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Dunn MJ, Alexander RG, Amiebenomo OM, Arblaster G, Atan D, Erichsen JT, Ettinger U, Giardini ME, Gilchrist ID, Hamilton R, Hessels RS, Hodgins S, Hooge ITC, Jackson BS, Lee H, Macknik SL, Martinez-Conde S, Mcilreavy L, Muratori LM, Niehorster DC, Nyström M, Otero-Millan J, Schlüssel MM, Self JE, Singh T, Smyrnis N, Sprenger A. Author Correction: Minimal reporting guideline for research involving eye tracking (2023 edition). Behav Res Methods 2024:10.3758/s13428-024-02438-9. [PMID: 38691219 DOI: 10.3758/s13428-024-02438-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Affiliation(s)
- Matt J Dunn
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK.
| | - Robert G Alexander
- Departments of Ophthalmology, Neurology, and Physiology/Pharmacology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | | | - Gemma Arblaster
- Health Sciences School, University of Sheffield, Sheffield, UK
- Orthoptic Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Denize Atan
- Bristol Medical School, University of Bristol, Bristol, UK
| | | | | | - Mario E Giardini
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - Iain D Gilchrist
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Ruth Hamilton
- Department of Clinical Physics & Bioengineering, Royal Hospital for Children, NHS Greater Glasgow & Clyde, Glasgow, UK
- College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
| | - Roy S Hessels
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | | | - Ignace T C Hooge
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Brooke S Jackson
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Helena Lee
- Clinical and Experimental Sciences, University of Southampton, Southampton, UK
| | - Stephen L Macknik
- Departments of Ophthalmology, Neurology, and Physiology/Pharmacology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Susana Martinez-Conde
- Departments of Ophthalmology, Neurology, and Physiology/Pharmacology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Lee Mcilreavy
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
| | - Lisa M Muratori
- Department of Physical Therapy, School of Health Professions, Stony Brook University, Stony Brook, NY, USA
| | - Diederick C Niehorster
- Lund University Humanities Lab, Lund University, Lund, Sweden
- Department of Psychology, Lund University, Lund, Sweden
| | - Marcus Nyström
- Lund University Humanities Lab, Lund University, Lund, Sweden
| | - Jorge Otero-Millan
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, CA, USA
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Michael M Schlüssel
- UK EQUATOR Centre, Centre for Statistics in Medicine (CSM), Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - Jay E Self
- Clinical and Experimental Sciences, University of Southampton, Southampton, UK
| | - Tarkeshwar Singh
- Department of Kinesiology, Pennsylvania State University, University Park, PA, USA
| | - Nikolaos Smyrnis
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, General University Hospital Attikon, Athens, Greece
| | - Andreas Sprenger
- Department of Neurology and Institute of Psychology II, Center of Brain, Behavior and Metabolism (CBBM), University of Luebeck, Luebeck, Germany
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Osborne D, Steele A, Evans M, Ellis H, Pancholi R, Harding T, Dee J, Leary R, Bradshaw J, O'Flynn E, Self JE. Children's visual acuity tests without professional supervision: a prospective repeated measures study. Eye (Lond) 2023; 37:3762-3767. [PMID: 37328509 PMCID: PMC10697985 DOI: 10.1038/s41433-023-02597-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/28/2022] [Revised: 04/11/2023] [Accepted: 05/19/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Home visual acuity tests could ease pressure on ophthalmic services by facilitating remote review of patients. Home tests may have further utility in giving service users frequent updates of vision outcomes during therapy, identifying vision problems in an asymptomatic population, and engaging stakeholders in therapy. METHODS Children attending outpatient clinics had visual acuity measured 3 times at the same appointment: Once by a registered orthoptist per clinical protocols, once by an orthoptist using a tablet-based visual acuity test (iSight Test Pro, Kay Pictures), and once by an unsupervised parent/carer using the tablet-based test. RESULTS In total, 42 children were recruited to the study. The mean age was 5.6 years (range 3.3 to 9.3 years). Median and interquartile ranges (IQR) for clinical standard, orthoptic-led and parent/carer-led iSight Test Pro visual acuity measurements were 0.155 (0.18 IQR), 0.180 (0.26 IQR), and 0.300 (0.33 IQR) logMAR respectively. The iSight Test Pro in the hands of parents/carers was significantly different from the standard of care measurements (P = 0.008). In the hands of orthoptists. There was no significant difference between orthoptists using the iSight Test Pro and standard of care (P = 0.289), nor between orthoptist iSight Test Pro and parents/carer iSight Test Pro measurements (P = 0.108). CONCLUSION This technique of unsupervised visual acuity measures for children is not comparable to clinical measures and is unlikely to be valuable to clinical decision making. Future work should focus on improving the accuracy of the test through better training, equipment/software or supervision/support.
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Affiliation(s)
- Daniel Osborne
- University Hospital Southampton NHS Foundation Trust, Department of Ophthalmology, Southampton, UK.
- University of Southampton, Faculty of Medicine, Southampton, UK.
| | - Aimee Steele
- University of Southampton, Faculty of Medicine, Southampton, UK
| | - Megan Evans
- University Hospital Southampton NHS Foundation Trust, Department of Ophthalmology, Southampton, UK
| | - Helen Ellis
- University Hospital Southampton NHS Foundation Trust, Department of Ophthalmology, Southampton, UK
| | - Roshni Pancholi
- University Hospital Southampton NHS Foundation Trust, Department of Ophthalmology, Southampton, UK
| | - Tomos Harding
- University Hospital Southampton NHS Foundation Trust, Department of Ophthalmology, Southampton, UK
| | - Jessica Dee
- University Hospital Southampton NHS Foundation Trust, Department of Ophthalmology, Southampton, UK
| | - Rachel Leary
- University Hospital Southampton NHS Foundation Trust, Department of Ophthalmology, Southampton, UK
| | - Jeremy Bradshaw
- University Hospital Southampton NHS Foundation Trust, Department of Ophthalmology, Southampton, UK
| | - Elizabeth O'Flynn
- University Hospital Southampton NHS Foundation Trust, Department of Ophthalmology, Southampton, UK
| | - Jay E Self
- University Hospital Southampton NHS Foundation Trust, Department of Ophthalmology, Southampton, UK
- University of Southampton, Faculty of Medicine, Southampton, UK
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3
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Sanchez-Bretano A, Keeling E, Scott JA, Lynn SA, Soundara-Pandi SP, Macdonald SL, Newall T, Griffiths H, Lotery AJ, Ratnayaka JA, Self JE, Lee H. Human equivalent doses of L-DOPA rescues retinal morphology and visual function in a murine model of albinism. Sci Rep 2023; 13:17173. [PMID: 37821525 PMCID: PMC10567794 DOI: 10.1038/s41598-023-44373-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/07/2023] [Indexed: 10/13/2023] Open
Abstract
L-DOPA is deficient in the developing albino eye, resulting in abnormalities of retinal development and visual impairment. Ongoing retinal development after birth has also been demonstrated in the developing albino eye offering a potential therapeutic window in humans. To study whether human equivalent doses of L-DOPA/Carbidopa administered during the crucial postnatal period of neuroplasticity can rescue visual function, OCA C57BL/6 J-c2J OCA1 mice were treated with a 28-day course of oral L-DOPA/Carbidopa at 3 different doses from 15 to 43 days postnatal age (PNA) and for 3 different lengths of treatment, to identify optimum dosage and treatment length. Visual electrophysiology, acuity, and retinal morphology were measured at 4, 5, 6, 12 and 16 weeks PNA and compared to untreated C57BL/6 J (WT) and OCA1 mice. Quantification of PEDF, βIII-tubulin and syntaxin-3 expression was also performed. Our data showed impaired retinal morphology, decreased retinal function and lower visual acuity in untreated OCA1 mice compared to WT mice. These changes were diminished or eliminated when treated with higher doses of L-DOPA/Carbidopa. Our results demonstrate that oral L-DOPA/Carbidopa supplementation at human equivalent doses during the postnatal critical period of retinal neuroplasticity can rescue visual retinal morphology and retinal function, via PEDF upregulation and modulation of retinal synaptogenesis, providing a further step towards developing an effective treatment for albinism patients.
