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Maclaren RE, Lam BL, Fischer MD, Holz FG, Pennesi ME, Birch DG, Sankila EM, Meunier IA, Stepien KE, Sallum JMF, Li J, Yoon D, Panda S, Gow JA. A Prospective, Observational, Non-interventional Clinical Study of Participants With Choroideremia: The NIGHT Study. Am J Ophthalmol 2024; 263:35-49. [PMID: 38311152 DOI: 10.1016/j.ajo.2024.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 02/10/2024]
Abstract
PURPOSE The NIGHT study aimed to assess the natural history of choroideremia (CHM), an X-linked inherited chorioretinal degenerative disease leading to blindness, and determine which outcomes would be the most sensitive for monitoring disease progression. DESIGN A prospective, observational, multicenter cohort study. METHODS Males aged ≥18 years with genetically confirmed CHM, visible active disease within the macular region, and best-corrected visual acuity (BCVA) ≥34 Early Treatment Diabetic Retinopathy Study (ETDRS) letters at baseline were assessed for 20 months. The primary outcome was the change in BCVA over time at Months 4, 8, 12, 16, and 20. A range of functional and anatomical secondary outcome measures were assessed up to Month 12, including retinal sensitivity, central ellipsoid zone (EZ) area, and total area of fundus autofluorescence (FAF). Additional ocular assessments for safety were performed. RESULTS A total of 220 participants completed the study. The mean BCVA was stable over 20 months. Most participants (81.4% in the worse eye and 77.8% in the better eye) had change from baseline > -5 ETDRS letters at Month 20. Interocular symmetry was low overall. Reductions from baseline to Month 12 were observed (worse eye, better eye) for retinal sensitivity (functional outcome; -0.68 dB, -0.48 dB), central EZ area (anatomical outcome; -0.276 mm2, -0.290 mm2), and total area of FAF (anatomical outcome; -0.605 mm2, -0.533 mm2). No assessment-related serious adverse events occurred. CONCLUSIONS Retinal sensitivity, central EZ area, and total area of FAF are more sensitive than BCVA in measuring the natural progression of CHM.
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Affiliation(s)
- Robert E Maclaren
- From the Oxford Eye Hospital (R.E.M.), Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
| | - Byron L Lam
- Bascom Palmer Eye Institute (B.L.L.), University of Miami, Miami, Florida, USA
| | - M Dominik Fischer
- University Eye Hospital, Centre for Ophthalmology (M.D.F.), University Hospital Tübingen, Tübingen, Germany
| | - Frank G Holz
- Department of Ophthalmology (F.-G.H.), University of Bonn, Bonn, Germany
| | - Mark E Pennesi
- Department of Ophthalmology, Casey Eye Institute (M.E.P.), Oregon Health & Science University, Portland, Oregon, USA
| | - David G Birch
- Retina Foundation of the Southwest (D.G.B.), Dallas, Texas, USA
| | - Eeva-Marja Sankila
- Department of Ophthalmology (E.-M.S.), University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Isabelle Anne Meunier
- National Reference Centre for Inherited Sensory Diseases (I.A.M.), University of Montpellier, Montpellier University Hospital, Montpellier, France
| | - Kimberly E Stepien
- Department of Ophthalmology and Visual Sciences (K.E.S.), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Juliana Maria Ferraz Sallum
- Department of Ophthalmology and Visual Sciences (J.M.F.S.), Federal University of São Paulo, São Paulo, São Paulo, Brazil
| | - Jiang Li
- Biogen Inc. (J.L., D.Y., S.P., J.A.G.), Cambridge, Massachusetts, USA
| | - Dan Yoon
- Biogen Inc. (J.L., D.Y., S.P., J.A.G.), Cambridge, Massachusetts, USA
| | - Sushil Panda
- Biogen Inc. (J.L., D.Y., S.P., J.A.G.), Cambridge, Massachusetts, USA
| | - James A Gow
- Biogen Inc. (J.L., D.Y., S.P., J.A.G.), Cambridge, Massachusetts, USA
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Grudzinska Pechhacker MK, Molnar A, Pekkola Pacheco N, Thonberg H, Querat L, Birkeldh U, Nordgren A, Lindstrand A. Reduced cone photoreceptor function and subtle systemic manifestations in two siblings with loss of SCLT1. Ophthalmic Genet 2024; 45:95-102. [PMID: 37246745 DOI: 10.1080/13816810.2023.2215332] [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: 12/21/2022] [Accepted: 05/14/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND The sodium channel and clathrin linker 1 gene (SCLT1) has been involved in the pathogenesis of various ciliopathy disorders such as Bardet-Biedl syndrome, orofaciodigital syndrome type IX, and Senior-Løken syndrome. Detailed exams are warranted to outline all clinical features. Here, we present a family with a milder phenotype of SCLT1-related disease. MATERIAL