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Cabral T, Lima de Carvalho JR, Kim J, Oh JK, Levi SR, Park KS, Duong JK, Park J, Boudreault K, Belfort R, Tsang SH. Comparative Analysis of Functional and Structural Decline in Retinitis Pigmentosas. Int J Mol Sci 2020; 21:ijms21082730. [PMID: 32326409 PMCID: PMC7215932 DOI: 10.3390/ijms21082730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/07/2020] [Accepted: 04/10/2020] [Indexed: 11/25/2022] Open
Abstract
Retinitis pigmentosa (RP) is a category of inherited retinal dystrophies that is best prognosticated using electroretinography (ERG). In this retrospective cohort study of 25 patients with RP, we evaluated the correlation between 30 Hz flicker ERG and structural parameters in the retina. Internationally standardized 30 Hz flicker ERG recordings, short-wavelength autofluorescence (SW-AF), and spectral domain–optical coherence tomography (SD-OCT) were acquired at two visits at least one year apart. Vertical and horizontal hyperautofluorescent ring diameter measurements with SW-AF, as well as ellipsoid zone (EZ) line width measurements with SD-OCT, were used as structural parameters of disease progression. The 30 Hz flicker ERG amplitude decreased by 2.2 ± 0.8 µV/year (p = 0.011), while implicit times remained unchanged. For SD-OCT, the EZ line decreased by 204.1 ± 34.7 µm/year (p < 0.001). Horizontal and vertical hyperautofluorescent ring diameters decreased by 161.9 ± 25.6 µm/year and 146.9 ± 34.6 µm/year, respectively (p = 0.001), with SW-AF. A correlation was found between the progression rates of the 30 Hz flicker amplitude recorded with Burian–Allen electrodes and both the horizontal ring diameter (p = 0.020) and EZ line (p = 0.044). SW-AF and SD-OCT, two readily available imaging techniques, may be used to prognosticate disease progression because of the reliability of their measurements and correlation with functional outcome.
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Affiliation(s)
- Thiago Cabral
- Department of Ophthalmology, Jonas Children’s Vision Care and Bernard & Shirlee Brown Glaucoma Laboratory, Columbia University, New York, NY 10032, USA; (T.C.); (J.R.L.d.C.J.); (J.K.O.); (S.R.L.); (K.S.P.); (K.B.)
- Department of Specialized Medicine, CCS and Vision Center Unit, Ophthalmology, EBSERH/HUCAM, CCS-UFES—Federal University of Espírito Santo (UFES), Vitória, ES 29047-105, Brazil
- Department of Ophthalmology, Federal University of São Paulo (UNIFESP), São Paulo, SP 04039-032, Brazil
| | - Jose Ronaldo Lima de Carvalho
- Department of Ophthalmology, Jonas Children’s Vision Care and Bernard & Shirlee Brown Glaucoma Laboratory, Columbia University, New York, NY 10032, USA; (T.C.); (J.R.L.d.C.J.); (J.K.O.); (S.R.L.); (K.S.P.); (K.B.)
- Department of Ophthalmology, Federal University of São Paulo (UNIFESP), São Paulo, SP 04039-032, Brazil
- Department of Ophthalmology, Empresa Brasileira de Serviços Hospitalares (EBSERH)–Hospital das Clínicas de Pernambuco (HCPE), Federal University of Pernambuco (UFPE), Recife, PE 50740-465, Brazil
| | - Joonpyo Kim
- Department of Statistics, Seoul National University, Seoul 08826, Korea;
| | - Jin Kyun Oh
- Department of Ophthalmology, Jonas Children’s Vision Care and Bernard & Shirlee Brown Glaucoma Laboratory, Columbia University, New York, NY 10032, USA; (T.C.); (J.R.L.d.C.J.); (J.K.O.); (S.R.L.); (K.S.P.); (K.B.)