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Affiliation(s)
- Aida Sanchez-Bretano
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Sir Henry Wellcome Laboratories, Southampton University Hospital, South Block Mail Point 806, Level D, Southampton, SO16 6YD, UK
| | - Eloise Keeling
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Sir Henry Wellcome Laboratories, Southampton University Hospital, South Block Mail Point 806, Level D, Southampton, SO16 6YD, UK
| | - Jennifer A Scott
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Sir Henry Wellcome Laboratories, Southampton University Hospital, South Block Mail Point 806, Level D, Southampton, SO16 6YD, UK
| | - Savannah A Lynn
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Sir Henry Wellcome Laboratories, Southampton University Hospital, South Block Mail Point 806, Level D, Southampton, SO16 6YD, UK
| | - Sudha Priya Soundara-Pandi
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Sir Henry Wellcome Laboratories, Southampton University Hospital, South Block Mail Point 806, Level D, Southampton, SO16 6YD, UK
| | - Sarah L Macdonald
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Sir Henry Wellcome Laboratories, Southampton University Hospital, South Block Mail Point 806, Level D, Southampton, SO16 6YD, UK
| | - Tutte Newall
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Sir Henry Wellcome Laboratories, Southampton University Hospital, South Block Mail Point 806, Level D, Southampton, SO16 6YD, UK
| | - Helen Griffiths
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Sir Henry Wellcome Laboratories, Southampton University Hospital, South Block Mail Point 806, Level D, Southampton, SO16 6YD, UK
| | - Andrew J Lotery
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Sir Henry Wellcome Laboratories, Southampton University Hospital, South Block Mail Point 806, Level D, Southampton, SO16 6YD, UK
- Eye Unit, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
| | - J Arjuna Ratnayaka
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Sir Henry Wellcome Laboratories, Southampton University Hospital, South Block Mail Point 806, Level D, Southampton, SO16 6YD, UK
| | - Jay E Self
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Sir Henry Wellcome Laboratories, Southampton University Hospital, South Block Mail Point 806, Level D, Southampton, SO16 6YD, UK
- Eye Unit, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
| | - Helena Lee
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Sir Henry Wellcome Laboratories, Southampton University Hospital, South Block Mail Point 806, Level D, Southampton, SO16 6YD, UK.
- Eye Unit, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK.
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4
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Dunn MJ, Alexander RG, Amiebenomo OM, Arblaster G, Atan D, Erichsen JT, Ettinger U, Giardini ME, Gilchrist ID, Hamilton R, Hessels RS, Hodgins S, Hooge ITC, Jackson BS, Lee H, Macknik SL, Martinez-Conde S, Mcilreavy L, Muratori LM, Niehorster DC, Nyström M, Otero-Millan J, Schlüssel MM, Self JE, Singh T, Smyrnis N, Sprenger A. Minimal reporting guideline for research involving eye tracking (2023 edition). Behav Res Methods 2023:10.3758/s13428-023-02187-1. [PMID: 37507649 DOI: 10.3758/s13428-023-02187-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2023] [Indexed: 07/30/2023]
Abstract
A guideline is proposed that comprises the minimum items to be reported in research studies involving an eye tracker and human or non-human primate participant(s). This guideline was developed over a 3-year period using a consensus-based process via an open invitation to the international eye tracking community. This guideline will be reviewed at maximum intervals of 4 years.
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Affiliation(s)
- Matt J Dunn
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK.
| | - Robert G Alexander
- Departments of Ophthalmology, Neurology, and Physiology/Pharmacology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | | | - Gemma Arblaster
- Health Sciences School, University of Sheffield, Sheffield, UK
- Orthoptic Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Denize Atan
- Bristol Medical School, University of Bristol, Bristol, UK
| | | | | | - Mario E Giardini
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - Iain D Gilchrist
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Ruth Hamilton
- Department of Clinical Physics & Bioengineering, Royal Hospital for Children, NHS Greater Glasgow & Clyde, Glasgow, UK
- College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
| | - Roy S Hessels
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | | | - Ignace T C Hooge
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Brooke S Jackson
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Helena Lee
- Clinical and Experimental Sciences, University of Southampton, Southampton, UK
| | - Stephen L Macknik
- Departments of Ophthalmology, Neurology, and Physiology/Pharmacology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Susana Martinez-Conde
- Departments of Ophthalmology, Neurology, and Physiology/Pharmacology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Lee Mcilreavy
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
| | - Lisa M Muratori
- Department of Physical Therapy, School of Health Professions, Stony Brook University, Stony Brook, NY, USA
| | - Diederick C Niehorster
- Lund University Humanities Lab, Lund University, Lund, Sweden
- Department of Psychology, Lund University, Lund, Sweden
| | - Marcus Nyström
- Lund University Humanities Lab, Lund University, Lund, Sweden
| | - Jorge Otero-Millan
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, CA, USA
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Michael M Schlüssel
- UK EQUATOR Centre, Centre for Statistics in Medicine (CSM), Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - Jay E Self
- Clinical and Experimental Sciences, University of Southampton, Southampton, UK
| | - Tarkeshwar Singh
- Department of Kinesiology, Pennsylvania State University, University Park, PA, USA
| | - Nikolaos Smyrnis
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, General University Hospital Attikon, Athens, Greece
| | - Andreas Sprenger
- Department of Neurology and Institute of Psychology II, Center of Brain, Behavior and Metabolism (CBBM), University of Luebeck, Luebeck, Germany
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5
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Hogg HDJ, Low L, Self JE, Rahi JS. Impact of the COVID-19 pandemic on the research activities of UK ophthalmologists. Eye (Lond) 2023; 37:2089-2094. [PMID: 36316557 PMCID: PMC9628368 DOI: 10.1038/s41433-022-02293-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 09/26/2022] [Accepted: 10/11/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has impacted negatively on many areas of biomedical research and there is concern that academic recovery will take several years. This survey aimed to define the impact of the COVID-19 pandemic on UK ophthalmologists' research activities and understand the implications for recovery. METHODS An online survey comprising multiple choice and free-text questions was designed, piloted and then distributed to Royal College of Ophthalmologists (RCOphth) members in January 2021. Respondent characteristics, research expectations and experiences through the pandemic were captured. Descriptive and comparative statistics were applied to quantitative data alongside content analysis of qualitative data. RESULTS In total, 148 respondents (3.7% of RCOphth membership) comprised 46 trainees (31.1%), 97 consultants (65.5%) and 5 SAS doctors (3.4%); 54 had clinical-academic roles (36.5%) and 65/94 (69.1%) ophthalmologists with fully clinical posts identified as research-active. Of 114 research-active respondents, 104 (91.2%) reported an impact on their research from COVID-19; negative impacts included loss of research time (n = 69), research delays (n = 96) and funding shortfalls (n = 63). Content analysis identified five common themes; type of research activity, clinical demands, institutional challenges, COVID-19 alignment and work-life balance. CONCLUSIONS UK ophthalmology research has been adversely impacted by the pandemic. A substantial proportion of UK ophthalmologists are research active, but 20.4% of those surveyed felt that the pandemic had made research less attractive. Strategic steps must be taken to nurture UK ophthalmologists' engagement with research, especially for those who currently do no research, if the profession is to align itself with the Government vision of 'Research for All'.
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Affiliation(s)
- H D J Hogg
- Population Health Science Institute, Newcastle University, Newcastle upon Tyne, UK
- Newcastle Eye Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- National Institute for Health Research Biomedical research Centre, Moorfields Eye Hospital, London, UK
| | - L Low
- Institute of Aging and Inflammation, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - J E Self
- Southampton General Hospital, Southampton, UK
- School of Clinical ad Experimental Sciences, University of Southampton, Southampton, UK
| | - J S Rahi
- National Institute for Health Research Biomedical research Centre, Moorfields Eye Hospital, London, UK.
- Great Ormond Street Institute of Child Health, University College London, London, UK.
- Great Ormond Street NHS Foundation Trust, London, UK.
- Institute of Ophthalmology, University College London, London, UK.
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6
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Ceroni F, Osborne D, Clokie S, Bax DA, Cassidy EJ, Dunn MJ, Harris CM, Self JE, Ragge NK. Analysis of Fibroblast Growth Factor 14 (FGF14) structural variants reveals the genetic basis of the early onset nystagmus locus NYS4 and variable ataxia. Eur J Hum Genet 2023; 31:353-359. [PMID: 36207621 PMCID: PMC9995494 DOI: 10.1038/s41431-022-01197-5] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/02/2022] [Accepted: 09/14/2022] [Indexed: 11/09/2022] Open
Abstract
Nystagmus (involuntary, rhythmical eye movements) can arise due to sensory eye defects, in association with neurological disorders or as an isolated condition. We identified a family with early onset nystagmus and additional neurological features carrying a partial duplication of FGF14, a gene associated with spinocerebellar ataxia type 27 (SCA27) and episodic ataxia. Detailed eye movement analysis revealed oculomotor anomalies strikingly similar to those reported in a previously described four-generation family with early onset nystagmus and linkage to a region on chromosome 13q31.3-q33.1 (NYS4). Since FGF14 lies within NYS4, we revisited the original pedigree using whole genome sequencing, identifying a 161 kb heterozygous deletion disrupting FGF14 and ITGBL1 in the affected individuals, suggesting an FGF14-related condition. Therefore, our study reveals the genetic variant underlying NYS4, expands the spectrum of pathogenic FGF14 variants, and highlights the importance of screening FGF14 in apparently isolated early onset nystagmus.
