Retinal sensitivity in hereditary retinal degeneration in Abyssinian cats: electrophysiological similarities between man and cat

Alternative splicing in CEP290 mutant cats results in a milder phenotype than LCACEP290 patients

PURPOSE

The rdAc cat has an intronic mutation in the centrosomal 290 kDa (CEP290) gene resulting in a frameshift and a premature stop codon (c.6960 + 9 T > G, p.Ile2321AlafsTer3) predicted to truncate the protein by 157 amino acids. CEP290 mutations in human patients cause a range or phenotypes including syndromic conditions and severe childhood loss of vision while the rdAc cat has a milder phenotype. We sought to further characterize the effect of rdAc mutation on CEP290 expression.

METHODS

TaqMan quantitative real-time polymerase chain reaction assays were used to compare wildtype and truncated transcript levels. Relative protein abundance was analyzed by Western blot. Immunohistochemistry (IHC) was performed to detect CEP290 protein.

RESULTS

CEP290 mutant cats show low-level (17.4% of wildtype cats) use of the wildtype splice site and usage of the mutant splice site. Western analysis shows retina from cats homozygous for the mutation has CEP290 protein that likely comprises a combination of both wildtype and truncated protein. IHC detects CEP290 in affected and control retina labeling the region of the interconnecting cilium.

CONCLUSIONS

The comparably milder phenotype of CEP290 mutant cats is likely due to the retained production of some full-length CEP290 protein with possible functional contributions from presence of truncated protein.

Central retinal preservation in rdAc cats

OBJECTIVE

Children with Leber congenital amaurosis (LCA) due to CEP290 mutations show characteristic macular preservation. Spectral domain-optical coherence tomography (SD-OCT) is a noninvasive technique to investigate retinal structural changes. Loss of integrity of the ellipsoid zone (EZ) on OCT in people with retinal disease has been associated with loss of visual function and is a useful measure of retinal disease progression. We hypothesized that rdAc felines with Cep290 mutation would have a similar pattern of degeneration, with relative central retinal preservation associated with maintenance of the EZ.

PROCEDURES

Fundus imaging, confocal scanning laser ophthalmoscopy, and SD-OCT cross-sectional imaging was performed on 11 rdAc cats ranging from 6 months to 10 years of age. Images were collected from the area centralis, visual streak, and the mid-superior and mid-inferior retina. Receptor plus (REC+, encompassing the entire length of photoreceptors) thicknesses were measured. Regional rates of degeneration were determined by regression analysis and compared using unpaired t-tests. The EZ was evaluated for the presence, absence, or loss of definition.

RESULTS

RdAc cats showed REC+ thinning over time in all regions. The area centralis and visual streak had a slower rate of thinning than the mid-peripheral retina. There was loss of integrity of the EZ initially in the more peripheral regions, while its integrity was maintained in the area centralis and visual streak at all ages studied.

CONCLUSIONS

rdAc cats show preservation of the central retina with maintenance of EZ integrity, which recapitulates findings in human patients.

Early-Onset Progressive Retinal Atrophy Associated with an IQCB1 Variant in African Black-Footed Cats (Felis nigripes)

African black-footed cats (Felis nigripes) are endangered wild felids. One male and full-sibling female African black-footed cat developed vision deficits and mydriasis as early as 3 months of age. The diagnosis of early-onset progressive retinal atrophy (PRA) was supported by reduced direct and consensual pupillary light reflexes, phenotypic presence of retinal degeneration, and a non-recordable electroretinogram with negligible amplitudes in both eyes. Whole genome sequencing, conducted on two unaffected parents and one affected offspring was compared to a variant database from 51 domestic cats and a Pallas cat, revealed 50 candidate variants that segregated concordantly with the PRA phenotype. Testing in additional affected cats confirmed that cats homozygous for a 2 base pair (bp) deletion within IQ calmodulin-binding motif-containing protein-1 (IQCB1), the gene that encodes for nephrocystin-5 (NPHP5), had vision loss. The variant segregated concordantly in other related individuals within the pedigree supporting the identification of a recessively inherited early-onset feline PRA. Analysis of the black-footed cat studbook suggests additional captive cats are at risk. Genetic testing for IQCB1 and avoidance of matings between carriers should be added to the species survival plan for captive management.

