stationary night blindness patients, specifically those with NYX and TRPM1 variants, were more myopic. CACNA1F patients showed the largest refractive variability, and the CABP4 patient was hyperopic. No significant differences were found in OCT structural analysis during the follow-up period. CONCLUSIONS Retinal structure in CSNB is stationary and no specific genotype-structure correlates were identified. Visual acuity seems to be relatively stable, with rare instances of progression. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Mohamed Katta
- UCL Institute of Ophthalmology, University College London, London, United Kingdom; Genetics Department, Moorfields Eye Hospital, London, United Kingdom
| | - Thales A C de Guimaraes
- UCL Institute of Ophthalmology, University College London, London, United Kingdom; Genetics Department, Moorfields Eye Hospital, 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, NHO Tokyo Medical Center, Tokyo, Japan; Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan
| | - Kaoru Fujinami
- UCL Institute of Ophthalmology, University College London, London, United Kingdom; Genetics Department, Moorfields Eye Hospital, London, United Kingdom; Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, NHO Tokyo Medical Center, Tokyo, Japan
| | - Michalis Georgiou
- UCL Institute of Ophthalmology, University College London, London, United Kingdom; Genetics Department, Moorfields Eye Hospital, London, United Kingdom; Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Omar A Mahroo
- UCL Institute of Ophthalmology, University College London, London, United Kingdom; Genetics Department, Moorfields Eye Hospital, London, United Kingdom
| | - Andrew R Webster
- UCL Institute of Ophthalmology, University College London, London, United Kingdom; Genetics Department, Moorfields Eye Hospital, London, United Kingdom
| | - Michel Michaelides
- UCL Institute of Ophthalmology, University College London, London, United Kingdom; Genetics Department, Moorfields Eye Hospital, London, United Kingdom.
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Lee D, Tomita Y, Shinojima A, Ban N, Yamaguchi S, Nishioka K, Negishi K, Yoshino J, Kurihara T. Nicotinamide mononucleotide, a potential future treatment in ocular diseases. Graefes Arch Clin Exp Ophthalmol 2024; 262:689-700. [PMID: 37335334 DOI: 10.1007/s00417-023-06118-w] [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: 02/06/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 06/21/2023] Open
Abstract
PURPOSE The burden of ocular diseases has been gradually increasing worldwide. Various factors are suggested for the development and progression of ocular diseases, such as ocular inflammation, oxidative stress, and complex metabolic dysregulation. Thus, managing ocular diseases requires the modulation of pathologic signaling pathways through many mechanisms. Nicotinamide mononucleotide (NMN) is a bioactive molecule naturally found in life forms. NMN is a direct precursor of the important molecule nicotinamide adenine dinucleotide (NAD+), an essential co-enzyme required for enormous cellular functions in most life forms. While the recent experimental evidence of NMN treatment in various metabolic diseases has been well-reviewed, NMN treatment in ocular diseases has not been comprehensively summarized yet. In this regard, we aimed to focus on the therapeutic roles of NMN treatment in various ocular diseases with recent advances. METHODS How we came to our current opinion with a recent summary was described based on our own recent reports as well as a search of the related literature. RESULTS We found that NMN treatment might be available for the prevention of and protection from various experimental ocular diseases, as NMN treatment modulated ocular inflammation, oxidative stress, and complex metabolic dysregulation in murine models for eye diseases such as ischemic retinopathy, corneal defect, glaucoma, and age-related macular degeneration. CONCLUSION Our current review suggests and discusses new modes of actions of NMN for the prevention of and protection from various ocular diseases and can urge future research to obtain more solid evidence on a potential future NMN treatment in ocular diseases at the preclinical stages.
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Affiliation(s)
- Deokho Lee
- Laboratory of Photobiology, Keio University School of Medicine, Tokyo, 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Yohei Tomita
- Laboratory of Photobiology, Keio University School of Medicine, Tokyo, 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Ari Shinojima
- Laboratory of Photobiology, Keio University School of Medicine, Tokyo, 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Norimitsu Ban
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Shintaro Yamaguchi
- Department of Internal Medicine, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Ken Nishioka
- Department of Internal Medicine, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Jun Yoshino
- Department of Internal Medicine, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Toshihide Kurihara
- Laboratory of Photobiology, Keio University School of Medicine, Tokyo, 160-8582, Japan.
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, 160-8582, Japan.
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Hassan S, Hsu Y, Thompson JM, Kalmanek E, VandeLune JA, Stanley S, Drack AV. The dose-response relationship of subretinal gene therapy with rAAV2tYF-CB-h RS1 in a mouse model of X-linked retinoschisis. Front Med (Lausanne) 2024; 11:1304819. [PMID: 38414621 PMCID: PMC10898246 DOI: 10.3389/fmed.2024.1304819] [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: 09/30/2023] [Accepted: 01/16/2024] [Indexed: 02/29/2024] Open
Abstract
Purpose X-linked retinoschisis (XLRS), due to loss-of-function mutations in the retinoschisin (RS1) gene, is characterized by a modest to severe decrease in visual acuity. Clinical trials for XLRS utilizing intravitreal (IVT) gene therapy showed ocular inflammation. We conducted a subretinal dose-response preclinical study using rAAV2tYF-CB-hRS1 utilizing the Rs1 knockout (Rs1-KO) mouse to investigate short- and long-term retinal rescue after subretinal gene delivery. Methods Rs1-KO mice were subretinally injected with 2 μL of rAAV2tYF-CB-hRS1 vector with 8E9 viral genomes (vg)/eye, 8E8 vg/eye, 8E7 vg/eye, or sham injection, and compared to untreated eyes. Reconstitution of human RS1 protein was detected using western blotting. Analysis of retinal function by electroretinography (ERG) and structural analysis by optical coherence tomography (OCT) were performed at 1, 2, 3, 5, 7, and 12 months post injection (MPI). Immunohistochemistry (IHC) was performed to evaluate cone rescue on the cellular level. Functional vision was evaluated using a visually guided swim assay (VGSA). Results Western blotting analysis showed human RS1 protein expression in a dose-dependent manner. Quantification of western blotting showed that the RS1 protein expression in mice treated with the 8E8 vg dose was near the wild-type (WT) expression levels. ERG demonstrated dose-dependent effects: At 1 MPI the 8E8 vg dose treated eyes had higher light-adapted (LA) ERG amplitudes in 3.0 flash and 5 Hz flicker compared to untreated (p < 0.0001) and sham-treated eyes (p < 0.0001) which persisted until the 12 MPI endpoint, consistent with improved cone function. ERG b-wave amplitudes were higher in response to dark-adapted (DA) 0.01 dim flash and 3.0 standard combined response (SCR) compared to sham-treated (p < 0.01) and untreated eyes (p < 0.001) which persisted until 3 MPI, suggesting short-term improvement of the rod photoreceptors. All injections, including sham-treated, resulted in a cyst severity score of 1 (no cavities), with significant reductions compared to untreated eyes up to 3 MPI (p < 0.05). The high and low dose groups showed inconsistent ERG improvements, despite reduced cyst severity, emphasizing the dose-dependent nature of gene augmentation's efficacy and the tenuous connection between cyst reduction and ERG improvement. IHC data showed a significant cone rescue in eyes treated with the 8E8 vg dose compared to sham-treated and untreated eyes. VGSA showed better functional vision in 8E8 vg dose treated mice. Eyes treated with the highest dose showed occasional localized degeneration in the outer nuclear layer. Conclusion Our data suggest that a dose of 8E8 vg/eye subretinally improves retinal function and structure in the Rs1-KO mouse. It improves cone function, rod function, and reduces cyst severity. Sham treatment resolves schisis cysts, but 8E8 vg/eye is needed for optimal retinal electrical function rescue. These findings offer a promising path for clinical translation to human trials.
