Membrane frizzled-related protein: a comprehensive analysis of genetic characteristics, phenotypic manifestations and impact on retinal microvasculature.

Abstract

Purpose: To assess the ocular characteristics, retinal microvasculature, and long-term outcomes of patients with nanophthalmos associated with mutations in the membrane frizzled-related protein (MFRP) gene, and to compare these findings with those observed in nanophthalmos cases without MFRP gene mutations.

Methods: In this retrospective cohort study, patients with MFRP-associated nanophthalmos and those with nanophthalmos without MFRP gene mutations were included. Best-corrected visual acuity (BCVA), spherical equivalent (SE), axial length (AL), optical coherence tomography (OCT), and OCT angiography parameters-including vascular density (VD) and foveal avascular zone (FAZ) measurements in the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC)-were evaluated at presentation and at the 5th-year follow-up.

Results: At presentation and 5-year follow-up, patients with MFRP-associated nanophthalmos exhibited significantly shorter AL and higher SE compared to those without MFRP mutations (all p < 0.001). Central macular thickness (CMT), subfoveal choroidal thickness (SFCT), and retinal nerve fiber layer (RNFL) thickness were significantly greater in the MFRP-associated group at presentation and 5-year follow-up (all p < 0.05). OCT angiography revealed reduced parafoveal VD in the SCP and DCP, as well as decreased foveal and parafoveal VD in the CC in the MFRP group compared to the group without MFRP mutations (all p < 0.05). FAZ areas in the SCP and DCP were also significantly smaller in the MFRP group (p < 0.001 and p = 0.01, respectively).

Conclusions: Eyes with MFRP-associated nanophthalmos exhibit significantly higher SE, shorter AL, and more pronounced alterations in retinal structure and microvasculature compared with eyes without MFRP mutations.