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Berni A, Arrigo A, Bianco L, Antropoli A, Saladino A, Mansour AM, Vilela M, Bandello F, Parodi MB. New insights in the multimodal imaging of retinitis pigmentosa. Eur J Ophthalmol 2024; 34:357-366. [PMID: 37113027 PMCID: PMC10898209 DOI: 10.1177/11206721231172863] [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: 01/15/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023]
Abstract
Retinitis pigmentosa (RP) is a group of inherited rod-cone dystrophies, noted for a high genotypical and phenotypical heterogeneity.Traditionally, VA, visual field, and electroretinography have been used to assess RP progression. However, visual acuity and visual field tests are essentially subjective and, especially in the late stages of the disease, are unable to confidently reveal minor progression. Therefore, there is a need for novel examination modalities that rely on quantitative, structural measurements. In this regard, several non-invasive imaging techniques have been studied, including spectral-domain optical coherence tomography, optical coherence tomography angiography, and fundus autofluorescence. By correlating surrogate biomarkers with functional measurements of the disease, these techniques may be able to develop reliable outcome meters that can be used to gain a deeper understanding of the underlying causes of the disease and to assess the effectiveness of therapy even before an actual loss of vision occurs.In this review, we will summarize the recent imaging findings and biomarkers that have been identified in RP patients. Our goal is to provide information that can promptly aid in selecting patients for clinical trials and new gene therapies, monitoring the disease progression, and evaluating treatment outcomes.
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Affiliation(s)
- Alessandro Berni
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessandro Arrigo
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lorenzo Bianco
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessio Antropoli
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Saladino
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Ahmad M. Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
| | - Manuel Vilela
- Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Francesco Bandello
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
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2
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Hu X, Wu H, Yong X, Wang Y, Yang S, Fan D, Xiao Y, Che L, Shi K, Li K, Xiong C, Zhu H, Qian Z. Cyclical endometrial repair and regeneration: Molecular mechanisms, diseases, and therapeutic interventions. MedComm (Beijing) 2023; 4:e425. [PMID: 38045828 PMCID: PMC10691302 DOI: 10.1002/mco2.425] [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: 04/06/2023] [Revised: 10/21/2023] [Accepted: 10/27/2023] [Indexed: 12/05/2023] Open
Abstract
The endometrium is a unique human tissue with an extraordinary ability to undergo a hormone-regulated cycle encompassing shedding, bleeding, scarless repair, and regeneration throughout the female reproductive cycle. The cyclical repair and regeneration of the endometrium manifest as changes in endometrial epithelialization, glandular regeneration, and vascularization. The mechanisms encompass inflammation, coagulation, and fibrinolytic system balance. However, specific conditions such as endometriosis or TCRA treatment can disrupt the process of cyclical endometrial repair and regeneration. There is uncertainty about traditional clinical treatments' efficacy and side effects, and finding new therapeutic interventions is essential. Researchers have made substantial progress in the perspective of regenerative medicine toward maintaining cyclical endometrial repair and regeneration in recent years. Such progress encompasses the integration of biomaterials, tissue-engineered scaffolds, stem cell therapies, and 3D printing. This review analyzes the mechanisms, diseases, and interventions associated with cyclical endometrial repair and regeneration. The review discusses the advantages and disadvantages of the regenerative interventions currently employed in clinical practice. Additionally, it highlights the significant advantages of regenerative medicine in this domain. Finally, we review stem cells and biologics among the available interventions in regenerative medicine, providing insights into future therapeutic strategies.
