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Tsai ASH, Kang EYC, Wang NK, Lee H, Seo GH, Khang R, Wu WC. LONG-TERM CLINICAL OUTCOMES AND GENOTYPE-PHENOTYPE CORRELATION IN FAMILIAL EXUDATIVE VITREORETINOPATHY IN A TERTIARY REFERRAL CENTER. Retina 2023; 43:1945-1950. [PMID: 37339455 DOI: 10.1097/iae.0000000000003868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
BACKGROUND/PURPOSE To evaluate clinical outcomes and assess genotype-phenotype correlations in patients with familial exudative vitreoretinopathy (FEVR). METHODS Clinical charts of 40 patients with FEVR were reviewed. FEVR was staged per Pendergast and Trese, and retinal dragging and folds further classified per Yaguchi et al. We performed whole-exome sequencing and compared clinical characteristics between genetic-positive and genetic-negative groups. RESULTS The mean duration of follow-up was 5.4 years (range: 0.33, 15) for genetic-positive and 6.9 (range: 1, 20) for genetic-negative patients. The mean age at diagnosis was 5.6 years (0.25, 27) for genetic-positive and 6.0 (0, 32) for genetic-negative patients. Genetic-positive patients reported 100% full-term births and genetic-negative patients reported 45% full-term births ( P = 0.0012). There were more patients with retinal folds with all major vessels affected (Yaguchi's Group 4) in genetic-positive compared with genetic-negative patients (21.4% vs. 2.6%, P = 0.045). TSPAN12 was the most common (57.1%) genetic mutation in our population of which 50% exhibited asymmetric presentation. CONCLUSION Patients who test positive for a typical FEVR gene mutation reported more term births and had more severe disease by Yaguchi's classification. TSPAN12 was the most common genetic mutation in our population and had highly asymmetrical disease.
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Affiliation(s)
- Andrew S H Tsai
- Singapore National Eye Centre, Singapore
- DUKE NUS Medical School, Singapore
| | - Eugene Y C Kang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Nan-Kai Wang
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, Columbia University, New York, New York; and
| | - Hane Lee
- Division of Medical Genetics, 3billion Inc., Seoul, South Korea
| | - Go Hun Seo
- Division of Medical Genetics, 3billion Inc., Seoul, South Korea
| | - Rin Khang
- Division of Medical Genetics, 3billion Inc., Seoul, South Korea
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Jiang Z, Hou A, Zhang T, Lai Y, Huang L, Ding X. Pattern of choroidal thickness in early-onset high myopia. Front Med (Lausanne) 2023; 10:1156259. [PMID: 37538314 PMCID: PMC10394095 DOI: 10.3389/fmed.2023.1156259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 07/05/2023] [Indexed: 08/05/2023] Open
Abstract
Purpose To explore the etiology and choroidal thickness (ChT) pattern in children with early-onset high myopia (eoHM). Methods Sixty children with eoHM and 20 healthy controls were enrolled in this study between January 2019 and December 2021. All children underwent comprehensive ophthalmologic examinations including swept-source optical coherence tomography. ChT was measured in the subfoveal region and at 1000 μm and 2,500 μm nasal, temporal, superior, and inferior to the fovea. Results Overall, 120 eyes of 60 children with eoHM were examined (mean spherical equivalent, -8.88 ± 3.05 D; mean axial length, 26.07 ± 1.59 mm). Simple high myopia (SHM), familial exudative vitreoretinopathy (FEVR), and Stickler syndrome (STL) were the most frequent etiologies of eoHM and were included in further ChT analysis. Adjusted the effect of SE, multivariate regression analysis showed that children with SHM had thinnest ChT at N2500 and I2500 among the subgroups (p = 0.039, p = 0.013). FEVR group showed thinner ChT at T2500 (p = 0.023), while STL patients exhibited thin ChT at all locations. Conclusion This study revealed that SHM, STL and FEVR was the most frequent etiology, and showed a distinctive pattern of ChT. Asymmetric nasal ChT thinning is a distinctive biomarker for SHM, asymmetric temporal ChT thinning might serve as a biomarker for FEVR, and symmetric diffuse thinning is more common in STL. These ChT patterns may provide a convenient, fast, and noninvasive strategy to differentiate the potential etiology of eoHM.