- College of Medicine, State University of New York at Downstate Medical Center, Brooklyn, NY 11203, USA
| | - Sarah R. Levi
- Department of Ophthalmology, Jonas Children’s Vision Care and Bernard & Shirlee Brown Glaucoma Laboratory, Columbia University, New York, NY 10032, USA; (T.C.); (J.R.L.d.C.J.); (J.K.O.); (S.R.L.); (K.S.P.); (K.B.)
| | - Karen Sophia Park
- Department of Ophthalmology, Jonas Children’s Vision Care and Bernard & Shirlee Brown Glaucoma Laboratory, Columbia University, New York, NY 10032, USA; (T.C.); (J.R.L.d.C.J.); (J.K.O.); (S.R.L.); (K.S.P.); (K.B.)
| | - Jimmy K. Duong
- Department of Biostatistics, Columbia University, New York, NY 10032, USA;
| | - Junhyung Park
- Department of Statistics, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA;
| | - Katherine Boudreault
- Department of Ophthalmology, Jonas Children’s Vision Care and Bernard & Shirlee Brown Glaucoma Laboratory, Columbia University, New York, NY 10032, USA; (T.C.); (J.R.L.d.C.J.); (J.K.O.); (S.R.L.); (K.S.P.); (K.B.)
| | - Rubens Belfort
- Department of Ophthalmology, Federal University of São Paulo (UNIFESP), São Paulo, SP 04039-032, Brazil
| | - Stephen H. Tsang
- Department of Ophthalmology, Jonas Children’s Vision Care and Bernard & Shirlee Brown Glaucoma Laboratory, Columbia University, New York, NY 10032, USA; (T.C.); (J.R.L.d.C.J.); (J.K.O.); (S.R.L.); (K.S.P.); (K.B.)
- Department of Pathology & Cell Biology, Stem Cell Initiative (CSCI), Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
- Correspondence: ; Tel.: +1-(212)-342-1189; Fax: +1-(212)-305-4987
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Affiliation(s)
- Katherine Boudreault
- Barbara and Donald Jonas Laboratory of Regenerative Medicine, Columbia University, New York, New York2Bernard and Shirlee Brown Glaucoma Laboratory, Department of Ophthalmology, Columbia University, New York, New York3Department of Ophthalmology, Universi
| | - Sally Justus
- Barbara and Donald Jonas Laboratory of Regenerative Medicine, Columbia University, New York, New York2Bernard and Shirlee Brown Glaucoma Laboratory, Department of Ophthalmology, Columbia University, New York, New York
| | - Winston Lee
- Barbara and Donald Jonas Laboratory of Regenerative Medicine, Columbia University, New York, New York2Bernard and Shirlee Brown Glaucoma Laboratory, Department of Ophthalmology, Columbia University, New York, New York
| | - Vinit B Mahajan
- Omics Laboratory, Department of Ophthalmology and Visual Science, University of Iowa, Iowa City
| | - Stephen H Tsang
- Barbara and Donald Jonas Laboratory of Regenerative Medicine, Columbia University, New York, New York2Bernard and Shirlee Brown Glaucoma Laboratory, Department of Ophthalmology, Columbia University, New York, New York
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Sengillo JD, Cabral T, Schuerch K, Duong J, Lee W, Boudreault K, Xu Y, Justus S, Sparrow JR, Mahajan VB, Tsang SH. Electroretinography Reveals Difference in Cone Function between Syndromic and Nonsyndromic USH2A Patients. Sci Rep 2017; 7:11170. [PMID: 28894305 PMCID: PMC5593892 DOI: 10.1038/s41598-017-11679-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 08/15/2017] [Indexed: 11/23/2022] Open
Abstract
Usher syndrome is an inherited and irreversible disease that manifests as retinitis pigmentosa (RP) and bilateral neurosensory hearing loss. Mutations in Usherin 2A (USH2A) are not only a frequent cause of Usher syndrome, but also nonsyndromic RP. Although gene- and cell-based therapies are on the horizon for RP and Usher syndrome, studies characterizing natural disease are lacking. In this retrospective analysis, retinal function of USH2A patients was quantified with electroretinography. Both groups had markedly reduced rod and cone responses, but nonsyndromic USH2A patients had 30 Hz-flicker electroretinogram amplitudes that were significantly higher than syndromic patients, suggesting superior residual cone function. There was a tendency for Usher syndrome patients to have a higher distribution of severe mutations, and alleles in this group had a higher odds of containing nonsense or frame-shift mutations. These data suggest that the previously reported severe visual phenotype seen in syndromic USH2A patients could relate to a greater extent of cone dysfunction. Additionally, a genetic threshold may exist where mutation burden relates to visual phenotype and the presence of hearing deficits. The auditory phenotype and allelic hierarchy observed among patients should be considered in prospective studies of disease progression and during enrollment for future clinical trials.