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Affiliation(s)
- Fabiola Ceroni
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Daniel Osborne
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Samuel Clokie
- West Midlands Regional Clinical Genetics Service and Birmingham Health Partners, Birmingham Women's and Children's Foundation Trust, Birmingham, UK
| | - Dorine A Bax
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Emma J Cassidy
- Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury District Hospital, Salisbury, UK
| | - Matt J Dunn
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
| | | | - Jay E Self
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Nicola K Ragge
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK.
- West Midlands Regional Clinical Genetics Service and Birmingham Health Partners, Birmingham Women's and Children's Foundation Trust, Birmingham, UK.
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7
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Evans MJ, Ellis HL, Self JE. Aetiologies of acquired pediatric sixth nerve palsies in a U.K. based population. Strabismus 2022; 30:196-199. [PMID: 36373618 DOI: 10.1080/09273972.2022.2138919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Due to the low incidence of sixth cranial nerve palsies in children, there has been limited evidence published on this subject, especially from a population based within the UK. The incidence of etiologies has been found to vary significantly within the literature, especially with regard to neoplasms. The main aim of this study is to present the etiologies of newly diagnosed pediatric sixth nerve palsies in a UK-based population. We also take into consideration if the palsies were isolated or associated with other neurological signs or symptoms. Retrospective data collection was carried out on the medical records of 50 pediatric patients with a new-onset sixth nerve palsy. They all presented to a large tertiary referral hospital in the South of the UK between 1 January 2007 and 31 December 2017. Data collected for each patient included age, gender, ethnicity, unilateral versus bilateral, other signs and symptoms, etiology, where the patient first presented, and whether the palsy was the first presenting feature. Thirty-three (66%) patients had a new-onset sixth nerve palsy in conjunction with other neurological signs or symptoms and were considered non-isolated. Seventeen cases (34%) were found to be isolated. Etiologies included high intracranial pressure (18%), neoplasm (14%), surgery for neoplasm (14%), viral (14%), infection (12%), trauma (8%), idiopathic (6%), benign space-occupying lesion (4%), congenital (2%), inflammation (2%), Alexander's disease (2%), Kawasaki syndrome (2%), and diabetes (2%). Our study found non-isolated sixth nerve palsies to be the most common presentation. These patients had a high number of potentially sinister etiologies, the most common being high intracranial pressure followed by post-surgery for neoplasm and neoplasm. Isolated sixth nerve palsies were more commonly due to viral or idiopathic etiology; however, two cases of benign space-occupying lesion and one of neoplasm were identified.
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Affiliation(s)
- Megan J Evans
- Orthoptic Department, University Hospitals Southampton NHS Foundation Trust, Southampton
| | - Helen L Ellis
- Orthoptic Department, University Hospitals Southampton NHS Foundation Trust, Southampton
| | - Jay E Self
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton
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8
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Lin S, Sanchez-Bretaño A, Leslie JS, Williams KB, Lee H, Thomas NS, Callaway J, Deline J, Ratnayaka JA, Baralle D, Schmitt MA, Norman CS, Hammond S, Harlalka GV, Ennis S, Cross HE, Wenger O, Crosby AH, Baple EL, Self JE. Evidence that the Ser192Tyr/Arg402Gln in cis Tyrosinase gene haplotype is a disease-causing allele in oculocutaneous albinism type 1B (OCA1B). NPJ Genom Med 2022; 7:2. [PMID: 35027574 PMCID: PMC8758782 DOI: 10.1038/s41525-021-00275-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 11/19/2021] [Indexed: 01/09/2023] Open
Abstract
Oculocutaneous albinism type 1 (OCA1) is caused by pathogenic variants in the TYR (tyrosinase) gene which encodes the critical and rate-limiting enzyme in melanin synthesis. It is the most common OCA subtype found in Caucasians, accounting for ~50% of cases worldwide. The apparent 'missing heritability' in OCA is well described, with ~25-30% of clinically diagnosed individuals lacking two clearly pathogenic variants. Here we undertook empowered genetic studies in an extensive multigenerational Amish family, alongside a review of previously published literature, a retrospective analysis of in-house datasets, and tyrosinase activity studies. Together this provides irrefutable evidence of the pathogenicity of two common TYR variants, p.(Ser192Tyr) and p.(Arg402Gln) when inherited in cis alongside a pathogenic TYR variant in trans. We also show that homozygosity for the p.(Ser192Tyr)/p.(Arg402Gln) TYR haplotype results in a very mild, but fully penetrant, albinism phenotype. Together these data underscore the importance of including the TYR p.(Ser192Tyr)/p.(Arg402Gln) in cis haplotype as a pathogenic allele causative of OCA, which would likely increase molecular diagnoses in this missing heritability albinism cohort by 25-50%.
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Affiliation(s)
- Siying Lin
- RILD Wellcome Wolfson Centre, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, UK
| | - Aida Sanchez-Bretaño
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Joseph S Leslie
- RILD Wellcome Wolfson Centre, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, UK
| | - Katie B Williams
- Center for Special Children, Vernon Memorial Healthcare, La Farge, WI, USA
| | - Helena Lee
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- Southampton Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - N Simon Thomas
- Faculty of Medicine, University of Southampton, Southampton, UK
- Wessex Regional Genetics Laboratory, Salisbury District Hospital, Salisbury, UK
| | - Jonathan Callaway
- Faculty of Medicine, University of Southampton, Southampton, UK
- Wessex Regional Genetics Laboratory, Salisbury District Hospital, Salisbury, UK
| | - James Deline
- Center for Special Children, Vernon Memorial Healthcare, La Farge, WI, USA
| | - J Arjuna Ratnayaka
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Diana Baralle
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Melanie A Schmitt
- University of Wisconsin School of Medicine and Public Health, Department of Ophthalmology & Visual Sciences, Madison, WI, USA
| | - Chelsea S Norman
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- The Rosalind Franklin Institute, Rutherford Appleton Laboratories, Harwell Science and Innovation Campus, Didcot, UK
| | - Sheri Hammond
- Center for Special Children, Vernon Memorial Healthcare, La Farge, WI, USA
| | - Gaurav V Harlalka
- RILD Wellcome Wolfson Centre, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, UK
- Rajarshi Shahu College of Pharmacy, Malvihir, Buldana, India
| | - Sarah Ennis
- Department of Human Genetics and Genomic Medicine, University of Southampton, Southampton, UK
| | - Harold E Cross
- Department of Ophthalmology, University of Arizona College of Medicine, Tucson, AZ, USA
| | - Olivia Wenger
- New Leaf Clinic, PO Box 336, 16014 East Chestnut Street, Mount Eaton, OH, 44691, USA
- Department of Pediatrics, Akron Children's Hospital, 214 West Bowery Street, Akron, OH, 44308, USA
| | - Andrew H Crosby
- RILD Wellcome Wolfson Centre, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, UK.
| | - Emma L Baple
- RILD Wellcome Wolfson Centre, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, UK.
- Peninsula Clinical Genetics Service, Royal Devon & Exeter Hospital (Heavitree), Gladstone Road, Exeter, UK.
| | - Jay E Self
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
- Southampton Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
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9
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Gazdagh G, Mawby R, Self JE, Baralle D. A severe case of Bosch-Boonstra-Schaaf optic atrophy syndrome with a novel description of coloboma and septo-optic dysplasia, owing to a start codon variant in the NR2F1 gene. Am J Med Genet A 2021; 188:900-906. [PMID: 34787370 DOI: 10.1002/ajmg.a.62569] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/29/2021] [Accepted: 11/02/2021] [Indexed: 11/09/2022]
Abstract
Bosch-Boonstra-Schaaf optic atrophy syndrome (BBSOAS) is a rare congenital syndrome characterized by a range of phenotypes including optic atrophy and intellectual disability among other features. Pathogenic variants in the NR2F1 (nuclear receptor subfamily 2 group F member 1) gene have been linked to this condition. A recent report has shown that pathogenic variants in the start codon lead to decreased expression of the NR2F1 protein and a relatively mild phenotype, similar to that seen in whole gene deletions, and due to the lack of the dominant negative effect. Here we describe a severe case of BBSOAS with an initiation codon missense variant. The developmental delay, seizures, optic atrophy are in keeping with features observed in this condition, however this is the first report to describe colobomas and septo-optic dysplasia as associated features potentially extending the phenotype linked to BBSOAS. In addition, this is the first description of a severe phenotype linked to a de novo missense variant in the start codon of the NR2F1 gene.