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Affiliation(s)
- Salma Hassan
- Department of Ophthalmology and Visual Sciences, Institute for Vision Research, and Carver College of Medicine, University of Iowa, Iowa City, IA, United States
- Biomedical Science-Cell and Developmental Biology Graduate Program, Department of Anatomy and Cell Biology, University of Iowa, Iowa City, IA, United States
| | - Ying Hsu
- Department of Ophthalmology and Visual Sciences, Institute for Vision Research, and Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Jacob M Thompson
- Department of Ophthalmology and Visual Sciences, Institute for Vision Research, and Carver College of Medicine, University of Iowa, Iowa City, IA, United States
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, United States
| | - Emily Kalmanek
- Department of Ophthalmology and Visual Sciences, Institute for Vision Research, and Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Joel A VandeLune
- Department of Ophthalmology and Visual Sciences, Institute for Vision Research, and Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Sarah Stanley
- Department of Ophthalmology and Visual Sciences, Institute for Vision Research, and Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Arlene V Drack
- Department of Ophthalmology and Visual Sciences, Institute for Vision Research, and Carver College of Medicine, University of Iowa, Iowa City, IA, United States
- Biomedical Science-Cell and Developmental Biology Graduate Program, Department of Anatomy and Cell Biology, University of Iowa, Iowa City, IA, United States
- Department of Pediatrics, University of Iowa, Iowa City, IA, United States
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Torrell-Belzach N, Miere A, Bhouri R, Srour M, Souied EH, Zambrowski O. An incipient late-onset retinal degeneration with a C1QTNF5 mutation: a case report with an 11-year follow-up. Doc Ophthalmol 2024; 148:57-64. [PMID: 38129706 DOI: 10.1007/s10633-023-09958-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE The purpose of this study was to describe and diagnose the difficulty in a long-term follow-up (eleven years) patient with a very early presentation of late-onset retinal degeneration (L-ORD) and the significance of electrophysiological examinations and follow-up in assessing undiagnosed inherited retinal diseases. METHODS This is an observational case report of a 56-year-old woman, with scattered multiple yellow-white retinal dots firstly diagnosed as fundus albipunctatus. Ten years after presentation, a deterioration in rod and cone responses in ff-ERG was detected, which allowed us to discard the first diagnostic hypothesis and proceed with a genetic testing. RESULTS Ten years after presentation, she presented a clear progression of the abnormal photoreceptor response with a cone and rod involvement in ff-ERG, which was not compatible with the previous suspicion of fundus albipunctatus. Six months later, genetic testing results together with the typical progression of atrophic patchy lesions in multimodal imaging allowed a certain diagnosis of L-ORD, caused by an already reported pathogenic variant in the C1QTNF5 gene (c.563C > T; p. Pro188 Leu). CONCLUSIONS We demonstrate the importance of the ff-ERG examination and the follow-up (or ERG and imaging repetition) in the differential diagnosis of an incipient L-ORD, which can be easily misdiagnosed in the early stages, before the appearance of the characteristic chorioretinal atrophy seen with the progression of this rare disease.
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Affiliation(s)
- Nuria Torrell-Belzach
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil (CHIC), 40 Av. de Verdun, 94000, Créteil, France.
- Université Paris-Est Créteil (UPEC), Créteil, France.
| | - Alexandra Miere
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil (CHIC), 40 Av. de Verdun, 94000, Créteil, France
- Université Paris-Est Créteil (UPEC), Créteil, France
| | - Rakia Bhouri
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil (CHIC), 40 Av. de Verdun, 94000, Créteil, France
| | - Mayer Srour
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil (CHIC), 40 Av. de Verdun, 94000, Créteil, France
| | - Eric H Souied
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil (CHIC), 40 Av. de Verdun, 94000, Créteil, France
- Université Paris-Est Créteil (UPEC), Créteil, France
| | - Olivia Zambrowski
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil (CHIC), 40 Av. de Verdun, 94000, Créteil, France
- Necker Enfants Malades APHP, Paris, France
- Centre Ophtalmo Odéon Paris, Paris, France
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Jiang X, Bhatti T, Tariq A, Leo SM, Aychoua N, Webster AR, Hysi PG, Hammond CJ, Mahroo OA. Cone-driven strong flash electroretinograms in healthy adults: Prevalence of negative waveforms. Doc Ophthalmol 2024; 148:25-36. [PMID: 37924416 PMCID: PMC10879345 DOI: 10.1007/s10633-023-09957-4] [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: 12/05/2022] [Accepted: 10/05/2023] [Indexed: 11/06/2023]
Abstract
PURPOSE Both rod and cone-driven signals contribute to the electroretinogram (ERG) elicited by a standard strong flash in the dark. Negative ERGs usually reflect inner retinal dysfunction. However, in diseases where rod photoreceptor function is selectively lost, a negative waveform might represent the response of the dark-adapted cone system. To investigate the dark-adapted cone-driven waveform in healthy individuals, we delivered flashes on a dim blue background, designed to saturate the rods, but minimally adapt the cones. METHODS ERGs were recorded, using conductive fibre electrodes, in adults from the TwinsUK cohort. Responses to 13 cd m-2 s white xenon flashes (similar to the standard DA 10 flash), delivered on a blue background, were analysed. Photopic and scotopic strengths of the background were 1.3 and 30 cd m-2, respectively; through a dilated pupil, this is expected to largely saturate the rods, but adapt the cones much less than the standard ISCEV background. RESULTS Mean (SD) participant age was 62.5 (11.3) years (93% female). ERGs from 203 right and 204 left eyes were included, with mean (SD) b/a ratios of 1.22 (0.28) and 1.18 (0.28), respectively (medians, 1.19 and 1.17). Proportions with negative waveforms were 23 and 26%, respectively. Right and left eye b/a ratios were strongly correlated (correlation coefficient 0.74, p < 0.0001). We found no significant correlation of b/a ratio with age. CONCLUSIONS Over 20% of eyes showed b/a ratios less than 1, consistent with the notion that dark-adapted cone-driven responses to standard bright flashes can have negative waveforms. The majority had ratios greater than 1. Thus, whilst selective loss of rod function can yield a negative waveform (with reduced a-wave) in some, our findings also suggest that loss of rod function can occur without necessarily yielding a negative ERG. One potential limitation is possible mild cone system adaptation by the background.