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Affiliation(s)
- Xulin Hu
- Clinical Medical College and Affiliated Hospital of Chengdu UniversityChengdu UniversityChengduSichuanChina
- Department of BiotherapyCancer Center and State Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduSichuanChina
| | - Haoming Wu
- Clinical Medical College and Affiliated Hospital of Chengdu UniversityChengdu UniversityChengduSichuanChina
| | - Xin Yong
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Department of Paediatrics, West China Second University Hospital, State Key Laboratory of Biotherapy and Collaborative Innovation Center of BiotherapySichuan UniversityChengduSichuanChina
| | - Yao Wang
- Clinical Medical College and Affiliated Hospital of Chengdu UniversityChengdu UniversityChengduSichuanChina
| | - Shuhao Yang
- Department of OrthopedicsThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Diyi Fan
- Clinical Medical College and Affiliated Hospital of Chengdu UniversityChengdu UniversityChengduSichuanChina
| | - Yibo Xiao
- Clinical Medical College and Affiliated Hospital of Chengdu UniversityChengdu UniversityChengduSichuanChina
| | - Lanyu Che
- Clinical Medical College and Affiliated Hospital of Chengdu UniversityChengdu UniversityChengduSichuanChina
| | - Kun Shi
- Department of BiotherapyCancer Center and State Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduSichuanChina
| | - Kainan Li
- Clinical Medical College and Affiliated Hospital of Chengdu UniversityChengdu UniversityChengduSichuanChina
| | | | - Huili Zhu
- Department of Reproductive Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of EducationWest China Second University Hospital of Sichuan UniversityChengduSichuanChina
| | - Zhiyong Qian
- Department of BiotherapyCancer Center and State Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengduSichuanChina
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3
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Arias JD, Kalaw FGP, Alex V, Yassin SH, Ferreyra H, Walker E, Wagner NE, Borooah S. Investigating the associations of macular edema in retinitis pigmentosa. Sci Rep 2023; 13:14187. [PMID: 37648803 PMCID: PMC10469217 DOI: 10.1038/s41598-023-41464-z] [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: 03/28/2023] [Accepted: 08/27/2023] [Indexed: 09/01/2023] Open
Abstract
Macular edema (ME), the accumulation of intraretinal fluid in the macula, is a common sight affecting sequelae of retinitis pigmentosa (RP). However, it is unclear why some patients develop ME, and others do not. This study aims to identify associations between clinical-genetic factors in RP with ME. Patients with clinically confirmed RP cases were identified from the inherited retinal disease database at a large tertiary referral academic center. Demographic and genetic testing findings were noted. Additionally, optical coherence tomography volume scans were graded using a validated grading system. One hundred and six patients (73.1%) were found to have ME in at least one eye (OD = 88, mean = 37.9%, OS = 98, mean = 31.7%). Structurally, the presence of epiretinal membrane (ERM) (p < 0.007) and vitreo-macular traction (VMT) (p < 0.003) were significantly associated with ME. Additionally, X-linked (p < 0.032) and autosomal dominant inheritance (p < 0.039) demonstrated a significant association with ME, with RP1 (p < 0.045) and EYS (p < 0.017) pathogenic variants also significantly associated with ME. This study, in a large cohort of RP patients, confirms previous retinal structural associations for ME in RP and identifies potential new genetic associations.
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Affiliation(s)
- Juan D Arias
- Jacobs Retina Center, University of California San Diego, San Diego, CA, USA
| | - Fritz Gerald P Kalaw
- Jacobs Retina Center, University of California San Diego, San Diego, CA, USA
- Ophthalmology - Retina Division, Shiley Eye Institute, The Viterbi Family Department of Ophthalmology, University of California San Diego, 9415 Campus Point Drive, San Diego, CA, 92093, USA
| | - Varsha Alex
- Jacobs Retina Center, University of California San Diego, San Diego, CA, USA
- Ophthalmology - Retina Division, Shiley Eye Institute, The Viterbi Family Department of Ophthalmology, University of California San Diego, 9415 Campus Point Drive, San Diego, CA, 92093, USA
| | - Shaden H Yassin
- Jacobs Retina Center, University of California San Diego, San Diego, CA, USA
- Ophthalmology - Retina Division, Shiley Eye Institute, The Viterbi Family Department of Ophthalmology, University of California San Diego, 9415 Campus Point Drive, San Diego, CA, 92093, USA
| | - Henry Ferreyra
- Jacobs Retina Center, University of California San Diego, San Diego, CA, USA
- Ophthalmology - Retina Division, Shiley Eye Institute, The Viterbi Family Department of Ophthalmology, University of California San Diego, 9415 Campus Point Drive, San Diego, CA, 92093, USA
| | - Evan Walker
- Jacobs Retina Center, University of California San Diego, San Diego, CA, USA
- Ophthalmology - Retina Division, Shiley Eye Institute, The Viterbi Family Department of Ophthalmology, University of California San Diego, 9415 Campus Point Drive, San Diego, CA, 92093, USA
| | - Naomi E Wagner
- Ophthalmology - Retina Division, Shiley Eye Institute, The Viterbi Family Department of Ophthalmology, University of California San Diego, 9415 Campus Point Drive, San Diego, CA, 92093, USA
| | - Shyamanga Borooah
- Jacobs Retina Center, University of California San Diego, San Diego, CA, USA.