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Affiliation(s)
- Gabriella Gazdagh
- Wessex Clinical Genetics Service, Princess Anne Hospital, University Hospital Southampton NHS Trust, Southampton, UK
| | - Rebecca Mawby
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Jay E Self
- Clinical and Experimental Sciences Faculty of Medicine, University of Southampton, Southampton, UK.,Department of Ophthalmology, University Hospital Southampton NHS Trust, Southampton, UK
| | - Diana Baralle
- Wessex Clinical Genetics Service, Princess Anne Hospital, University Hospital Southampton NHS Trust, Southampton, UK.,Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | -
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
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10
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Self JE, Lee H. Novel therapeutics in nystagmus: what has the genetics taught us so far? Ther Adv Rare Dis 2021; 2:2633004021998714. [PMID: 37181109 PMCID: PMC10032456 DOI: 10.1177/2633004021998714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 02/08/2021] [Indexed: 05/16/2023]
Abstract
Nystagmus is a disorder characterised by uncontrolled, repetitive, to-and-fro movement of the eyes. It can occur as a seemingly isolated disorder but is most commonly the first, or most obvious, feature in a host of ophthalmic and systemic disorders. The number of underlying causes is vast, and recent improvements in the provision of genetic testing have shown that many conditions can include nystagmus as a feature, but that phenotypes overlap significantly. Therefore, an increase in the understanding of the genetic causes of nystagmus has shown that successful novel therapeutics for 'nystagmus' can target either specific underlying disorders and mechanisms (aiming to treat the underlying condition as a whole), or a final common pathway (aiming to treat the nystagmus directly). Plain language summary Novel treatments for a disorder of eye movement (nystagmus): what has the genetics taught us so far? Nystagmus is a disorder of eye movement characterised by uncontrolled, to-and-fro movements. It can occur as an isolated disorder, in conditions affecting other parts of the eye, in conditions affecting multiple other parts of the body or secondary to neurological diseases (brain diseases). In recent years, advances in genetic testing methods and increase in genetic testing in healthcare systems have provided a greater understanding of the underlying causes of nystagmus. They have highlighted the bewildering number of genetic causes that can result in what looks like a very similar eye movement disorder.In recent years, new classes of drugs have been developed for some of the causes of nystagmus, and some new drugs have been developed for other conditions which have the potential to work in certain types of nystagmus. For these reasons, genetics has taught us that identifying new possible treatments for nystagmus can either be dependent on identifying the underlying genetic cause and aiming to treat that, or aiming to treat the nystagmus per se by targeting a final common pathway. A toolkit based on specific treatments for specific conditions is more to have meaningful impact on 'nystagmus' than pursuing a panacea based on a 'one size fits all' approach.
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Affiliation(s)
- Jay E Self
- Clinical and Experimental Sciences, Faculty of
Medicine, University of Southampton, Tremona Road, Southampton SO16 6YD,
UK
- University Hospital Southampton, Southampton,
UK
| | - Helena Lee
- Clinical and Experimental Sciences, Faculty of
Medicine, University of Southampton, Southampton, UK
- University Hospital Southampton, Southampton,
UK
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11
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Carter P, Gordon-Reid A, Shawkat F, Self JE. Correction: Comparison of the handheld RETeval ERG system with a routine ERG system in healthy adults and in paediatric patients. Eye (Lond) 2020; 35:2907. [PMID: 33128025 DOI: 10.1038/s41433-020-01248-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Perry Carter
- The Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - Arabella Gordon-Reid
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Fatima Shawkat
- The Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Jay E Self
- The Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Clinical and Experimental Sciences, School of Medicine, University of Southampton, Southampton, UK
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12
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Carter P, Gordon-Reid A, Shawkat F, Self JE. Comparison of the handheld RETeval ERG system with a routine ERG system in healthy adults and in paediatric patients. Eye (Lond) 2020; 35:2180-2189. [PMID: 33077909 DOI: 10.1038/s41433-020-01221-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 10/01/2020] [Accepted: 10/06/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Electroretinograms (ERG) are necessary for the evaluation of retinal function, however testing children is challenging and only performed at a few specialised centres. The handheld RETeval ERG instrument could prove a valuable tool for clinicians in assessing retinal function. This study evaluates this device using an ISCEV approved modified paediatric protocol and compares it to standard methods using a photic stimulator. SUBJECTS AND METHOD Cone and rod ERGs were recorded using a standard photic stimulator (Grass) and the RETeval device. Both methods involve using skin electrodes, without mydriasis and under dark and light conditions. Two groups of participants were recruited: 44 healthy adult subjects (mean age = 39 years) and 37 paediatric patients (mean = 5 years). Three of the paediatric patients were not sufficiently compliant to undertake the RETeval recording. RESULTS Adult ERG reference range data are presented for the RETeval and compared to the standard system. There is lack of absolute agreement in the measurements between the two devices, highlighting the need for device-specific reference data. In the paediatric group there is a high level of diagnostic agreement between both systems (Cohen's Kappa k = 0.80). The relative sensitivity and specificity of the RETeval was 1.0 and 0.91. Qualitative patient and user feedback is discussed. CONCLUSIONS ERGs are similar between the two methodologies. This study demonstrates that the RETeval device is a useful tool for assessing retinal function in children. Importantly, it is quick, relatively easy to use and can potentially reduce the burden and costs of paediatric electrodiagnostic assessments.
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Affiliation(s)
- Perry Carter
- The Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - Arabella Gordon-Reid
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Fatima Shawkat
- The Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Jay E Self
- The Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Clinical and Experimental Sciences, School of Medicine, University of Southampton, Southampton, UK
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13
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Salman A, Hutton SB, Newall T, Scott JA, Griffiths HL, Lee H, Gomez-Nicola D, Lotery AJ, Self JE. Characterization of the Frmd7 Knock-Out Mice Generated by the EUCOMM/COMP Repository as a Model for Idiopathic Infantile Nystagmus (IIN). Genes (Basel) 2020; 11:genes11101157. [PMID: 33007925 PMCID: PMC7601595 DOI: 10.3390/genes11101157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/21/2020] [Accepted: 09/24/2020] [Indexed: 12/30/2022] Open
Abstract
In this study, we seek to exclude other pathophysiological mechanisms by which Frmd7 knock-down may cause Idiopathic Infantile Nystagmus (IIN) using the Frmd7.tm1a and Frmd7.tm1b murine models. We used a combination of genetic, histological and visual function techniques to characterize the role of Frmd7 gene in IIN using a novel murine model for the disease. We demonstrate that the Frmd7.tm1b allele represents a more robust model of Frmd7 knock-out at the mRNA level. The expression of Frmd7 was investigated using both antibody staining and X-gal staining confirming previous reports that Frmd7 expression in the retina is restricted to starburst amacrine cells and demonstrating that X-gal staining recapitulates the expression pattern in this model. Thus, it offers a useful tool for further expression studies. We also show that gross retinal morphology and electrophysiology are unchanged in these Frmd7 mutant models when compared with wild-type mice. High-speed eye-tracking recordings of Frmd7 mutant mice confirm a specific horizontal optokinetic reflex defect. In summary, our study confirms the likely role for Frmd7 in the optokinetic reflex in mice mediated by starburst amacrine cells. We show that the Frmd7.tm1b model provides a more robust knock-out than the Frmd7.tm1a model at the mRNA level, although the functional consequence is unchanged. Finally, we establish a robust eye-tracking technique in mice that can be used in a variety of future studies using this model and others. Although our data highlight a deficit in the optiokinetic reflex as a result of the starburst amacrine cells in the retina, this does not rule out the involvement of other cells, in the brain or the retina where Frmd7 is expressed, in the pathophysiology of IIN.
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MESH Headings
- Alleles
- Amacrine Cells/metabolism
- Animals
- Cytoskeletal Proteins/genetics
- Cytoskeletal Proteins/metabolism
- Disease Models, Animal
- Electroretinography
- Female
- Gene Expression
- Genetic Diseases, X-Linked/genetics
- Genetic Diseases, X-Linked/pathology
- Genetic Diseases, X-Linked/physiopathology
- Male
- Mice
- Mice, Knockout
- Mutation
- Nystagmus, Congenital/genetics
- Nystagmus, Congenital/pathology
- Nystagmus, Congenital/physiopathology
- Nystagmus, Optokinetic
- Retina/metabolism
- Retina/pathology
- Retina/physiopathology
- Tomography, Optical Coherence
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Affiliation(s)
- Ahmed Salman
- Clinical and Experimental Neurosciences, University of Southampton, Southampton SO16 6YD, UK; (T.N.); (J.A.S.); (H.L.G.); (H.L.); (A.J.L.); (J.E.S.)
- Correspondence:
| | - Samuel B. Hutton
- School of Psychology, University of Sussex, Brighton BN1 9QH, UK;
| | - Tutte Newall
- Clinical and Experimental Neurosciences, University of Southampton, Southampton SO16 6YD, UK; (T.N.); (J.A.S.); (H.L.G.); (H.L.); (A.J.L.); (J.E.S.)
| | - Jennifer A. Scott
- Clinical and Experimental Neurosciences, University of Southampton, Southampton SO16 6YD, UK; (T.N.); (J.A.S.); (H.L.G.); (H.L.); (A.J.L.); (J.E.S.)
| | - Helen L. Griffiths
- Clinical and Experimental Neurosciences, University of Southampton, Southampton SO16 6YD, UK; (T.N.); (J.A.S.); (H.L.G.); (H.L.); (A.J.L.); (J.E.S.)
| | - Helena Lee
- Clinical and Experimental Neurosciences, University of Southampton, Southampton SO16 6YD, UK; (T.N.); (J.A.S.); (H.L.G.); (H.L.); (A.J.L.); (J.E.S.)
| | - Diego Gomez-Nicola
- School of Biological Sciences, University of Southampton, Southampton SO171BJ, UK;
| | - Andrew J. Lotery
- Clinical and Experimental Neurosciences, University of Southampton, Southampton SO16 6YD, UK; (T.N.); (J.A.S.); (H.L.G.); (H.L.); (A.J.L.); (J.E.S.)
| | - Jay E. Self
- Clinical and Experimental Neurosciences, University of Southampton, Southampton SO16 6YD, UK; (T.N.); (J.A.S.); (H.L.G.); (H.L.); (A.J.L.); (J.E.S.)
