1
|
Authié CN, Poujade M, Talebi A, Defer A, Zenouda A, Coen C, Mohand-Said S, Chaumet-Riffaud P, Audo I, Sahel JA. Development and Validation of a Novel Mobility Test for Rod-Cone Dystrophies: From Reality to Virtual Reality. Am J Ophthalmol 2024; 258:43-54. [PMID: 37437832 DOI: 10.1016/j.ajo.2023.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 07/14/2023]
Abstract
PURPOSE To validate a novel mobility test (MOST, MObility Standardized Test) and performance outcomes in real (RL) and virtual (VR) environments to be used for interventional clinical studies in order to characterize vision impairment in rod-cone dystrophies, also known as retinitis pigmentosa (RP). DESIGN Prospective, interventional, noninvasive, reliability and validity analysis. METHODS We designed MOST to be used in both VR and RL and conducted 3 experimental studies with 89 participants to (1) validate the difficulty of the mobility courses (15 controls), (2) determine the optimal number of light levels and training trials (14 participants with RP), and (3) validate the reproducibility (test-retest), reliability (VR/RL), sensitivity, and construct/content validity of the test (30 participants with RP and 30 controls). A comprehensive ophthalmologic examination was performed in all subjects. Outcomes of interest included MOST performance score, visual acuity, contrast sensitivity, dark adaptation thresholds, visual field parameters, and correlation between the performance score and visual function. RESULTS The mobility courses exhibited statistically similar difficulty, and 5 trials are sufficient to control for the learning effect. MOST is highly reproducible (test-retest correlations >0.98) and reliable (correlations VR/RL = 0.98). MOST achieved a discrimination between participants with RP and controls (accuracy >95%) and between early and late stages of the disease (82.3% accuracy). The performance score is correlated with visual function parameter (0.57-0.94). CONCLUSION MOST is a validated mobility test, with the controlled learning effect, excellent reproducibility, and high agreement between RL and VR conditions, as well as sensitivity and specificity to measure disease progression and therapeutic benefit in rod-cone dystrophies.
Collapse
Affiliation(s)
- Colas Nils Authié
- From the Streetlab (C.N.A., M.P., A.T., A.D., A.Z., C.C.), Paris, France.
| | - Mylène Poujade
- From the Streetlab (C.N.A., M.P., A.T., A.D., A.Z., C.C.), Paris, France
| | - Alireza Talebi
- From the Streetlab (C.N.A., M.P., A.T., A.D., A.Z., C.C.), Paris, France; Institut de la Vision, Sorbonne Universités, INSERM, CNRS (A.T., I.A., J.-A.S.), Paris, France
| | - Alexis Defer
- From the Streetlab (C.N.A., M.P., A.T., A.D., A.Z., C.C.), Paris, France
| | - Ariel Zenouda
- From the Streetlab (C.N.A., M.P., A.T., A.D., A.Z., C.C.), Paris, France
| | - Cécilia Coen
- From the Streetlab (C.N.A., M.P., A.T., A.D., A.Z., C.C.), Paris, France
| | - Saddek Mohand-Said
- Hôpital National de la Vision des Quinze-Vingts, DHU Sight Restore, Centre de Référence Maladies Rares REFERET, INSERM-DHOS CIC 1423 (S.M.-S., P.C.-R., I.A., J.-A.S.), Paris, France
| | - Philippe Chaumet-Riffaud
- Hôpital National de la Vision des Quinze-Vingts, DHU Sight Restore, Centre de Référence Maladies Rares REFERET, INSERM-DHOS CIC 1423 (S.M.-S., P.C.-R., I.A., J.-A.S.), Paris, France
| | - Isabelle Audo
- Institut de la Vision, Sorbonne Universités, INSERM, CNRS (A.T., I.A., J.-A.S.), Paris, France; Hôpital National de la Vision des Quinze-Vingts, DHU Sight Restore, Centre de Référence Maladies Rares REFERET, INSERM-DHOS CIC 1423 (S.M.-S., P.C.-R., I.A., J.-A.S.), Paris, France
| | - José-Alain Sahel
- Institut de la Vision, Sorbonne Universités, INSERM, CNRS (A.T., I.A., J.-A.S.), Paris, France; Hôpital National de la Vision des Quinze-Vingts, DHU Sight Restore, Centre de Référence Maladies Rares REFERET, INSERM-DHOS CIC 1423 (S.M.-S., P.C.-R., I.A., J.-A.S.), Paris, France; Department of Ophthalmology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA (J.-A.S.)
| |
Collapse
|
2
|
Nassisi M, De Bartolo G, Mohand-Said S, Condroyer C, Antonio A, Lancelot ME, Bujakowska K, Smirnov V, Pugliese T, Neidhardt J, Sahel JA, Zeitz C, Audo I. Retrospective Natural History Study of RPGR-Related Cone- and Cone-Rod Dystrophies While Expanding the Mutation Spectrum of the Disease. Int J Mol Sci 2022; 23:7189. [PMID: 35806195 PMCID: PMC9266815 DOI: 10.3390/ijms23137189] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 03/13/2022] [Revised: 06/24/2022] [Accepted: 06/24/2022] [Indexed: 01/06/2023] Open
Abstract
Variants in the X-linked retinitis pigmentosa GTPase regulator gene (RPGR) and, specifically, in its retinal opening reading frame-15 isoform (RPGRORF15) may cause rod-cone (RCD), cone, and cone-rod dystrophies (CDs and CRDs). While RPGR-related RCDs have been frequently evaluated, the characteristics and progression of RPGR-related CD/CRDs are largely unknown. Therefore, the goal of our work was to perform genotype-phenotype correlations specifically in RPGRORF15-related CD/CRDs. This retrospective longitudinal study included 34 index patients and two affected relatives with a molecular diagnosis of RPGR-related CD/CRDs. Patients were recruited at the "Quinze-Vingts" Hospital, Paris, France and screened for mutations in RPGRORF15 at the Institut de la Vision, Paris, France. We identified 29 distinct variants, of which 27 were truncating. All were located in the 3' half of the RPGRORF15 transcript. Twenty of them were novel. Fifteen subjects were affected by CD, the remaining had CRD. When analyzing the longitudinal data, a progressive decline in visual acuity (VA) was noted, with more than 60% of the patients reaching VA ≥ 1 LogMar in the best eye after the fifth decade of life. To our knowledge, this is the largest described study of a cohort of CD/CRD patients affected by RPGRORF15 variants. Longitudinal data showed a rapidly progressive disease, possibly locating an optimal window of intervention for future therapies in younger ages.
Collapse
Affiliation(s)
- Marco Nassisi
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 75012 Paris, France; (M.N.); (G.D.B.); (S.M.-S.); (C.C.); (A.A.); (M.-E.L.); (K.B.); (V.S.); (T.P.); (J.-A.S.)
- Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, National Rare Disease Center REFERET and INSERM-DGOS CIC 1423, 75012 Paris, France
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Ophthalmology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, 20122 Milan, Italy
| | - Giuseppe De Bartolo
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 75012 Paris, France; (M.N.); (G.D.B.); (S.M.-S.); (C.C.); (A.A.); (M.-E.L.); (K.B.); (V.S.); (T.P.); (J.-A.S.)
- Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, National Rare Disease Center REFERET and INSERM-DGOS CIC 1423, 75012 Paris, France
| | - Saddek Mohand-Said
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 75012 Paris, France; (M.N.); (G.D.B.); (S.M.-S.); (C.C.); (A.A.); (M.-E.L.); (K.B.); (V.S.); (T.P.); (J.-A.S.)
- Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, National Rare Disease Center REFERET and INSERM-DGOS CIC 1423, 75012 Paris, France
| | - Christel Condroyer
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 75012 Paris, France; (M.N.); (G.D.B.); (S.M.-S.); (C.C.); (A.A.); (M.-E.L.); (K.B.); (V.S.); (T.P.); (J.-A.S.)
| | - Aline Antonio
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 75012 Paris, France; (M.N.); (G.D.B.); (S.M.-S.); (C.C.); (A.A.); (M.-E.L.); (K.B.); (V.S.); (T.P.); (J.-A.S.)
- Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, National Rare Disease Center REFERET and INSERM-DGOS CIC 1423, 75012 Paris, France
| | - Marie-Elise Lancelot
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 75012 Paris, France; (M.N.); (G.D.B.); (S.M.-S.); (C.C.); (A.A.); (M.-E.L.); (K.B.); (V.S.); (T.P.); (J.-A.S.)
| | - Kinga Bujakowska
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 75012 Paris, France; (M.N.); (G.D.B.); (S.M.-S.); (C.C.); (A.A.); (M.-E.L.); (K.B.); (V.S.); (T.P.); (J.-A.S.)
- Ocular Genomics Institute, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
| | - Vasily Smirnov
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 75012 Paris, France; (M.N.); (G.D.B.); (S.M.-S.); (C.C.); (A.A.); (M.-E.L.); (K.B.); (V.S.); (T.P.); (J.-A.S.)
- Exploration de la Vision et Neuro-Ophthalmologie, Centre Hospitalier Universitaire de Lille, 59000 Lille, France
- Faculté de Médecine, Université de Lille, 59000 Lille, France
| | - Thomas Pugliese
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 75012 Paris, France; (M.N.); (G.D.B.); (S.M.-S.); (C.C.); (A.A.); (M.-E.L.); (K.B.); (V.S.); (T.P.); (J.-A.S.)
- Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, National Rare Disease Center REFERET and INSERM-DGOS CIC 1423, 75012 Paris, France
| | - John Neidhardt
- Human Genetics, Faculty VI, School of Medicine and Health Sciences, University of Oldenburg, 26129 Oldenburg, Germany;
- Research Center Neurosensory Science, University Oldenburg, 26129 Oldenburg, Germany
| | - José-Alain Sahel
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 75012 Paris, France; (M.N.); (G.D.B.); (S.M.-S.); (C.C.); (A.A.); (M.-E.L.); (K.B.); (V.S.); (T.P.); (J.-A.S.)
- Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, National Rare Disease Center REFERET and INSERM-DGOS CIC 1423, 75012 Paris, France
- Department of Ophthalmology, University of Pittsburgh Medical School, Pittsburgh, PA 15213, USA
| | - Christina Zeitz
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 75012 Paris, France; (M.N.); (G.D.B.); (S.M.-S.); (C.C.); (A.A.); (M.-E.L.); (K.B.); (V.S.); (T.P.); (J.-A.S.)
| | - Isabelle Audo
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 75012 Paris, France; (M.N.); (G.D.B.); (S.M.-S.); (C.C.); (A.A.); (M.-E.L.); (K.B.); (V.S.); (T.P.); (J.-A.S.)