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Affiliation(s)
- Jesse D Sengillo
- Jonas Children's Vision Care, and Bernard & Shirlee Brown Glaucoma Laboratory, Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA.,Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, New York, NY, USA.,State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Thiago Cabral
- Jonas Children's Vision Care, and Bernard & Shirlee Brown Glaucoma Laboratory, Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA.,Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, New York, NY, USA.,Department of Ophthalmology, Federal University of Espírito Santo, Vitoria, Brazil.,Department of Ophthalmology, Federal University of São Paulo, Sao Paulo, Brazil
| | - Kaspar Schuerch
- Jonas Children's Vision Care, and Bernard & Shirlee Brown Glaucoma Laboratory, Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA.,Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, New York, NY, USA
| | - Jimmy Duong
- Department of Biostatistics, Columbia University, New York, NY, USA
| | - Winston Lee
- Jonas Children's Vision Care, and Bernard & Shirlee Brown Glaucoma Laboratory, Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA.,Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, New York, NY, USA
| | - Katherine Boudreault
- Jonas Children's Vision Care, and Bernard & Shirlee Brown Glaucoma Laboratory, Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA.,Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, New York, NY, USA.,Department of Ophthalmology, University of Montreal, Montreal, Canada
| | - Yu Xu
- Department of Ophthalmology, Xin Hua Hospital affiliate of Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sally Justus
- Jonas Children's Vision Care, and Bernard & Shirlee Brown Glaucoma Laboratory, Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA.,Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, New York, NY, USA
| | - Janet R Sparrow
- Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, New York, NY, USA.,Department of Pathology & Cell Biology, Stem Cell Initiative (CSCI), Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Vinit B Mahajan
- Omics Laboratory, Byers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, CA, USA
| | - Stephen H Tsang
- Jonas Children's Vision Care, and Bernard & Shirlee Brown Glaucoma Laboratory, Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA. .,Edward S. Harkness Eye Institute, New York-Presbyterian Hospital, New York, NY, USA. .,Department of Pathology & Cell Biology, Stem Cell Initiative (CSCI), Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
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Gaier ED, Boudreault K, Nakata I, Janessian M, Skidd P, DelBono E, Allen KF, Pasquale LR, Place E, Cestari DM, Stacy RC, Rizzo JF, Wiggs JL. Diagnostic genetic testing for patients with bilateral optic neuropathy and comparison of clinical features according to OPA1 mutation status. Mol Vis 2017; 23:548-560. [PMID: 28848318 PMCID: PMC5561143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 08/08/2017] [Indexed: 10/26/2022] Open
Abstract
PURPOSE Inherited optic neuropathy is genetically heterogeneous, and genetic testing has an important role in risk assessment and counseling. The purpose of this study is to determine the prevalence and spectrum of mutations in a group of patients referred for genetic testing to a tertiary center in the United States. In addition, we compared the clinical features of patients with and without mutations in OPA1, the gene most commonly involved in dominantly inherited optic atrophy. METHODS Clinical data and genetic testing results were reviewed for 74 unrelated, consecutive patients referred with a history of insidious, relatively symmetric, bilateral visual loss secondary to an optic neuropathy. Patients were evaluated for disease-causing variants in OPA1, OPA3, WFS1, and the entire mitochondrial genome with DNA sequencing and copy number variation (CNV) testing. RESULTS Pathogenic DNA variants were found in 25 cases, with the majority (24 patients) located in OPA1. Demographics, clinical history, and clinical features for the group of patients with mutations in OPA1 were compared to those without disease-causing variants. Compared to the patients without mutations, cases with mutations in OPA1 were more likely to have a family history of optic nerve disease (p = 0.027); however, 30.4% of patients without a family history of disease also had mutations in OPA1. OPA1 mutation carriers had less severe mean deviation and pattern standard deviation on automated visual field testing than patients with optic atrophy without mutations in OPA1 (p<0.005). Other demographic and ocular features were not statistically significantly different between the two groups, including the fraction of patients with central scotomas (42.9% of OPA1 mutation positive and 66.0% of OPA1 mutation negative). CONCLUSIONS Genetic testing identified disease-causing mutations in 34% of referred cases, with the majority of these in OPA1. Patients with mutations in OPA1 were more likely to have a family history of disease; however, 30.4% of patients without a family history were also found to have an OPA1 mutation. This observation, as well as similar frequencies of central scotomas in the groups with and without mutations in OPA1, underscores the need for genetic testing to establish an OPA1 genetic diagnosis.