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14
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Self JE, Dunn MJ, Erichsen JT, Gottlob I, Griffiths HJ, Harris C, Lee H, Owen J, Sanders J, Shawkat F, Theodorou M, Whittle JP. Management of nystagmus in children: a review of the literature and current practice in UK specialist services. Eye (Lond) 2020; 34:1515-1534. [PMID: 31919431 PMCID: PMC7608566 DOI: 10.1038/s41433-019-0741-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 10/18/2019] [Accepted: 11/24/2019] [Indexed: 11/09/2022] Open
Abstract
Nystagmus is an eye movement disorder characterised by abnormal, involuntary rhythmic oscillations of one or both eyes, initiated by a slow phase. It is not uncommon in the UK and regularly seen in paediatric ophthalmology and adult general/strabismus clinics. In some cases, it occurs in isolation, and in others, it occurs as part of a multisystem disorder, severe visual impairment or neurological disorder. Similarly, in some cases, visual acuity can be normal and in others can be severely degraded. Furthermore, the impact on vision goes well beyond static acuity alone, is rarely measured and may vary on a minute-to-minute, day-to-day or month-to-month basis. For these reasons, management of children with nystagmus in the UK is varied, and patients report hugely different experiences and investigations. In this review, we hope to shine a light on the current management of children with nystagmus across five specialist centres in the UK in order to present, for the first time, a consensus on investigation and clinical management.
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Affiliation(s)
- J E Self
- University Hospital Southampton, Southampton, UK.
- Clinical and Experimental Sciences, School of Medicine, University of Southampton, Southampton, UK.
| | - M J Dunn
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
| | - J T Erichsen
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
| | - I Gottlob
- Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - H J Griffiths
- Division of Ophthalmology and Orthoptics, Health Sciences School, University of Sheffield, Sheffield, UK
| | - C Harris
- Royal Eye Infirmary, Derriford Hospital, Plymouth, UK
| | - H Lee
- University Hospital Southampton, Southampton, UK
- Clinical and Experimental Sciences, School of Medicine, University of Southampton, Southampton, UK
| | - J Owen
- Royal Eye Infirmary, Derriford Hospital, Plymouth, UK
| | - J Sanders
- Patient Representative, Plymouth, UK
| | - F Shawkat
- University Hospital Southampton, Southampton, UK
| | - M Theodorou
- Paediatric Ophthalmology and Strabismus, Moorfields Eye Hospital, London, UK
- National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital, London, UK
| | - J P Whittle
- Eye Department, Sheffield Children's Hospital, Sheffield, UK
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15
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Shakil M, Harlalka GV, Ali S, Lin S, D'Atri I, Hussain S, Nasir A, Shahzad MA, Ullah MI, Self JE, Baple EL, Crosby AH, Mahmood S. Tyrosinase (TYR) gene sequencing and literature review reveals recurrent mutations and multiple population founder gene mutations as causative of oculocutaneous albinism (OCA) in Pakistani families. Eye (Lond) 2019; 33:1339-1346. [PMID: 30996339 PMCID: PMC7005860 DOI: 10.1038/s41433-019-0436-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 01/21/2019] [Accepted: 03/25/2019] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To investigate eight previously unreported Pakistani families with genetically undefined OCA for mutations in TYR. METHODS Sanger sequencing of TYR has been performed in eight families with OCA phenotype. Mutation analysis was performed to establish the pathogenic role of novel mutation. Bioinformatics analysis was performed to predict the structural and functional impacts on protein due to the mutation. RESULTS In this study, we identified six likely pathogenic variants of TYR (c.272 G>A, c.308 G>A, c.346C>T, c.715 C>T, c.832 C>T and c.1255 G>A), including one novel variant (c.308 G>A; p.Cys103Tyr), segregating as appropriate in each family. Cys103 lies in the highly conserved region of the tyrosinase enzyme, and p.Cys103Tyr is predicted to disturb enzymatic function via alteration of the configurational orientation of TYR leading to a more rigid polypeptide structure. We have also reviewed the mutation spectrum of TYR in Pakistani ethnicity. Published data on OCA families proposed that ~40% have been associated with genetic variations in the TYR gene. The mutations reported in this study have now been described with varying frequencies in Pakistani families, including very rare/unique mutations. CONCLUSION A literature review of TYR gene mutations in Pakistani populations, combined with our genetic data, identified a number of gene mutations likely to represent regional ancestral founder mutations of relevance to Pakistani populations, in addition to sporadic and recurrent 'hotspot' mutations present repeatedly in other regions worldwide.
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Affiliation(s)
- Muhammad Shakil
- Department of Biochemistry, University of Health Sciences (UHS), Lahore, Pakistan
- RD&E (Wonford) NHS Foundation Trust, University of Exeter Medical School, Barrack Road, Exeter, Devon, EX2 5DW, UK
- Department of Biochemistry, Services Institute of Medical Sciences, Services Hospital, Lahore, Pakistan
| | - Gaurav V Harlalka
- RD&E (Wonford) NHS Foundation Trust, University of Exeter Medical School, Barrack Road, Exeter, Devon, EX2 5DW, UK
| | - Shamshad Ali
- Department of Ophthalmology, Services Institute of Medical Sciences, Services Hospital, Lahore, Pakistan
| | - Siying Lin
- RD&E (Wonford) NHS Foundation Trust, University of Exeter Medical School, Barrack Road, Exeter, Devon, EX2 5DW, UK
| | - Ilaria D'Atri
- RD&E (Wonford) NHS Foundation Trust, University of Exeter Medical School, Barrack Road, Exeter, Devon, EX2 5DW, UK
| | - Shabbir Hussain
- Department of Biochemistry, University of Health Sciences (UHS), Lahore, Pakistan
| | - Abdul Nasir
- Synthetic Protein Engineering Lab (SPEL), Department of Molecular Science and Technology, Ajou University, Suwon, 443-749, South Korea
| | - Muhammad Aiman Shahzad
- Department of Human Genetics and Molecular Biology, University of Health Sciences (UHS), Lahore, Pakistan
| | - Muhammad Ikram Ullah
- Department of Biochemistry, University of Health Sciences (UHS), Lahore, Pakistan
- Department of Clinical Laboratory Sciences, Jouf University, Sakaka-2014, Saudi Arabia
| | - Jay E Self
- Clinical and Experimental Sciences, University of Southampton, Southampton, UK
| | - Emma L Baple
- RD&E (Wonford) NHS Foundation Trust, University of Exeter Medical School, Barrack Road, Exeter, Devon, EX2 5DW, UK
| | - Andrew H Crosby
- RD&E (Wonford) NHS Foundation Trust, University of Exeter Medical School, Barrack Road, Exeter, Devon, EX2 5DW, UK
| | - Saqib Mahmood
- Department of Human Genetics and Molecular Biology, University of Health Sciences (UHS), Lahore, Pakistan.
- Institute of Biomedical and Allied Health Sciences, University of Health Sciences (UHS), Lahore, Pakistan.