- Centre Hospitalier National d’Ophtalmologie des Quinze-Vingts, National Rare Disease Center REFERET and INSERM-DGOS CIC 1423, 75012 Paris, France
| |
Collapse
|
3
|
Parker MA, Erker LR, Audo I, Choi D, Mohand-Said S, Sestakauskas K, Benoit P, Appelqvist T, Krahmer M, Ségaut-Prévost C, Lujan BJ, Faridi A, Chegarnov EN, Steinkamp PN, Ku C, da Palma MM, Barale PO, Ayelo-Scheer S, Lauer A, Stout T, Wilson DJ, Weleber RG, Pennesi ME, Sahel JA, Yang P. Three-Year Safety Results of SAR422459 (EIAV-ABCA4) Gene Therapy in Patients With ABCA4-Associated Stargardt Disease: An Open-Label Dose-Escalation Phase I/IIa Clinical Trial, Cohorts 1-5. Am J Ophthalmol 2022; 240:285-301. [PMID: 35248547 DOI: 10.1016/j.ajo.2022.02.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 12/10/2021] [Accepted: 02/09/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE To report on the safety of the first 5 cohorts of a gene therapy trial using recombinant equine infectious anemia virus expressing ABCA4 (EIAV-ABCA4) in adults with Stargardt dystrophy due to mutations in ABCA4. DESIGN Nonrandomized multicenter phase I/IIa clinical trial. METHODS Patients received a subretinal injection of EIAVABCA4 in the worse-seeing eye at 3 dose levels and were followed for 3 years after treatment. MAIN OUTCOME MEASURES The primary end point was ocular and systemic adverse events. The secondary end points were best-corrected visual acuity, static perimetry, kinetic perimetry, total field hill of vision, full field electroretinogram, multifocal ERG, color fundus photography, short-wavelength fundus autofluorescence, and spectral domain optical coherence tomography. RESULTS The subretinal injections were well tolerated by all 22 patients across 3 dose levels. There was 1 case of a treatment-related ophthalmic serious adverse event in the form of chronic ocular hypertension. The most common adverse events were associated with the surgical procedure. In 1 patient treated with the highest dose, there was a significant decline in the number of macular flecks as compared with the untreated eye. However, in 6 patients, hypoautofluorescent changes were worse in the treated eye than in the untreated eye. Of these, 1 patient had retinal pigment epithelium atrophy that was characteristic of tissue damage likely associated with bleb induction. No patients had any clinically significant changes in best-corrected visual acuity, static perimetry, kinetic perimetry, total field hill of vision, full field electroretinogram, or multifocal ERG attributable to the treatment. CONCLUSIONS Subretinal treatment with EIAV-ABCA4 was well tolerated with only 1 case of ocular hypertension. No clinically significant changes in visual function tests were found to be attributable to the treatment. However, 27% of treated eyes showed exacerbation of retinal pigment epithelium atrophy on fundus autofluorescence. There was a significant reduction in macular flecks in 1 treated eye from the highest dose cohort. Additional follow-up and continued investigation in more patients will be required to fully characterize the safety and efficacy of EIAV-ABCA4.
Collapse
|
4
|
Abstract
Loss of photoreceptors in atrophic age-related macular degeneration (AMD) results in severe visual impairment. Since the low-resolution peripheral vision is retained in such conditions, restoration of central vision should not jeopardize the surrounding healthy retina and allow for simultaneous use of the natural and prosthetic sight. This interim report, prespecified in the study protocol, presents the first clinical results with a photovoltaic substitute of the photoreceptors providing simultaneous use of the central prosthetic and peripheral natural vision in atrophic AMD. In this open-label single group feasibility trial (NCT03333954, recruitment completed), five patients with geographic atrophy have been implanted with a wireless 2 x 2 mm-wide 30 µm-thick device, having 378 pixels of 100 µm in size. All 5 patients achieved the primary outcome of the study by demonstrating the prosthetic visual perception in the former scotoma. The four patients with a subretinal placement of the chip demonstrated the secondary outcome: Landolt acuity of 1.17 ± 0.13 pixels, corresponding to the Snellen range of 20/460-20/565. With electronic magnification of up to a factor of 8, patients demonstrated prosthetic acuity in the range of 20/63-20/98. Under room lighting conditions, patients could simultaneously use prosthetic central vision and their remaining peripheral vision in the implanted eye and in the fellow eye.
Collapse
Affiliation(s)
- D Palanker
- Department of Ophthalmology and Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA.
| | - Y Le Mer
- Department of Ophthalmology, Fondation Ophtalmologique A. de Rothschild, Paris, France
| | - S Mohand-Said
- Clinical Investigation Center INSERM-DGOS 1423, Quinze-Vingts National Eye Hospital, Paris, France
| | - J A Sahel
- Department of Ophthalmology, Fondation Ophtalmologique A. de Rothschild, Paris, France
- Clinical Investigation Center INSERM-DGOS 1423, Quinze-Vingts National Eye Hospital, Paris, France
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| |
Collapse
|
5
|
Smirnov VM, Nassisi M, Solis Hernandez C, Méjécase C, El Shamieh S, Condroyer C, Antonio A, Meunier I, Andrieu C, Defoort-Dhellemmes S, Mohand-Said S, Sahel JA, Audo I, Zeitz C. Retinal Phenotype of Patients With Isolated Retinal Degeneration Due to CLN3 Pathogenic Variants in a French Retinitis Pigmentosa Cohort. JAMA Ophthalmol 2021; 139:278-291. [PMID: 33507216 DOI: 10.1001/jamaophthalmol.2020.6089] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Importance Biallelic variants in CLN3 lead to a spectrum of diseases, ranging from severe neurodegeneration with retinal involvement (juvenile neuronal ceroid lipofuscinosis) to retina-restricted conditions. Objective To provide a detailed description of the retinal phenotype of patients with isolated retinal degeneration harboring biallelic CLN3 pathogenic variants and to attempt a phenotype-genotype correlation associated with this gene defect. Design, Setting, and Participants This retrospective cohort study included patients carrying biallelic CLN3 variants extracted from a cohort of patients with inherited retinal disorders (IRDs) investigated at the National Reference Center for Rare Ocular Diseases of the Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts from December 2007 to August 2020. Data were analyzed from October 2019 to August 2020. Main Outcome and Measures Functional (best-corrected visual acuity, visual field, color vision, and full-field electroretinogram), morphological (multimodal retinal imaging), and clinical data from patients were collected and analyzed. Gene defect was identified by either next-generation sequencing or whole-exome sequencing and confirmed by Sanger sequencing, quantitative polymerase chain reaction, and cosegregation analysis. Results Of 1533 included patients, 843 (55.0%) were women and 690 (45.0%) were men. A total of 15 cases from 11 unrelated families harboring biallelic CLN3 variants were identified. All patients presented with nonsyndromic IRD. Two distinct patterns of retinal disease could be identified: a mild rod-cone degeneration of middle-age onset (n = 6; legal blindness threshold reached by 70s) and a severe retinal degeneration with early macular atrophic changes (n = 9; legal blindness threshold reached by 40s). Eleven distinct pathogenic variants were detected, of which 4 were novel. All but 1, p.(Arg405Trp), CLN3 point variants and their genotypic associations were clearly distinct between juvenile neuronal ceroid lipofuscinosis and retina-restricted disease. Mild and severe forms of retina-restricted CLN3-linked IRDs also had different genetic background. Conclusions and Relevance These findings suggest CLN3 should be included in next-generation sequencing panels when investigating patients with nonsyndromic rod-cone dystrophy. These results document phenotype-genotype correlations associated with specific variants in CLN3. However, caution seems warranted regarding the potential neurological outcome if a pathogenic variant in CLN3 is detected in a case of presumed isolated IRD for the onset of neurological symptoms could be delayed.
Collapse
Affiliation(s)
- Vasily M Smirnov
- Sorbonne Université, INSERM, Centre national de la recherche scientifique, Institut de la Vision, Paris, France.,Université de Lille, Faculté de Médecine, Lille, France.,Exploration de la Vision et Neuro-Ophtalmologie, CHU de Lille, Lille, France
| | - Marco Nassisi
- Sorbonne Université, INSERM, Centre national de la recherche scientifique, Institut de la Vision, Paris, France
| | - Cyntia Solis Hernandez
- Sorbonne Université, INSERM, Centre national de la recherche scientifique, Institut de la Vision, Paris, France
| | - Cécile Méjécase
- Sorbonne Université, INSERM, Centre national de la recherche scientifique, Institut de la Vision, Paris, France.,Institute of Ophthalmology, University College London, London, United Kingdom
| | - Said El Shamieh
- Sorbonne Université, INSERM, Centre national de la recherche scientifique, Institut de la Vision, Paris, France.,Department of Medical Laboratory Technology, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Christel Condroyer
- Sorbonne Université, INSERM, Centre national de la recherche scientifique, Institut de la Vision, Paris, France
| | - Aline Antonio
- Sorbonne Université, INSERM, Centre national de la recherche scientifique, Institut de la Vision, Paris, France
| | - Isabelle Meunier
- Institute for Neurosciences Montpellier, INSERM U1051, University of Monpellier, Montpellier, France.,National Center for Rare Genetic Retinal Dystrophies, Hôpital Guy de Chauliac, Montpellier, France
| | - Camille Andrieu
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, INSERM-DHOS CIC 1423, Paris, France
| | | | - Saddek Mohand-Said
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, INSERM-DHOS CIC 1423, Paris, France
| | - José-Alain Sahel
- Sorbonne Université, INSERM, Centre national de la recherche scientifique, Institut de la Vision, Paris, France.,Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, INSERM-DHOS CIC 1423, Paris, France.,Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.,Académie des Sciences, Institut de France, Paris, France.,Department of Ophthalmology, The University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Isabelle Audo
- Sorbonne Université, INSERM, Centre national de la recherche scientifique, Institut de la Vision, Paris, France.,Institute of Ophthalmology, University College London, London, United Kingdom.,Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, INSERM-DHOS CIC 1423, Paris, France
| | - Christina Zeitz
- Sorbonne Université, INSERM, Centre national de la recherche scientifique, Institut de la Vision, Paris, France
| |
Collapse
|
6
|
Nassisi M, Wohlschlegel J, Liu B, Letellier C, Michiels C, Aubois A, Mohand-Said S, Habas C, Sahel JA, Zeitz C, Audo I. DEEP PHENOTYPING AND FURTHER INSIGHTS INTO ITM2B-RELATED RETINAL DYSTROPHY. Retina 2021; 41:872-881. [PMID: 32826790 DOI: 10.1097/iae.0000000000002953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE To reappraise the presentation and the course of ITM2B-related retinal dystrophy and give further insights into ITM2B expression in the retina. METHODS The clinical data of nine subjects with ITM2B-related retinal dystrophy were retrospectively reviewed. The genetic mutation was assessed for its influence on splicing in cultured fibroblasts. The cellular expression of ITM2B within the inner retina was investigated in wild-type mice through mRNA in situ hybridization. RESULTS All patients complained of decreased vision and mild photophobia around their twenties-thirties. The peculiar feature was the hyperreflective material on optical coherence tomography within the inner retina and the central outer nuclear layer with thinning of the retinal nerve fiber layer. Although retinal imaging revealed very mild or no changes over the years, the visual acuity slowly decreased with about one Early Treatment Diabetic Retinopathy Study letter per year. Finally, full-field electroretinography showed a mildly progressive inner retinal and cone dysfunction. ITM2B mRNA is expressed in all cellular types of the inner retina. Disease mechanism most likely involves mutant protein misfolding and/or modified protein interaction rather than misplicing. CONCLUSION ITM2B-related retinal dystrophy is a peculiar, rare, slowly progressive retinal degeneration. Functional examinations (full-field electroretinography and visual acuity) seem more accurate in monitoring the progression in these patients because imaging tends to be stable over the years.
Collapse
Affiliation(s)
- Marco Nassisi
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
- CHNO des Quinze-Vingts, DHU Sight Restore, INSERM-DGOS CIC1423, Paris, France
| | | | - Bingqian Liu
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Camille Letellier
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | | | - Anne Aubois
- CHNO des Quinze-Vingts, DHU Sight Restore, INSERM-DGOS CIC1423, Paris, France
| | - Saddek Mohand-Said
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
- CHNO des Quinze-Vingts, DHU Sight Restore, INSERM-DGOS CIC1423, Paris, France
| | | | - José-Alain Sahel
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
- CHNO des Quinze-Vingts, DHU Sight Restore, INSERM-DGOS CIC1423, Paris, France
- Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
- Department of Ophthalmology, University of Pittsburgh Medical School, Pittsburgh, Pennsylvania
- Académie des Sciences-Institut de France, Paris, France ; and
| | - Christina Zeitz
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Isabelle Audo
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
- CHNO des Quinze-Vingts, DHU Sight Restore, INSERM-DGOS CIC1423, Paris, France
- Institute of Ophthalmology, University College of London, London, United Kingdom
| |
Collapse
|
7
|
Nassisi M, Lavia C, Mohand-Said S, Smirnov V, Antonio A, Condroyer C, Sancho S, Varin J, Gaudric A, Zeitz C, Sahel JA, Audo I. Near-infrared fundus autofluorescence alterations correlate with swept-source optical coherence tomography angiography findings in patients with retinitis pigmentosa. Sci Rep 2021; 11:3180. [PMID: 33542393 PMCID: PMC7862375 DOI: 10.1038/s41598-021-82757-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 08/20/2020] [Accepted: 12/21/2020] [Indexed: 11/09/2022] Open
Abstract
Thirty-eight patients from 37 families with retinitis pigmentosa (RP) underwent macular 6 × 6-mm swept-source optical coherence tomography angiography (SS-OCTA) and 30° near-infrared fundus autofluorescence (NIR-FAF) acquisitions in one eye. Superficial vascular complex (SVC), deep capillary complex (DCC) and choriocapillaris (CC) angiograms were registered with NIR-FAF acquisitions to comparatively assess subjects with and without central area of preserved NIR-FAF (APA). On the subset of patients showing an APA, the vessel densities for SVC and DCC and flow deficits for CC were assessed in three directions (superior, inferior and temporal) from the fovea and compared to healthy 1:1 age-matched controls. Nine patients with no APA had evidence of severe central OCTA alterations at all levels, especially in the DCC. In the other 29 subjects presenting APA, all OCTA parameters were similar to healthy eyes within the APA, where the retina preserves its structural integrity. Outside the APA, both the DCC and CC were significantly reduced in all directions. These alterations are probably related to the outer retinal atrophy outside the APA. Comparing OCTA to other imaging modalities is helpful to determine the potential interest of OCTA findings as an outcome measure for disease status and progression.
