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Voretigene Neparvovec 治疗 RPE65 相关视网膜营养不良:韩国 RPE65-IRD 共识文件委员会的共识和建议。

Voretigene Neparvovec for the Treatment of RPE65-associated Retinal Dystrophy: Consensus and Recommendations from the Korea RPE65-IRD Consensus Paper Committee.

机构信息

Institute of Vision Research, Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

出版信息

Korean J Ophthalmol. 2023 Apr;37(2):166-186. doi: 10.3341/kjo.2023.0008. Epub 2023 Mar 23.

Abstract

Mutations in the RPE65 gene, associated with Leber congenital amaurosis, early-onset severe retinal dystrophy, and retinitis pigmentosa, gained growing attention since gene therapy for patients with RPE65-associated retinal dystrophy is available in clinical practice. RPE65 gene accounts for a very small proportion of patients with inherited retinal degeneration, especially Asian patients. Because RPE65-associated retinal dystrophy shares common clinical characteristics, such as early-onset severe nyctalopia, nystagmus, low vision, and progressive visual field constriction, with retinitis pigmentosa by other genetic mutations, appropriate genetic testing is essential to make a correct diagnosis. Also, fundus abnormalities can be minimal in early childhood, and the phenotype is highly variable depending on the type of mutations in RPE65-associated retinal dystrophy, which makes a diagnostic difficulty. The aim of this paper is to review the epidemiology of RPE65-associated retinal dystrophy, mutation spectrum, genetic diagnosis, clinical characteristics, and voretigene neparvovec, a gene therapy product for the treatment of RPE65-related retinal dystrophy.

摘要

RPE65 基因突变与莱伯先天性黑矇、早发性严重视网膜营养不良和色素性视网膜炎有关,由于针对 RPE65 相关视网膜营养不良患者的基因治疗已在临床实践中应用,因此该基因受到越来越多的关注。RPE65 基因在遗传性视网膜变性患者中所占比例很小,尤其是亚洲患者。由于 RPE65 相关视网膜营养不良与其他基因突变引起的色素性视网膜炎具有共同的临床特征,如早发性严重夜盲、眼球震颤、视力低下和进行性视野缩小,因此进行适当的基因检测对于做出正确诊断至关重要。此外,眼底异常在儿童早期可能很小,表型因 RPE65 相关视网膜营养不良的突变类型而异,这使得诊断变得困难。本文旨在综述 RPE65 相关视网膜营养不良的流行病学、突变谱、基因诊断、临床特征以及 voretigene neparvovec(一种用于治疗 RPE65 相关视网膜营养不良的基因治疗产品)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7af6/10151174/b1a7fdc1f374/kjo-2023-0008f1.jpg

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