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16
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Fasham J, Arno G, Lin S, Xu M, Carss KJ, Hull S, Lane A, Robson AG, Wenger O, Self JE, Harlalka GV, Salter CG, Schema L, Moss TJ, Cheetham ME, Moore AT, Raymond FL, Chen R, Baple EL, Webster AR, Crosby AH. Delineating the expanding phenotype associated with SCAPER gene mutation. Am J Med Genet A 2019; 179:1665-1671. [PMID: 31192531 PMCID: PMC6772143 DOI: 10.1002/ajmg.a.61202] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/01/2019] [Accepted: 05/05/2019] [Indexed: 11/19/2022]
Affiliation(s)
- James Fasham
- Medical Research, RILD Wellcome Wolfson Centre, University of Exeter Medical School, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom.,Peninsula Clinical Genetics Service, Royal Devon and Exeter Hospital (Heavitree), Exeter, United Kingdom
| | - Gavin Arno
- UCL Institute of Ophthalmology, University College London, London, United Kingdom.,Moorfields Eye Hospital, London, United Kingdom
| | - Siying Lin
- Medical Research, RILD Wellcome Wolfson Centre, University of Exeter Medical School, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom
| | - Mingchu Xu
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas.,Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas
| | - Keren J Carss
- Department of Haematology, NHS Blood and Transplant Centre, University of Cambridge, Cambridge, United Kingdom.,NIHR BioResource - Rare Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Sarah Hull
- UCL Institute of Ophthalmology, University College London, London, United Kingdom.,Moorfields Eye Hospital, London, United Kingdom
| | - Amelia Lane
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Anthony G Robson
- UCL Institute of Ophthalmology, University College London, London, United Kingdom.,Moorfields Eye Hospital, London, United Kingdom
| | - Olivia Wenger
- New Leaf Center, Clinic for Special Children, Mount Eaton, Ohio
| | - Jay E Self
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Gaurav V Harlalka
- Medical Research, RILD Wellcome Wolfson Centre, University of Exeter Medical School, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom
| | - Claire G Salter
- Medical Research, RILD Wellcome Wolfson Centre, University of Exeter Medical School, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom
| | - Lynn Schema
- Division of Genetics and Metabolism, University of Minnesota Medical Center - Fairview, Minneapolis, Minnesota
| | - Timothy J Moss
- Division of Genetics and Metabolism, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Michael E Cheetham
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Anthony T Moore
- UCL Institute of Ophthalmology, University College London, London, United Kingdom.,Moorfields Eye Hospital, London, United Kingdom.,Ophthalmology Department, UCSF School of Medicine, Koret Vision Centre, San Francisco, California
| | - F Lucy Raymond
- NIHR BioResource - Rare Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.,Department of Medical Genetics, Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom
| | - Rui Chen
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas.,Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas
| | - Emma L Baple
- Medical Research, RILD Wellcome Wolfson Centre, University of Exeter Medical School, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom.,Peninsula Clinical Genetics Service, Royal Devon and Exeter Hospital (Heavitree), Exeter, United Kingdom
| | - Andrew R Webster
- UCL Institute of Ophthalmology, University College London, London, United Kingdom.,Moorfields Eye Hospital, London, United Kingdom
| | - Andrew H Crosby
- Medical Research, RILD Wellcome Wolfson Centre, University of Exeter Medical School, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom
| | -
- NIHR BioResource - Rare Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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17
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Khan S, Lin S, Harlalka GV, Ullah A, Shah K, Khalid S, Mehmood S, Hassan MJ, Ahmad W, Self JE, Crosby AH, Baple EL, Gul A. BBS5 and INPP5E mutations associated with ciliopathy disorders in families from Pakistan. Ann Hum Genet 2019; 83:477-482. [PMID: 31173343 DOI: 10.1111/ahg.12336] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 04/17/2019] [Accepted: 05/18/2019] [Indexed: 11/28/2022]
Abstract
Ciliopathies are a clinically and genetically heterogeneous group of disorders often exhibiting phenotypic overlap and caused by abnormalities in the structure or function of cellular cilia. As such, a precise molecular diagnosis is important for guiding clinical management and genetic counseling. In the present study, two Pakistani families comprising individuals with overlapping clinical features suggestive of a ciliopathy syndrome, including intellectual disability, obesity, congenital retinal dystrophy, and hypogonadism (in males), were investigated clinically and genetically. Whole-exome sequencing identified the likely causes of disease as a novel homozygous frameshift mutation (NM_152384.2: c.196delA; p.(Arg66Glufs*12); family 1) in BBS5, and a nonsense mutation (NM_019892.5:c.1879C>T; p.Gln627*; family 2) in INPP5E, previously reported in an extended Pakistani family with MORM syndrome. Our findings expand the molecular spectrum associated with BBS5 mutations in Pakistan and provide further supportive evidence that the INPP5E mutation is a common cause of ciliopathy in Northern Pakistan, likely representing a regional founder mutation. This study also highlights the value of genomic studies in Pakistan for families affected by rare heterogeneous developmental disorders and where clinical phenotyping may be limited by geographical and financial constraints. The identification of the spectrum and frequency of disease-causing variants within this setting enables the development of population-specific genetic testing strategies targeting variants common to the local population and improving health care outcomes.
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Affiliation(s)
- Shazia Khan
- Department of Biological Sciences, International Islamic University Islamabad, Islamabad, Pakistan.,RILD Wellcome Wolfson Centre, Royal Devon and Exeter Hospital, Exeter, UK
| | - Siying Lin
- RILD Wellcome Wolfson Centre, Royal Devon and Exeter Hospital, Exeter, UK
| | - Gaurav V Harlalka
- RILD Wellcome Wolfson Centre, Royal Devon and Exeter Hospital, Exeter, UK
| | - Asmat Ullah
- Department of Biochemistry, Quaid-i-Azam University, Islamabad, Pakistan.,Department of Molecualr Biology, Shaheed Zulfiqar Ali Bhutto Medical University, PIMS, Islamabad, Pakistan
| | - Khadim Shah
- Department of Biotechnology, COMSATS University Islamabad, Abbotabad Campus, Pakistan
| | - Sumbul Khalid
- Department of Biological Sciences, International Islamic University Islamabad, Islamabad, Pakistan
| | - Sarmad Mehmood
- Atta ur Rahman School of Applied Biosciences, National University of Sciences & Technology, Islamabad, Pakistan
| | - Muhammad Jawad Hassan
- Atta ur Rahman School of Applied Biosciences, National University of Sciences & Technology, Islamabad, Pakistan
| | - Wasim Ahmad
- Department of Biochemistry, Quaid-i-Azam University, Islamabad, Pakistan
| | - Jay E Self
- Clinical and Experimental Sciences, University of Southampton, Southampton, UK
| | - Andrew H Crosby
- RILD Wellcome Wolfson Centre, Royal Devon and Exeter Hospital, Exeter, UK
| | - Emma L Baple
- RILD Wellcome Wolfson Centre, Royal Devon and Exeter Hospital, Exeter, UK.,Peninsula Clinical Genetics Service, Royal Devon & Exeter Hospital, Exeter, UK
| | - Asma Gul
- Department of Biological Sciences, International Islamic University Islamabad, Islamabad, Pakistan
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18
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Lee H, Scott J, Griffiths H, Self JE, Lotery A. Oral levodopa rescues retinal morphology and visual function in a murine model of human albinism. Pigment Cell Melanoma Res 2019; 32:657-671. [PMID: 30851223 PMCID: PMC6766973 DOI: 10.1111/pcmr.12782] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 10/25/2018] [Revised: 02/07/2019] [Accepted: 03/04/2019] [Indexed: 01/10/2023]
Abstract
Albinism is a group of disorders characterized by pigment deficiency and abnormal retinal development. Despite being a common cause for visual impairment worldwide, there is a paucity of treatments and patients typically suffer lifelong visual disability. Residual plasticity of the developing retina in young children with albinism has been demonstrated, suggesting a post-natal window for therapeutic rescue. L-3, 4 dihydroxyphenylalanine (L-DOPA), a key signalling molecule which is essential for normal retinal development, is known to be deficient in albinism. In this study, we demonstrate for the first time that post-natal L-DOPA supplementation can rescue retinal development, morphology and visual function in a murine model of human albinism, but only if administered from birth or 15 days post-natal age.
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Affiliation(s)
- Helena Lee
- Clinical and Experimental Sciences, Faculty of Medicine, Sir Henry Wellcome Laboratories, Southampton University Hospital, University of Southampton, Southampton, UK.,Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Jennifer Scott
- Clinical and Experimental Sciences, Faculty of Medicine, Sir Henry Wellcome Laboratories, Southampton University Hospital, University of Southampton, Southampton, UK
| | - Helen Griffiths
- Clinical and Experimental Sciences, Faculty of Medicine, Sir Henry Wellcome Laboratories, Southampton University Hospital, University of Southampton, Southampton, UK
| | - Jay E Self
- Clinical and Experimental Sciences, Faculty of Medicine, Sir Henry Wellcome Laboratories, Southampton University Hospital, University of Southampton, Southampton, UK.,Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Andrew Lotery
- Clinical and Experimental Sciences, Faculty of Medicine, Sir Henry Wellcome Laboratories, Southampton University Hospital, University of Southampton, Southampton, UK.,Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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19
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O'Gorman L, Cree AJ, Ward D, Griffiths HL, Sood R, Denniston AK, Self JE, Ennis S, Lotery AJ, Gibson J. Comprehensive sequencing of the myocilin gene in a selected cohort of severe primary open-angle glaucoma patients. Sci Rep 2019; 9:3100. [PMID: 30816137 PMCID: PMC6395666 DOI: 10.1038/s41598-019-38760-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 07/24/2018] [Accepted: 01/07/2019] [Indexed: 11/16/2022] Open
Abstract
Primary open-angle glaucoma (POAG) is the most common form of glaucoma, prevalent in approximately 1–2% of Caucasians in the UK over the age of 40. It is characterised by an open anterior chamber angle, raised intraocular pressure (IOP) and optic nerve damage leading to loss of sight. The myocilin gene (MYOC) is the most common glaucoma-causing gene, accounting for ~2% of British POAG cases. 358 patients were selected for next generation sequencing (NGS) with the following selection criteria: Caucasian ethnicity, intraocular pressure (IOP) 21–40 mm Hg, cup:disc ratio ≥0.6 and visual field mean deviation ≤−3. The entire MYOC gene (17,321 bp) was captured including the promoter, introns, UTRs and coding exons. We identify 12 exonic variants (one stop-gain, five missense and six synonymous variants), two promoter variants, 133 intronic variants, two 3′ UTR variants and 23 intergenic variants. Four known or predicted pathogenic exonic variants (p.R126W, p.K216K, p.Q368* and p.T419A) were identified across 11 patients, which accounts for 3.07% of this POAG cohort. This is the first time that the entire region of MYOC has been sequenced and variants reported for a cohort of POAG patients.