Collapse
Affiliation(s)
- Marco Nassisi
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, 75012, Paris, France. .,CHNO des Quinze-Vingts, INSERM-DGOS CIC1423, 28 rue de Charenton, 75012, Paris, France. .,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. .,Ophthalmological Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
| | - Carlo Lavia
- Université de Paris, Ophthalmology Department, AP-HP, Hôpital Lariboisière, 75010, Paris, France.,Surgical Department, Ophthalmology Service, Azienda Sanitaria Locale TO 5, 10023, Chieri, Italy
| | - Saddek Mohand-Said
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, 75012, Paris, France.,CHNO des Quinze-Vingts, INSERM-DGOS CIC1423, 28 rue de Charenton, 75012, Paris, France
| | - Vasily Smirnov
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, 75012, Paris, France
| | - Aline Antonio
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, 75012, Paris, France
| | - Christel Condroyer
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, 75012, Paris, France
| | - Serge Sancho
- CHNO des Quinze-Vingts, INSERM-DGOS CIC1423, 28 rue de Charenton, 75012, Paris, France
| | - Juliette Varin
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, 75012, Paris, France
| | - Alain Gaudric
- Université de Paris, Ophthalmology Department, AP-HP, Hôpital Lariboisière, 75010, Paris, France
| | - Christina Zeitz
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, 75012, Paris, France
| | - José-Alain Sahel
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, 75012, Paris, France.,CHNO des Quinze-Vingts, INSERM-DGOS CIC1423, 28 rue de Charenton, 75012, Paris, France.,Fondation Ophtalmologique Adolphe de Rothschild, 75019, Paris, France.,Department of Ophthalmology, University of Pittsburgh Medical School, Pittsburgh, PA, 15213, USA.,Académie des Sciences-Institut de France, 75006, Paris, France
| | - Isabelle Audo
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, 75012, Paris, France. .,CHNO des Quinze-Vingts, INSERM-DGOS CIC1423, 28 rue de Charenton, 75012, Paris, France. .,Institute of Ophthalmology, University College of London, London, EC1V 9EL, UK.
| |
Collapse
|
8
|
Chatard H, Tepenier L, Beydoun T, Offret O, Salah S, Sahel JA, Mohand-Said S, Bucci MP. Effect of Visual Search Training on Saccades in Age-related Macular Degeneration Subjects. Curr Aging Sci 2020; 13:62-71. [PMID: 31518228 DOI: 10.2174/1874609812666190913125705] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/06/2019] [Accepted: 08/08/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To compare the impact of unilateral versus bilateral Age-related Macular Degeneration (AMD) on saccadic movements, and to show the effect of visual search training on these eye movement performances in AMD subjects. We hypothesized that unilateral and bilateral AMD subjects had abnormal saccadic performances, and that visual search training could improve their performances. METHODS Three groups participated in visual search training: 13 elderly unilateral AMD subjects (mean age: 74.6 ± 1.6 years), 15 elderly bilateral AMD subjects (mean age: 74.2 ± 1.2 years), and 15 healthy age-matched control subjects (mean age: 70.9 ± 1.3 years). Horizontal saccadic performances were recorded before and after visual search training (Metrisquare®) with the Mobile Eye Tracker (Mobile EBT®). We analyzed the saccadic movement performances: latency, mean velocity and gain. We measured the training performances for each exercise: the time, the number of omissions and the number of errors. We analyzed the performances with Kruskal-Wallis and posthoc tests. RESULTS The latency of saccades in AMD subjects is significantly longer compared to healthy elderly for 15° (p<0.03), 10° (p<0.003) and 5° (p<10-3). Unilateral and bilateral AMD subjects normalized their latency of saccades after training for small saccades (respectively p=0.30 and p=0.23 for 10°, and p=0.09 and p=0.52 for 5°). In elderly, performances depend on the saccade's amplitude. CONCLUSION AMD subjects' saccadic movements are disrupted: the execution needs more time but is efficient. The visual search training improved the saccadic performances in AMD subjects. Further studies will aim to improve knowledge on such issues and to explore the benefit of training over time in unilateral AMD subjects.
Collapse
Affiliation(s)
- Hortense Chatard
- UMR 1141, INSERM- Université Paris 7, Robert Debré University Hospital, Paris, France
- Vestibular and Oculomotor Evaluation Unit, ENT Department, Robert Debré University Hospital, Paris, France
| | - Laure Tepenier
- Groupe Hospitalier Cochin- Hôtel-Dieu, Department of Ophthalmology, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France
| | - Talal Beydoun
- Groupe Hospitalier Cochin- Hôtel-Dieu, Department of Ophthalmology, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France
| | - Olivier Offret
- Groupe Hospitalier Cochin- Hôtel-Dieu, Department of Ophthalmology, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France
| | - Sawsen Salah
- Groupe Hospitalier Cochin- Hôtel-Dieu, Department of Ophthalmology, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France
| | - José-Alain Sahel
- Institut de la Vision, Centre Hospitalier National d'Ophtalmologie (CHNO) des Quinze-Vingts, Sorbonne Universites, University Pierre et Marie Curie (UPMC), Paris, France
| | - Saddek Mohand-Said
- Institut de la Vision, Centre Hospitalier National d'Ophtalmologie (CHNO) des Quinze-Vingts, Sorbonne Universites, University Pierre et Marie Curie (UPMC), Paris, France
| | - Maria Pia Bucci
- UMR 1141, INSERM- Université Paris 7, Robert Debré University Hospital, Paris, France
- Vestibular and Oculomotor Evaluation Unit, ENT Department, Robert Debré University Hospital, Paris, France
| |
Collapse
|
9
|
Chatard H, Tepenier L, Beydoun T, Offret O, Salah S, Sahel JA, Mohand-Said S, Bucci MP. Analyse temporelle des oscillations du centre de pression chez les sujets atteints de DMLA. Neurophysiol Clin 2018. [DOI: 10.1016/j.neucli.2018.10.070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
10
|
Fujinami K, Strauss RW, Chiang JPW, Audo IS, Bernstein PS, Birch DG, Bomotti SM, Cideciyan AV, Ervin AM, Marino MJ, Sahel JA, Mohand-Said S, Sunness JS, Traboulsi EI, West S, Wojciechowski R, Zrenner E, Michaelides M, Scholl HPN. Detailed genetic characteristics of an international large cohort of patients with Stargardt disease: ProgStar study report 8. Br J Ophthalmol 2018; 103:390-397. [PMID: 29925512 PMCID: PMC6579578 DOI: 10.1136/bjophthalmol-2018-312064] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [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: 02/09/2018] [Accepted: 04/12/2018] [Indexed: 12/03/2022]
Abstract
Background/aims To describe the genetic characteristics of the cohort enrolled in the international multicentre progression of Stargardt disease 1 (STGD1) studies (ProgStar) and to determine geographic differences based on the allele frequency. Methods 345 participants with a clinical diagnosis of STGD1 and harbouring at least one disease-causing ABCA4 variant were enrolled from 9 centres in the USA and Europe. All variants were reviewed and in silico analysis was performed including allele frequency in public databases and pathogenicity predictions. Participants with multiple likely pathogenic variants were classified into four national subgroups (USA, UK, France, Germany), with subsequent comparison analysis of the allele frequency for each prevalent allele. Results 211 likely pathogenic variants were identified in the total cohort, including missense (63%), splice site alteration (18%), stop (9%) and others. 50 variants were novel. Exclusively missense variants were detected in 139 (50%) of 279 patients with multiple pathogenic variants. The three most prevalent variants of these patients with multiple pathogenic variants were p.G1961E (15%), p.G863A (7%) and c.5461-10 T>C (5%). Subgroup analysis revealed a statistically significant difference between the four recruiting nations in the allele frequency of nine variants. Conclusions There is a large spectrum of ABCA4 sequence variants, including 50 novel variants, in a well-characterised cohort thereby further adding to the unique allelic heterogeneity in STGD1. Approximately half of the cohort harbours missense variants only, indicating a relatively mild phenotype of the ProgStar cohort. There are significant differences in allele frequencies between nations, although the three most prevalent variants are shared as frequent variants.