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Affiliation(s)
- Xiaofan Jiang
- Institute of Ophthalmology, University College London, Bath Street, London, UK
- Department of Ophthalmology, King's College London, St Thomas' Hospital Campus, Westminster Bridge Road, London, UK
- Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Hospital Campus, Westminster Bridge Road, London, UK
| | - Taha Bhatti
- Department of Ophthalmology, King's College London, St Thomas' Hospital Campus, Westminster Bridge Road, London, UK
- Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Hospital Campus, Westminster Bridge Road, London, UK
| | - Ambreen Tariq
- Department of Ophthalmology, King's College London, St Thomas' Hospital Campus, Westminster Bridge Road, London, UK
- Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Hospital Campus, Westminster Bridge Road, London, UK
| | - Shaun M Leo
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and the UCL Institute of Ophthalmology, 162 City Road, London, UK
| | - Nancy Aychoua
- Institute of Ophthalmology, University College London, Bath Street, London, UK
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and the UCL Institute of Ophthalmology, 162 City Road, London, UK
| | - Andrew R Webster
- Institute of Ophthalmology, University College London, Bath Street, London, UK
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and the UCL Institute of Ophthalmology, 162 City Road, London, UK
| | - Pirro G Hysi
- Department of Ophthalmology, King's College London, St Thomas' Hospital Campus, Westminster Bridge Road, London, UK
- Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Hospital Campus, Westminster Bridge Road, London, UK
| | - Christopher J Hammond
- Department of Ophthalmology, King's College London, St Thomas' Hospital Campus, Westminster Bridge Road, London, UK
- Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Hospital Campus, Westminster Bridge Road, London, UK
| | - Omar A Mahroo
- Institute of Ophthalmology, University College London, Bath Street, London, UK.
- Department of Ophthalmology, King's College London, St Thomas' Hospital Campus, Westminster Bridge Road, London, UK.
- Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Hospital Campus, Westminster Bridge Road, London, UK.
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and the UCL Institute of Ophthalmology, 162 City Road, London, UK.
- Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK.
- Department of Translational Ophthalmology, Wills Eye Hospital, Philadelphia, PA, USA.
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10
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Wang H, Ruan G, Yang S, Li H, Sun Z, Tian B, Yan P, Li Y, Yang H, Zhong Y, Qian J. Ocular manifestations of mitochondrial neurogastrointestinal encephalomyopathy: A case report and literature review. Am J Med Genet A 2023; 191:2819-2824. [PMID: 37530213 DOI: 10.1002/ajmg.a.63361] [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: 04/28/2023] [Revised: 06/29/2023] [Accepted: 07/19/2023] [Indexed: 08/03/2023]
Abstract
Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is a rare autosomal recessive multisystem disorder that often presents with gastrointestinal and neurological symptoms. Here we report a 33-year-old male who presented with a 16-year history of diarrhea with black stool and progressive weight loss. He complained of progressive bilateral blurred vision, upper eyelids heaviness, ocular motility impairment, and color blindness. Peripheral neuropathy, bilateral sensorineural deafness, hyperlactatemia, diabetes mellitus, hepatic steatosis, blood coagulation dysfunction, and diffuse leukoencephalopathy were detected in the systemic evaluation. Based on the novel homozygous pathogenic variant in the TYMP gene (c.1159+1G>A), he was diagnosed with MNGIE. On ophthalmic examinations, the thickness of the inner retina and ganglion cell complex significantly decreased. ERG showed diffusely decreased amplitudes. The electronegative electroretinogram, which was first reported in MNGIE, indicated a more severe inner retina impairment. The bilateral papillomacular bundle defect and central vision loss in MNGIE are consistent with classical mitochondrial optic neuropathies' features. According to the literature, pigmentary retinopathy, optic neuropathy, and abnormal pupillary reflexes are uncommon ocular features of MNGIE. This study contributes to a better understanding of ocular manifestations in MNGIE and demonstrates that MNGIE may have dyschromatopsia and an electronegative electroretinogram.
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Affiliation(s)
- Heng Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Gechong Ruan
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shan Yang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hui Li
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zixi Sun
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Bowen Tian
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Pengguang Yan
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yue Li
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hong Yang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yong Zhong
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jiaming Qian
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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11
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Yang TH, Kang EYC, Lin PH, Wu PL, Sachs JA, Wang NK. The Value of Electroretinography in Identifying Candidate Genes for Inherited Retinal Dystrophies: A Diagnostic Guide. Diagnostics (Basel) 2023; 13:3041. [PMID: 37835784 PMCID: PMC10572658 DOI: 10.3390/diagnostics13193041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/08/2023] [Accepted: 09/13/2023] [Indexed: 10/15/2023] Open
Abstract
Inherited retinal dystrophies (IRDs) are a group of heterogeneous diseases caused by genetic mutations that specifically affect the function of the rod, cone, or bipolar cells in the retina. Electroretinography (ERG) is a diagnostic tool that measures the electrical activity of the retina in response to light stimuli, and it can help to determine the function of these cells. A normal ERG response consists of two waves, the a-wave and the b-wave, which reflect the activity of the photoreceptor cells and the bipolar and Muller cells, respectively. Despite the growing availability of next-generation sequencing (NGS) technology, identifying the precise genetic mutation causing an IRD can be challenging and costly. However, certain types of IRDs present with unique ERG features that can help guide genetic testing. By combining these ERG findings with other clinical information, such as on family history and retinal imaging, physicians can effectively narrow down the list of candidate genes to be sequenced, thereby reducing the cost of genetic testing. This review article focuses on certain types of IRDs with unique ERG features. We will discuss the pathophysiology and clinical presentation of, and ERG findings on, these disorders, emphasizing the unique role ERG plays in their diagnosis and genetic testing.