Cats: a gold mine for ophthalmology

Over 200 hereditary diseases have been identified and reported in the cat, several of which affect the eye, with homology to human hereditary disease. Compared with traditional murine models, the cat demonstrates more features in common with humans, including many anatomic and physiologic similarities, longer life span, increased size, and a genetically more heterogeneous background. The development of genomic resources in the cat has facilitated mapping and further characterization of feline models. During recent years, the wealth of knowledge in feline ophthalmology and neurophysiology has been extended to include new diseases of significant interest for comparative ophthalmology. This makes the cat an extremely valuable animal species to utilize for further research into disease processes affecting both cats and humans. This is especially true in the advancement and study of new treatment regimens and for extended therapeutic trials. Groups of feline eye diseases reviewed in the following are lysosomal storage disorders, congenital glaucoma, and neuroretinal degenerations. Each has important implications for human ophthalmic research.

Characterization of feline hereditary retinal dystrophies using clinical, functional, structural and molecular genetic studies

Only in recent years have specific mutations been elucidated for feline hereditary retinal dystrophies. Molecular genetic characterization of feline diseases has so far been a slow process but with a full genome sequence for the cat recently completed and the development of a feline single nucleotide polymorphism chip, the characterization of feline monogenic disorders will be significantly simplified. This review summarizes current knowledge with regard to specific hereditary retinal dystrophies in cats and gives an overview of how cats can be used as models in translational research.

The domestic cat as a large animal model for characterization of disease and therapeutic intervention in hereditary retinal blindness

Large mammals, including canids and felids, are affected by spontaneously occurring hereditary retinal diseases with similarities to those of humans. The large mammal models may be used for thorough clinical characterization of disease processes, understanding the effects of specific mutations, elucidation of disease mechanisms, and for development of therapeutic intervention. Two well-characterized feline models are addressed in this paper. The first model is the autosomal recessive, slowly progressive, late-onset, rod-cone degenerative disease caused by a mutation in the CEP290 gene. The second model addressed in this paper is the autosomal dominant early onset rod cone dysplasia, putatively caused by the mutation found in the CRX gene. Therapeutic trials have been performed mainly in the former type including stem cell therapy, retinal transplantation, and development of ocular prosthetics. Domestic cats, having large human-like eyes with comparable spontaneous retinal diseases, are also considered useful for gene replacement therapy, thus functioning as effective model systems for further research.

Widespread retinal degenerative disease mutation (rdAc) discovered among a large number of popular cat breeds

The recent discovery of a mutational variant in the CEP290 gene (CEP290: IVS50+9T>G), conferring recessive retinal degeneration in Abyssinian and Somali (long-haired Abyssinian) cats (rdAc) prompted a survey among 41 cat breeds (846 individuals) to assess the incidence, frequency and clinical consequence of rdAc. The rdAc allele displayed widespread distribution, observed in 16/43 (37%) breeds, exhibiting a high allele frequency (∼33%) in North American and European Siamese populations. Clinical evaluations demonstrated high concordance between rdAc pathology and the CEP290 (IVS50+9T>G) homozygous genotype (P=1.1E-6), with clinical disease similar to affected Abyssinians/Somalis. This retinal degeneration has not been reported in breeds other than the Abyssinian/Somali and poses a significant health risk particularly in the Siamese breed group. Alertness of the veterinary community and the present availability of commercial diagnostic testing could synergistically enable breeders to reduce the incidence of rdAc blindness in pure-bred cat populations.

Functional and structural assessment of retinal sheet allograft transplantation in feline hereditary retinal degeneration

PURPOSE

To investigate whether sheets of fetal retinal allografts can integrate into the dystrophic Abyssinian cat retina with progressive rod cone degeneration.

METHODS

Fetal retinal sheets (cat gestational day 42), incubated with BDNF microspheres, were transplanted to the subretinal space of four cats at an early disease stage. Cats were studied by fundus examinations, bilateral full-field flash ERGs, and indocyanine green and fluorescein angiograms up to 4 months following surgery. E42 donor and transplanted eyes were analyzed by histology and immunohistochemistry for retinal markers.