Collapse
Affiliation(s)
- Kaoru Fujinami
- Laboratory of Visual Physiology, Division for Vision Research, National Institute of Sensory Organs, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan.,Department of Ophthalmology, Keio University, School of Medicine, Tokyo, Japan.,UCL Institute of Ophthalmology, London, UK.,Moorfields Eye Hospital, London, UK
| | - Rupert W Strauss
- UCL Institute of Ophthalmology, London, UK.,Moorfields Eye Hospital, London, UK.,Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA.,Department of Ophthalmology, Johannes Kepler University Linz, Linz, Austria.,Department of Ophthalmology, Medical University of Graz, Graz, Austria
| | | | - Isabelle S Audo
- Institute de la Vision, Sorbonne Université, Paris, France.,CHNO des Quinze-Vingts, DHU Sight Restore, Charenton, France
| | | | - David G Birch
- Retina Foundation of the Southwest, Dallas, Texas, USA
| | | | - Artur V Cideciyan
- Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | - José-Alain Sahel
- CHNO des Quinze-Vingts, DHU Sight Restore, Charenton, France.,Department of Ophthalmology, Fondation Ophtalmologique Rothschild, Paris, France.,Department of Ophthalmology, The University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - Saddek Mohand-Said
- Institute de la Vision, Sorbonne Université, Paris, France.,CHNO des Quinze-Vingts, DHU Sight Restore, Charenton, France
| | - Janet S Sunness
- Richard E Hoover Low Vision Rehabilitation Services, Greater Baltimore Medical Center, Baltimore, Maryland, USA
| | | | - Sheila West
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA
| | | | - Eberhart Zrenner
- Center for Ophthalmology, Eberhard-Karls University Hospital, Tuebingen, Germany.,Werner Reichardt Centre for Integrative Neuroscience, University of Tuebingen, Tuebingen, Germany
| | - Michel Michaelides
- UCL Institute of Ophthalmology, London, UK .,Moorfields Eye Hospital, London, UK
| | - Hendrik P N Scholl
- Department of Ophthalmology, University of Basel, Basel, Switzerland .,Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
| | | | | |
Collapse
|
11
|
Audo I, Mohand-Said S, Boulanger-Scemama E, Zanlonghi X, Condroyer C, Démontant V, Boyard F, Antonio A, Méjécase C, El Shamieh S, Sahel JA, Zeitz C. MERTK
mutation update in inherited retinal diseases. Hum Mutat 2018; 39:887-913. [DOI: 10.1002/humu.23431] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 03/22/2018] [Accepted: 03/29/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Isabelle Audo
- Sorbonne Université; INSERM; CNRS; Institut de la Vision; Paris France
- CHNO des Quinze-Vingts; DHU Sight Restore; INSERM-DGOS CIC1423 Paris France
- University College London Institute of Ophthalmology; London UK
| | - Saddek Mohand-Said
- Sorbonne Université; INSERM; CNRS; Institut de la Vision; Paris France
- CHNO des Quinze-Vingts; DHU Sight Restore; INSERM-DGOS CIC1423 Paris France
| | - Elise Boulanger-Scemama
- Sorbonne Université; INSERM; CNRS; Institut de la Vision; Paris France
- Fondation Ophtalmologique Adolphe de Rothschild; Paris France
| | | | | | - Vanessa Démontant
- Sorbonne Université; INSERM; CNRS; Institut de la Vision; Paris France
| | - Fiona Boyard
- Sorbonne Université; INSERM; CNRS; Institut de la Vision; Paris France
| | - Aline Antonio
- Sorbonne Université; INSERM; CNRS; Institut de la Vision; Paris France
| | - Cécile Méjécase
- Sorbonne Université; INSERM; CNRS; Institut de la Vision; Paris France
| | - Said El Shamieh
- Sorbonne Université; INSERM; CNRS; Institut de la Vision; Paris France
- Department of Medical Laboratory Technology; Faculty of Health Sciences; Beirut Arab University; Beirut Lebanon
| | - José-Alain Sahel
- Sorbonne Université; INSERM; CNRS; Institut de la Vision; Paris France
- CHNO des Quinze-Vingts; DHU Sight Restore; INSERM-DGOS CIC1423 Paris France
- University College London Institute of Ophthalmology; London UK
- Fondation Ophtalmologique Adolphe de Rothschild; Paris France
- Académie des Sciences-Institut de France; Paris France. Department of Ophthalmology; University of Pittsburgh Medical School; Pittsburgh Pennsylvania
| | - Christina Zeitz
- Sorbonne Université; INSERM; CNRS; Institut de la Vision; Paris France
| |
Collapse
|
12
|
Orès R, Mohand-Said S, Dhaenens CM, Antonio A, Zeitz C, Augstburger E, Andrieu C, Sahel JA, Audo I. Phenotypic Characteristics of a French Cohort of Patients with X-Linked Retinoschisis. Ophthalmology 2018; 125:1587-1596. [PMID: 29739629 DOI: 10.1016/j.ophtha.2018.03.057] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/25/2018] [Accepted: 03/28/2018] [Indexed: 10/17/2022] Open
Abstract
PURPOSE To analyze the retinal structure in patients with X-linked retinoschisis (XLRS) using spectral-domain OCT and to correlate the morphologic findings with visual acuity, electroretinographic results, and patient age. DESIGN Retrospective, observational study. PARTICIPANTS Data from 52 consecutive male patients with molecularly confirmed XLRS were collected retrospectively. METHODS Complete clinical evaluation included best-corrected visual acuity, full-field electroretinography, fundus photography, spectral-domain OCT, and fundus autofluorescence. Spectral-domain OCT images were analyzed to determine full thickness of the retina and tomographic structural changes. MAIN OUTCOME MEASURES Relationships between age, OCT, and visual acuity were assessed. RESULTS One hundred four eyes of 52 patients were included. The mean age at inclusion was 24±15 years (range, 3-57 years). The best-corrected visual acuity ranged from no light perception to 0.1 logarithm of the minimum angle of resolution (mean, 0.6±0.38 logarithm of the minimum angle of resolution). Macular schisis was found in 88% of eyes and macular atrophy was found in 11% of eyes, whereas peripheral schisis was present in 30% of eyes. A spoke-wheel pattern of high and low intensity was the most frequently observed fundus autofluorescence abnormality (51/94 eyes [54%]). The b-to-a amplitude ratio on bright-flash dark-adapted electroretinography was reduced significantly in 45 of 64 eyes (70%). Spectral-domain OCT was available for 97 eyes and showed foveoschisis in 76 of 97 eyes (78%), parafoveal schisis in 10 of 97 eyes (10%), and foveal atrophy in 11 of 97 eyes (11%). Mean central macular thickness (CMT) was of 373.6±140 μm. Cystoid changes were localized mainly in the inner nuclear layer (85/97 eyes [88%]). Qualitative defects in photoreceptor structures were found in most eyes (79/97 eyes [81%]), and the most frequent abnormality was an interruption of the photoreceptor cell outer segment tips (79/79 eyes [100%]). Older age correlated well with lower CMT (correlation coefficient [CC], -0.44; P < 0.001) and with lower photoreceptor outer segment (PROS) length (CC, -0.42; P < 0.001). Lower visual acuity correlated strongly with lower PROS length (CC, -0.53; P < 0.001). CONCLUSIONS This study underlined the wide variety of clinical features of XLRS. It highlighted the correlation between visual acuity, patient age, and OCT features, emphasizing the relevance of the latter as potential outcome measure in clinical trials.
Collapse
Affiliation(s)
- Raphaëlle Orès
- Centre de Maladies Rares "Dystrophies Rétiniennes d'Origine Génétique," DHU Sight Restore INSERM-DHOS CIC 1423, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France
| | - Saddek Mohand-Said
- Centre de Maladies Rares "Dystrophies Rétiniennes d'Origine Génétique," DHU Sight Restore INSERM-DHOS CIC 1423, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France; INSERM, CNRS, Institut de la Vision, Sorbonne Université, Paris, France
| | - Claire-Marie Dhaenens
- Department of Biochemistry and Molecular Biology-UF Génopathies, Université Lille, Inserm UMR-S 1172, CHU Lille, Lille, France
| | - Aline Antonio
- INSERM, CNRS, Institut de la Vision, Sorbonne Université, Paris, France
| | - Christina Zeitz
- INSERM, CNRS, Institut de la Vision, Sorbonne Université, Paris, France
| | - Edouard Augstburger
- Centre de Maladies Rares "Dystrophies Rétiniennes d'Origine Génétique," DHU Sight Restore INSERM-DHOS CIC 1423, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France
| | - Camille Andrieu
- Centre de Maladies Rares "Dystrophies Rétiniennes d'Origine Génétique," DHU Sight Restore INSERM-DHOS CIC 1423, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France
| | - José-Alain Sahel
- Centre de Maladies Rares "Dystrophies Rétiniennes d'Origine Génétique," DHU Sight Restore INSERM-DHOS CIC 1423, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France; INSERM, CNRS, Institut de la Vision, Sorbonne Université, Paris, France; Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Isabelle Audo
- Centre de Maladies Rares "Dystrophies Rétiniennes d'Origine Génétique," DHU Sight Restore INSERM-DHOS CIC 1423, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France; INSERM, CNRS, Institut de la Vision, Sorbonne Université, Paris, France.
| |
Collapse
|
13
|
Matet A, Kohl S, Baumann B, Antonio A, Mohand-Said S, Sahel JA, Audo I. Multimodal imaging including semiquantitative short-wavelength and near-infrared autofluorescence in achromatopsia. Sci Rep 2018; 8:5665. [PMID: 29618791 PMCID: PMC5884771 DOI: 10.1038/s41598-018-23919-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 03/20/2018] [Indexed: 11/11/2022] Open
Abstract
Multimodal imaging provides insights into phenotype and disease progression in inherited retinal disorders. Congenital achromatopsia (ACHM), a cone dysfunction syndrome, has been long considered a stable condition, but recent evidence suggests structural progression. With gene replacement strategies under development for ACHM, there is a critical need for imaging biomarkers to define progression patterns and follow therapy. Using semiquantitative plots, near-infrared (NIR-AF) and short-wavelength autofluorescence (SW-AF) were explored and correlated with clinical characteristics and retinal structure on optical coherence tomography (OCT). In sixteen ACHM patients with genetic confirmation (CNGA3, n = 8; CNGB3, n = 7; PDE6C, n = 1), semiquantitative plots allowed the detailed analysis of autofluorescence patterns, even in poorly fixating eyes. Twelve eyes showed perifoveal hyperautofluorescent rings on SW-AF, and 7 eyes had central hypoautofluorescent areas on NIR-AF, without association between these alterations (P = 0.57). Patients with central NIR-AF hypoautofluorescence were older (P = 0.004) and showed more advanced retinal alterations on OCT than those with normal NIR-AF (P = 0.051). NIR-AF hypoautofluorescence diameter was correlated to patient age (r = 0.63, P = 0.009), size of ellipsoid zone defect on OCT (r = 0.67, P = 0.005), but not to the size of SW-AF hyperautofluorescence (P = 0.27). These results demonstrate the interest of NIR-AF as imaging biomarker in ACHM, suggesting a relationship with age and disease progression.
Collapse
Affiliation(s)
- Alexandre Matet
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France
- INSERM-DHOS, CIC1423, DHU ViewMaintain, CHNO des Quinze-Vingts, Paris, 75012, France
| | - Susanne Kohl
- Institute for Ophthalmic Research, Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany
| | - Britta Baumann
- Institute for Ophthalmic Research, Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany
| | - Aline Antonio
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France
| | - Saddek Mohand-Said
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France
- INSERM-DHOS, CIC1423, DHU ViewMaintain, CHNO des Quinze-Vingts, Paris, 75012, France
| | - José-Alain Sahel
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France
- INSERM-DHOS, CIC1423, DHU ViewMaintain, CHNO des Quinze-Vingts, Paris, 75012, France
- Fondation Ophtalmologique Adolphe de Rothschild, Paris, F-75019, France
- Académie des Sciences, Institut de France, Paris, F-75006, France
- Department of Ophthalmology, The University of Pittsburgh School of Medicine, Pittsburg, PA, United States
- University College London, Institute of Ophthalmology, London, EC1V 9EL, UK
| | - Isabelle Audo
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France.
- INSERM-DHOS, CIC1423, DHU ViewMaintain, CHNO des Quinze-Vingts, Paris, 75012, France.
- University College London, Institute of Ophthalmology, London, EC1V 9EL, UK.
| |
Collapse
|
14
|
Strauss RW, Muñoz B, Ho A, Jha A, Michaelides M, Mohand-Said S, Cideciyan AV, Birch D, Hariri AH, Nittala MG, Sadda S, Scholl HPN. Incidence of Atrophic Lesions in Stargardt Disease in the Progression of Atrophy Secondary to Stargardt Disease (ProgStar) Study: Report No. 5. JAMA Ophthalmol 2017; 135:687-695. [PMID: 28542697 DOI: 10.1001/jamaophthalmol.2017.1121] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Importance Outcome measures that are sensitive to disease progression are needed as clinical end points for future treatment trials in Stargardt disease. Objective To examine the incidence of atrophic lesions of the retinal pigment epithelium in patients with Stargardt disease as determined by fundus autofluorescence imaging. Design, Setting, and Participants In this retrospective multicenter cohort study, 217 patients 6 years and older at baseline at tertiary referral centers in Europe, the United States, and the United Kingdom who were harboring disease-causing variants in the adenosine triphosphate (ATP)-binding cassette subfamily A member 4 (ABCA4) gene and who met the following criteria were enrolled: (1) at least 1 well-demarcated area of atrophy with a minimum diameter of 300 µm, with the total area of all atrophic lesions being less than or equal to 12 mm2 in at least 1 eye at the most recent visit, and (2) fundus autofluorescence images for at least 2 visits with a minimum of 6 months between at least 2 visits. Data were collected between August 22, 2013, and December 12, 2014. Data analysis was performed from March 15, 2015, through January 31, 2017. Exposures Images were evaluated by staff at a central reading center. Areas of definitely decreased autofluorescence (DDAF) and questionably decreased autofluorescence (QDAF) were outlined and quantified. Lesion-free survival rates were estimated using Kaplan-Meier survival curves. Main Outcomes and Measures Incidence of atrophic lesions as determined by fundus autofluorescence. Results The 217 patients (mean [SD] age, 21.8 [13.3] years; 127 female [57.5%]; 148 white [68.2%]) contributed 390 eyes for which the mean (SD) follow-up time was 3.9 (1.6) years (range, 0.7-12.1 years). Among eyes without DDAF at first visit, the median time to develop a DDAF lesion was 4.9 years (95% CI, 4.3-5.6 years). Among eyes without QDAF, the median time to develop a QDAF lesion was 6.3 years (95% CI, 5.6-9.7 years). Eyes with a lesion of DDAF at the first visit were less likely to develop a QDAF lesion compared with eyes without a lesion of DDAF (hazard ratio, 0.19; 95% CI, 0.05-0.70; P = .01). Conclusions and Relevance An estimated 50% of the eyes without DDAF at first visit will develop the lesion in less than 5 years, suggesting that incidence of DDAF could serve as an outcome measure for treatment trials.