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Affiliation(s)
- Tsai-Hsuan Yang
- Department of Education, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33305, Taiwan;
- College of Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan
| | - Eugene Yu-Chuan Kang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33305, Taiwan;
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Pei-Hsuan Lin
- National Taiwan University Hospital, Yunlin 640203, Taiwan;
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, Columbia University, New York, NY 10032, USA; (P.-L.W.); (J.A.S.)
| | - Pei-Liang Wu
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, Columbia University, New York, NY 10032, USA; (P.-L.W.); (J.A.S.)
- Department of Medicine, National Taiwan University, Taipei 10617, Taiwan
| | - Jacob Aaron Sachs
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, Columbia University, New York, NY 10032, USA; (P.-L.W.); (J.A.S.)
- College of Arts and Sciences, University of Miami, Coral Gables, FL 33146, USA
| | - Nan-Kai Wang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33305, Taiwan;
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, Columbia University, New York, NY 10032, USA; (P.-L.W.); (J.A.S.)
- Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
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12
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Günter A, Sothilingam V, Orlich MM, Nordheim A, Seeliger MW, Mühlfriedel R. Mural Serum Response Factor (SRF) Deficiency Provides Insights into Retinal Vascular Functionality and Development. Int J Mol Sci 2023; 24:12597. [PMID: 37628776 PMCID: PMC10454173 DOI: 10.3390/ijms241612597] [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: 06/30/2023] [Revised: 07/28/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
Serum response factor (SRF) controls the expression of muscle contraction and motility genes in mural cells (MCs) of the vasculature. In the retina, MC-SRF is important for correct angiogenesis during development and the continuing maintenance of the vascular tone. The purpose of this study was to provide further insights into the effects of MC SRF deficiency on the vasculature and function of the mature retina in SrfiMCKO mice that carry a MC-specific deletion of Srf. Retinal morphology and vascular integrity were analyzed in vivo via scanning laser ophthalmoscopy (SLO), angiography, and optical coherence tomography (OCT). Retinal function was evaluated with full-field electroretinography (ERG). We found that retinal blood vessels of these mutants exhibited different degrees of morphological and functional alterations. With increasing severity, we found vascular bulging, the formation of arteriovenous (AV) anastomoses, and ultimately, a retinal detachment (RD). The associated irregular retinal blood pressure and flow distribution eventually induced hypoxia, indicated by a negative ERG waveform shape. Further, the high frequency of interocular differences in the phenotype of individual SrfiMCKO mice points to a secondary nature of these developments far downstream of the genetic defect and rather dependent on the local retinal context.
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Affiliation(s)
- Alexander Günter
- Division of Ocular Neurodegeneration, Institute for Ophthalmic Research, University of Tübingen, 72076 Tübingen, Germany; (V.S.); (M.W.S.)
| | - Vithiyanjali Sothilingam
- Division of Ocular Neurodegeneration, Institute for Ophthalmic Research, University of Tübingen, 72076 Tübingen, Germany; (V.S.); (M.W.S.)
| | - Michael M. Orlich
- Rudbeck Laboratory, Department of Immunology, Genetics and Pathology, Uppsala University, 75185 Uppsala, Sweden;
| | - Alfred Nordheim
- Department of Molecular Biology, Interfaculty Institute of Cell Biology, University of Tübingen, 72076 Tübingen, Germany;
| | - Mathias W. Seeliger
- Division of Ocular Neurodegeneration, Institute for Ophthalmic Research, University of Tübingen, 72076 Tübingen, Germany; (V.S.); (M.W.S.)
| | - Regine Mühlfriedel
- Division of Ocular Neurodegeneration, Institute for Ophthalmic Research, University of Tübingen, 72076 Tübingen, Germany; (V.S.); (M.W.S.)
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13
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Mahroo OA. Visual electrophysiology and "the potential of the potentials". Eye (Lond) 2023; 37:2399-2408. [PMID: 36928229 PMCID: PMC10397240 DOI: 10.1038/s41433-023-02491-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/09/2023] [Accepted: 03/06/2023] [Indexed: 03/18/2023] Open
Abstract
Visual electrophysiology affords direct, quantitative, objective assessment of visual pathway function at different levels, and thus yields information complementary to, and not necessarily obtainable from, imaging or psychophysical testing. The tests available, and their indications, have evolved, with many advances, both in technology and in our understanding of the neural basis of the waveforms, now facilitating more precise evaluation of physiology and pathophysiology. After summarising the visual pathway and current standard clinical testing methods, this review discusses, non-exhaustively, several developments, focusing particularly on human electroretinogram recordings. These include new devices (portable, non-mydiatric, multimodal), novel testing protocols (including those aiming to separate rod-driven and cone-driven responses, and to monitor retinal adaptation), and developments in methods of analysis, including use of modelling and machine learning. It is likely that several tests will become more accessible and useful in both clinical and research settings. In future, these methods will further aid our understanding of common and rare eye disease, will help in assessing novel therapies, and will potentially yield information relevant to neurological and neuro-psychiatric conditions.
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Affiliation(s)
- Omar A Mahroo
- Institute of Ophthalmology, University College London, 11-43 Bath Street, London, UK.
- Retinal and Genetics Services, Moorfields Eye Hospital, 162 City Road, London, UK.
- Section of Ophthalmology and Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Hospital Campus, Westminster Bridge Road, London, UK.
- Physiology, Development and Neuroscience, University of Cambridge, Downing Street, Cambridge, UK.
- Department of Translational Ophthalmology, Wills Eye Hospital, Philadelphia, PA, USA.
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14
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Naaman E, Malul N, Safuri S, Bar N, Pollack S, Magen D, Leibu R, Perlman I, Zayit-Soudry S. Reduced Electroretinogram Responses in Morphologically Normal Retina in Patients with Primary Hyperoxaluria Type 1. OPHTHALMOLOGY SCIENCE 2023; 3:100268. [PMID: 36909147 PMCID: PMC9996110 DOI: 10.1016/j.xops.2022.100268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/23/2022] [Accepted: 12/29/2022] [Indexed: 01/04/2023]
Abstract
Purpose To describe ocular findings in individuals with primary hyperoxaluria type 1 (PH1), focusing on the correlations between retinal anatomy and retinal function. To characterize the retinal alterations that occur at different disease stages by evaluating individuals with diverse degrees of renal impairment associated with PH1. Design A cross-sectional study. Participants Patients diagnosed with PH1 based on clinical criteria and genetic testing, treated in the Pediatric Nephrology Unit of the Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel between 2013 and 2021. Methods The ophthalmological assessment included a slit-lamp biomicroscopy of the anterior and posterior segment or indirect ophthalmoscopy. Electroretinography was employed for assessment of the retinal function, and retinal imaging included spectral-domain OCT and fundus autofluorescence. A systematic evaluation of the disease stage was based on clinical criteria including physical examination, purposeful imaging (X-ray, echocardiography, and US abdomen), and laboratory tests as needed. Main Outcome Measures Anatomical and functional assessment of the retina in patients with PH1, and the relationship between retinal dysfunction and kidney impairment. Results A total of 16 eyes were examined in the study of 8 children ranging in age from 4 to 19 years. Four eyes (25%) showed normal structural and functional retinal findings, 8 eyes (50%) presented functional impairment in the absence of pathological structural findings, and 4 eyes (25%) had advanced retinal damage that manifested as significant morphological and functional impairment. There was no direct relationship between the severity of the renal disease and the severity of the retinal phenotype. Conclusions Subjects with PH1 present varying severity levels of the retinal phenotype, with possible discrepancy between the clinical retinal morphology and the retinal function noted on electroretinography. These findings raise questions about the molecular basis of the retinal manifestations in PH1. The presence of functional impairment in the absence of evident crystal deposition in the retina suggests that, in addition to oxalate crystal accumulation, other biomolecular processes may play a role in the development of retinopathy.
