1
|
Vergaro A, Pankievic M, Jedlickova J, Dudakova L, Vajter M, Michaelides M, Meliska M, Nemec P, Babincova D, Kousal B, Liskova P. Disease-Causing TIMP3 Variants and Deep Phenotyping of Two Czech Families with Sorsby Fundus Dystrophy Associated with Novel p.(Tyr152Cys) Mutation. Int J Mol Sci 2024; 25:3744. [PMID: 38612555 PMCID: PMC11011298 DOI: 10.3390/ijms25073744] [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: 02/12/2024] [Revised: 03/20/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
We aim to report the ocular phenotype and molecular genetic findings in two Czech families with Sorsby fundus dystrophy and to review all the reported TIMP3 pathogenic variants. Two probands with Sorsby fundus dystrophy and three first-degree relatives underwent ocular examination and retinal imaging, including optical coherence tomography angiography. The DNA of the first proband was screened using a targeted ocular gene panel, while, in the second proband, direct sequencing of the TIMP3 coding region was performed. Sanger sequencing was also used for segregation analysis within the families. All the previously reported TIMP3 variants were reviewed using the American College of Medical Genetics and the Association for Molecular Pathology interpretation framework. A novel heterozygous variant, c.455A>G p.(Tyr152Cys), in TIMP3 was identified in both families and potentially de novo in one. Optical coherence tomography angiography documented in one patient the development of a choroidal neovascular membrane at 54 years. Including this study, 23 heterozygous variants in TIMP3 have been reported as disease-causing. Application of gene-specific criteria denoted eleven variants as pathogenic, eleven as likely pathogenic, and one as a variant of unknown significance. Our study expands the spectrum of TIMP3 pathogenic variants and highlights the importance of optical coherence tomography angiography for early detection of choroidal neovascular membranes.
Collapse
Affiliation(s)
- Andrea Vergaro
- Department of Paediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, 121 08 Prague, Czech Republic; (A.V.); (J.J.); (L.D.); (M.V.)
- Department of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital in Prague, 128 08 Prague, Czech Republic; (M.M.); (B.K.)
| | - Monika Pankievic
- Department of Paediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, 121 08 Prague, Czech Republic; (A.V.); (J.J.); (L.D.); (M.V.)
| | - Jana Jedlickova
- Department of Paediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, 121 08 Prague, Czech Republic; (A.V.); (J.J.); (L.D.); (M.V.)
| | - Lubica Dudakova
- Department of Paediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, 121 08 Prague, Czech Republic; (A.V.); (J.J.); (L.D.); (M.V.)
| | - Marie Vajter
- Department of Paediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, 121 08 Prague, Czech Republic; (A.V.); (J.J.); (L.D.); (M.V.)
- Department of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital in Prague, 128 08 Prague, Czech Republic; (M.M.); (B.K.)
| | - Michel Michaelides
- UCL Institute of Ophthalmology, University College London and Moorfields Eye Hospital, London EC1V 9EL, UK;
| | - Martin Meliska
- Department of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital in Prague, 128 08 Prague, Czech Republic; (M.M.); (B.K.)
| | - Pavel Nemec
- Department of Ophthalmology, First Faculty of Medicine and Military University Hospital Prague, 162 00 Prague, Czech Republic;
| | - Daniela Babincova
- Laboratory of Molecular Biology, AGEL, 741 01 Nový Jíčín, Czech Republic;
| | - Bohdan Kousal
- Department of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital in Prague, 128 08 Prague, Czech Republic; (M.M.); (B.K.)
| | - Petra Liskova
- Department of Paediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, 121 08 Prague, Czech Republic; (A.V.); (J.J.); (L.D.); (M.V.)
- Department of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital in Prague, 128 08 Prague, Czech Republic; (M.M.); (B.K.)
| |
Collapse
|
2
|
Makuloluwa A, Madhusudhan S. Clinical outcomes of treated macular neovascularisation secondary to inherited retinal diseases: a literature review. BMJ Open Ophthalmol 2023; 8:e001309. [PMID: 37493670 PMCID: PMC10364169 DOI: 10.1136/bmjophth-2023-001309] [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: 04/06/2023] [Accepted: 07/10/2023] [Indexed: 07/27/2023] Open
Abstract
Many inherited retinal diseases (IRD) can be associated with, or be secondarily complicated by, macular neovascularisation (MNV), which has been variably treated with intravitreal antivascular endothelial growth factor, steroids, laser and surgery. In this article, we aim to present a consolidated literature review of management of IRD-related MNV.
Collapse
Affiliation(s)
- Aruni Makuloluwa
- St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - Savita Madhusudhan
- St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
- Department of Eye and Vision Science, University of Liverpool, Liverpool, UK
| |
Collapse
|
3
|
Abstract
Sorsby fundus dystrophy (SFD) is a rare autosomal dominant disorder with complete penetrance affecting the macula. This is caused by a mutation in the TIMP-3. This objective narrative review aims to provide an overview of the pathophysiology, current treatment modalities, and future perspectives. A literature search was performed using "PubMed," "Web of Science," "Scopus," "ScienceDirect," "Google Scholar," "medRxiv," and "bioRxiv." The molecular mechanisms underlying SFD are not completely understood. Novel advancements in cell culture techniques, including induced pluripotent stem cells, may enable more reliable modeling of SFD. These cell culture techniques aim to shed more light on the pathophysiology of SFD, and hopefully, this may lead to the future development of treatment strategies for SFD. Currently, no gene therapy is available. The main treatment is the use of anti-vascular endothelial growth factors (anti-VEGF) to treat secondary choroidal neovascular membrane (CNV), which is a major complication observed in this condition. If CNV is detected and treated promptly, patients with SFD have a good chance of maintaining a functional central vision. Other treatment modalities have been tried but have shown limited benefit, and therefore, have not managed to be more widely accepted. In summary, although there is no definitive cure yet, the use of anti-VEGF treatment for secondary CNV has provided the opportunity to maintain functional vision in individuals with SFD, provided CNV is detected and treated early.