Collapse
Affiliation(s)
- Rupert W Strauss
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland2Moorfields Eye Hospital, National Health Service Foundation Trust, London, England3Department of Ophthalmology, Johannes Kepler University Linz, Linz, Austria4Department of Ophthalmology, Medical University Graz, Graz, Austria5Department of Ophthalmology, University of Basel, Basel, Switzerland
| | - Beatriz Muñoz
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
| | - Alex Ho
- Doheny Eye Institute, David Geffen School of Medicine at UCLA (University of California, Los Angeles)
| | - Anamika Jha
- Doheny Eye Institute, David Geffen School of Medicine at UCLA (University of California, Los Angeles)
| | - Michel Michaelides
- Moorfields Eye Hospital, National Health Service Foundation Trust, London, England
| | - Saddek Mohand-Said
- Sorbonne Universités, University Pierre et Marie Curie, Université de Paris 06, Institut national de la santé et de la recherche médicale, Centre national de la recherche scientifique, Institut de la Vision, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France
| | - Artur V Cideciyan
- Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - David Birch
- Retina Foundation of the Southwest, Dallas, Texas
| | - Amir H Hariri
- Doheny Eye Institute, David Geffen School of Medicine at UCLA (University of California, Los Angeles)
| | - Muneeswar G Nittala
- Doheny Eye Institute, David Geffen School of Medicine at UCLA (University of California, Los Angeles)
| | - SriniVas Sadda
- Doheny Eye Institute, David Geffen School of Medicine at UCLA (University of California, Los Angeles)
| | - Hendrik P N Scholl
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland5Department of Ophthalmology, University of Basel, Basel, Switzerland
| | | |
Collapse
|
15
|
Parker MA, Choi D, Erker LR, Pennesi ME, Yang P, Chegarnov EN, Steinkamp PN, Schlechter CL, Dhaenens CM, Mohand-Said S, Audo I, Sahel J, Weleber RG, Wilson DJ. Test-Retest Variability of Functional and Structural Parameters in Patients with Stargardt Disease Participating in the SAR422459 Gene Therapy Trial. Transl Vis Sci Technol 2016; 5:10. [PMID: 27730010 PMCID: PMC5054761 DOI: 10.1167/tvst.5.5.10] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [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: 03/25/2016] [Accepted: 08/22/2016] [Indexed: 11/30/2022] Open
Abstract
Purpose The goal of this analysis was to determine the test–retest variability of functional and structural measures from a cohort of patients with advanced forms of Stargardt Disease (STGD) participating in the SAR422459 (NCT01367444) gene therapy clinical trial. Methods Twenty-two participants, aged 24 to 66, diagnosed with advanced forms of STGD, with at least one pathogenic ABCA4 mutation on each chromosome participating in the SAR422459 (NCT01367444) gene therapy clinical trial, were screened over three visits within 3 weeks or less. Functional visual evaluations included: best-corrected visual acuity (BCVA) Early Treatment Diabetic Retinopathy Study (ETDRS) letter score, semiautomated kinetic perimetry (SKP) using isopters I4e, III4e, and V4e, hill of vision (HOV) calculated from static visual fields (SVF) by using a 184n point centrally condensed grid with the stimulus size V test target. Retinal structural changes such as central macular thickness and macular volume were assessed by spectral-domain optical coherence tomography (SD-OCT). Repeatability coefficients (RC) and 95% confidential intervals (CI) were calculated for each parameter using a hierarchical mixed-effects model and bootstrapping. Results Criteria for statistically significant changes for various parameters were found to be the following: BCVA letter score (8 letters), SKP isopters I4e, III4e, and V4e (3478.85; 2488.02 and 2622.46 deg2, respectively), SVF full volume HOV (VTOT, 14.62 dB-sr), central macular thickness, and macular volume (4.27 μm and 0.15 mm3, respectively). Conclusions This analysis provides important information necessary to determine if significant changes are occurring in structural and functional assessments commonly used to measure disease progression in this cohort of patients with STGD. Moreover, this information is useful for future trials assessing safety and efficacy of treatments in STGD. Translational Relevance Determination of variability of functional and structural measures in participants with advanced stages of the STGD is necessary to assess efficacy and safety in treatment trials involving STGD patients.
Collapse
Affiliation(s)
- Maria A Parker
- Oregon Health & Science University, Casey Eye Institute, Portland, OR, USA
| | - Dongseok Choi
- Oregon Health & Science University, Casey Eye Institute, Portland, OR, USA ; OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - Laura R Erker
- Oregon Health & Science University, Casey Eye Institute, Portland, OR, USA
| | - Mark E Pennesi
- Oregon Health & Science University, Casey Eye Institute, Portland, OR, USA
| | - Paul Yang
- Oregon Health & Science University, Casey Eye Institute, Portland, OR, USA
| | - Elvira N Chegarnov
- Oregon Health & Science University, Casey Eye Institute, Portland, OR, USA
| | - Peter N Steinkamp
- Oregon Health & Science University, Casey Eye Institute, Portland, OR, USA
| | | | - Claire-Marie Dhaenens
- Univ. Lille, Inserm UMR-S 1172, CHU Lille - Biochemistry and Molecular Biology Department - UF Génopathies -F-59000 Lille, France
| | - Saddek Mohand-Said
- Sorbornne Universités, UPMC Univ Paris 06, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Isabelle Audo
- Sorbornne Universités, UPMC Univ Paris 06, INSERM, CNRS, Institut de la Vision, Paris, France ; Institute of Ophthalmology, University College of London, London, UK
| | - Jose Sahel
- Sorbornne Universités, UPMC Univ Paris 06, INSERM, CNRS, Institut de la Vision, Paris, France ; Institute of Ophthalmology, University College of London, London, UK ; Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Richard G Weleber
- Oregon Health & Science University, Casey Eye Institute, Portland, OR, USA
| | - David J Wilson
- Oregon Health & Science University, Casey Eye Institute, Portland, OR, USA
| |
Collapse
|
16
|
Matet A, Amar N, Mohand-Said S, Sahel JA, Barale PO. Argus II retinal prosthesis implantation with scleral flap and autogenous temporalis fascia as alternative patch graft material: a 4-year follow-up. Clin Ophthalmol 2016; 10:1565-71. [PMID: 27574397 PMCID: PMC4993412 DOI: 10.2147/opth.s112403] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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] [Indexed: 12/02/2022] Open
Abstract
Introduction The Argus II retinal prosthesis is composed of an epiretinal electrode array positioned over the macula and connected to an extrascleral electronics case via a silicone cable, running through a sclerotomy. During implantation, the manufacturer recommends to cover the sclerotomy site with a patch of processed human pericardium to prevent postoperative hypotony and conjunctival erosion by the underlying electronics case. Due to biomedical regulations prohibiting the use of this material in France, we developed an alternative technique combining a scleral flap protecting the sclerotomy and an autogenous graft of superior temporalis fascia overlying the electronics case. Methods The purpose of this study is to describe the 4-year outcomes of this modified procedure in three subjects who underwent Argus II Retinal Prosthesis System implantation. Clinical data consisting of intraocular pressure measurements and tolerance in terms of conjunctival erosion or inflammation were retrospectively assessed over a 4-year postoperative follow-up. Results None of the three patients implanted with the modified technique developed ocular hypotony over 4 years. A normal, transient conjunctival inflammation occurred during the first postoperative month but conjunctival erosion was not observed in any of the three patients over 4 years. Four years after implantation, the autogenous temporalis fascia graft remained well tolerated and the retinal prosthesis was functional in all three patients. Conclusion The combination of an autograft of superficial temporalis fascia and a scleral flap efficiently prevented leakage through the sclerotomy site, ocular hypotony, and conjunctival erosion by the extrascleral electronics case. This modified technique is suitable for the implantation of existing and forthcoming retinal prostheses. Superficial temporalis fascia may also be used as alternative to commercial tectonic tissues for scleral wound repair in clinical settings where they are not available.
Collapse
Affiliation(s)
- Alexandre Matet
- INSERM and DHOS, CHNO des Quinze-Vingts; Sorbonne Universités, UPMC Univ Paris 6, Institut de la Vision
| | - Nawel Amar
- INSERM and DHOS, CHNO des Quinze-Vingts; Sorbonne Universités, UPMC Univ Paris 6, Institut de la Vision
| | - Saddek Mohand-Said
- INSERM and DHOS, CHNO des Quinze-Vingts; Sorbonne Universités, UPMC Univ Paris 6, Institut de la Vision; INSERM; CNRS, Paris, France
| | - José-Alain Sahel
- INSERM and DHOS, CHNO des Quinze-Vingts; Sorbonne Universités, UPMC Univ Paris 6, Institut de la Vision; INSERM; CNRS, Paris, France; Institute of Ophthalmology, University College London, London, UK; Fondation Ophtalmologique Adolphe de Rothschild; Académie des Sciences, Institut de France, Paris, France
| | - Pierre-Olivier Barale
- INSERM and DHOS, CHNO des Quinze-Vingts; Sorbonne Universités, UPMC Univ Paris 6, Institut de la Vision
| |
Collapse
|
17
|
Chaumet-Riffaud AE, Cariou A, Audo I, Sahel J, Mohand-Said S. Handicap visuel et maintien en emploi : étude dans la rétinite pgimentaire. ARCH MAL PROF ENVIRO 2016. [DOI: 10.1016/j.admp.2016.03.073] [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: 11/25/2022]
|
18
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
19
|
Sabbah N, Authié CN, Sanda N, Mohand-Said S, Sahel JA, Safran AB. Importance of eye position on spatial localization in blind subjects wearing an Argus II retinal prosthesis. Invest Ophthalmol Vis Sci 2014; 55:8259-66. [PMID: 25414187 DOI: 10.1167/iovs.14-15392] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE With a retinal prosthesis connected to a head-mounted camera (camera-connected prosthesis [CC-P]), subjects explore the visual environment through head-scanning movements. As eye and camera misalignment might alter the spatial localization of images generated by the device, we investigated if such misalignment occurs in blind subjects wearing a CC-P and whether it impacts spatial localization, even years after the implantation. METHODS We studied three subjects blinded by retinitis pigmentosa, fitted with a CC-P (Argus II) 4 years earlier. Eye/head movements were video recorded as subjects tried to localize a visual target. Pointing coordinates were collected as subjects were requested to orient their gaze toward predetermined directions, and to point their finger to the corresponding perceived spot locations on a touch screen. Finally, subjects were asked to give a history of their everyday behavior while performing visually controlled grasping tasks. RESULTS Misaligned head and gaze directions occurred in all subjects during free visual search. Pointing coordinates were collected in two subjects and showed that median pointing directions shifted toward gaze direction. Reportedly all subjects were unable to accurately determine their eye position, and they developed adapted strategies to perform visually directed movements. CONCLUSIONS Eye position affected perceptual localization of images generated by the Argus II prosthesis, and consequently visuomotor coordination, even 4 years following implantation. Affected individuals developed strategies for visually guided movements to attenuate the impact of eye and head misalignment. Our observations provide indications for rehabilitation procedures and for the design of upcoming retinal prostheses. (ClinicalTrials.gov number, NCT00407602.).