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Katargina LA, Chesnokova NB, Denisova EV, Geraskina EA, Pavlenko TA, Beznos OV, Lisovskaja OA. [The role of endothelin-1 in the pathogenesis of familial exudative vitreoretinopathy]. Vestn Oftalmol 2023; 139:14-18. [PMID: 37942592 DOI: 10.17116/oftalma202313905114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Familial exudative vitreoretinopathy (FEVR) is a rare hereditary disease characterized by pathological retinal vascularization with a progressive and variable course. The mechanisms of disease progression remain unclear. One substance that plays an important role in the pathogenesis of retinal vascular diseases is endothelin (ET). It was found that tissue hypoxia enhances the expression of the gene encoding ET-1, and ET-1 can be locally produced in the eye. PURPOSE The study evaluates the possible role of endothelin-1 in the pathogenesis of FEVR. MATERIAL AND METHODS The study included 85 patients with FEVR aged from 1 months to 17 years who were examined in Helmholtz National Medical Research Center of Eye Diseases. The concentration of ET-1 was evaluated in 19 patients with FEVR in the blood serum (n=17), lacrimal fluid (n=18) and 16 patients from the control group. RESULTS The median of ET-1 in the lacrimal fluid in patients with FEVR was 13.74 pg/mL, respectively, which exceeded the same indicator of the control group 4.66 pg/mL by 2.5 times (p<0.001). The median of ET-1 in the blood serum exceeded the control group by 2.4 times (21.61 pg/mL and 9.21 pg/mL, respectively, p<0.001). CONCLUSIONS An increase in the concentration of ET-1 in the lacrimal fluid and blood serum of patients with FEVR in comparison with the control group indicates its involvement in the pathogenesis of the disease.
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Affiliation(s)
- L A Katargina
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - N B Chesnokova
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - E V Denisova
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - E A Geraskina
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - T A Pavlenko
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - O V Beznos
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - O A Lisovskaja
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
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Arepalli S, DeBenedictis MM, Yuan A, Traboulsi EI. Severe retinal complications in Knobloch Syndrome - Three siblings without clinically apparent occipital defects and a review of the literature. Ophthalmic Genet 2022; 43:1-9. [PMID: 35387550 DOI: 10.1080/13816810.2022.2028297] [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: 06/24/2020] [Revised: 11/28/2021] [Accepted: 01/02/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Knobloch syndrome results from recessive mutations in COL18A1 and is characterized by retinopathy and occipital scalp, brain and skull defects. METHODS AND MATERIALS We report three siblings, born to consanguineous parents, two of whom with genetically confirmed Knobloch syndrome due to a homozygous pathogenic variant c.4054_4055del; p.Leu1352Valfs*72 in COL18A1. RESULTS With the lack of classic occipital findings, an initial diagnosis of familial exudative vitreoretinopathy was entertained in these siblings because of the history of retinal detachments, retinal pigmentary changes and abnormal vitreous. The diagnosis of Knobloch syndrome was eventually made through molecular genetic testing using an extensive panel. In one patient presenting with acute retinal detachment and posteriorly dislocated intraocular lens implant, reattachment surgery was successful in stabilizing vision. CONCLUSION The clinical diagnosis of Knobloch syndrome can be difficult to reach in the absence of the typical occipital scalp defects. A careful medical history, detailed clinical examination and molecular genetic testing will reveal the correct diagnosis of Knobloch syndrome in atypical cases.
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Affiliation(s)
- Sruthi Arepalli
- Ophthalmology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Tennessee Retina Associates, Nashville, Tennessee, USA
| | | | - Alex Yuan
- Ophthalmology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Elias I Traboulsi
- Ophthalmology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA
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Peng Y, Zhao R, Dai E, Peng L, He Y, Li S, Yang M. Whole-Exome Sequencing Reveals Novel NDP Variants in X-Linked Familial Exudative Vitreoretinopathy. Eur J Ophthalmol 2022; 32:3220-3226. [PMID: 35037517 DOI: 10.1177/11206721221074209] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
PURPOSE To investigate causative variants in three Chinese families affected with familial exudative vitreoretinopathy (FEVR). METHODS Three unrelated Chinese families were recruited in this study. The three probands and their family members experienced a comprehensive age-appropriate eye examination and genetic analysis. Luciferase assay was performed to evaluate impacts of variants on Norrin/β-catenin signaling activity. RESULTS Here we report two novel NDP variants associated with FEVR in three families, including c.17T>C (p.Leu6Pro) in family 1 and c.58G>A (p.Gly20Arg) in family 2 and 3. These two variants were co-segregated with the disease phenotypes within each family. In addition, both variants resulted in compromised Norrin/β-catenin signaling activity. CONCLUSION Our study identified two FEVR-associated pathogenic variants in NDP, which expanded the variant spectrum and provided information for the genetic diagnosis of FEVR.
