Institute for Ophthalmic Research, Centre for Ophthalmology, Eberhard Karls University Tübingen, 72076 Tübingen, Germany.
University Eye Hospital, Centre for Ophthalmology, Eberhard Karls University Tübingen, 72076 Tübingen, Germany.
Int J Mol Sci. 2021 Feb 27;22(5):2374. doi: 10.3390/ijms22052374.
In this retrospective, longitudinal, observational cohort study, we investigated the phenotypic and genotypic features of retinitis pigmentosa associated with variants in the gene. Patients underwent clinical examination and genetic testing at a single tertiary referral center, including best-corrected visual acuity (BCVA), kinetic visual field (VF), full-field electroretinography, full-field stimulus threshold, spectral domain optical coherence tomography, and fundus autofluorescence imaging. The genetic testing comprised candidate gene sequencing, inherited retinal disease gene panel sequencing, whole-genome sequencing, and testing for familial variants by Sanger sequencing. Twenty-four patients with mutations in from 21 families were included in the study (mean age at the first visit: 32.1 ± 13.5 years). The majority of variants were putative splicing defects (8/23) and missense (7/23) mutations. Seventy-nine percent (38/48) of eyes had no visual acuity impairment at the first visit. Visual acuity impairment was mild in 4% (2/48), moderate in 13% (6/48), and severe in 4% (2/48). BCVA was symmetrical in the right and left eyes. The kinetic VF measurements were highly symmetrical in the right and left eyes, as was the horizontal ellipsoid zone (EZ) width. Regarding the genetic findings, 43% of the variants found in our patients were novel. Thus, this study contributed substantially to the mutation spectrum. The visual acuity impairment was mild in 83% of eyes, providing a window of opportunity for investigational new drugs. The EZ width was reduced in all patients and was highly symmetric between the eyes, making it a promising outcome measure. We expect these findings to have implications on the design of future -related retinitis pigmentosa (RP) clinical trials.
在这项回顾性、纵向、观察性队列研究中,我们研究了与 基因变异相关的色素性视网膜炎的表型和基因型特征。患者在一家三级转诊中心接受临床检查和基因检测,包括最佳矫正视力(BCVA)、动力学视野(VF)、全视野视网膜电图、全视野刺激阈值、谱域光学相干断层扫描和眼底自发荧光成像。基因检测包括候选基因测序、遗传性视网膜疾病基因panel 测序、全基因组测序以及 Sanger 测序检测家族变异。从 21 个家系中纳入了 24 名携带 基因突变的患者(首次就诊时的平均年龄:32.1 ± 13.5 岁)。大多数变异为推测的剪接缺陷(8/23)和错义(7/23)突变。79%(38/48)的眼睛在首次就诊时视力无损害。视力损害轻度占 4%(2/48),中度占 13%(6/48),重度占 4%(2/48)。双眼 BCVA 对称。右眼和左眼的动力学 VF 测量高度对称,水平椭圆区(EZ)宽度也是如此。关于基因发现,我们患者中发现的 变异有 43%是新的。因此,本研究为 突变谱做出了重要贡献。83%的眼睛视力损害轻微,为研究新药提供了机会。所有患者的 EZ 宽度均降低,双眼之间高度对称,这是一种很有前途的结果测量方法。我们预计这些发现将对未来与 相关的色素性视网膜炎(RP)临床试验的设计产生影响。