Collapse
Affiliation(s)
- Norman Sabbah
- Sorbonne Universités, UPMC Université Paris 06, UMR S968, Institut de la Vision, Paris, France
| | - Colas N Authié
- Sorbonne Universités, UPMC Université Paris 06, UMR S968, Institut de la Vision, Paris, France
| | - Nicolae Sanda
- Sorbonne Universités, UPMC Université Paris 06, UMR S968, Institut de la Vision, Paris, France
| | - Saddek Mohand-Said
- Sorbonne Universités, UPMC Université Paris 06, UMR S968, Institut de la Vision, Paris, France
| | - José-Alain Sahel
- Sorbonne Universités, UPMC Université Paris 06, UMR S968, Institut de la Vision, Paris, France
| | - Avinoam B Safran
- Sorbonne Universités, UPMC Université Paris 06, UMR S968, Institut de la Vision, Paris, France Department of Clinical Neurosciences, Geneva University School of Medicine, Geneva, Switzerland
| |
Collapse
|
20
|
Lauritzen TZ, Harris J, Mohand-Said S, Sahel JA, Dorn JD, McClure K, Greenberg RJ. Reading visual braille with a retinal prosthesis. Front Neurosci 2012; 6:168. [PMID: 23189036 PMCID: PMC3504310 DOI: 10.3389/fnins.2012.00168] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [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: 07/07/2012] [Accepted: 11/01/2012] [Indexed: 11/13/2022] Open
Abstract
Retinal prostheses, which restore partial vision to patients blinded by outer retinal degeneration, are currently in clinical trial. The Argus II retinal prosthesis system was recently awarded CE approval for commercial use in Europe. While retinal prosthesis users have achieved remarkable visual improvement to the point of reading letters and short sentences, the reading process is still fairly cumbersome. This study investigates the possibility of using an epiretinal prosthesis to stimulate visual braille as a sensory substitution for reading written letters and words. The Argus II retinal prosthesis system, used in this study, includes a 10 × 6 electrode array implanted epiretinally, a tiny video camera mounted on a pair of glasses, and a wearable computer that processes the video and determines the stimulation current of each electrode in real time. In the braille reading system, individual letters are created by a subset of dots from a 3 by 2 array of six dots. For the visual braille experiment, a grid of six electrodes was chosen out of the 10 × 6 Argus II array. Groups of these electrodes were then directly stimulated (bypassing the camera) to create visual percepts of individual braille letters. Experiments were performed in a single subject. Single letters were stimulated in an alternative forced choice (AFC) paradigm, and short 2-4-letter words were stimulated (one letter at a time) in an open-choice reading paradigm. The subject correctly identified 89% of single letters, 80% of 2-letter, 60% of 3-letter, and 70% of 4-letter words. This work suggests that text can successfully be stimulated and read as visual braille in retinal prosthesis patients.
Collapse
|
21
|
Pérez Fornos A, Sommerhalder J, da Cruz L, Sahel JA, Mohand-Said S, Hafezi F, Pelizzone M. Temporal Properties of Visual Perception on Electrical Stimulation of the Retina. ACTA ACUST UNITED AC 2012; 53:2720-31. [DOI: 10.1167/iovs.11-9344] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | - Jörg Sommerhalder
- Ophthalmology Clinic, Geneva University Hospitals, Geneva, Switzerland
| | - Lyndon da Cruz
- Vitreoretinal Surgery, Moorfields Eye Hospital, London, UK
| | - Jose Alain Sahel
- and Ophthalmology Department, Quinze-Vingts National Eye Hospital, Paris, France
| | - Saddek Mohand-Said
- and Ophthalmology Department, Quinze-Vingts National Eye Hospital, Paris, France
| | - Farhad Hafezi
- Ophthalmology Clinic, Geneva University Hospitals, Geneva, Switzerland
| | - Marco Pelizzone
- Ophthalmology Clinic, Geneva University Hospitals, Geneva, Switzerland
| |
Collapse
|
22
|
Busskamp V, Duebel J, Balya D, Fradot M, Viney TJ, Siegert S, Groner AC, Cabuy E, Forster V, Seeliger M, Biel M, Humphries P, Paques M, Mohand-Said S, Trono D, Deisseroth K, Sahel JA, Picaud S, Roska B. Genetic reactivation of cone photoreceptors restores visual responses in retinitis pigmentosa. Science 2010; 329:413-7. [PMID: 20576849 DOI: 10.1126/science.1190897] [Citation(s) in RCA: 476] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Retinitis pigmentosa refers to a diverse group of hereditary diseases that lead to incurable blindness, affecting two million people worldwide. As a common pathology, rod photoreceptors die early, whereas light-insensitive, morphologically altered cone photoreceptors persist longer. It is unknown if these cones are accessible for therapeutic intervention. Here, we show that expression of archaebacterial halorhodopsin in light-insensitive cones can substitute for the native phototransduction cascade and restore light sensitivity in mouse models of retinitis pigmentosa. Resensitized photoreceptors activate all retinal cone pathways, drive sophisticated retinal circuit functions (including directional selectivity), activate cortical circuits, and mediate visually guided behaviors. Using human ex vivo retinas, we show that halorhodopsin can reactivate light-insensitive human photoreceptors. Finally, we identified blind patients with persisting, light-insensitive cones for potential halorhodopsin-based therapy.
Collapse
Affiliation(s)
- Volker Busskamp
- Neural Circuit Laboratories, Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Humayun MS, Dorn JD, Ahuja AK, Caspi A, Filley E, Dagnelie G, Salzmann J, Santos A, Duncan J, daCruz L, Mohand-Said S, Eliott D, McMahon MJ, Greenberg RJ. Preliminary 6 month results from the Argus II epiretinal prosthesis feasibility study. Annu Int Conf IEEE Eng Med Biol Soc 2010; 2009:4566-8. [PMID: 19963839 DOI: 10.1109/iembs.2009.5332695] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The Argus II 60 channel epiretinal prosthesis has been developed in order to provide partial restoration of vision to subjects blinded from outer retinal degenerative disease. To date the device has been implanted in 21 subjects as part of a feasibility study. In 6 month post-implantation door finding and line tracking orientation and mobility testing, subjects have shown improvements of 86% and 73%, respectively, for system on vs. system off. In high-contrast Square Localization tests using a touch screen monitor 87% of tested subjects performed significantly better with the system on compared with off. These preliminary results show that the Argus II system provides some functional vision to blind subjects.
Collapse
|
24
|
Laurent Coriat C, Tick S, Sahel J, Mohand-Said S, Paques M. 494 Imagerie vasculaire rétinienne et choroïdienne : apport de l’OCT haute résolution. J Fr Ophtalmol 2009. [DOI: 10.1016/s0181-5512(09)73618-6] [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: 10/20/2022]
|
25
|
Audo I, Mohand-Said S, Zeitz C, Bhattacharya S, Sahel J. 094 Screening à haut débit du gène ABCA4 dans une cohorte de patients français atteints de maladie de Stargardt et de forme récessive de dystrophies de type cônes-bâtonnets. J Fr Ophtalmol 2009. [DOI: 10.1016/s0181-5512(09)73231-0] [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: 11/26/2022]
|
26
|
Tick S, Rossant F, Girmens J, Sahel J, Mohand-Said S, Paques M. 289 Étude de la variabilité de la segmentation maculaire dans une population de sujets normaux OCT haute résolution (OCT-HR). J Fr Ophtalmol 2009. [DOI: 10.1016/s0181-5512(09)73412-6] [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: 11/17/2022]
|
27
|
Yang Y, Mohand-Said S, Danan A, Simonutti M, Fontaine V, Clerin E, Picaud S, Léveillard T, Sahel JA. Functional cone rescue by RdCVF protein in a dominant model of retinitis pigmentosa. Mol Ther 2009; 17:787-95. [PMID: 19277021 DOI: 10.1038/mt.2009.28] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
In retinitis pigmentosa (RP), a majority of causative mutations affect genes solely expressed in rods; however, cone degeneration inevitably follows rod cell loss. Following transplantation and in vitro studies, we demonstrated the role of photoreceptor cell paracrine interactions and identified a Rod-derived Cone Viability Factor (RdCVF), which increases cone survival. In order to establish the clinical relevance of such mechanism, we assessed the functional benefit afforded by the injection of this factor in a frequent type of rhodopsin mutation, the P23H rat. In this model of autosomal dominant RP, RdCVF expression decreases in parallel with primary rod degeneration, which is followed by cone loss. RdCVF protein injections induced an increase in cone cell number and, more important, a further increase in the corresponding electroretinogram (ERG). These results indicate that RdCVF can not only rescue cones but also preserve significantly their function. Interestingly, the higher amplitude of the functional versus the survival effect of RdCVF on cones indicates that RdCVF is acting more directly on cone function. The demonstration at the functional level of the therapeutic potential of RdCVF in the most frequent of dominant RP mutations paves the way toward the use of RdCVF for preserving central vision in many RP patients.
Collapse
Affiliation(s)
- Ying Yang
- Université Pierre et Marie Curie-Paris6, UMR-S 592, Paris, France
| | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Lecleire Collet A, Erginay A, Sofroni R, Conrath J, Mohand-Said S, Gaudric A, Sahel J, Massin P. 128 Étude des anomalies fonctionnelles rétiniennes observées chez des patients diabétiques sans rétinopathie diabétique. J Fr Ophtalmol 2008. [DOI: 10.1016/s0181-5512(08)70724-1] [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: 10/22/2022]
|
29
|
Girmens J, Mohand-Said S, Sahel J. Un exemple de Centre d’Investigation Clinique dédié à l’ophtalmologie. J Fr Ophtalmol 2008; 31:128-9. [DOI: 10.1016/s0181-5512(08)70345-0] [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: 10/22/2022]
|
30
|
Gendron G, Iordanidou V, Bellmann C, Fardeau C, Ionica N, Mohand-Said S, Girmens J, Baudouin C, Sahel J, Lehoang P, Ullern M. 460 Autofluorescence dans les pathologies inflammatoires et infectieuses du fond d’œil : étude préliminaire. J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)80273-7] [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: 11/15/2022]
|
31
|
Abstract
Neuroprotection of photoreceptor cells in rod-cone dystrophies: from cell therapy to cell signalling. Neuroprotection of photoreceptor cells in rod-cone degenerations is primarily targeted at preventing the loss of function. Strategies for protecting rod cells should therefore aim not only at structural preservation but also must be assessed using functional parameters (e.g., electroretinogram). Given the number of mutations leading to an impaired visual response of rods, the preservation of cones is a realistic approach since (1) numerous mutations do not affect proteins expressed by cones; (2) the secondary degeneration of cones is the main event leading to profound visual impairment; (3) even a small proportion of functional cones is sufficient for major visual functions. Our group has (1) established and confirmed the existence of non cell autonomous mechanisms promoting cone cell viability; (2) shown that rod cell protection or replacement provides a mean to extend the survival of cones; (3) demonstrated that rod-cone trophic interactions are mediated by diffusible proteins; (4) identified by expression cloning a protein mediating such interactions: RdCVF (Rod-derived Cone Viability Factor). These studies provide clues for broad neuroprotective therapies of rod-cone dystrophies.
Collapse
Affiliation(s)
- José-Alain Sahel
- Laboratoire de physiopathologie cellulaire et moléculaire de la rétine, unité 592 Inserm-université Pierre-et-Marie-Curie, 4, place Jussieu, 75252 Paris, France.
| | | | | |
Collapse
|
32
|
Gendron G, Bonnel S, De Nicola R, Mohand-Said S, Dayma K, Sahel J. 258 Dystrophies des cônes : au sujet de six cas. J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)74656-8] [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: 10/22/2022]
|
33
|
Bonnel S, Mohand-Said S, Barale PO, De Nicola R, Sahel JA. Pathologies rétiniennes d’origine héréditaire et DMLA : nouvelles perspectives thérapeutiques. J Fr Ophtalmol 2004; 27:623-33. [PMID: 15343122 DOI: 10.1016/s0181-5512(04)96188-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This article summarizes our current knowledge on two types of retinal diseases: hereditary retinal degeneration and wet aged-related macular degeneration. Our understanding of retinal physiopathology in hereditary retinal degeneration and the successful experimental therapeutic results on animal models call for a new approach to these patients to prepare future clinical trials. Longitudinal follow-up of the functional alteration rhythm based on international standards and by expert centers is an essential prerequisite to including these patients in future clinical trials. Creating international databases that include data on follow-up using electrophysiological, psychophysical and morphological analyses would require standards defining how each of these procedures should be carried out. Furthermore, the relevance and value of the various examinations would then be evaluated in a longitudinal manner. The repeated use of these procedures in the various centers would bring to light any limitations these techniques may have for use in prospective studies. Continuous re-evaluation of these investigative techniques will therefore be necessary, a crucial factor in the preparation of multicenter clinical studies. The inclusion of patients phenotyped at different centers would require that certification procedures be set up for these centers. A great leap forward, clinical trials on new antiangiogenic approaches for the treatment of neovascular AMD are currently underway. The reasons for the switch between the neovascular and atrophic forms of AMD are as yet unknown, but these new approaches are based on the events that occur sequentially during the angiogenic response.