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Affiliation(s)
- Luke O'Gorman
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Angela J Cree
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Daniel Ward
- Molecular Genetics Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury, UK
| | - Helen L Griffiths
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Roshan Sood
- Biological Sciences, Faculty of Natural and Environmental Sciences, University of Southampton, Southampton, UK
| | - Alastair K Denniston
- Department of Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Jay E Self
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Eye Unit, University Hospital Southampton, Southampton, UK
| | - Sarah Ennis
- Human Genetics & Genomic Medicine, Faculty of Medicine, University of Southampton, Southampton, UK.
| | - Andrew J Lotery
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Eye Unit, University Hospital Southampton, Southampton, UK
| | - Jane Gibson
- Biological Sciences, Faculty of Natural and Environmental Sciences, University of Southampton, Southampton, UK
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20
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Osborne DC, Greenhalgh KM, Evans MJE, Self JE. Atropine Penalization Versus Occlusion Therapies for Unilateral Amblyopia after the Critical Period of Visual Development: A Systematic Review. Ophthalmol Ther 2018; 7:323-332. [PMID: 30328078 PMCID: PMC6258585 DOI: 10.1007/s40123-018-0151-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 09/12/2018] [Indexed: 12/03/2022] Open
Abstract
Introduction Amblyopia therapy appears to be most effective in children under the age of 7 years, but results from randomized control trials (RCTs) have shown that occlusion therapy and/or atropine penalization therapy may improve visual acuity in an older age group. Which of these two therapies is the most effective with fewer adverse effects in an older age group has not yet been agreed upon. Methods We systematically searched the literature for RCTs that compared atropine penalization therapy and occlusion therapy in terms of their visual acuity outcomes and adverse events and performed a meta-analysis on the visual acuity data obtained. The adverse effects reported and their implications for clinical practice are discussed. Results Two RCTs were identified, with the authors of both concluding that there was no detectable difference between the two therapies for the age groups they studied. The mean difference between atropine penalization and occlusion therapies was calculated to be − 0.01 logMAR (95% confidence interval − 0.07 to 0.03 logMAR) in favor of occlusion therapy, and no statistical difference between the two groups was detected (P = 0.45). Neither study detected a marked difference in terms of reported adverse effects from the two interventions. Conclusion Based on the results of our meta-analysis we conclude that there is no difference in visual acuity outcomes between atropine penalization therapy and occlusion therapy after 17 to 24 weeks of treatment in children aged 7–12 years. Further evidence to determine the efficacy of amblyopia therapy for an older patient population is required before studies comparing atropine penalization and occlusion therapy in patients older than 12 years can be performed. Atropine penalization therapy may cause more frequent minor adverse effects, such as light sensitivity, but in the clinical setting this needs to be balanced with the potential practical benefits of twice-weekly eye drops versus daily occlusion. Funding The funding for this study was provided by the National Institute for Health Research (NIHR) and Health Education England (HEE). Plain Language Summary A plain language summary is available for this article. Electronic supplementary material The online version of this article (10.1007/s40123-018-0151-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Daniel C Osborne
- Orthoptic Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | | | - Megan J E Evans
- Orthoptic Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Jay E Self
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
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21
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Arshad MW, Harlalka GV, Lin S, D'Atri I, Mehmood S, Shakil M, Hassan MJ, Chioza BA, Self JE, Ennis S, O'Gorman L, Norman C, Aman T, Ali SS, Kaul H, Baple EL, Crosby AH, Ullah MI, Shabbir MI. Mutations in TYR and OCA2 associated with oculocutaneous albinism in Pakistani families. Meta Gene 2018. [DOI: 10.1016/j.mgene.2018.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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22
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Reijnders MRF, Janowski R, Alvi M, Self JE, van Essen TJ, Vreeburg M, Rouhl RPW, Stevens SJC, Stegmann APA, Schieving J, Pfundt R, van Dijk K, Smeets E, Stumpel CTRM, Bok LA, Cobben JM, Engelen M, Mansour S, Whiteford M, Chandler KE, Douzgou S, Cooper NS, Tan EC, Foo R, Lai AHM, Rankin J, Green A, Lönnqvist T, Isohanni P, Williams S, Ruhoy I, Carvalho KS, Dowling JJ, Lev DL, Sterbova K, Lassuthova P, Neupauerová J, Waugh JL, Keros S, Clayton-Smith J, Smithson SF, Brunner HG, van Hoeckel C, Anderson M, Clowes VE, Siu VM, DDD study T, Selber P, Leventer RJ, Nellaker C, Niessing D, Hunt D, Baralle D. PURA syndrome: clinical delineation and genotype-phenotype study in 32 individuals with review of published literature. J Med Genet 2018; 55:104-113. [PMID: 29097605 PMCID: PMC5800346 DOI: 10.1136/jmedgenet-2017-104946] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [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: 07/27/2017] [Revised: 08/29/2017] [Accepted: 09/13/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND De novo mutations in PURA have recently been described to cause PURA syndrome, a neurodevelopmental disorder characterised by severe intellectual disability (ID), epilepsy, feeding difficulties and neonatal hypotonia. OBJECTIVES To delineate the clinical spectrum of PURA syndrome and study genotype-phenotype correlations. METHODS Diagnostic or research-based exome or Sanger sequencing was performed in individuals with ID. We systematically collected clinical and mutation data on newly ascertained PURA syndrome individuals, evaluated data of previously reported individuals and performed a computational analysis of photographs. We classified mutations based on predicted effect using 3D in silico models of crystal structures of Drosophila-derived Pur-alpha homologues. Finally, we explored genotype-phenotype correlations by analysis of both recurrent mutations as well as mutation classes. RESULTS We report mutations in PURA (purine-rich element binding protein A) in 32 individuals, the largest cohort described so far. Evaluation of clinical data, including 22 previously published cases, revealed that all have moderate to severe ID and neonatal-onset symptoms, including hypotonia (96%), respiratory problems (57%), feeding difficulties (77%), exaggerated startle response (44%), hypersomnolence (66%) and hypothermia (35%). Epilepsy (54%) and gastrointestinal (69%), ophthalmological (51%) and endocrine problems (42%) were observed frequently. Computational analysis of facial photographs showed subtle facial dysmorphism. No strong genotype-phenotype correlation was identified by subgrouping mutations into functional classes. CONCLUSION We delineate the clinical spectrum of PURA syndrome with the identification of 32 additional individuals. The identification of one individual through targeted Sanger sequencing points towards the clinical recognisability of the syndrome. Genotype-phenotype analysis showed no significant correlation between mutation classes and disease severity.