RESULTS

Funduscopy and angiography showed good integration of the transplants in two of four cats, including extension of host blood vessels into the transplant and some scarring in the host. In these two, transplants were found in the subretinal space with laminated areas, with photoreceptor outer segments in normal contacts with the host retinal pigment epithelium. In some areas, transplants appeared to be well-integrated within the host neural retina. Neither of these two cats showed functional improvement in ERGs. In the other two cats, only remnants of donor tissue were left. Transplants stained for all investigated cellular markers. No PKC immunoreactivity was detected in the fetal donor retina at E42, but developed in the 4-month-old grafts.

CONCLUSIONS

Fetal sheet transplants can integrate well within a degenerating cat retina and develop good lamination of photoreceptors. Functional improvement was not demonstrated by ERG in cats with well-laminated grafts. Transplants need to be further evaluated in cat host retinas with a more advanced retinal degeneration using longer follow-up times.

Amax to scotopic Imax diagnoses feline hereditary rod cone degeneration more efficiently than any other combination of long protocol electroretinogram parameters

AIM

To evaluate two recent methods for detecting feline hereditary rod cone degeneration with maximum efficiency from a long full-field flash ERG protocol. One combines 12 of these measures in an equation that is derived from iterative principal components factor analysis. The other uses the amplitude of the a-wave to the brightest available flash alone.

METHODS

We tested the original 12-parameter equation, by applying it to 50 new ERG series in 23 backcrossed cats. They were necessarily either heterozygous or homozygous for hereditary rod cone degeneration. A masked observer compared the ERG score and fundus examinations. We reanalyzed the old, new and combined data sets. Data sets with only one session per animal were analysed to avoid problems from non-random sampling. A two factor linear model of the a-wave was evaluated.

RESULTS

The prior equation, applied to the new data, discriminated the groups as well as it had initially. In the reanalysis, group separation continued to increase with even fewer measures compared to the previously reported study. Eventually, one measure, the amplitude of the a-wave (amax) to the brightest scotopic flash (Imax) discriminated the groups better than any other measure or combination of measures in all analyses, including data sets using only one session for each animal and in a two factor linear model of the a-wave.

CONCLUSION

Amax to Imax alone proved to be the best diagnostic criterion in all analyses. No linear model is likely to discriminate affected from unaffected animals more effectively because additional variables increased variance more rapidly than they increased discrimination. Amax to Imax may detect other rod and rod/cone dystrophies equally efficiently.

Amax is the Best a-wave Measure for Classifying Abyssinian Cat Rod/Cone Dystrophy

AIM

To see if any a-wave measure segregated normal cats from those affected by a recessively inherited Abyssinian rod/cone dystrophy more efficiently than a(max) to scotopic I(max).

METHOD

A-waves to electroretinograms (ERGs) evoked by a 4 cd x s/m(2) scotopic flash were extracted from 241 ERG sessions using 108 cats. They were either wild type or from an affected Abyssinian stock. Fourty four were bred by back-crossing to have a 50% probability of being affected. Most were diagnosed by retinal appearance or by the pattern of loss in a long protocol ERG. Eight were still unclassified. The diagnostic efficiency of amplitudes at 7, 8, 9, and 10 ms and a(max), of a(max) peak time, age at testing, and the main components of principal components factor analysis were compared by scaling their ability to segregate affected and normal cats.

RESULTS

Variance and overlap between the groups both decreased as time along the a-wave increased. The loading of each animal on the largest factor also gave considerable overlap. There was a small absolute separation between groups when a(max) itself was used. Age and peak time were uncorrelated with disease. The light intensity used could be calculated to be equivalent to one sufficient for about 75% of full saturation in man.

CONCLUSION

A(max) is a simple measure that is already in routine clinical use. When the flash is very bright and the animal fully dark adapted, this single measure is the most efficient sign of this rod/cone degeneration and possibly of all degenerations involving rods.

Morphological changes in the anterior segment of the Abyssinian cat eye with hereditary rod-cone degeneration

PURPOSE

The purpose of this study was to investigate morphological changes of the anterior segment of the eye in Abyssinian cats with progressive rod-cone degeneration and to correlate them with blood flow data obtained in the same animals.

METHODS

Sections of the left eyes of six normal cats and of eight cats with different stages of hereditary retinal degeneration were prepared for transmission and scanning electron microscopy. Tangential and sagittal sections were also stained with antibodies against substance P, tyrosine hydroxylase, panneuronal marker PGP9.5, nitric oxide synthase, synaptophysin, and smooth muscle alpha-actin.