Collapse
Affiliation(s)
- S Bonnel
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | | | | | | | | |
Collapse
|
34
|
Abstract
This mini-review summarizes our current knowledge concerning the age-related changes that affect the retina. Over the last 10 years, our understanding of the genetics of hereditary retinal diseases has improved considerably. However, the modifications that occur in the retina as a result of aging are still under investigation. In this review, we place particular emphasis on the normal retinal alterations that occur with aging (gene modulation; psychophysical, structural and cellular alterations). We describe the events that occur during the pathological aging process, such as in age-related macular degeneration. Understanding these different modifications is essential if we are to find key players on which to base therapeutic interventions that may help to prevent the passage of normal aging process to the pathological aging process.
Collapse
Affiliation(s)
- Sébastien Bonnel
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, F-75012 Paris, France
| | | | | |
Collapse
|
35
|
Fintz AC, Audo I, Hicks D, Mohand-Said S, Léveillard T, Sahel J. Partial characterization of retina-derived cone neuroprotection in two culture models of photoreceptor degeneration. Invest Ophthalmol Vis Sci 2003; 44:818-25. [PMID: 12556418 DOI: 10.1167/iovs.01-1144] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To define the nature and estimate the molecular weight range of soluble endogenous retinal trophic activities on cone photoreceptor survival in two models of cone degeneration. METHODS Diffusible factors from dissociated retinal cell cultures of 8-day normal-sighted (C57BL/6J) mice were tested for cone-survival-promoting activity by two approaches and by using two independent photoreceptor degeneration models. In the first approach, mouse retinal cells were cultured on semi-permeable membranes apposed to dissociated cultures of chick embryo retina. In the second approach, conditioned medium was collected from normal mouse retinal cultures and added to embryonic chicken retina cultures or to retinal explants obtained from 5-week retinal degeneration (rd1) mice. In some experiments, conditioned medium was heated or sequentially fractionated in dialysis tubing with molecular weight cutoffs of 8, 15, and 25 kDa. The number of chicken cones and viability were determined by using morphologic criteria, colorimetric assays, and labeling with antibodies raised against visinin. Mouse cones were counted by differential double immunolabeling with antibodies against rhodopsin (rods) and arrestin (rods and cones). RESULTS . Coculturing with normal mouse retinal cells delayed cone loss in dispersed embryonic chicken retina, by a maximum of 50% relative to the control. Conditioned medium derived from normal mouse retinas also significantly delayed cone loss in chicken cone cultures by a maximum of 1300%, compared with the control, and 40% in rd1 mouse retinal explant cultures. The survival activity in conditioned medium was destroyed by heat denaturation, and was partially retained by dialysis with a molecular weight cutoff of 25 kDa in both models. CONCLUSIONS These strategies have identified cone-survival-stimulating activities in normal mouse retina, capable of acting across species and enhancing both structural protection and viability. Such molecules may represent candidates for clinical treatment of inherited retinal degeneration.
Collapse
Affiliation(s)
- Anne-Claire Fintz
- Laboratory of Molecular and Cellular Pathophysiology of the Retina, National Institute of Health and Medical Research (INSERM), Strasbourg, France
| | | | | | | | | | | |
Collapse
|
36
|
Mohand-Said S, Jacquet A, Lucien A, Espinasse-Berrod MA, Frasson Correa De Silva M, Sahel J. Protective effect of trimetazidine in a model of ischemia-reperfusion in the rat retina. Ophthalmic Res 2002; 34:300-5. [PMID: 12381891 DOI: 10.1159/000065603] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Trimetazidine is an anti-ischemic agent which is frequently prescribed as a prophylactic treatment of episodes of angina pectoris and as a symptomatic treatment of vertigo and tinnitus. It has also shown beneficial effects in models of visual dysfunction, but the mechanism(s) by which this occurs is as yet undefined. The present study was intended to evaluate the influence of trimetazidine on retinal damage induced by ischemia-reperfusion in a rat model. Retinal ischemia was induced by increasing intraocular pressure to 160 mm Hg for 60 min. Trimetazidine or buffer controls were administered 3 days before the ischemia or in the postischemic period. The degree of retinal damage was assessed after 15 and 30 days of reperfusion after the ischemic insult by histopathologic study according to Hughes' quantification of ischemic damage. Retinal ischemia led to significant reductions in thickness and cell number, mainly in the inner retinal layers. The results from the study demonstrate that treatment with intraperitoneally injected trimetazidine conferred significant protection against retinal ischemic damage. Better results were obtained in the pretreatment group after 15 days of reperfusion. Trimetazidine protects the rat retina from pressure-induced ischemic injury and might be considered a potential therapeutic modality for combating retinal ischemia.
Collapse
Affiliation(s)
- S Mohand-Said
- Laboratory of Retinal Physiopathology, Louis Pasteur University, Strasbourg, France.
| | | | | | | | | | | |
Collapse
|
37
|
Lorentz O, Léveillard T, Mohand-Said S, Sahel J. Identification de gènes candidats responsables de pathologies rétiniennes. Med Sci (Paris) 2002. [DOI: 10.1051/medsci/2002185528] [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: 11/14/2022] Open
|
38
|
Sahel JA, Mohand-Said S, Léveillard T, Hicks D, Picaud S, Dreyfus H. Rod-cone interdependence: implications for therapy of photoreceptor cell diseases. Prog Brain Res 2001; 131:649-61. [PMID: 11420978 DOI: 10.1016/s0079-6123(01)31051-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- J A Sahel
- Laboratoire de Physiopathologie Cellulaire et Moléculaire de la Rétine, EMI 9918 INSERM, Université Louis Pasteur and Clinique Médicale A, Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, 67091 Strasbourg, France.
| | | | | | | | | | | |
Collapse
|
39
|
Abstract
During the last decade, numerous research reports have considerably improved our knowledge about the physiopathology of retinal degenerations. Three non-mutually exclusive general areas dealing with therapeutic approaches have been proposed; gene therapy, pharmacology and retinal transplantations. The first approach involving correction of the initial mutation, will need a great deal of time and further development before becoming a therapeutic tool in human clinical practice. The observation that cone photoreceptors, even those seemingly unaffected by any described anomaly, die secondarily to rod disappearance related to mutations expressed specifically in the latter, led us to study the interactions between these two photoreceptor populations to search for possible causal links between rod degeneration and cone death. These in vivo and in vitro studies suggest that paracrine interactions between both cell types exist and that rods are necessary for continued cone survival. Since the role of cones in visual perception is essential, pending the identification of the factors mediating these interactions underway, rod replacement by transplantation and/or neuroprotection by trophic factors or alternative pharmacological means appear as promising approaches for limiting secondary cone loss in currently untreatable blinding conditions.
Collapse
Affiliation(s)
- S Mohand-Said
- Laboratoire de Physiopathologie Cellulaire et Moléculaire de la Rétine, EMI 99-8 INSERM Université Louis Pasteur, Clinique Médicale A, Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital 67091 Cedex, Strasbourg, France
| | | | | | | | | | | |
Collapse
|
40
|
Abstract
BACKGROUND Rod-cone retinal degenerations (retinitis pigmentosa) are typified by initial rod loss followed by secondary cone death. Rod death, predominantly caused by gene mutations expressed specifically in these cells, induces scotopic vision loss. Cone death, the overriding cause of blindness, has no current explanation. Disease progression and preliminary data suggest that cone survival depends on rods. OBJECTIVE To establish whether rod transplantation into mutant rodless retinas could halt cone loss. METHODS We transplanted pure sheets of rods isolated from normal-sighted mice into the subretinal space of recipient retinal degeneration mice lacking rods but possessing approximately 30% residual cones. Control animals were unoperated on or grafted with inner retinal cells from young normal donors, entire retinas from aged retinal degeneration mice, or gelatin. Two weeks after surgery, we quantified by an unbiased method the numbers of host retinal cones after immunolabeling with specific markers. RESULTS Only mice receiving rod-rich transplants demonstrated statistically significant greater cone numbers, with rescue of 40% of host cones normally destined to die during this period. CONCLUSION Cone survival depends specifically on rods. CLINICAL RELEVANCE Such findings indicate that transplantation of rods could limit loss of cones, thus preserving useful vision in human retinitis pigmentosa. Arch Ophthalmol. 2000;118:807-811
Collapse
Affiliation(s)
- S Mohand-Said
- Laboratoire de Physiopathologie Cellulaire et Moléculaire de la Rétine, EMI 9918 INSERM, Clinique Médicale A, Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, 67091 Strasbourg Cédex, France
| | | | | | | |
Collapse
|
41
|
Frasson M, Picaud S, Léveillard T, Simonutti M, Mohand-Said S, Dreyfus H, Hicks D, Sabel J. Glial cell line-derived neurotrophic factor induces histologic and functional protection of rod photoreceptors in the rd/rd mouse. Invest Ophthalmol Vis Sci 1999; 40:2724-34. [PMID: 10509671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
PURPOSE To evaluate the neuroprotective potential of glial cell line-derived neurotrophic factor (GDNF) in the retinal degeneration (rd/rd) mouse model of human retinitis pigmentosa. METHODS Subretinal injections of GDNF were made into rd/rd mice at 13 and 17 days of age and electroretinograms (ERGs) recorded at 22 days. Control mice received saline vehicle injections or underwent no procedure. At 23 days of age, retinas from treated and control mice were fixed and processed for wholemount immunohistochemistry using an anti-rod opsin antibody, and rod numbers were estimated using an unbiased stereological systematic random approach. Subsequent to counting, immunolabeled retinas were re-embedded and sectioned in a transverse plane and the numbers of rods recalculated. RESULTS Although ERGs could not be recorded from sham-operation or nonsurgical rd/rd mice at 22 days of age, detectable responses (both a- and b-waves) were observed in 4 of 10 GDNF-treated mice. Stereological assessment of immunolabeled rods at 23 days showed that control rd/rd retinas contained 41,880+/-3,890 (mean +/- SEM; n = 6), phosphate-buffered saline (PBS)-injected retinas contained 61,165+/-4,932 (n = 10; P < 0.001 versus control retinas) and GDNF-injected retinas contained 89,232+/-8,033 (n = 10; P < 0.001 versus control retinas, P < 0.002 versus PBS). This increase in rod numbers after GDNF treatment was confirmed by cell counts obtained from frozen sections. CONCLUSIONS GDNF exerts both histologic and functional neuroprotective effects on rod photoreceptors in the rd/rd mouse. Thus rescue was demonstrated in an animal model of inherited retinal degeneration in which the gene defect was located within the rods themselves, similar to most forms of human retinitis pigmentosa. GDNF represents a candidate neurotrophic factor for palliating some forms of hereditary human blindness.
Collapse
Affiliation(s)
- M Frasson
- Laboratoire de Physiopathologie Rétinienne, Clinique Ophthalmologique, Université Louis Pasteur, Centre Hospitalier Régional Universitaire, Strasbourg, France
| | | | | | | | | | | | | | | |
Collapse
|
42
|
Mack G, Dollfus H, Flament J, Mohand-Said S, Sahel J. [A new mode of recording retinal activity: multifocal ERG]. J Fr Ophtalmol 1999; 22:221-5. [PMID: 10327355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Global ERG recordings are only modified in conditions with diffuse or extensive retinal involvement. The use, over the last 6 months, of a new functional testing device: VERIS (visual evoked response imaging system) allows accurate detection and quantification of localized retinal function defects. Our preliminary experience shows that a careful preparation of subjects, standardized testing protocols and a good understanding of the device technology, especially software parameters are mandatory. We report our results on a series of 28 normal volunteers, grouped by age and describe the various graphic presentation of data collected. This technology should allow accurate detection and quantification of retinal functional defects in patients with age related macular degeneration as well as evaluation of visual function in retinitis pigmentosa patients before and after photoreceptor transplantation.