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Affiliation(s)
- Efrat Naaman
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
| | - Netta Malul
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Shadi Safuri
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
| | - Nitai Bar
- Department of Radiology, Rambam Health Care Campus, Haifa, Israel
| | - Shirley Pollack
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Pediatric Nephrology Institute, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Daniella Magen
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Pediatric Nephrology Institute, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Rina Leibu
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
| | - Ido Perlman
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Shiri Zayit-Soudry
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel.,Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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15
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Fan NW, Zhu Q, Wang S, Ortiz G, Huckfeldt RM, Chen Y. Long-lived autoreactive memory CD4 + T cells mediate the sustained retinopathy in chronic autoimmune uveitis. FASEB J 2023; 37:e22855. [PMID: 36906286 PMCID: PMC10478160 DOI: 10.1096/fj.202202164r] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/07/2023] [Accepted: 02/21/2023] [Indexed: 03/13/2023]
Abstract
Chronic uveitis comprises heterogeneous clinical entities characterized by sustained and recurrent intraocular inflammation that is believed to be driven by autoimmune responses. The management of chronic uveitis is challenging with the limited availability of efficacious treatments, and the underlying mechanisms mediating disease chronicity remain poorly understood as the majority of experimental data are derived from the acute phase of the disease (the first 2-3 weeks post-induction). Herein, we investigated the key cellular mechanisms underlying chronic intraocular inflammation using our recently established murine model of chronic autoimmune uveitis. We demonstrate unique long-lived CD44hi IL-7R+ IL-15R+ CD4+ memory T cells in both retina and secondary lymphoid organs after 3 months postinduction of autoimmune uveitis. These memory T cells functionally exhibit antigen-specific proliferation and activation in response to retinal peptide stimulation in vitro. Critically, these effector-memory T cells are capable of effectively trafficking to the retina and accumulating in the local tissues secreting both IL-17 and IFN-γ upon adoptively transferred, leading to retinal structural and functional damage. Thus, our data reveal the critical uveitogenic functions of memory CD4+ T cells in sustaining chronic intraocular inflammation, suggesting that memory T cells can be a novel and promising therapeutic target for treating chronic uveitis in future translational studies.
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Affiliation(s)
- Nai-Wen Fan
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Qiurong Zhu
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114
| | - Shudan Wang
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114
| | - Gustavo Ortiz
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114
| | - Rachel M. Huckfeldt
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114
| | - Yihe Chen
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114
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Peeters R, Peeters F, Jacob J, Draganova D, Casteels I, Poesen K, Balikova I. Unilateral Melanoma-Associated Retinopathy Case Report. Case Rep Ophthalmol 2023; 14:498-506. [PMID: 37901652 PMCID: PMC10601888 DOI: 10.1159/000533769] [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: 05/22/2023] [Accepted: 08/17/2023] [Indexed: 10/31/2023] Open
Abstract
In this report, we present a case of unilateral melanoma-associated retinopathy in a 72-year-old woman. The patient's main symptoms were decreased vision and positive dysphotopsia. Unilateral electronegative electroretinogram (ERG) was suggestive for melanoma retinopathy. PET-CT discovered metastatic disease, 3 years after the initial melanoma. A prompt treatment with corticosteroids was started, followed by immunotherapy. The central and peripheral vision of the patient improved, and the ERG showed normalization of the responses. This case highlights the importance of early recognition and individualized treatment strategies for melanoma-associated retinopathy.
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Affiliation(s)
- Reinout Peeters
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
- Research Group Ophthalmology, Biomedical Science Group, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Freya Peeters
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
- Research Group Ophthalmology, Biomedical Science Group, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Julie Jacob
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
- Research Group Ophthalmology, Biomedical Science Group, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Dafina Draganova
- Department of Ophthalmology, Free University of Brussels, Brussels, Belgium
| | - Ingele Casteels
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
- Research Group Ophthalmology, Biomedical Science Group, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Koen Poesen
- Department of Neurosciences, Laboratory for Molecular Neurobiomarker Research, Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Irina Balikova
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
- Research Group Ophthalmology, Biomedical Science Group, Department of Neurosciences, KU Leuven, Leuven, Belgium
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17
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Holder GE, Mahroo O. Electronegative ERG or pseudo-negative ERG? Doc Ophthalmol 2022; 145:283-286. [PMID: 36149542 DOI: 10.1007/s10633-022-09881-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/30/2022] [Indexed: 12/29/2022]
Affiliation(s)
- Graham E Holder
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore, 119228, Singapore.