- Ophthalmology - Retina Division, Shiley Eye Institute, The Viterbi Family Department of Ophthalmology, University of California San Diego, 9415 Campus Point Drive, San Diego, CA, 92093, USA.
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4
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Khojasteh H, Riazi-Esfahani H, Mirghorbani M, Khalili Pour E, Mahmoudi A, Mahdizad Z, Akhavanrezayat A, Ghoraba H, Do DV, Nguyen QD. Cataract surgery in patients with retinitis pigmentosa: systematic review. J Cataract Refract Surg 2023; 49:312-320. [PMID: 36730350 PMCID: PMC9981325 DOI: 10.1097/j.jcrs.0000000000001101] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 11/09/2022] [Accepted: 11/13/2022] [Indexed: 02/03/2023]
Abstract
Retinitis pigmentosa (RP) is an inherited bilateral retinal degenerative disease with an incidence of 1 in 4000 people. RP affects more than 1 million individuals worldwide. Although night blindness and restricted visual field are the most typical symptoms of these individuals, generalized vision loss due to cataracts can be expected in the latter stages of the disease. It has been demonstrated that posterior subcapsular cataract is the most prevalent cataract in younger individuals with RP, as opposed to age-related cataracts. Although most ophthalmologists may have a negative view of cataract surgery in patients with RP, it appears that it can play an important role in the visual restoration of patients with RP. However, there are concerns about performing cataract surgery for patients with RP. Herein, a systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses on databases of MEDLINE and Scopus.
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Affiliation(s)
- Hassan Khojasteh
- From the Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California (Khojasteh, Akhavanrezayat, Ghoraba, Do, Nguyen); Farabi Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (Khojasteh, Riazi-Esfahani, Mirghorbani, Pour, Mahmoudi, Mahdizad)
| | - Hamid Riazi-Esfahani
- From the Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California (Khojasteh, Akhavanrezayat, Ghoraba, Do, Nguyen); Farabi Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (Khojasteh, Riazi-Esfahani, Mirghorbani, Pour, Mahmoudi, Mahdizad)
| | - Masoud Mirghorbani
- From the Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California (Khojasteh, Akhavanrezayat, Ghoraba, Do, Nguyen); Farabi Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (Khojasteh, Riazi-Esfahani, Mirghorbani, Pour, Mahmoudi, Mahdizad)
| | - Elias Khalili Pour
- From the Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California (Khojasteh, Akhavanrezayat, Ghoraba, Do, Nguyen); Farabi Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (Khojasteh, Riazi-Esfahani, Mirghorbani, Pour, Mahmoudi, Mahdizad)
| | - Alireza Mahmoudi
- From the Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California (Khojasteh, Akhavanrezayat, Ghoraba, Do, Nguyen); Farabi Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (Khojasteh, Riazi-Esfahani, Mirghorbani, Pour, Mahmoudi, Mahdizad)
| | - Zahra Mahdizad
- From the Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California (Khojasteh, Akhavanrezayat, Ghoraba, Do, Nguyen); Farabi Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (Khojasteh, Riazi-Esfahani, Mirghorbani, Pour, Mahmoudi, Mahdizad)
| | - Amir Akhavanrezayat
- From the Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California (Khojasteh, Akhavanrezayat, Ghoraba, Do, Nguyen); Farabi Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (Khojasteh, Riazi-Esfahani, Mirghorbani, Pour, Mahmoudi, Mahdizad)
| | - Hashem Ghoraba