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Affiliation(s)
- Yujiao Peng
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, 12599University of Electronic Science and Technology of China, Chengdu, Sichuan, China
- Research Unit for Blindness Prevention of Chinese Academy of Medical Sciences (2019RU026), Sichuan Academy of Medical Sciences & 89669Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
| | - Rulian Zhao
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, 12599University of Electronic Science and Technology of China, Chengdu, Sichuan, China
- Research Unit for Blindness Prevention of Chinese Academy of Medical Sciences (2019RU026), Sichuan Academy of Medical Sciences & 89669Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
| | - Erkuan Dai
- Ophthalmology, 91603Shanghai Jiaotong University School of Medicine Xinhua Hospital, Shanghai, China
| | - Li Peng
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, 12599University of Electronic Science and Technology of China, Chengdu, Sichuan, China
- Research Unit for Blindness Prevention of Chinese Academy of Medical Sciences (2019RU026), Sichuan Academy of Medical Sciences & 89669Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
- Chinese Academy of Sciences Sichuan Translational Medicine Hospital, Chengdu, Sichuan, China
| | - Yunqi He
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, 12599University of Electronic Science and Technology of China, Chengdu, Sichuan, China
- Research Unit for Blindness Prevention of Chinese Academy of Medical Sciences (2019RU026), Sichuan Academy of Medical Sciences & 89669Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
- Chinese Academy of Sciences Sichuan Translational Medicine Hospital, Chengdu, Sichuan, China
| | - Shujin Li
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, 12599University of Electronic Science and Technology of China, Chengdu, Sichuan, China
- Research Unit for Blindness Prevention of Chinese Academy of Medical Sciences (2019RU026), Sichuan Academy of Medical Sciences & 89669Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
- Chinese Academy of Sciences Sichuan Translational Medicine Hospital, Chengdu, Sichuan, China
| | - Mu Yang
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People's Hospital, 12599University of Electronic Science and Technology of China, Chengdu, Sichuan, China
- Research Unit for Blindness Prevention of Chinese Academy of Medical Sciences (2019RU026), Sichuan Academy of Medical Sciences & 89669Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
- Chinese Academy of Sciences Sichuan Translational Medicine Hospital, Chengdu, Sichuan, China
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Pathogenic variants and associated phenotypic spectrum of TSPAN12 based on data from a large cohort. Graefes Arch Clin Exp Ophthalmol 2021; 259:2929-2939. [PMID: 33907885 DOI: 10.1007/s00417-021-05196-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 03/01/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE The pathogenic variants in TSPAN12 could lead to familial exudative vitreoretinopathy (FEVR), which has high clinical variability. This study aims to assess the pathogenicity of TSPAN12 variants and their phenotypic spectrum based on exome sequencing from 7092 probands with different eye conditions. METHODS The variants in TSPAN12 were selected from exome sequencing data of samples from 7092 probands with different forms of eye conditions. Potentially pathogenic variants were evaluated through the annotation of types, locations, population frequencies, and in silico predictions of variants from in-house data, gnomAD, and published literature. The clinical features of patients with potentially pathogenic variants in TSPAN12 were assessed. RESULTS A total of 45 variants in TSPAN12 with coding effects were detected based on the exome data from 7092 probands, among which 31 were classified as pathogenic variants including 15 novels. The 31 variants were identified in 34 probands with various initial diagnoses, including FEVR in 21 probands and diseases other than FEVR in the remaining 13 probands. Biallelic pathogenic variants were identified in one proband with initial diagnosis of high myopia. CONCLUSION Truncating variants and the missense variants that are predicted as deleterious are likely pathogenic variants of TSPAN12. Approximately 61.8% of patients with pathogenic variants in this gene had an initial diagnosis of FEVR, and the remaining 38.2% of patients had various initial diagnoses. These findings expand the understanding about variant evaluation of TSPAN12 and phenotypic spectrum of TSPAN12-associated FEVR.
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