Qi Yu-He, Gao Feng-Juan, Hu Fang-Yuan, Zhang Sheng-Hai, Chen Jun-Yi, Huang Wan-Jing, Tian Guo-Hong, Wang Min, Gan De-Kang, Wu Ji-Hong, Xu Ge-Zhi
Eye Institute, Eye and ENT Hospital, College of Medicine, Fudan UniversityShanghai, China.
Shanghai Key Laboratory of Visual Impairment and Restoration, Science and Technology Commission of Shanghai MunicipalityShanghai, China.
Front Genet. 2017 Aug 25;8:107. doi: 10.3389/fgene.2017.00107. eCollection 2017.
To show early, rapid and accurate molecular diagnosis of occult macular dystrophy (OMD) in a four-generation Chinese family with inherited macular dystrophy. In the current study, we comprehensively screened 130 genes involved in common inherited non-syndromic eye diseases with next-generation sequencing-based target capture sequencing of the proband of a four-generation Chinese family that has suffered from maculopathy without a definitive diagnosis for over 10 years. Variants were filtered and analyzed to identify possible disease-causing variants before validation by Sanger sequencing. Two heterozygous mutations- c.133 C > T (p.Arg45Trp), which is a hot spot for OMD, and c.6119 G > A (p.Arg2040Gln), which was identified in Stargardt's disease were found in three patients, but neither of the mutations was found in the unaffected individuals in the same family, who are phenotypically normal or in the normal control volunteers. These results cannot only confirm the diagnosis of OMD in the proband, but also provide presymptomatic diagnosis of the proband's children before the onset of visual acuity impairment and guidance regarding the prognosis and management of these patients. Heterozygous mutations of c.133 C > T (p.Arg45Trp) and c.6119 G > A (p.Arg2040Gln) are likely responsible for OMD. Our results further extend our current understanding of the genetic basis of OMD, and emphasize the importance of molecular diagnosis and genetic counseling for OMD.
为了对一个患有遗传性黄斑营养不良的四代中国家系中的隐匿性黄斑营养不良(OMD)进行早期、快速且准确的分子诊断。在本研究中,我们对一个四代中国家系的先证者进行了基于新一代测序的目标捕获测序,全面筛查了130个与常见遗传性非综合征性眼病相关的基因。该家系患有黄斑病变且超过10年未得到明确诊断。对变异进行筛选和分析,以识别可能的致病变异,然后通过桑格测序进行验证。在三名患者中发现了两个杂合突变——c.133 C>T(p.Arg45Trp),这是OMD的一个热点突变,以及c.6119 G>A(p.Arg2040Gln),该突变在斯塔加特病中被发现,但在同一家庭中表型正常的未受影响个体或正常对照志愿者中均未发现这两个突变。这些结果不仅可以确诊先证者的OMD,还能在其子女视力损害发作前进行症状前诊断,并为这些患者的预后和管理提供指导。c.133 C>T(p.Arg45Trp)和c.6119 G>A(p.Arg2040Gln)的杂合突变可能是OMD的病因。我们的结果进一步扩展了我们目前对OMD遗传基础的理解,并强调了OMD分子诊断和遗传咨询的重要性。