- From the Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California (Khojasteh, Akhavanrezayat, Ghoraba, Do, Nguyen); Farabi Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (Khojasteh, Riazi-Esfahani, Mirghorbani, Pour, Mahmoudi, Mahdizad)
| | - Diana V. Do
- From the Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California (Khojasteh, Akhavanrezayat, Ghoraba, Do, Nguyen); Farabi Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (Khojasteh, Riazi-Esfahani, Mirghorbani, Pour, Mahmoudi, Mahdizad)
| | - Quan Dong Nguyen
- From the Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California (Khojasteh, Akhavanrezayat, Ghoraba, Do, Nguyen); Farabi Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (Khojasteh, Riazi-Esfahani, Mirghorbani, Pour, Mahmoudi, Mahdizad)
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5
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Yoon CK, Bae K, Yu HG. Longitudinal Microstructure Changes of the Retina and Choroid in Retinitis Pigmentosa. Am J Ophthalmol 2022; 241:149-159. [PMID: 35551907 DOI: 10.1016/j.ajo.2022.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/25/2022] [Accepted: 05/02/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate longitudinal changes in the retinal and choroidal microstructure of the macula in patients with retinitis pigmentosa (RP). DESIGN Retrospective, observational cohort study. METHODS A total of 69 patients with RP and 69 age- and sex-matched controls who underwent optical coherence tomography (OCT) over a 4-year follow-up period were included. The severity of RP was classified into 3 stages according to the integrity of the inner segment ellipsoid zone. The retinal and choroidal layers were segmented manually from OCT images. The areas of retinal pigment epithelium (RPE) atrophy and choroidal vascular index (CVI) were also analyzed. Longitudinal changes in the OCT parameters were compared among the groups. RESULTS Significant decreases (median [interquartile range]) in the thickness of the ganglion cell inner plexiform layer (GCIPL; -1.04 [-2.41 to -0.17]), outer nuclear layer (ONL; -1.44 [-1.86 to -0.28]), and inner segment ellipsoid (ISE; -0.74 [-1.33 to -0.49]) at the moderate stage and retinal nerve fiber layer (RNFL; -1.49 [-2.08 to -0.66]) and GCIPL (0.58 [-1.79 to 0.06]) at the advanced stage were observed. Choroidal thickness decreased significantly from -7.62 to -9.40 μm per year at all stages. RPE atrophy and CVI reduction were observed at the advanced stage. There was no change in the control group. CONCLUSIONS ONL and GCIPL thicknesses decreased at the moderate and advanced stages of RP; RNFL thickness decreased only at the advanced stage; and choroidal thickness decreased continuously. In addition, RPE atrophy and CVI reduction were prominent at the advanced stage. These results indicate that there is a temporal variation in the damage of each retinal layer and the choroid in RP patients.
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Affiliation(s)
- Chang Ki Yoon
- from the Department of Ophthalmology (C.K.Y., K.H.B., H.G.Y.), Seoul National University College of Medicine, Seoul, Korea; Department of Ophthalmology (C.K.Y., K.H.B., H.G.Y.), Seoul National University Hospital, Seoul, Korea
| | - Kunho Bae
- from the Department of Ophthalmology (C.K.Y., K.H.B., H.G.Y.), Seoul National University College of Medicine, Seoul, Korea; Department of Ophthalmology (C.K.Y., K.H.B., H.G.Y.), Seoul National University Hospital, Seoul, Korea
| | - Hyeong Gon Yu
- from the Department of Ophthalmology (C.K.Y., K.H.B., H.G.Y.), Seoul National University College of Medicine, Seoul, Korea; Department of Ophthalmology (C.K.Y., K.H.B., H.G.Y.), Seoul National University Hospital, Seoul, Korea; Retina Center (H.G.Y.), Sky Eye Institute, Seoul, Korea.