| | - Omar Mahroo
- UCL Institute of Ophthalmology, 11-43 Bath St, London, EC1V 9EL, UK
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18
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Barboni MTS, Joachimsthaler A, Roux MJ, Nagy ZZ, Ventura DF, Rendon A, Kremers J, Vaillend C. Retinal dystrophins and the retinopathy of Duchenne muscular dystrophy. Prog Retin Eye Res 2022:101137. [DOI: 10.1016/j.preteyeres.2022.101137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 10/25/2022] [Accepted: 11/03/2022] [Indexed: 11/21/2022]
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19
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Williams KM, Georgiou M, Kalitzeos A, Chow I, Hysi PG, Robson AG, Lingham G, Chen FK, Mackey DA, Webster AR, Hammond CJ, Prokhoda P, Carroll J, Michaelides M, Mahroo OA. Axial Length Distributions in Patients With Genetically Confirmed Inherited Retinal Diseases. Invest Ophthalmol Vis Sci 2022; 63:15. [PMID: 35704304 PMCID: PMC9206393 DOI: 10.1167/iovs.63.6.15] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose We investigated axial length (AL) distributions in inherited retinal diseases (IRDs), comparing them with reference cohorts. Methods AL measurements from IRD natural history study participants were included and compared with reference cohorts (TwinsUK, Raine Study Gen2-20, and published studies). Comparing with the Raine Study cohort, formal odds ratios (ORs) for AL ≥ 26 mm or AL ≤ 22 mm were derived for each IRD (Firth's logistic regression model, adjusted for age and sex). Results Measurements were available for 435 patients (median age, 19.5 years). Of 19 diseases, 10 had >10 participants: ABCA4 retinopathy; CNGB3- and CNGA3-associated achromatopsia; RPGR-associated disease; RPE65-associated disease; blue cone monochromacy (BCM); Bornholm eye disease (BED); TYR- and OCA2-associated oculocutaneous albinism; and GPR143-associated ocular albinism. Compared with the TwinsUK cohort (n = 322; median age, 65.1 years) and Raine Study cohort (n = 1335; median age, 19.9 years), AL distributions were wider in the IRD groups. Increased odds for longer ALs were observed for BCM, BED, RPGR, RPE65, OCA2, and TYR; increased odds for short AL were observed for RPE65, TYR, and GPR143. In subanalysis of RPGR-associated disease, longer average ALs occurred in cone-rod dystrophy (n = 5) than rod-cone dystrophy (P = 0.002). Conclusions Several diseases showed increased odds for longer AL (highest OR with BCM); some showed increased odds for shorter AL (highest OR with GPR143). Patients with RPE65- and TYR-associated disease showed increased odds for longer and for shorter eyes. Albinism genes were associated with different effects on AL. These findings add to the phenotype of IRDs and may yield insights into mechanisms of refractive error development.
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Affiliation(s)
- Katie M Williams
- UCL Institute of Ophthalmology, University College London, London, United Kingdom.,Moorfields Eye Hospital, London, United Kingdom.,Section of Academic Ophthalmology, School of Life Course Sciences, FoLSM, King's College London, United Kingdom.,Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, FoLSM, King's College London, London, United Kingdom
| | - Michalis Georgiou
- UCL Institute of Ophthalmology, University College London, London, United Kingdom.,Moorfields Eye Hospital, London, United Kingdom.,Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
| | - Angelos Kalitzeos
- UCL Institute of Ophthalmology, University College London, London, United Kingdom.,Moorfields Eye Hospital, London, United Kingdom
| | - Isabelle Chow
- Section of Academic Ophthalmology, School of Life Course Sciences, FoLSM, King's College London, United Kingdom.,Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, FoLSM, King's College London, London, United Kingdom
| | - Pirro G Hysi
- Section of Academic Ophthalmology, School of Life Course Sciences, FoLSM, King's College London, United Kingdom.,Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, FoLSM, King's College London, London, United Kingdom
| | - Anthony G Robson
- UCL Institute of Ophthalmology, University College London, London, United Kingdom.,Moorfields Eye Hospital, London, United Kingdom
| | - Gareth Lingham
- Centre for Ophthalmology and Visual Sciences (Incorporating Lions Eye Institute), The University of Western Australia, Perth, Western Australia, Australia
| | - Fred K Chen
- Centre for Ophthalmology and Visual Sciences (Incorporating Lions Eye Institute), The University of Western Australia, Perth, Western Australia, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Sciences (Incorporating Lions Eye Institute), The University of Western Australia, Perth, Western Australia, Australia
| | - Andrew R Webster
- UCL Institute of Ophthalmology, University College London, London, United Kingdom.,Moorfields Eye Hospital, London, United Kingdom
| | - Christopher J Hammond
- Section of Academic Ophthalmology, School of Life Course Sciences, FoLSM, King's College London, United Kingdom.,Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, FoLSM, King's College London, London, United Kingdom
| | - Polina Prokhoda
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Joseph Carroll
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States.,Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Michel Michaelides
- UCL Institute of Ophthalmology, University College London, London, United Kingdom.,Moorfields Eye Hospital, London, United Kingdom
| | - Omar A Mahroo
- UCL Institute of Ophthalmology, University College London, London, United Kingdom.,Moorfields Eye Hospital, London, United Kingdom.,Section of Academic Ophthalmology, School of Life Course Sciences, FoLSM, King's College London, United Kingdom.,Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, FoLSM, King's College London, London, United Kingdom
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20
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Jiang X, Xu Z, Soorma T, Tariq A, Bhatti T, Baneke AJ, Pontikos N, Leo SM, Webster AR, Williams KM, Hammond CJ, Hysi PG, Mahroo OA. Electrical responses from human retinal cone pathways associate with a common genetic polymorphism implicated in myopia. Proc Natl Acad Sci U S A 2022; 119:e2119675119. [PMID: 35594404 PMCID: PMC9173800 DOI: 10.1073/pnas.2119675119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 04/08/2022] [Indexed: 11/25/2022] Open
Abstract
Myopia is the commonest visual impairment. Several genetic loci confer risk, but mechanisms by which they do this are unknown. Retinal signals drive eye growth, and myopia usually results from an excessively long eye. The common variant most strongly associated with myopia is near the GJD2 gene, encoding connexin-36, which forms retinal gap junctions. Light-evoked responses of retinal neurons can be recorded noninvasively as the electroretinogram (ERG). We analyzed these responses from 186 adult twin volunteers who had been genotyped at this locus. Participants underwent detailed ERG recordings incorporating international standard stimuli as well as experimental protocols aiming to separate dark-adapted rod- and cone-driven responses. A mixed linear model was used to explore association between allelic dosage at the locus and international standard ERG parameters after adjustment for age, sex, and family structure. Significant associations were found for parameters of light-adapted, but not dark-adapted, responses. Further investigation of isolated rod- and cone-driven ERGs confirmed associations with cone-driven, but not rod-driven, a-wave amplitudes. Comparison with responses to similar experimental stimuli from a patient with a prior central retinal artery occlusion, and from two patients with selective loss of ON-bipolar cell signals, was consistent with the associated parameters being derived from signals from cone-driven OFF-bipolar cells. Analysis of single-cell transcriptome data revealed strongest GJD2 expression in cone photoreceptors; bipolar cell expression appeared strongest in OFF-bipolar cells and weakest in rod-driven ON-bipolar cells. Our findings support a potential role for altered signaling in cone-driven OFF pathways in myopia development.