Collapse
Affiliation(s)
- G Mack
- Clinique Ophtalmologique, Hôpital civil, Hôpitaux Universitaires de Strasbourg
| | | | | | | | | |
Collapse
|
43
|
Mohand-Said S, Deudon-Combe A, Hicks D, Simonutti M, Forster V, Fintz AC, Léveillard T, Dreyfus H, Sahel JA. Normal retina releases a diffusible factor stimulating cone survival in the retinal degeneration mouse. Proc Natl Acad Sci U S A 1998; 95:8357-62. [PMID: 9653191 PMCID: PMC20980 DOI: 10.1073/pnas.95.14.8357] [Citation(s) in RCA: 127] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The role of cellular interactions in the mechanism of secondary cone photoreceptor degeneration in inherited retinal degenerations in which the mutation specifically affects rod photoreceptors was studied. We developed an organ culture model of whole retinas from 5-week-old mice carrying the retinal degeneration mutation, which at this age contain few remaining rods and numerous surviving cones cocultured with primary cultures of mixed cells from postnatal day 8 normal-sighted mice (C57BL/6) retinas or retinal explants from normal (C57BL/6) or dystrophic (C3H/He) 5-week-old mice. After 7 days, the numbers of residual cone photoreceptors were quantified after specific peanut lectin or anti-arrestin antibody labeling by using an unbiased stereological approach. Examination of organ cultured retinas revealed significantly greater numbers of surviving cones (15-20%) if cultured in the presence of retinas containing normal rods as compared with controls or cocultures with rod-deprived retinas. These data indicate the existence of a diffusible trophic factor released from retinas containing rod cells and acting on retinas in which only cones are present. Because cones are responsible for high acuity and color vision, such data could have important implications not only for eventual therapeutic approaches to human retinal degenerations but also to define interactions between retinal photoreceptor types.
Collapse
Affiliation(s)
- S Mohand-Said
- Laboratoire de Physiopathologie Rétinienne, Université Louis Pasteur, Clinique Ophtalmologique, Centre Hospitalier et Universitaire, BP 426, 1, Place de l'Hôpital, 67091 Strasbourg Cedex, France
| | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Mohand-Said S, Weber M, Hicks D, Dreyfus H, Sahel J. Gangliosides. A potential therapeutic approach in retinal ischemia. Ann N Y Acad Sci 1998; 845:421-2. [PMID: 9668385 DOI: 10.1111/j.1749-6632.1998.tb09709.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S Mohand-Said
- Laboratoire de Physiopathologie Retinienne ULP, Strasbourg, CJF-INSERM 92-02, France
| | | | | | | | | |
Collapse
|
45
|
Dreyfus H, Sahel J, Heidinger V, Mohand-Said S, Guérold B, Meuillet E, Fontaine V, Hicks D. Gangliosides and neurotrophic growth factors in the retina. Molecular interactions and applications as neuroprotective agents. Ann N Y Acad Sci 1998; 845:240-52. [PMID: 9668358 DOI: 10.1111/j.1749-6632.1998.tb09677.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Polypeptide growth factors and gangliosides can both be considered as trophic agents involved in almost all stages of neural cell development, differentiation, survival, and pathology. In most cases their physiological roles are still not clear due to the considerable complexity in their regulation. Several growth factors [e.g., basic fibroblast growth factor (bFGF) and epidermal growth factor (EGF)] and one species of ganglioside (GM1) have been shown to exert interactions with each other and also to exhibit neuroprotective effects against retinal ischemia in vivo and cerebral excitotoxicity in vitro. Different experimental models are used to investigate their relevance to ischemic and excitotoxic conditions in the retina, and it is shown that (1) both bFGF and EGF show very effective neuroprotection for rat retinal neurones exposed to toxic levels of glutamate or its nonphysiological agonist kainate in vitro; (2) GM1 (10(-5M) used under the same conditions does not afford protection; (3) retinal glial cells also suffer morphological perturbations following glutamate or kainate treatment, but this effect is dependent on neuron-glial interactions, indicating the existence of intermediate neuron-derived messenger molecules; (4) these glial changes can be corrected by posttreatment with either bFGF or EGF in vitro; (5) using an in vivo animal model involving anterior chamber pressure-induced ischemia in adult rats, it is shown that either pretreatment by intraperitoneal injection of GM1, or posttreatment by intraocular injection of the same ganglioside, reduces significantly histological damage to inner nuclear regions; and (6) in cultured retinal Müller glial cells the existence of molecular and metabolic interactions between both types of trophic factors is demonstrated. Hence both these groups of trophic molecules show interesting features for retinal ischemic treatment.
Collapse
Affiliation(s)
- H Dreyfus
- Laboratoire de Physiopathologie Rétinienne, INSERM CJF 92-02, Centre Hospitalier et Universitaire Régional, Strasbourg, France.
| | | | | | | | | | | | | | | |
Collapse
|
46
|
Hicks D, Heidinger V, Mohand-Said S, Sahel J, Dreyfus H. Growth factors and gangliosides as neuroprotective agents in excitotoxicity and ischemia. Gen Pharmacol 1998; 30:265-73. [PMID: 9510073 DOI: 10.1016/s0306-3623(97)00356-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
1. At least two different groups of molecules can be considered neurotrophic factors because they exert a variety of effects upon neural cells. The first consists of the numerous families of polypeptide growth factors known to take part in almost all stages of neural cell growth and functioning, including development, differentiation, survival and pathology. The second group also is characterized by extensive complexity of multiple forms, and consists of the sialic acid-containing glycosphingolipids or gangliosides. These molecules also take part in the transfer of information from the extracellular milieu to the cell interior, and, similarly to growth factors, are participants in such aspects as development, differentiation and functioning. 2. In this short overview, we consider the existing data on the neuroprotective effects of growth factors [e.g., basic fibroblast growth factor (bFGF), epidermal growth factor (EGF) and brain-derived neurotrophic factor] and one species of ganglioside (GM1) against retinal ischemia in vivo and cerebral excitotoxicity in vitro. 3. We used three different experimental models to investigate their relevance to ischemic and excitotoxic conditions in the retina and have shown that: (a) both bFGF and EGF show highly effective neuroprotection for rat retinal neurons exposed to toxic levels of glutamate or its nonphysiological agonist kainate in vitro (b) retinal glial cells suffer morphological perturbations after glutamate or kainate treatment, and this effect depends on neuron-glial interactions; (c) these glial changes can also be corrected by posttreatment with either bFGF or EGF in vitro; (d) with the use of an in vivo animal model involving anterior chamber pressure-induced ischemia in adult rats, either pretreatment by intraperitoneal injection of GM1 or posttreatment by intraocular injection of the same ganglioside significantly reduces histological damage to inner nuclear regions. 4. Hence both groups of trophic molecules show interesting features for retinal ischemic treatment.
Collapse
Affiliation(s)
- D Hicks
- INSERM CJF 92-02, Centre Hospitalier et Universitaire Régional, Strasbourg, France.
| | | | | | | | | |
Collapse
|
47
|
Sahel JA, Mohand-Said S, Léveillard T, Fintz AC, Dreyfus H, Hicks D. Transplantations rétiniennes : résultats, perspectives et interrogations. Med Sci (Paris) 1998. [DOI: 10.4267/10608/972] [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: 11/30/2022] Open
|
48
|
Mohand-Said S, Hicks D, Simonutti M, Tran-Minh D, Deudon-Combe A, Dreyfus H, Silverman MS, Ogilvie JM, Tenkova T, Sahel J. Photoreceptor transplants increase host cone survival in the retinal degeneration (rd) mouse. Ophthalmic Res 1997; 29:290-7. [PMID: 9323720 DOI: 10.1159/000268027] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Retinal transplants offer a potentially interesting approach to treating human retinal degenerations, but so far little quantitative data are available on possible beneficial effects. We isolated photoreceptor layers from normal-sighted mice and grafted them into the subretinal space of retinal degeneration (rd) mice lacking rod photoreceptors. At 2 weeks after surgery, the numbers of residual host cone photoreceptors outside the graft zone were quantified following specific labelling. Examination of operated retinas revealed highly significantly greater numbers of surviving cones (mean of 38% more at 2 weeks) within the central field compared to sham-operated paired control retinas (p < 0.01). These are the first quantified data indicating a trophic effect of transplanted photoreceptors upon host cone cells. As cone cells are responsible for high acuity and colour vision, such data could have important implications not only for eventual therapeutic approaches to human retinal degenerations but also to understanding underlying interactions between retinal photoreceptors.
Collapse
Affiliation(s)
- S Mohand-Said
- Laboratoire de Physiopathologie Rétinienne INSERM CJF 92/02-ULP, Centre Hospitalier et Universitaire, Strasbourg, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Mohand-Said S, Weber M, Hicks D, Dreyfus H, Sahel JA. Intravitreal injection of ganglioside GM1 after ischemia reduces retinal damage in rats. Stroke 1997; 28:617-21; discussion 622. [PMID: 9056621 DOI: 10.1161/01.str.28.3.617] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND PURPOSE Gangliosides are normal components of cell membranes and contribute to structural rigidity and membrane function. They have been shown to protect against various insults in the brain. We have shown previously that GM1 administered intraperitoneally before the induction of retinal ischemia provides a protective effect. This study evaluates the protective effect of GM1 administered intravitreally after ischemia on retinal lesions. METHODS We induced retinal ischemia unilaterally in Long-Evans rats by increasing intraocular pressure to 160 mm Hg for 60 minutes. GM1 (20 microL x 10(-5) mol/L) or saline (20 microL) was injected into the vitreous 15 minutes after ischemia, and the postischemic survival time was either 8 or 15 days. The degree of retinal damage was assessed by histopathological study. RESULTS Retinal ischemia led to reductions in thickness and cell number, principally in the inner retinal layers (39% to 80%) and to a lesser extent in the outer retinal layers (26% to 45%). Postischemic treatment with intravitreally injected GM1 conferred significant protection against retinal ischemic damage after both 8 and 15 days of survival time. After 8 days of reperfusion, the ischemia-induced loss in overall retinal thickness was reduced by 15% and those of the inner nuclear and plexiform layers by 44% and 17%, respectively. Ischemic-induced ganglion cell and inner nuclear cell density losses were reduced by 37% and 27%, respectively. After 15 days of reperfusion, approximately the same statistically significant differences could be observed in comparison with the 15-day saline-injected group. CONCLUSIONS GM1 protects the rat retina from pressure-induced ischemic injury when given intravitreally after the insult. The protection provided by GM1 after initiation of retinal damage could be of therapeutic interest.
Collapse
Affiliation(s)
- S Mohand-Said
- Laboratoire de Physiopathologie Retinienne, INSERM CJF 92-02, Universite Louis Pasteur, Strasbourg, France
| | | | | | | | | |
Collapse
|
50
|
Sahel JA, Hicks D, Mohand-Said S, Tran Minh D, Deudon-Combe A, Silverman M, Dreyfus H. [Retinal grafts: biological problems and clinical stakes]. Bull Acad Natl Med 1996; 180:633-43; discussion 643-4. [PMID: 8766244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Retinal transplantation, formerly perceived as unrealistic, has become over the past decade a major clinical and biological undertaking in several laboratories and eye clinics. We describe the insights gained through the pioneering experimental works of Del Cerro et al, Turner et al, Gouras et al, Aramant et al, Lund et al e.g. the survival of transplants, the lack of immune response to photoreceptors, their integration and expression of neuronal markers, but also the dysplastic arrangement into rosettes and the lack of a definitive proof for functionality. Our laboratory has undertaken to establish the trophic and synaptic functions of sheets of photoreceptors transplanted, as described by Silverman et al, in the subretinal space of mutant rd mice carrying a retinal degeneration similar to human retinitis pigmentosa. Clinical applications to this condition as well as in cases of end-stage age related macular degeneration are discussed.
Collapse
Affiliation(s)
- J A Sahel
- Faculté de Médecine, Université Louis Pasteur, Clinique Ophtalmologique & Laboratoire Physiopathologie rétinienne, INSERM CJF 92-02, Hôpital Civil, Strasbourg
| | | | | | | | | | | | | |
Collapse
|