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6
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Li Y, Li R, Dai H, Li G. Novel variants in PDE6A and PDE6B genes and its phenotypes in patients with retinitis pigmentosa in Chinese families. BMC Ophthalmol 2022; 22:27. [PMID: 35033039 PMCID: PMC8761266 DOI: 10.1186/s12886-021-02242-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 12/30/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Retinitis pigmentosa (RP) is a genetically heterogeneous disease with 89 causative genes identified to date. However, only approximately 60% of RP cases genetically solved to date, predicating that many novel disease-causing variants are yet to be identified. The purpose of this study is to identify novel variants in PDE6A and PDE6B genes and present its phenotypes in patients with retinitis pigmentosa in Chinese families. METHODS Five retinitis pigmentosa patients with PDE6A variants and three with PDE6B variants were identified through a hereditary eye disease enrichment panel (HEDEP), all patients' medical and ophthalmic histories were collected, and ophthalmological examinations were performed, followed by an analysis of the possible causative variants. Sanger sequencing was used to verify the variants. RESULTS We identified 20 variants in eight patients: 16 of them were identified in either PDE6A or PDE6B in a compound heterozygous state. Additional four heterozygous variants were identified in the genes ADGRA3, CA4, OPTN, RHO. Two novel genetic changes in PDE6A were identified (c.1246G > A and c.1747 T > A), three novel genetic changes in PDE6B were identified (c.401 T > C, c.2293G > C and c.1610-1612del), out of the novel identified variants one was most probably non-pathogenic (c.2293G > C), all other novel variants are pathogenic. Additional variant was identified in CA4 and RHO, which can cause ADRP (c.243G > A, c.688G > A). In addition, a novel variant in ADGRA3 was identified (c.921-1G > A). CONCLUSIONS This study reveals novel and known variants in PDE6A and PDE6B genes in Chinese families with autosomal recessive RP, and expands the clinical and genetic findings of photoreceptor-specific enzyme deficiencies.
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Affiliation(s)
- Yuyu Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing, 100730 People’s Republic of China
| | - Ruyi Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing, 100730 People’s Republic of China
| | - Hehua Dai
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing, 100730 People’s Republic of China
| | - Genlin Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing, 100730 People’s Republic of China
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7
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Kuehlewein L, Zobor D, Andreasson SO, Ayuso C, Banfi S, Bocquet B, Bernd AS, Biskup S, Boon CJF, Downes SM, Fischer MD, Holz FG, Kellner U, Leroy BP, Meunier I, Nasser F, Rosenberg T, Rudolph G, Stingl K, Thiadens AAHJ, Wilhelm B, Wissinger B, Zrenner E, Kohl S, Weisschuh N. Clinical Phenotype and Course of PDE6A-Associated Retinitis Pigmentosa Disease, Characterized in Preparation for a Gene Supplementation Trial. JAMA Ophthalmol 2021; 138:1241-1250. [PMID: 33057649 DOI: 10.1001/jamaophthalmol.2020.4206] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Importance Treatment trials require sound knowledge on the natural course of disease. Objective To assess clinical features, genetic findings, and genotype-phenotype correlations in patients with retinitis pigmentosa (RP) associated with biallelic sequence variations in the PDE6A gene in preparation for a gene supplementation trial. Design, Setting, and Participants This prospective, longitudinal, observational cohort study was conducted from January 2001 to December 2019 in a single center (Centre for Ophthalmology of the University of Tübingen, Germany) with patients recruited multinationally from 12 collaborating European tertiary referral centers. Patients with retinitis pigmentosa, sequence variants in PDE6A, and the ability to provide informed consent were included. Exposures Comprehensive ophthalmological examinations; validation of compound heterozygosity and biallelism by familial segregation analysis, allelic cloning, or assessment of next-generation sequencing-read data, where possible. Main Outcomes and Measures Genetic findings and clinical features describing the entire cohort and comparing patients harboring the 2 most common disease-causing variants in a homozygous state (c.304C>A;p.