AND METHODS Comprehensive eye examination including fundus images, OCT, color vision, visual fields and electroretinography were performed. Affected individuals were assessed by a pediatrician and a medical geneticist for systemic features of ciliopathy. Investigations included echocardiography, abdominal ultrasonography, blood work-up for diabetes, liver and kidney function. Genetic testing included NGS retinal dystrophy panel, segregation analysis and transcriptome sequencing. RESULTS Two male children, age 10 and 8 years, were affected with attention deficit hyperactivity disorder (ADHD), obesity and mild photophobia. The ophthalmic exam revealed reduced best-corrected visual acuity (BCVA), strabismus, hyperopia, astigmatism and moderate red-green defects. Milder changes suggesting photoreceptors disease were found on retinal imaging. Electroretinogram confirmed cone photoreceptors dysfunction. Genetic testing revealed a homozygous likely pathogenic, splice-site variant in SCLT1 gene NM_144643.3: c.1439 + 1del in the proband and in the affected brother. The unaffected parents were heterozygous for the SCLT1 variant. Transcriptome sequencing showed retention of intron 16 in the proband. CONCLUSIONS In this report, we highlight the importance of further extensive diagnostics in patients with unexplained reduced vision, strabismus, refractive errors and ADHD spectrum disorders. SCLT1-related retinal degeneration is very rare and isolated reduced function of cone photoreceptors has not previously been observed.
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Affiliation(s)
- Monika K Grudzinska Pechhacker
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatric Ophthalmology, Strabismus and Electrophysiology, St. Erik Eye Hospital, Stockholm, Sweden
| | - Anna Molnar
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatric Ophthalmology, Strabismus and Electrophysiology, St. Erik Eye Hospital, Stockholm, Sweden
| | - Nadja Pekkola Pacheco
- Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Håkan Thonberg
- Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Laurence Querat
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatric Ophthalmology, Strabismus and Electrophysiology, St. Erik Eye Hospital, Stockholm, Sweden
| | - Ulrika Birkeldh
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatric Ophthalmology, Strabismus and Electrophysiology, St. Erik Eye Hospital, Stockholm, Sweden
| | - Ann Nordgren
- Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Anna Lindstrand
- Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
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Binder A, Kohl S, Grasshoff U, Schäferhoff K, Stingl K. An early onset cone dystrophy due to CEP290 mutation: a case report. Doc Ophthalmol 2023; 147:203-209. [PMID: 37642804 PMCID: PMC10638109 DOI: 10.1007/s10633-023-09940-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: 06/24/2022] [Accepted: 06/15/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE Biallelic mutations in the CEP290 gene cause early onset retinal dystrophy or syndromic disease such as Senior-Loken or Joubert syndrome. Here, we present an unusual non-syndromic case of a juvenile retinal dystrophy caused by biallelic CEP290 mutations imitating initially the phenotype of achromatopsia or slowly progressing cone dystrophy. METHODS We present 13 years of follow-up of a female patient who presented first with symptoms and findings typical for achromatopsia. The patient underwent functional and morphologic examinations, including fundus autofluorescence imaging, spectral-domain optical coherence tomography, electroretinography, color vision and visual field testing. RESULTS Diagnostic genetic testing via whole genome sequencing and virtual inherited retinal disease gene panel evaluation finally identified two compound heterozygous variants c.4452_4455del;p.(Lys1484Asnfs*4) and c.2414T > C;p.(Leu805Pro) in the CEP290 gene. CONCLUSIONS CEP290 mutation causes a wide variety of clinical phenotypes. The presented case shows a phenotype resembling achromatopsia or early onset slowly progressing cone dystrophy.
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Affiliation(s)
| | - Susanne Kohl
- Institute for Ophthalmic Research, Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
| | - Ute Grasshoff
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Karin Schäferhoff
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Katarina Stingl
- University Eye Hospital Tübingen, Centre for Ophthalmology, University of Tübingen, Tübingen, Germany.
- Center for Rare Eye Diseases, University of Tübingen, Tübingen, Germany.