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Affiliation(s)
- Margot R F Reijnders
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Robert Janowski
- Institute of Structural Biology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - Mohsan Alvi
- Visual Geometry Group, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Jay E Self
- Department of Ophthalmology, Southampton General Hospital, Southampton, UK
- Department of Clinical and Experimental Sciences, School of Medicine, University of Southampton, Southampton, UK
| | - Ton J van Essen
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Maaike Vreeburg
- Department of Clinical Genetics and School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Rob P W Rouhl
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Academic Center for Epileptology, Kempenhaeghe/MUMC, Maastricht, The Netherlands
| | - Servi J C Stevens
- Department of Clinical Genetics and School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Alexander P A Stegmann
- Department of Clinical Genetics and School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jolanda Schieving
- Department of Pediatric Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rolph Pfundt
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Katinke van Dijk
- Department of Pediatrics, Rijnstate Hospital, Arnhem, The Netherlands
| | - Eric Smeets
- Department of Clinical Genetics and School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Connie T R M Stumpel
- Department of Clinical Genetics and School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Levinus A Bok
- Department of Pediatrics, Máxima Medisch Centrum, Veldhoven, The Netherlands
| | - Jan Maarten Cobben
- Department of Pediatric Neurology, Academic Medical Center, Amsterdam, The Netherlands
| | - Marc Engelen
- Department of Neurology and Pediatric Neurology, Emma Children’s Hospital/Academic Medical Center, Amsterdam, The Netherlands
| | - Sahar Mansour
- SW Thames Regional Genetics Service, St. George’s University NHS Foundation Trust, London, UK
| | - Margo Whiteford
- Department of Clinical Genetics, Laboratory Medicine Building, Queen Elizabeth University Hospital, Glasgow, UK
| | - Kate E Chandler
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Manchester Centre for Genomic Medicine, St Mary’s Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Sofia Douzgou
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Manchester Centre for Genomic Medicine, St Mary’s Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Nicola S Cooper
- West Midlands Regional Clinical Genetics Service, Birmingham Women’s NHS Foundation Trust, Birmingham, UK
| | - Ene-Choo Tan
- KK Research Laboratory, KK Women’s and Children’s Hospital, Singapore
| | - Roger Foo
- National University Health Systems, Cardiovascular Research Institute, Singapore, Singapore
- Genome Institute of Singapore, Singapore, Singapore
| | - Angeline H M Lai
- Departmentof Paediatrics, Genetics Service, KK Women’s and Children’s Hospital, Singapore
| | - Julia Rankin
- Department of Clinical Genetics, Royal Devon and Exeter NHS Trust, Exeter, UK
| | - Andrew Green
- Department of Clinical Genetics, School of Medicine and Medical Science, Our Lady’s Hospital, University College Dublin, Dublin, Ireland
| | - Tuula Lönnqvist
- Department of Child Neurology, Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pirjo Isohanni
- Department of Child Neurology, Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Programs Unit, Molecular Neurology, Biomedicum-Helsinki, University of Helsinki, Helsinki, Finland
| | - Shelley Williams
- Department of Pediatric Neurology, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, USA
| | - Ilene Ruhoy
- Division of Pediatric Neurology, Seattle Children’s Hospital/University of Washington, Seattle, Washington, USA
| | - Karen S Carvalho
- Department of Pediatrics, Section of Neurology, St. Christopher’s Hospital for Children, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - James J Dowling
- Division of Neurology and Program for Genetics and Genome Biology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Dorit L Lev
- The Rina Mor Institute of Medical Genetics, Holon, Israel
| | - Katalin Sterbova
- Department of Pediatric Neurology, Second Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
| | - Petra Lassuthova
- Department of Pediatric Neurology, Second Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
| | - Jana Neupauerová
- Department of Pediatric Neurology, Second Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic
| | - Jeff L Waugh
- Department of Neurology, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Sotirios Keros
- Sanford Children’s Hospital, University of South Dakota, Sioux Falls, South Dakota, USA
| | - Jill Clayton-Smith
- Faculty of Medical and Human Sciences, Institute of Evolution, Systems and Genomics, University of Manchester, Manchester Centre for Genomic Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Sarah F Smithson
- Department of Clinical Genetics, University Hospitals Bristol, Bristol, UK
| | - Han G Brunner
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Clinical Genetics and School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center, Maastricht, The Netherlands
| | | | | | - Virginia E Clowes
- North West Thames Regional Genetics Service, London North West Healthcare NHS Trust, London, UK
| | - Victoria Mok Siu
- Division of Medical Genetics, Department of Pediatrics, Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada
| | - The DDD study
- Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
| | - Paulo Selber
- Department of Orthopaedics, Royal Children’s Hospital, Melbourne, Victoria, Australia
| | - Richard J Leventer
- Department of Neurology, University of Melbourne Department of Paediatrics, The Royal Children’s Hospital, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - Christoffer Nellaker
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
- Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital Women’s Centre, University of Oxford, Oxford, UK
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, UK
| | - Dierk Niessing
- Institute of Structural Biology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
- Department of Cell Biology, Biomedical Center of the Ludwig-Maximilians-Universität München, Planegg-Martinsried, Germany
| | - David Hunt
- Department of Human Genetics and Genomic Medicine, Faculty of Medicine, University of Southampton, Southampton, UK
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK
| | - Diana Baralle
- Department of Human Genetics and Genomic Medicine, Faculty of Medicine, University of Southampton, Southampton, UK
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK
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23
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Ahmed MY, Al-Khayat A, Al-Murshedi F, Al-Futaisi A, Chioza BA, Pedro Fernandez-Murray J, Self JE, Salter CG, Harlalka GV, Rawlins LE, Al-Zuhaibi S, Al-Azri F, Al-Rashdi F, Cazenave-Gassiot A, Wenk MR, Al-Salmi F, Patton MA, Silver DL, Baple EL, McMaster CR, Crosby AH. A mutation of EPT1 (SELENOI) underlies a new disorder of Kennedy pathway phospholipid biosynthesis. Brain 2017; 140:547-554. [PMID: 28052917 PMCID: PMC5382949 DOI: 10.1093/brain/aww318] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 10/19/2016] [Indexed: 12/20/2022] Open
Abstract
Mutations in genes involved in lipid metabolism have increasingly been associated with various subtypes of hereditary spastic paraplegia, a highly heterogeneous group of neurodegenerative motor neuron disorders characterized by spastic paraparesis. Here, we report an unusual autosomal recessive neurodegenerative condition, best classified as a complicated form of hereditary spastic paraplegia, associated with mutation in the ethanolaminephosphotransferase 1 (EPT1) gene (now known as SELENOI), responsible for the final step in Kennedy pathway forming phosphatidylethanolamine from CDP-ethanolamine. Phosphatidylethanolamine is a glycerophospholipid that, together with phosphatidylcholine, constitutes more than half of the total phospholipids in eukaryotic cell membranes. We determined that the mutation defined dramatically reduces the enzymatic activity of EPT1, thereby hindering the final step in phosphatidylethanolamine synthesis. Additionally, due to central nervous system inaccessibility we undertook quantification of phosphatidylethanolamine levels and species in patient and control blood samples as an indication of liver phosphatidylethanolamine biosynthesis. Although this revealed alteration to levels of specific phosphatidylethanolamine fatty acyl species in patients, overall phosphatidylethanolamine levels were broadly unaffected indicating that in blood EPT1 inactivity may be compensated for, in part, via alternate biochemical pathways. These studies define the first human disorder arising due to defective CDP-ethanolamine biosynthesis and provide new insight into the role of Kennedy pathway components in human neurological function.
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Affiliation(s)
- Mustafa Y Ahmed
- Medical Research (Level 4), University of Exeter Medical School, RILD Wellcome Wolfson Centre, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK
| | - Aisha Al-Khayat
- Department of Biology, College of Science, Sultan Qaboos University, Sultanate of Oman
| | - Fathiya Al-Murshedi
- Department of Genetics, College of Medicine, Sultan Qaboos University, Sultanate of Oman
| | - Amna Al-Futaisi
- Department of Paediatrics, Sultan Qaboos University Hospital, Sultanate of Oman
| | - Barry A Chioza
- Medical Research (Level 4), University of Exeter Medical School, RILD Wellcome Wolfson Centre, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK
| | | | - Jay E Self
- Faculty of Medicine, University of Southampton, UK
| | - Claire G Salter
- West Midlands Regional Genetics Service, Birmingham Women's NHS Foundation Trust, Mindelsohn Way, Birmingham, B15 2TG, UK
| | - Gaurav V Harlalka
- Medical Research (Level 4), University of Exeter Medical School, RILD Wellcome Wolfson Centre, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK
| | - Lettie E Rawlins
- Medical Research (Level 4), University of Exeter Medical School, RILD Wellcome Wolfson Centre, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK
| | - Sana Al-Zuhaibi
- Department of Ophthalmology, Sultan Qaboos University Hospital, Sultanate of Oman
| | - Faisal Al-Azri
- Department of Radiology and Molecular Imaging, Sultan Qaboos University Hospital, Sultanate of Oman
| | - Fatma Al-Rashdi
- Department of Paediatrics, Sameal Hospital, Ministry of Health, Sultanate of Oman
| | - Amaury Cazenave-Gassiot
- SLING, Life Sciences Institute, National University of Singapore, Singapore.,Department of Biochemistry, National University of Singapore, Singapore
| | - Markus R Wenk
- SLING, Life Sciences Institute, National University of Singapore, Singapore.,Department of Biochemistry, National University of Singapore, Singapore
| | - Fatema Al-Salmi
- Department of Biology, College of Science, Sultan Qaboos University, Sultanate of Oman
| | - Michael A Patton
- Medical Research (Level 4), University of Exeter Medical School, RILD Wellcome Wolfson Centre, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK.,Department of Biology, College of Science, Sultan Qaboos University, Sultanate of Oman
| | - David L Silver
- Signature Research Program in Cardiovascular and Metabolic Disorders, Duke-NUS Medical School, Singapore
| | - Emma L Baple
- Medical Research (Level 4), University of Exeter Medical School, RILD Wellcome Wolfson Centre, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK
| | | | - Andrew H Crosby
- Medical Research (Level 4), University of Exeter Medical School, RILD Wellcome Wolfson Centre, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK
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24
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Affiliation(s)
- Jay E Self
- Paediatric Ophthalmology Department, Southampton Eye Unit, Southampton General Hospital, Southampton, UK; Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Ahmed Salman
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Marion F Hedley-Lewis
- Paediatric Ophthalmology Department, Southampton Eye Unit, Southampton General Hospital, Southampton, UK
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