(R102S) and c.998 + 1G>A;p.?). Results Fifty-seven patients (32 female patients [56%]; mean [SD], 40 [14] years) from 44 families were included. All patients completed the study. Thirty patients were homozygous for disease-causing alleles. Twenty-seven patients were heterozygous for 2 different PDE6A variants each. The most frequently observed alleles were c.304C>A;p.(R102S), c.998 + 1G>A;p.?, and c.2053G>A;p.(V685M). The mean (SD) best-corrected visual acuity was 0.43 (0.48) logMAR (Snellen equivalent, 20/50). The median visual field area with object III4e was 660 square degrees (5th and 95th percentiles, 76 and 11 019 square degrees; 25th and 75th percentiles, 255 and 3923 square degrees). Dark-adapted and light-adapted full-field electroretinography showed no responses in 88 of 108 eyes (81.5%). Sixty-nine of 108 eyes (62.9%) showed additional findings on optical coherence tomography imaging (eg, cystoid macular edema or macular atrophy). The variant c.998 + 1G>A;p.? led to a more severe phenotype when compared with the variant c.304C>A;p.(R102S). Conclusions and Relevance Seventeen of the PDE6A variants found in these patients appeared to be novel. Regarding the clinical findings, disease was highly symmetrical between the right and left eyes and visual impairment was mild or moderate in 90% of patients, providing a window of opportunity for gene therapy.
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Affiliation(s)
- Laura Kuehlewein
- Institute for Ophthalmic Research, Centre for Ophthalmology, Eberhard Karls University Tübingen, Germany.,University Eye Hospital, Centre for Ophthalmology, Eberhard Karls University Tübingen, Germany
| | - Ditta Zobor
- Institute for Ophthalmic Research, Centre for Ophthalmology, Eberhard Karls University Tübingen, Germany
| | - Sten Olof Andreasson
- Lund University, Skane University Hospital, Department of Ophthalmology, Lund, Sweden
| | - Carmen Ayuso
- Department of Genetics, IIS-Fundación Jiménez Díaz-University Hospital; Universidad Autónoma de Madrid, Madrid, Spain.,Centre for Biomedical Research on Rare Diseases, Madrid, Spain
| | - Sandro Banfi
- Telethon Institute of Genetics and Medicine, Pozzuoli (NA) and Medical Genetics, Department of Precision Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Beatrice Bocquet
- Institute for Neurosciences of Montpellier Unité 1051, University of Montpellier, Montpellier, France.,National Center for Rare Diseases, Genetics of Sensory Diseases, University Hospital, Montpellier, France
| | - Antje S Bernd
- University Eye Hospital, Centre for Ophthalmology, Eberhard Karls University Tübingen, Germany
| | | | - Camiel J F Boon
- Department of Ophthalmology, Leiden University Medical Center, Leiden University, Leiden, the Netherlands.,Department of Ophthalmology, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Susan M Downes
- Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, United Kingdom
| | - M Dominik Fischer
- Institute for Ophthalmic Research, Centre for Ophthalmology, Eberhard Karls University Tübingen, Germany.,University Eye Hospital, Centre for Ophthalmology, Eberhard Karls University Tübingen, Germany
| | - Frank G Holz
- Department of Ophthalmology, University of Bonn, Germany
| | - Ulrich Kellner
- Rare Retinal Disease Center, AugenZentrum Siegburg, MVZ Augenärztliches Diagnostik- und Therapiecentrum GmbH, Siegburg, Germany.,RetinaScience, Bonn, Germany
| | - Bart P Leroy
- Department of Ophthalmology Ghent University Hospital, Ghent, Belgium.,Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium.,Division of Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Center for Cellular & Molecular Therapeutics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Isabelle Meunier
- Institute for Neurosciences of Montpellier Unité 1051, University of Montpellier, Montpellier, France.,National Center for Rare Diseases, Genetics of Sensory Diseases, University Hospital, Montpellier, France
| | - Fadi Nasser
- Institute for Ophthalmic Research, Centre for Ophthalmology, Eberhard Karls University Tübingen, Germany
| | - Thomas Rosenberg
- Department of Ophthalmology, Kennedy Center, Rigshospitalet, Copenhagen, Denmark
| | - Günther Rudolph
- Ophthalmogenetik, Augenklinik, Klinikum der Universität München, Munich, Germany
| | - Katarina Stingl
- University Eye Hospital, Centre for Ophthalmology, Eberhard Karls University Tübingen, Germany
| | | | - Barbara Wilhelm
- STZ Eyetrial, Centre for Ophthalmology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Bernd Wissinger
