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Phenotypic diversity in autosomal-dominant cone-rod dystrophy elucidated by adaptive optics retinal imaging
Journal article   Open access   Peer reviewed

Phenotypic diversity in autosomal-dominant cone-rod dystrophy elucidated by adaptive optics retinal imaging

Hongxin Song, Ethan A Rossi, Edwin Stone, Lisa Latchney, David Williams, Alfredo Dubra and Mina Chung
British journal of ophthalmology, Vol.102(1), pp.136-141
01/2018
DOI: 10.1136/bjophthalmol-2017-310498
PMCID: PMC5754866
PMID: 29074494
url
https://doi.org/10.1136/bjophthalmol-2017-310498View
Published (Version of record) Open Access

Abstract

Several genes causing autosomal-dominant cone-rod dystrophy (AD-CRD) have been identified. However, the mechanisms by which genetic mutations lead to cellular loss in human disease remain poorly understood. Here we combine genotyping with high-resolution adaptive optics retinal imaging to elucidate the retinal phenotype at a cellular level in patients with AD-CRD harbouring a defect in the gene. Nine affected members of a four-generation AD-CRD pedigree and three unaffected first-degree relatives underwent clinical examinations including visual acuity, fundus examination, Goldmann perimetry, spectral domain optical coherence tomography and electroretinography. Genome-wide scan followed by bidirectional sequencing was performed on all affected participants. High-resolution imaging using a custom adaptive optics scanning light ophthalmoscope (AOSLO) was performed for selected participants. Clinical evaluations showed a range of disease severity from normal fundus appearance in teenaged patients to pronounced macular atrophy in older patients. Molecular genetic testing showed a mutation in in segregating with disease. AOSLO imaging revealed that of the two teenage patients with mild disease, one had severe disruption of the photoreceptor mosaic while the other had a normal cone mosaic. AOSLO imaging demonstrated variability in the pattern of cone and rod cell loss between two teenage cousins with early AD-CRD, who had similar clinical features and had the identical disease-causing mutation in . This finding suggests that a mutation in does not lead to the same degree of AD-CRD in all patients. Modifying factors may mitigate or augment disease severity, leading to different retinal cellular phenotypes.
Phenotype Humans Middle Aged Electroretinography - instrumentation Genotype Male Visual Acuity Equipment Design Cone-Rod Dystrophies - genetics Young Adult Cone-Rod Dystrophies - therapy Cone-Rod Dystrophies - diagnosis Pedigree Adolescent Tomography, Optical Coherence - instrumentation Adult Female Aged Optics and Photonics Child Fundus Oculi Fluorescein Angiography - instrumentation

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