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RDH12 基因突变患者眼底类型与临床表现的相关性研究。

Associations Between Fundus Types and Clinical Manifestations in Patients with RDH12 Gene Mutations.

机构信息

Affiliated Eye Center, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, 430060, China.

Medical Research Institute, Wuhan University, Wuhan, 430071, China.

出版信息

Brain Topogr. 2022 Jul;35(4):525-535. doi: 10.1007/s10548-021-00885-7. Epub 2022 Jan 10.

DOI:10.1007/s10548-021-00885-7
PMID:35006499
Abstract

To study the associations between RDH12 gene mutations, fundus types, and clinical manifestations. In total, 46 patients with inherited eye diseases caused by RDH12 gene mutations were included in this study. High-throughput chip capture sequencing, Sanger sequencing, and gene panel detection were used to determine that RDH12 was the pathogenic gene. All patients underwent the following detailed ophthalmic examinations: visual acuity, visual field, intraocular pressure, fundus photography, electroretinography, and optical coherence tomography (OCT). Statistical analysis was used to evaluate the clinical phenotype. A total of 32 mutations were identified in 46 patients. The most common mutations were c.437T > A, c.184C > T, and c.524C > T; the corresponding amino acid changes were p.Val146Asp, p.Arg62Ter, and p.Ser175Leu. Of the 46 patients, retinitis pigmentosa (RP) was found in 31 (68.9%); leber congenital amaurosis (LVA) was found in 11 (24.4%); early onset of severe retinal dystrophy (EOSRD) was found in one (2.2%); cone rod dystrophy (CORD) was found in one (2.2%); and Stargardt disease was found in one (2.2%). There was a significant difference in best-corrected visual acuity among patients based on fundus type (p = 0.0124). Linear trend analysis showed that best-corrected visual acuity gradually decreased as the fundus type increased in severity. In addition, there was a significant difference in the incidence of night blindness among patients with different fundus types (p = 0.0429): types I and IV fundi were associated with the highest incidences of night blindness. RDH12 gene mutation can cause serious inherited retinal diseases, which primarily include RP and LCA. Combined with clinical symptoms and fundus types, the progression of the disease can be characterized and used to guide genetic diagnosis and gene therapy.

摘要

研究 RDH12 基因突变、眼底类型和临床表现之间的关系。本研究纳入了 46 例由 RDH12 基因突变引起的遗传性眼病患者。采用高通量芯片捕获测序、Sanger 测序和基因panel 检测确定 RDH12 为致病基因。所有患者均行以下详细眼科检查:视力、视野、眼压、眼底照相、视网膜电图和光学相干断层扫描(OCT)。统计分析评估临床表型。在 46 例患者中发现了 32 种突变。最常见的突变为 c.437T > A、c.184C > T 和 c.524C > T;对应的氨基酸变化为 p.Val146Asp、p.Arg62Ter 和 p.Ser175Leu。46 例患者中,发现视网膜色素变性(RP)31 例(68.9%);发现莱伯先天性黑矇(LVA)11 例(24.4%);发现早发性严重视网膜营养不良(EOSRD)1 例(2.2%);发现 cone-rod 营养不良(CORD)1 例(2.2%);发现 Stargardt 病 1 例(2.2%)。不同眼底类型患者最佳矫正视力存在显著差异(p=0.0124)。线性趋势分析显示,随着眼底类型严重程度的增加,最佳矫正视力逐渐下降。此外,不同眼底类型患者夜间视力障碍的发生率存在显著差异(p=0.0429):I 型和 IV 型眼底与夜间视力障碍的发生率最高有关。RDH12 基因突变可引起严重的遗传性视网膜疾病,主要包括 RP 和 LCA。结合临床症状和眼底类型,可对疾病的进展进行特征描述,用于指导遗传诊断和基因治疗。

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