- Molecular Genetics Laboratory, Institute for Ophthalmic Research, Centre for Ophthalmology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Eberhart Zrenner
- Institute for Ophthalmic Research, Centre for Ophthalmology, Eberhard Karls University Tübingen, Germany.,Werner Reichardt Centre for Integrative Neuroscience, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Susanne Kohl
- Molecular Genetics Laboratory, Institute for Ophthalmic Research, Centre for Ophthalmology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Nicole Weisschuh
- Molecular Genetics Laboratory, Institute for Ophthalmic Research, Centre for Ophthalmology, Eberhard Karls University Tübingen, Tübingen, Germany
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8
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Oh JK, Nuzbrokh Y, Lima de Carvalho JR, Ryu J, Tsang SH. Optical coherence tomography in the evaluation of retinitis pigmentosa. Ophthalmic Genet 2020; 41:413-419. [PMID: 32552399 DOI: 10.1080/13816810.2020.1780619] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Optical coherence tomography (OCT) is a non-invasive imaging test that provides easily obtainable and highly reproducible cross-sectional images of the retina. Improved modalities of the OCT that are capable of providing high quality images of not only the retina, but also the deeper structures and vasculature have been developed, including swept-source OCTs and OCT angiography. MATERIALS AND METHODS Review. RESULTS The use of OCT in the monitoring of retinitis pigmentosa has been well described and numerous signs of disease progression have been studied. Notably among them are the detection of changes to retinal thickness, the ellipsoid zone, the vasculature on OCT angiography, and cystoid macular edema. CONCLUSION In this review, we discuss the multiple applications of OCT as a tool in the monitoring of retinitis pigmentosa and its potential use as an outcome measurement in current and future therapeutic endeavors.
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Affiliation(s)
- Jin Kyun Oh
- Department of Ophthalmology, Columbia University Irving Medical Center , New York, NY, USA.,College of Medicine at the State University of New York at Downstate Medical Center , Brooklyn, NY, USA
| | - Yan Nuzbrokh
- Department of Ophthalmology, Columbia University Irving Medical Center , New York, NY, USA.,Renaissance School of Medicine at Stony Brook University , Stony Brook, NY, USA
| | - Jose Ronaldo Lima de Carvalho
- Department of Ophthalmology, Columbia University Irving Medical Center , New York, NY, USA.,Department of Ophthalmology, Empresa Brasileira de Servicos Hospitalares (EBSERH) - Hospital das Clinicas de Pernambuco (HCPE), Federal University of Pernambuco (UFPE) , Recife, Brazil.,Department of Ophthalmology, Federal University of São Paulo (UNIFESP) , São Paulo, Brazil
| | - Joseph Ryu
- Department of Ophthalmology, Columbia University Irving Medical Center , New York, NY, USA
| | - Stephen H Tsang
- Department of Ophthalmology, Columbia University Irving Medical Center , New York, NY, USA.,Department of Pathology & Cell Biology, Columbia University Irving Medical Center , New York, NY, USA
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Puthalath A, Samanta R, Saraswat N, Agrawal A, Singh A, Jamil M. A rare case of type 3 usher syndrome with bilateral cystoid macular edema treated with topical dorzolamide. Taiwan J Ophthalmol 2020; 11:183-186. [PMID: 34295626 PMCID: PMC8259521 DOI: 10.4103/tjo.tjo_6_20] [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: 09/06/2019] [Accepted: 01/02/2020] [Indexed: 12/03/2022] Open
Abstract
A 30-year-old female presented with gradually progressive diminution of vision for 1 month, with night blindness for the past 5 years and difficulty in hearing for the past 10 years. Her developmental history and family history were unremarkable. Ocular examination revealed visual acuity of 6/36 in both eyes. Fundus showed features of retinitis pigmentosa with bilateral macular edema. Audiometry revealed bilateral sensorineural hearing loss; although, her vestibular functions were preserved. Clinical diagnosis of Usher syndrome type 3 was made based on normal hearing at birth, delayed presentation of progressive visual and auditory impairment with normal vestibular function, and developmental milestones. Her macular edema resolved after 3 months of treatment with topical dorzolamide therapy. The unique feature of this case is the presence of bilateral macular edema in type 3 Usher syndrome, which is rarely reported in literature.