RESULTS

In Abyssinian cats with hereditary rod-cone degeneration, significant changes were observed in the iris consisting of irregularities in the vascular wall of smaller arteries without changes in their innervation pattern. The ciliary processes were shorter than in normal cats, and their structure appeared more compact and retracted. Slight changes were also observed in the anterior part of the ciliary epithelium. The anterior chamber angle region did not appear to be affected.

CONCLUSIONS

Clear morphological correlations to the physiological blood flow data were observed in the anterior eye segment, pointing not only to functional but also morphological vascular abnormalities in this animal model for retinitis pigmentosa.

Electrophysiologic differentiation of homozygous and heterozygous Abyssinian-crossbred cats with late-onset hereditary retinal degeneration

OBJECTIVE

To develop a method to electrophysiologically differentiate heterozygous-carrier Abyssinian-crossbred cats from homozygous-affected Abyssinian-crossbred cats before clinical onset of inherited rod-cone retinal degeneration.

ANIMALS

14 back-crossed Abyssinian-crossbred cats of unknown genotype (homozygous or heterozygous) for inherited rod-cone retinal degeneration, 24 age-matched mixed-breed control cats, 6 age-matched heterozygous Abyssinian-crossbred cats, and 6 homozygous Abyssinian cats.

PROCEDURE

Electroretinography (ERG) of heterozygous and homozygous cats revealed differences, especially for scotopic recordings. Frequent ophthalmoscopy and ERG (2 to 5 times; at intervals of 3 to 6 months) of back-crossed cats were performed. Amplitudes and implicit times were analyzed by use of a graphic representation of results. Ratios for amplitudes of the b-waves to amplitudes of the a-waves (b-wave:a-wave) were compared.

RESULTS

8 back-crossed cats had decreased a-wave amplitudes, increased b-wave implicit times, and abnormal ERG waveforms. Values for the b-wave:a-wave for the highest scotopic light intensity were significantly higher for those same 8 cats.

CONCLUSIONS AND CLINICAL RELEVANCE

The 8 back-crossed Abyssinian-crossbred cats with abnormal results developed fundus changes over time consistent with disease. A graphic representation of ERG results can be used to differentiate between genotypes prior to funduscopic changes. Values for the b-wave:a-wave ratio provide confirmation. These ERG analyses may be applied clinically in the diagnosis of retinal degenerations in various species.

IMPACT FOR HUMAN MEDICINE

Cats with hereditary rod-cone degeneration may be a useful model for comparative studies in relation to retinitis pigmentosa in humans. Similar evaluations of ERG results could possibly be used for humans with suspected generalized retinal degeneration.

Optimal discrimination of an Abyssinian cat recessive retinal degeneration: a short electroretinogram protocol is more efficient than a long one

AIM

To determine the diagnostic efficiency of scores in a long protocol ectroretinogram (ERG) for Abyssinian cat slow recessive rod/cone dystrophy.

METHODS

Kittens (n = 22) were bred from homozygous,affected and heterozygous normals. Ophthalmoscopy was regularly performed and disease signs noted. Cats (age > or = 8 months, 40 sessions, 1-3 repeats) were dark-adapted overnight, anaesthetized and simultaneous binocular ERG recorded using a long protocol. Conventional a- and b-amplitudes and peak implicit times were measured and b/a ratios calculated, initially only for ERG to the maximum photopic and scotopic stimulus. Principal components factor analysis was applied to various subsets of these scores plus age at testing.

RESULTS

Six cats with ophthalmoscopic change were classed as affected. Three cats, one tested three times, were suspect. The rest were considered normal. The first analysis, of 80 eyes and 37 parameters, showed that the first factor was the only effective one. Using it, the groups overlapped 5%, scotopic amplitudes and b/a ratios loaded higher than peak times, the eyes were very similar, and age and photopic b/a ratios loaded poorly. The groups were discriminable with all the data. A second analysis, with eyes averaged and the 20 measures loading over 0.5 on the first factor, showed better group separation on factor I alone. An iterative search with varying data sets found that factor I was optimal, with eight ERG measures to the three brightest scotopic and one brightest photopic response. It produced a large absolute separation and classified the suspects consistently. With b/a ratios on these four ERG also included, 12 parameters gave better separation.

