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  Vol. 120 No. 10, October 2002 TABLE OF CONTENTS
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Electroretinographic Abnormalities in Parents of Patients With Leber Congenital Amaurosis Who Have Heterozygous GUCY2D Mutations

Robert K. Koenekoop, MD, PhD; Gerald A. Fishman, MD; Alessandro Iannaccone, MD; Hany Ezzeldin, PhD; Maria L. Ciccarelli, COMT, CO; Alfonso Baldi, MD; Janet S. Sunness, MD; Andrew J. Lotery, MD; Monica M. Jablonski, PhD; Steven J. Pittler, PhD; Irene Maumenee, MD

Arch Ophthalmol. 2002;120:1325-1330.

Background  Leber congenital amaurosis (LCA) is an infrequently encountered congenital form of retinitis pigmentosa with marked genetic and clinical heterogeneity. Thus far, 10 genes have been identified in this disorder since 1996. In the future, LCA may become treatable by gene and/or pharmacological intervention, and these therapies will likely be gene specific, giving major significance to rapid gene identification and gene-phenotype studies.

Objective  To test the hypothesis that parents of patients with LCA have identifiable electroretinographic and psychophysical changes.

Subjects, Materials, and Methods  Complete eye examinations and electroretinographic studies were performed on 2 sets of parents whose offspring were diagnosed as having LCA and who were found to carry a mutation in 1 of the 10 LCA genes—GUCY2D. One set of parents also underwent static perimetry threshold measurements.

Results  We found that single flash-light–adapted a- and b-wave amplitudes, 30-Hz flicker, or both cone signals were significantly decreased in amplitude in 4 heterozygotes, while 2 parents showed delayed 30-Hz flicker implicit times. Electroretinographic rod-mediated signals were normal in 2 of the heterozygotes, but subnormal in 2. Static perimetry testing showed normal thresholds in the 2 heterozygotes tested.

Main Outcome Measures  Single flash-light–adapted a- and b-wave amplitudes and implicit times, 30- or 32-Hz flicker amplitudes and implicit times, rod-mediated signals, and dark-adapted, rod-mediated thresholds.

Conclusions  Some carrier parents of patients with LCA and a GUCY2D mutation develop measurable, cone and possibly rod abnormalities most consistent with a mild cone-rod dysfunction. This correlates well with the known retinal expression pattern of GUCY2D, which is considerably higher in cone compared with rod photoreceptor cells.


From the McGill Ocular Genetics Laboratory, Montreal Children's Hospital, McGill University, Montreal, Quebec (Dr Koenekoop); Department of Ophthalmology, University of Illinois at Chicago (Dr Fishman); Retinal Degeneration Research Center, University of Tennessee Health Sciences Center, Memphis (Drs Iannaccone and Jablonski); Vision Science Research Center, University of Alabama, Birmingham (Drs Ezzeldin and Pittler); Division of Ophthalmology, Fatebenefratelli Hospital (Ms Ciccarelli), and the Regina Elena Institute (Dr Baldi), Rome, Italy; Lions Vision Center of the Wilmer Eye Institute (Dr Sunness), and The Johns Hopkins Center for Hereditary Eye Diseases (Dr Maumenee), The Johns Hopkins University, Baltimore, Md; and the Department of Ophthalmology, University of Iowa, Iowa City (Dr Lotery).



THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Identification of Novel Mutations in Patients with Leber Congenital Amaurosis and Juvenile RP by Genome-wide Homozygosity Mapping with SNP Microarrays
den Hollander et al.
IOVS 2007;48:5690-5698.
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CRB1 Heterozygotes with Regional Retinal Dysfunction: Implications for Genetic Testing of Leber Congenital Amaurosis.
Yzer et al.
IOVS 2006;47:3736-3744.
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Genotyping Microarray (Disease Chip) for Leber Congenital Amaurosis: Detection of Modifier Alleles
Zernant et al.
IOVS 2005;46:3052-3059.
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The Phenotype of Leber Congenital Amaurosis in Patients With AIPL1 Mutations
Dharmaraj et al.
Arch Ophthalmol 2004;122:1029-1037.
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Novel Complex GUCY2D Mutation in Japanese Family with Cone-Rod Dystrophy
Ito et al.
IOVS 2004;45:1480-1485.
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