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Affiliation(s)
- Eric D. Gaier
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, MA
| | - Katherine Boudreault
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, MA
| | - Isao Nakata
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, MA
| | - Maria Janessian
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, MA
| | - Philip Skidd
- Departments of Ophthalmology and Neurology, University of Vermont College of Medicine, Burlington, MA
| | - Elizabeth DelBono
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, MA
| | - Keri F. Allen
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, MA
| | - Louis R. Pasquale
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, MA,Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Emily Place
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, MA
| | - Dean M. Cestari
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, MA
| | - Rebecca C. Stacy
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, MA
| | - Joseph F. Rizzo
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, MA
| | - Janey L. Wiggs
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, MA
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Toral MA, Velez G, Boudreault K, Schaefer KA, Xu Y, Saffra N, Bassuk AG, Tsang SH, Mahajan VB. Structural modeling of a novel SLC38A8 mutation that causes foveal hypoplasia. Mol Genet Genomic Med 2017; 5:202-209. [PMID: 28546991 PMCID: PMC5441399 DOI: 10.1002/mgg3.266] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 11/07/2016] [Accepted: 11/13/2016] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Foveal hypoplasia (FH) in the absence of albinism, aniridia, microphthalmia, or achromatopsia is exceedingly rare, and the molecular basis for the disorder remains unknown. FH is characterized by the absence of both the retinal foveal pit and avascular zone, but with preserved retinal architecture. SLC38A8 encodes a sodium-coupled neutral amino acid transporter with a preference for glutamate as a substrate. SLC38A8 has been linked to FH. Here, we describe a novel mutation to SLC38A8 which causes FH, and report the novel use of OCT-angiography to improve the precision of FH diagnosis. More so, we used computational modeling to explore possible functional effects of known SLC38A8 mutations. METHODS Fundus autofluorescence, SD-OCT, and OCT-angiography were used to make the clinical diagnosis. Whole-exome sequencing led to the identification of a novel disease-causing variant in SLC38A8. Computational modeling approaches were used to visualize known SLC38A8 mutations, as well as to predict mutation effects on transporter structure and function. RESULTS We identified a novel point mutation in SLC38A8 that causes FH. A conclusive diagnosis was made using OCT-angiography, which more clearly revealed retinal vasculature penetrating into the foveal region. Structural modeling of the channel showed the mutation was near previously published mutations, clustered on an extracellular loop. Our modeling also predicted that the mutation destabilizes the protein by altering the electrostatic potential within the channel pore. CONCLUSION Our results demonstrate a novel use for OCT-angiography in confirming FH, and also uncover genotype-phenotype correlations of FH-linked SLC38A8 mutations.
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Affiliation(s)
- Marcus A Toral
- Omics LaboratoryUniversity of IowaIowa CityIowa.,Department of Ophthalmology and Visual SciencesUniversity of IowaIowa CityIowa.,Medical Scientist Training ProgramUniversity of IowaIowa CityIowa
| | - Gabriel Velez
- Omics LaboratoryUniversity of IowaIowa CityIowa.,Department of Ophthalmology and Visual SciencesUniversity of IowaIowa CityIowa.,Medical Scientist Training ProgramUniversity of IowaIowa CityIowa
| | | | - Kellie A Schaefer
- Omics LaboratoryUniversity of IowaIowa CityIowa.,Department of Ophthalmology and Visual SciencesUniversity of IowaIowa CityIowa
| | - Yu Xu
- Department of OphthalmologyUniversity of MontrealMontrealQuebecCanada
| | - Norman Saffra
- Department of OphthalmologyMaimonides Medical CenterBrooklynNew York
| | | | - Stephen H Tsang
- The Barbara & Donald Jonas Laboratory of Regenerative Medicine and Bernard & Shirlee Brown Glaucoma LaboratoryDepartments of Ophthalmology, Pathology & Cell BiologyCollege of Physicians & SurgeonsColumbia UniversityNew York CityNew York.,Edward S. Harkness Eye InstituteNew York-Presbyterian HospitalNew York CityNew York
| | - Vinit B Mahajan
- Omics LaboratoryUniversity of IowaIowa CityIowa.,Department of Ophthalmology and Visual SciencesUniversity of IowaIowa CityIowa
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Simon R, Latreille J, Matte C, Desjardins P, Boudreault K, Bergeron E. Adherence to adjuvant endocrine therapy in estrogen receptor-positive breast cancer patients with regular follow-up. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e11039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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