CONCLUSION

Twelve scores on four ERG separate affected from normal cats with a wide gap and consistently classify suspects. It may work for earlier ages. Additional data probably adds noise. This combination of optimal scores needs confirmation in new data.

Abnormal dark-adapted ERG in cats heterozygous for a recessively inherited rod-cone degeneration

PURPOSE

To study retinal function in cats homozygous and heterozygous for a recessively inherited rod-cone degeneration.

METHODS

Dark-adapted electroretinograms (ERGs) were performed on early affected, heterozygous (ophthalmoscopically normal), and clinically normal, nonrelated cats. Responses to blue stimuli over a 3.9-log unit range were recorded.

RESULTS

Lower b-wave amplitudes than normal were observed in heterozygotes and early affected cats. The amplitudes of the heterozygotes took an intermediate position between normal and early affected cats. Normalized amplitude/intensity data suggest a normal dynamic range in carriers. B-wave implicit times in carriers were comparable to those of normal cats.

CONCLUSIONS

These results show that heterozygotes have an altered retinal function, although they are ophthalmoscopically normal. It is difficult to electrophysiologically differentiate heterozygotes from affected cats with the very early stage of retinal degeneration.

Lens sparing pars plana vitrectomy and retinal transplantation in cats

Neuroretinal transplantation techniques have been evolving during recent years. Experiments in rodent models with degenerative retinal disease have been encouraging. This paper describes a surgical technique developed for use in the Abyssinian cat mutant. After two-port pars plana vitrectomy, retinotomy and bleb formation, whole sheets of neonatal neuroretinal allografts were placed into the subretinal space. The surgery was difficult but feasible, and the main complication was intraoperative hemorrhage.

Sequence analysis and exclusion of phosducin as the gene for the recessive retinal degeneration of the Abyssinian cat

Phosducin was evaluated as a candidate gene for the recessive retinal degeneration in the Abyssinan cat, rdAc, using reverse transcription and polymerase chain amplification. The nucleotide sequence of the cat phosducin coding region was determined except for 23 bp at the 5' end. Single-strand conformation analysis of a silent polymorphism within the coding region established the nonlinkage of the phosducin gene with the rdAc locus.

Autosomal dominant rod-cone dysplasia in the Rdy cat. 2. Electrophysiological findings

Electroretinography was performed on cats affected with autosomal dominant rod-cone dysplasia (gene symbol Rdy). In normal kittens it was found that retinal sensitivity increased and rod thresholds decreased as the animals matured. Electroretinogram (ERG) amplitudes were mature by 4.5 weeks and adult timing was attained by 6 weeks of age, consistent with the findings of other workers. In Rdy-affected heterozygous kittens the ERG was absent or barely recordable using conventional corneal contact lens electrodes. However, the enhanced sensitivity of an intravitreal needle electrode permitted the recording of ERGs from affected kittens aged 4.5 weeks and older. The intravitreally recorded scotopic ERG in Rdy-affected kittens was a very low amplitude, largely negative response with prolonged a- and b-wave times-to-peak (two to threefold longer than in comparable recordings from an age-matched normal kitten). The b-wave lacked oscillatory potentials and was relatively small so that the ERG was a-wave dominated. This was attributed to delayed and defective synaptogenesis in the outer plexiform layer of dystrophic retinas. In contrast to normal kittens, the b-wave threshold was higher than that of the a-wave in affected kittens. Photopic responses were unrecordable. The intravitreal ERG was barely recordable in a 5-month-old Rdy-affected cat and was apparently extinguished by 7 months of age. In vitro electroretinography permitted a comparison of the photoreceptor responses (fast PIII) from the isolated retinas of 6-week-old control and Rdy-affected heterozygous kittens. Maximum fast PIII amplitudes were reduced by about 75% in affected retinas compared with age-matched normal retinas (P less than 0.005). The mean fast PIII time-to-peak, at maximum light intensity, in Rdy-affected retinas was prolonged by about 15 msec and was approximately twofold longer than the time-to-peak of normal retinas (P less than 0.005).4+ steeper slope with relatively greater prolongations in time-to-peak at lower luminances compared with normal retinas (P less than 0.025). These changes in temporal characteristics may be explained either by severe disorganization of photoreceptor outer segments or by altered phototransduction kinetics.