PDE6A-Associated Retinitis Pigmentosa, Clinical Characteristics, Genetics, and Natural History.

IF 4.4 Q1 OPHTHALMOLOGY
Shaima Awadh Hashem, Michalis Georgiou, Genevieve Wright, Yu Fujinami-Yokokawa, Yannik Laich, Malena Daich Varela, Thales A C de Guimaraes, Omar A Mahroo, Andrew R Webster, Kaoru Fujinami, Michel Michaelides
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Abstract

Purpose: To analyze the genetics, clinical characteristics, and natural history of PDE6A-associated retinitis pigmentosa.

Design: Retrospective, longitudinal, observational cohort study.

Participants: Patients with molecularly confirmed PDE6A-associated retinal dystrophy in a single tertiary referral center.

Methods: Review of medical records and retinal imaging, including fundus autofluorescence (FAF) imaging and spectral-domain OCT. Genetic results were reviewed, and the detected variants were assessed.

Main outcome measures: Molecular genetic testing, clinical findings including best-corrected visual acuity (BCVA), qualitative and quantitative retinal imaging analysis.

Results: Sixteen patients (32 eyes) were identified and evaluated longitudinally. Genetic analysis identified 14 variants in the PDE6A gene, including 8 novel variants. The mean age (± standard deviation, range) was 34.8 years (± 17.4, 12-76) at baseline, with a mean follow-up time of 4.8 years. Best-corrected visual acuity was 0.45 ± 0.45 logarithm of the minimum angle of resolution (logMAR) (range 0.0-1.6) at baseline and 0.65 ± 0.7 logMAR (range 0.0-2.3) at the last visit. Best-corrected visual acuity was similar among eyes in 88% of patients. A hyperautofluorescent ring was observed on FAF in 50% and 43.8% of the eyes at baseline and follow-up visit, respectively, with a mean area of 9.7 ± 4.5 mm2 at baseline and mean of 8.6 ± 4.8 mm2 at the follow-up visit. Mean horizontal ellipsoid zone width (EZW) at baseline was 1765 ± 1093 μm, which decreased to 1580 ± 1077 μm at follow-up. Eighteen eyes exhibited cystoid macular edema at baseline (56%), and 17 eyes (53%) at follow-up. There were statistically significant changes during the follow-up period in terms of BCVA, hyperautofluorescent ring area, and the EZW.

Conclusions: This study highlights the natural history of PDE6A-retinopathy. Most patients in this cohort had mild BCVA loss, and slowly progressive disease, based on FAF and OCT measurements.

Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

与 PDE6A 相关的视网膜色素变性、临床特征、遗传学和自然史。
目的:分析与 PDE6A 相关的视网膜色素变性的遗传学、临床特征和自然病史:回顾性、纵向、观察性队列研究:方法:回顾病历和视网膜成像:回顾病历和视网膜成像,包括眼底自动荧光(FAF)成像和光谱域光学相干断层扫描(SD-OCT)。审查基因结果,评估检测到的变异:结果:对 16 名患者(32 只眼睛)进行了鉴定和纵向评估。遗传分析确定了 PDE6A 基因中的 14 个变异,包括 8 个新型变异。基线平均年龄(±SD,范围)为 34.8 岁(±17.4,12 - 76),平均随访时间为 4.8 年。基线最佳矫正视力(BCVA)为 0.45 ± 0.45 LogMAR(范围 0.0 - 1.6),最后一次就诊时为 0.65 ± 0.7 LogMAR(范围 0.0 - 2.3)。88%的患者双眼BCVA相似。在基线和随访时,分别有 50%和 44% 的眼睛在 FAF 上观察到高荧光环,基线时的平均面积为 9.7 ± 4.5 mm2,随访时的平均面积为 8.6 ± 4.8 mm2。基线时的平均水平椭圆带宽度(EZW)为 1765 ± 1093 μm,随访时降至 1580 ± 1077 μm。基线时有 18 只眼睛(56%)出现囊样黄斑水肿,随访时有 17 只眼睛(53%)出现囊样黄斑水肿。随访期间,BCVA、高自发光环面积和EZW均发生了统计学意义上的显著变化:本研究强调了PDE6A视网膜病变的自然史。根据FAF和OCT测量结果,该队列中的大多数患者BCVA轻度减退,病情缓慢进展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Ophthalmology. Retina
Ophthalmology. Retina Medicine-Ophthalmology
CiteScore
7.80
自引率
6.70%
发文量
274
审稿时长
33 days
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