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Affiliation(s)
- Xiaofan Jiang
- Institute of Ophthalmology, University College London, London EC1V 9EL, United Kingdom
- Department of Ophthalmology, King’s College London, London SE1 7EH, United Kingdom
- Department of Twin Research and Genetic Epidemiology, King’s College London, London SE1 7EH, United Kingdom
| | - Zihe Xu
- Department of Ophthalmology, King’s College London, London SE1 7EH, United Kingdom
- Department of Twin Research and Genetic Epidemiology, King’s College London, London SE1 7EH, United Kingdom
| | - Talha Soorma
- Department of Ophthalmology, King’s College London, London SE1 7EH, United Kingdom
| | - Ambreen Tariq
- Department of Ophthalmology, King’s College London, London SE1 7EH, United Kingdom
- Department of Twin Research and Genetic Epidemiology, King’s College London, London SE1 7EH, United Kingdom
| | - Taha Bhatti
- Department of Ophthalmology, King’s College London, London SE1 7EH, United Kingdom
- Department of Twin Research and Genetic Epidemiology, King’s College London, London SE1 7EH, United Kingdom
| | - Alexander J. Baneke
- Department of Ophthalmology, King’s College London, London SE1 7EH, United Kingdom
| | - Nikolas Pontikos
- Institute of Ophthalmology, University College London, London EC1V 9EL, United Kingdom
| | - Shaun M. Leo
- Institute of Ophthalmology, University College London, London EC1V 9EL, United Kingdom
- Medical Retina Service, Moorfields Eye Hospital, London EC1V 2PD, United Kingdom
- Inherited Eye Disease Service, Moorfields Eye Hospital, London EC1V 2PD, United Kingdom
| | - Andrew R. Webster
- Institute of Ophthalmology, University College London, London EC1V 9EL, United Kingdom
- Medical Retina Service, Moorfields Eye Hospital, London EC1V 2PD, United Kingdom
- Inherited Eye Disease Service, Moorfields Eye Hospital, London EC1V 2PD, United Kingdom
| | - Katie M. Williams
- Institute of Ophthalmology, University College London, London EC1V 9EL, United Kingdom
- Department of Ophthalmology, King’s College London, London SE1 7EH, United Kingdom
- Department of Twin Research and Genetic Epidemiology, King’s College London, London SE1 7EH, United Kingdom
- Medical Retina Service, Moorfields Eye Hospital, London EC1V 2PD, United Kingdom
- Inherited Eye Disease Service, Moorfields Eye Hospital, London EC1V 2PD, United Kingdom
| | - Christopher J. Hammond
- Department of Ophthalmology, King’s College London, London SE1 7EH, United Kingdom
- Department of Twin Research and Genetic Epidemiology, King’s College London, London SE1 7EH, United Kingdom
| | - Pirro G. Hysi
- Department of Ophthalmology, King’s College London, London SE1 7EH, United Kingdom
- Department of Twin Research and Genetic Epidemiology, King’s College London, London SE1 7EH, United Kingdom
| | - Omar A. Mahroo
- Institute of Ophthalmology, University College London, London EC1V 9EL, United Kingdom
- Department of Ophthalmology, King’s College London, London SE1 7EH, United Kingdom
- Department of Twin Research and Genetic Epidemiology, King’s College London, London SE1 7EH, United Kingdom
- Medical Retina Service, Moorfields Eye Hospital, London EC1V 2PD, United Kingdom
- Inherited Eye Disease Service, Moorfields Eye Hospital, London EC1V 2PD, United Kingdom
- Physiology, Development and Neuroscience, University of Cambridge, Cambridge CB2 3EG, United Kingdom
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21
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Sakti DH, Ali H, Korsakova M, Saakova N, Mustafic N, Fraser CL, Jamieson RV, Cornish EE, Grigg JR. Electronegative electroretinogram in the modern multimodal imaging era. Clin Exp Ophthalmol 2022; 50:429-440. [PMID: 35212129 PMCID: PMC9544723 DOI: 10.1111/ceo.14065] [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: 10/20/2021] [Revised: 02/16/2022] [Accepted: 02/19/2022] [Indexed: 11/29/2022]
Abstract
Background The electronegative electroretinogram (ERG) reflecting inner retinal dysfunction can assist as a diagnostic tool to determine the anatomical location in eye disease. The aim of this study is to determine the frequency and aetiology of electronegative ERG in a tertiary ophthalmology centre and to develop a clinical algorithm to assist patient management. Methods Retrospective review of ERGs performed at the Save Sight Institute from January 2011 to December 2020. ERGs were performed according to ISCEV standard. The b:a ratio was analysed in dark adapted (DA) 3.0 or 12.0 recordings. Patients with ratio of ≤1.0 were included. Results A total of 4421 patients had ERGs performed during study period, of which 139 patients (3.1%) had electronegative ERG. The electronegative ERG patients' median age at referral time was 37 (0.7–90.6) years. The causative aetiologies were photoreceptor dystrophy (48, 34.5%), Congenital Stationary Night Blindness (CSNB) (33, 23.7%), retinal ischemia (18, 12.9%), retinoschisis (15, 10.8%), paraneoplastic autoimmune retinopathy (PAIR) and nonPAIR (14, 10.1%), batten disease (4, 2.9%), and inflammatory retinopathy (4, 2.9%). There were three patients with an unclassified diagnosis. Thirty‐two patients (23%) had good vision and a normal fundus appearance. Eleven patients (7.9%) had good vision and normal results in all multimodal imaging. Conclusions The frequency of electronegative ERG in our referral centre was 3.1% with photoreceptor dystrophy as the main aetiology. A significant number of the cases had good vision with normal fundus or normal multimodal imaging. This further highlights the value of an ERG in this modern multimodal imaging era.