Collapse
Affiliation(s)
- Georgios Tsokolas
- Medical Retina and Uveitis Fellow, Moorfields Eye Hospital, London, United Kingdom
| |
Collapse
|
4
|
Spaide RF. Treatment of Sorsby fundus dystrophy with anti-tumor necrosis factor-alpha medication. Eye (Lond) 2022; 36:1810-1812. [PMID: 34376817 PMCID: PMC9391384 DOI: 10.1038/s41433-021-01735-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 07/21/2021] [Accepted: 07/29/2021] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Tissue inhibitor of matrix metalloproteinase (TIMP)-3 has many functions, including preventing the constituent formation of tumor necrosis factor-alpha (TNFα) in tissue. Sorsby macular dystrophy is caused by a mutation in the gene responsible for TIMP-3, suggesting a potential treatment. METHODS Comprehensive ophthalmologic examination with multimodal imaging to include optical coherence tomography (OCT) and OCT angiography were used to evaluate a patient with Sorsby fundus dystrophy treated first with intravitreal triamcinolone, then with adalimumab. RESULTS A 35-year-old woman presented in 2003 with aggressive macular neovascularization in both eyes related to Sorsby macular dystrophy c.610A>T (p.Ser204Cys). Her visual acuity was 20/25 in the right and 20/400 in the left eye. She was treated with periodic intravitreal injections of 4 mg triamcinolone, which caused the neovascularization to become inactive. When switched to intravitreal bevacizumab, she showed disease activity. She was switched back to intravitreal triamcinolone with minimal signs of exudation and hemorrhage. Because of the high lifetime risk of complication, she was switched to subcutaneous adalimumab and in follow-up over 18 months had no signs of disease activity. The visual acuity in the right eye was 20/20. CONCLUSIONS TIMP3 has numerous effects including controlling local TNFα production. It is possible with the mutation in the gene for TIMP-3, abnormally high tissue levels of TNFα are produced in the eye. Direct inhibition of TNFα action by adalimumab offers a molecularly targeted approach to the disease pathophysiology and merits increased study.
Collapse
Affiliation(s)
- Richard F Spaide
- Vitreous Retina Macula Consultants of New York, New York, NY, USA.
| |
Collapse
|
5
|
Baston A, Gerhardt C, Zandi S, Garweg JG. Visual Outcome after Intravitreal Anti-VEGF Therapy for Macular Neovascularisation Secondary to Sorsby's Fundus Dystrophy: A Systematic Review. J Clin Med 2021; 10:2433. [PMID: 34070857 PMCID: PMC8198854 DOI: 10.3390/jcm10112433] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/24/2021] [Accepted: 05/27/2021] [Indexed: 12/31/2022] Open
Abstract
The aim of this paper is to summarise our own and to review published experience regarding the long-term outcome of intravitreal treatment for macular neovascularisation (MNV) secondary to Sorsby's fundus dystrophy (SFD). A systematic literature search using the MeSH terms [Sorsby] and [anti-vascular endothelial growth factor (VEGF)] was conducted in NCBI/PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), ScienceDirect, Google Scholar and ClinicalTrials.gov to identify publications reporting anti-VEGF treatment outcomes in SFD. Treatment outcomes were extracted for this meta-analysis from 14 publications and an own patient reporting a total of 31 cases with a mean follow-up (FU) of 54 months. Both eyes were affected in ten (32.3%) instances. Heterogenous reporting limited the comparability of the outcomes. All papers in common, however, reported satisfied to excellent responses to anti-VEGF therapy if patients were diagnosed and treated immediately after onset of symptoms. Of 20 eyes, for which visual acuity was reported before and after treatment, five worsened and seven improved by more than 1 line, whereas eight eyes maintained their function by end of the follow up, and 11 eyes (55%) maintained a driving vision (Snellen VA ≥ 0.5). Of six eyes with a VA < 0.5, VA improved in one to VA ≥ 0.5, whereas of 14 eyes with an initial VA ≥ 0.5, this dropped to <0.5 despite therapy. In MNV secondary to SFD, the delay between first symptoms and access to anti-VEGF treatment determines subretinal scar formation and thereby, functional prognosis. If treated early, this is generally favourable under regular controls and a consequent anti-VEGF treatment of MNV activity.
Collapse
Affiliation(s)
- Arthur Baston
- Swiss Eye Institute, Rotkreuz, and Retina Clinic, Berner Augenklinik am Lindenhofspital, 3012 Bern, Switzerland; (A.B.); (C.G.)
| | - Christin Gerhardt
- Swiss Eye Institute, Rotkreuz, and Retina Clinic, Berner Augenklinik am Lindenhofspital, 3012 Bern, Switzerland; (A.B.); (C.G.)
| | - Souska Zandi
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland;
| | - Justus G. Garweg
- Swiss Eye Institute, Rotkreuz, and Retina Clinic, Berner Augenklinik am Lindenhofspital, 3012 Bern, Switzerland; (A.B.); (C.G.)
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland;
| |
Collapse
|