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Affiliation(s)
- Athul Puthalath
- Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Ramanuj Samanta
- Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Neeraj Saraswat
- Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Ajai Agrawal
- Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Anupam Singh
- Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Mahsa Jamil
- Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
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Liu G, Liu X, Li H, Du Q, Wang F. Optical Coherence Tomographic Analysis of Retina in Retinitis Pigmentosa Patients. Ophthalmic Res 2016; 56:111-22. [DOI: 10.1159/000445063] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 02/27/2016] [Indexed: 11/19/2022]
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11
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Sliesoraityte I, Peto T, Mohand-Said S, Sahel JA. Novel grading system for quantification of cystic macular lesions in Usher syndrome. Orphanet J Rare Dis 2015; 10:157. [PMID: 26654877 PMCID: PMC4676164 DOI: 10.1186/s13023-015-0372-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 11/25/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate novel grading system used to quantify optical coherence tomography (OCT) scans for cystic macular lesions (CML) in Usher syndrome (USH) patients, focusing on CML associated alterations in MOY7A and USH2A mutations. METHODS Two readers evaluated 76 patients' (mean age 42 ± 14 years) data prospectively uploaded on Eurush database. OCT was used to obtain high quality cross-sectional images through the fovea. The CML was graded as none, mild, moderate or severe, depending on the following features set: subretinal fluid without clearly detectable CML boundaries; central macular thickness; largest diameter of CML; calculated mean of all detectable CML; total number of detectable CML; retinal layers affected by CML. Intra-and inter-grader reproducibility was evaluated. RESULTS CML were observed in 37 % of USH eyes, while 45 % were observed in MYO7A and 29 % in USH2A cases. Of those with CML: 52 % had mild, 22 % had moderate and 26 % had severe changes, respectively. CML were found in following retinal layers: 50 % inner nuclear layer, 44 % outer nuclear layer, 6 % retinal ganglion cell layer. For the inter-grader repeatability analysis, agreements rates for CML were 97 % and kappa statistics was 0.91 (95 % CI 0.83-0.99). For the intra-grader analysis, agreement rates for CML were 98 %, while kappa statistics was 0.96 (95 % CI 0.92-0.99). CONCLUSIONS The novel grading system is a reproducible tool for grading OCT images in USH complicated by CML, and potentially could be used for objective tracking of macular pathology in clinical therapy trials.
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Affiliation(s)
- Ieva Sliesoraityte
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU Sight Restore, INSERM-DHOS CIC 1243, 28 rue de Charenton, 75012, Paris, France.
| | - Tunde Peto
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, 162 City Road, ECV1 2PD, London, UK
| | - Saddek Mohand-Said
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU Sight Restore, INSERM-DHOS CIC 1243, 28 rue de Charenton, 75012, Paris, France
| | - Jose Alain Sahel
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU Sight Restore, INSERM-DHOS CIC 1243, 28 rue de Charenton, 75012, Paris, France.,INSERM, CNRS, Institut de la Vision, Sorbonne Universités, UPMC Univ Paris 06, 17 rue Moreau, 75012, Paris, France
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