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Affiliation(s)
- Dhimas H. Sakti
- Visual electrophysiology Unit, Save Sight Institute, Speciality of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
- Eye Genetics Research Unit, The Children's Hospital at Westmead, Save Sight Institute Children's Medical Research Institute, The University of Sydney Sydney New South Wales Australia
- Department of Ophthalmology, Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada Yogyakarta Indonesia
| | - Haipha Ali
- Visual electrophysiology Unit, Save Sight Institute, Speciality of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
| | - Maria Korsakova
- Visual electrophysiology Unit, Save Sight Institute, Speciality of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
| | - Nonna Saakova
- Visual electrophysiology Unit, Save Sight Institute, Speciality of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
| | - Nina Mustafic
- Visual electrophysiology Unit, Save Sight Institute, Speciality of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
| | - Clare L. Fraser
- Visual electrophysiology Unit, Save Sight Institute, Speciality of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
- Sydney Eye Hospital Sydney New South Wales Australia
| | - Robyn V. Jamieson
- Eye Genetics Research Unit, The Children's Hospital at Westmead, Save Sight Institute Children's Medical Research Institute, The University of Sydney Sydney New South Wales Australia
- Specialty of Genetic Medicine, Faculty of Medicine and Health, Sydney Medical School The University of Sydney Sydney New South Wales Australia
- Department of Clinical Genetics, The Children's Hospital at Westmead Sydney Children's Hospital Network Sydney New South Wales Australia
| | - Elisa E. Cornish
- Visual electrophysiology Unit, Save Sight Institute, Speciality of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
- Eye Genetics Research Unit, The Children's Hospital at Westmead, Save Sight Institute Children's Medical Research Institute, The University of Sydney Sydney New South Wales Australia
- Sydney Eye Hospital Sydney New South Wales Australia
| | - John R. Grigg
- Visual electrophysiology Unit, Save Sight Institute, Speciality of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
- Eye Genetics Research Unit, The Children's Hospital at Westmead, Save Sight Institute Children's Medical Research Institute, The University of Sydney Sydney New South Wales Australia
- Sydney Eye Hospital Sydney New South Wales Australia
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22
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Cell Type-Selective Loss of Peroxisomal β-Oxidation Impairs Bipolar Cell but Not Photoreceptor Survival in the Retina. Cells 2022; 11:cells11010161. [PMID: 35011723 PMCID: PMC8750404 DOI: 10.3390/cells11010161] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/20/2021] [Accepted: 12/29/2021] [Indexed: 12/12/2022] Open
Abstract
Retinal degeneration is a common feature in peroxisomal disorders leading to blindness. Peroxisomes are present in the different cell types of the retina; however, their precise contribution to retinal integrity is still unclear. We previously showed that mice lacking the central peroxisomal β-oxidation enzyme, multifunctional protein 2 (MFP2), develop an early onset retinal decay including photoreceptor cell death. To decipher the function of peroxisomal β-oxidation in photoreceptors, we generated cell type selective Mfp2 knockout mice, using the Crx promotor targeting photoreceptors and bipolar cells. Surprisingly, Crx-Mfp2−/− mice maintained photoreceptor length and number until the age of 1 year. A negative electroretinogram was indicative of preserved photoreceptor phototransduction, but impaired downstream bipolar cell signaling from the age of 6 months. The photoreceptor ribbon synapse was affected, containing free-floating ribbons and vesicles with altered size and density. The bipolar cell interneurons sprouted into the ONL and died. Whereas docosahexaenoic acid levels were normal in the neural retina, levels of lipids containing very long chain polyunsaturated fatty acids were highly increased. Crx-Pex5−/− mice, in which all peroxisomal functions are inactivated in photoreceptors and bipolar cells, developed the same phenotype as Crx-Mfp2−/− mice. In conclusion, the early photoreceptor death in global Mfp2−/− mice is not driven cell autonomously. However, peroxisomal β-oxidation is essential for the integrity of photoreceptor ribbon synapses and of bipolar cells.
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23
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Jiang X, Bhatti T, Tariq A, Williams KM, Chow I, Dar T, Webster AR, Hysi PG, Hammond CJ, Mahroo OA. Prevalence of electronegative electroretinograms in a healthy adult cohort. BMJ Open Ophthalmol 2021; 6:e000751. [PMID: 34368462 PMCID: PMC8291303 DOI: 10.1136/bmjophth-2021-000751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/12/2021] [Indexed: 01/08/2023] Open
Abstract
Objective An electronegative electroretinogram (ERG) can indicate important ocular or systemic disease. This study explored the prevalence of electronegative responses to dark-adapted stimuli in a largely healthy cohort. Methods and Analysis 211 participants recruited from the TwinsUK cohort underwent ERG testing incorporating international standard (International Society for Clinical Electrophysiology of Vision (ISCEV)) protocols and additional stimuli. Responses were recorded using conductive fibre electrodes, following pupil dilation and 20 min dark adaptation. Responses analysed were to the ISCEV standard and strong flashes (3.0 and 10 cd/m2 s), and to additional white flashes (0.67–67 cd/m2 s). A-wave and b-wave amplitudes were extracted; b:a ratios were calculated and proportions of eyes with ratios<1 were noted. Results Mean (SD) age was 62.4 (11.4) years (median, 64.3; range 23–86 years). 93% were female. Mean (SD) b:a ratios for right and left eyes, respectively, were 1.86 (0.33) and 1.81 (0.29) for the standard flash, and 1.62 (0.25) and 1.58 (0.23) for the stronger flash; average b:a ratio was lower for the stronger flash (p<0.0001). No waveforms were electronegative. For additional flashes, b:a ratio decreased with increasing flash strength. No electronegative waveforms were seen except in three eyes (0.7%) for the strongest flash; in some cases, drift in the waveform may have artefactually reduced the b:a ratio. Conclusion For standard dark-adapted stimuli, no participants had electronegative waveforms. The findings support the notion that electronegative waveforms (in response to standard flash strengths) are unusual, and should prompt further investigation.
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Affiliation(s)
- Xiaofan Jiang
- Institute of Ophthalmology, University College London, London, UK.,Section of Academic Ophthalmology, School of Life Course Sciences, FoLSM, Kings College London, London, UK.,Department of Twin Research and Genetic Epidemiology, King's College London, London, UK.,NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and the UCL Institute of Ophthalmology, London, UK
| | - Taha Bhatti
- Section of Academic Ophthalmology, School of Life Course Sciences, FoLSM, Kings College London, London, UK.,Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Ambreen Tariq
- Section of Academic Ophthalmology, School of Life Course Sciences, FoLSM, Kings College London, London, UK.,Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Katie M Williams
- Section of Academic Ophthalmology, School of Life Course Sciences, FoLSM, Kings College London, London, UK.,Department of Twin Research and Genetic Epidemiology, King's College London, London, UK.,NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and the UCL Institute of Ophthalmology, London, UK
| | - Isabelle Chow
- Section of Academic Ophthalmology, School of Life Course Sciences, FoLSM, Kings College London, London, UK.,Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Talib Dar
- Section of Academic Ophthalmology, School of Life Course Sciences, FoLSM, Kings College London, London, UK.,Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Andrew R Webster
- Institute of Ophthalmology, University College London, London, UK.,NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and the UCL Institute of Ophthalmology, London, UK
| | - Pirro G Hysi
- Section of Academic Ophthalmology, School of Life Course Sciences, FoLSM, Kings College London, London, UK.,Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Christopher J Hammond
- Section of Academic Ophthalmology, School of Life Course Sciences, FoLSM, Kings College London, London, UK.,Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Omar A Mahroo
- Institute of Ophthalmology, University College London, London, UK.,Section of Academic Ophthalmology, School of Life Course Sciences, FoLSM, Kings College London, London, UK.,Department of Twin Research and Genetic Epidemiology, King's College London, London, UK.,NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and the UCL Institute of Ophthalmology, London, UK.,Physiology, University of Cambridge, Cambridge, UK
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