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Uda D, Kondo H, Tanda K, Kizaki Z, Nishida M, Dai H, Itoh M. Two Siblings Showing a Mild Phenotype of Joubert Syndrome with a Specific CEP290 Variant. Neuropediatrics 2022; 54:217-221. [PMID: 35642300 DOI: 10.1055/a-1865-6890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Joubert syndrome (JS) is a genetic neurodevelopmental disorder characterized by lower brainstem dysplasia and cerebellar vermis agenesis termed molar tooth sign (MTS), psychomotor retardation, abnormal respiratory pattern in infancy, and oculomotor abnormalities. Arima syndrome (AS), which is a severe form of JS, is characterized by severe psychomotor retardation, congenital visual impairment, progressive renal dysfunction, and lower brainstem dysplasia from early infancy. Numerous patients with AS expire in early childhood. Recently, c.6012-12T> A in the CEP290 gene was reported as a specific variant of AS. Herein, we report the cases of two siblings showing a phenotype of JS with compound heterozygous mutations (c.6012-12T > A / c.5924delT) in the CEP290 gene. The older sister (aged 19 years) had hypotonia, hypertelorism, and anteverted nares since birth. As a neonate, she developed a transient abnormal respiratory pattern and nystagmus, and brain magnetic resonance imaging (MRI) showed MTS. The younger sister (aged 13 years) exhibited mild hypotonia and pendular nystagmus as a neonate; MRI revealed MTS. Both sisters had psychomotor retardation, oculomotor dysfunction, and bilateral renal cysts with normal renal function. They can walk and have simple conversation. They do not meet the diagnostic criteria for AS, and their symptoms were milder than those of previously reported cases with this specific mutation. This report indicates the expanding spectrum of the CEP290 variant.
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Affiliation(s)
- Daisuke Uda
- Department of Pediatrics and Neonatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Hidehito Kondo
- Department of Pediatrics and Neonatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Koichi Tanda
- Department of Pediatrics and Neonatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Zenro Kizaki
- Department of Pediatrics and Neonatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Masashi Nishida
- Department of Pediatrics and Neonatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Hongmei Dai
- Department of Mental Retardation and Birth Defect Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Masayuki Itoh
- Department of Mental Retardation and Birth Defect Research, National Center of Neurology and Psychiatry, Tokyo, Japan
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Peng M, Han S, Sun J, He X, Lv Y, Yang L. Evaluation of novel compound variants of CEP290 in prenatally suspected case of Meckel syndrome through whole exome sequencing. Mol Genet Genomic Med 2022; 10:e1935. [PMID: 35352487 PMCID: PMC9034663 DOI: 10.1002/mgg3.1935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 02/16/2022] [Accepted: 03/17/2022] [Indexed: 11/29/2022] Open
Abstract
Background Meckel syndrome (MKS) is a fatal disease characterized by multisystem fibrosis during the prenatal or perinatal period. It has an autosomal recessive genetic pattern and is characterized by meningo occipital encephalocele, polycystic kidney dysplasia, polydactyly, and hepatobiliary ductal plate malformation. Germline variations in CEP290 have been shown to cause MKS4. Methods In this study, a 23‐year‐old Chinese woman who was 18 weeks pregnant was examined. The pregnancy was terminated due to occipital meningocele and enlarged cystic dysplastic kidney revealed by ultrasonography. In addition, the patient had a history of adverse pregnancy whereby the fetus presented with double kidney enlargement. Karyotype analysis and chromosomal microarray examination (CMA) were carried out using amniotic fluid samples. Whole exome sequencing (WES) was performed using tissue specimens of the aborted fetus. Results Karyotype and CMA analyses showed normal results. However, compound heterozygous mutations of CEP290 c.3175dup and CEP290 c.1201dup were detected through WES. CEP290 c.1201dup is a novel heterozygous mutation of CEP290 that has not been reported previously. Conclusions The findings of this study provide information on the correlation between MKS phenotype and genotype in CEP290. In addition, these findings indicate that WES is an effective method for detecting genetic causes of multiple structural defects especially those showing normal karyotype and CMA results.
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Affiliation(s)
- Meilian Peng
- Center for Reproductive Medicine, Department of Obstetrics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Shuai Han
- Center for Reproductive Medicine, Department of Obstetrics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Juan Sun
- Center for Reproductive Medicine, Department of Ultrasound Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Xiaodong He
- Cancer Center, Department of Radiology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Yaer Lv
- Center for Reproductive Medicine, Department of Ultrasound Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Liwei Yang
- Center for Reproductive Medicine, Department of Obstetrics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
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Shughoury A, Ciulla TA, Bakall B, Pennesi ME, Kiss S, Cunningham ET. Genes and Gene Therapy in Inherited Retinal Disease. Int Ophthalmol Clin 2021; 61:3-45. [PMID: 34584043 DOI: 10.1097/iio.0000000000000377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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