Department of Ophthalmology, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan.
Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
Invest Ophthalmol Vis Sci. 2019 Aug 1;60(10):3432-3446. doi: 10.1167/iovs.19-26650.
Cone/cone-rod dystrophy is a large group of retinal disorders with both phonotypic and genetic heterogeneity. The purpose of this study was to characterize the phenotype of eight patients from seven families harboring POC1B mutations in a cohort of the Japan Eye Genetics Consortium (JEGC).
Whole-exome sequencing with targeted analyses identified homozygous or compound heterozygous mutations of the POC1B gene in 7 of 548 families in the JEGC database. Ophthalmologic examinations including the best-corrected visual acuity, perimetry, fundus photography, fundus autofluorescence imaging, optical coherence tomography, and full-field and multifocal electroretinography (ERGs) were performed.
There were four men and four women whose median age at the onset of symptoms was 15.6 years (range, 6-23 years) and that at the time of examination was 40.3 years (range, 22-67 years). The best-corrected visual acuity ranged from -0.08 to 1.52 logMAR units. The funduscopic appearance was normal in all the cases except in one case with faint mottling in the fovea. Optical coherence tomography revealed an absence of the interdigitation zone and blurred ellipsoid zone in the posterior pole, but the foveal structures were preserved in three cases. The full-field photopic ERGs were reduced or extinguished with normal scotopic responses. The central responses of the multifocal ERGs were preserved in two cases. The diagnosis was either generalized cone dystrophy in five cases or cone dystrophy with foveal sparing in three cases.
Generalized or peripheral cone dystrophy with normal funduscopic appearance is the representative phenotype of POC1B-associated retinopathy in our cohort.
Cone/cone-rod 营养不良是一组具有表型和遗传异质性的视网膜疾病。本研究的目的是在日本眼遗传学联合会(JEGC)的队列中,对七个家系的八名 POC1B 突变患者的表型进行特征描述。
对 JEGC 数据库中的 548 个家系进行全外显子组测序,对目标分析进行靶向分析,发现 POC1B 基因存在纯合子或复合杂合突变。进行眼科检查,包括最佳矫正视力、视野检查、眼底照相、眼底自发荧光成像、光学相干断层扫描以及全视野和多焦视网膜电图(ERG)。
有 4 名男性和 4 名女性,症状起始时的中位年龄为 15.6 岁(范围为 6-23 岁),检查时的中位年龄为 40.3 岁(范围为 22-67 岁)。最佳矫正视力范围从 -0.08 到 1.52 logMAR 单位。除了一个病例在黄斑区有微弱的斑点状改变外,所有病例的眼底外观均正常。光学相干断层扫描显示后极的内插带缺失和椭圆体带模糊,但有三个病例的黄斑结构保留。全视野明视 ERG 降低或熄灭,暗视反应正常。多焦 ERG 的中央反应在两个病例中得到保留。诊断为 5 例弥漫性或周围性 cone 营养不良,3 例黄斑区 spared 的 cone 营养不良。
在我们的队列中,POC1B 相关视网膜病变的代表性表型为眼底外观正常的弥漫性或周围性 cone 营养不良。