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Published in: Documenta Ophthalmologica 3/2009

01-06-2009 | Case Report

Detailed analysis of retinal function and morphology in a patient with autosomal recessive bestrophinopathy (ARB)

Authors: Christina Gerth, Robert J. Zawadzki, John S. Werner, Elise Héon

Published in: Documenta Ophthalmologica | Issue 3/2009

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Abstract

The objective of the paper is to study the retinal microstructure and function in a patient with autosomal recessive bestrophinopathy (ARB). Retinal function and morphology assessment in a patient diagnosed with a biallelic mutation in the BEST1 gene (heterozygote mutations: Leu88del17 and A195V) included: full-field electroretinogram (ffERG) and multifocal electroretinogram (mfERG), electro-oculogram (EOG) testing, and imaging with a high-resolution Fourier-domain optical coherence tomography (Fd-OCT) system (UC Davis Medical Center; axial resolution: 4.5 μm, acquisition speed: 9 frames/s, 1,000 A-scans/frame) combined with a flexible scanning head (Bioptigen Inc.). The 11-year old asymptomatic boy showed a well-demarcated retinopathy with deposits. Functional assessment revealed normal visual acuity, reduced central mfERG responses, delayed rod and rod-cone b-wave ffERG responses, and reduced light rise in the EOG. Fd-OCT demonstrated RPE deposits, photoreceptor detachment, elongated and thickened photoreceptor outer segments, but preserved inner retinal layers. In conclusion, ARB associated retinal dystrophy shows functional and morphological changes that overlap with classic Best disease. For the first time, high-resolution imaging provided in vivo evidence of RPE and photoreceptor involvement in ARB.
Literature
3.
go back to reference Stohr H, Marquardt A, Rivera A et al (1998) A gene map of the Best’s vitelliform macular dystrophy region in chromosome 11q12–q13.1. Genome Res 8:48–56PubMed Stohr H, Marquardt A, Rivera A et al (1998) A gene map of the Best’s vitelliform macular dystrophy region in chromosome 11q12–q13.1. Genome Res 8:48–56PubMed
4.
go back to reference Marquardt A, Stohr H, Passmore LA et al (1998) Mutations in a novel gene, VMD2, encoding a protein of unknown properties cause juvenile-onset vitelliform macular dystrophy (Best’s disease). Hum Mol Genet 7:1517–1525. doi:10.1093/hmg/7.9.1517 PubMedCrossRef Marquardt A, Stohr H, Passmore LA et al (1998) Mutations in a novel gene, VMD2, encoding a protein of unknown properties cause juvenile-onset vitelliform macular dystrophy (Best’s disease). Hum Mol Genet 7:1517–1525. doi:10.​1093/​hmg/​7.​9.​1517 PubMedCrossRef
7.
go back to reference Marmor MF, Zrenner E (1993) Standard for clinical electro-oculography. International society for clinical electrophysiology of vision. Arch Ophthalmol 111:601–604PubMed Marmor MF, Zrenner E (1993) Standard for clinical electro-oculography. International society for clinical electrophysiology of vision. Arch Ophthalmol 111:601–604PubMed
10.
go back to reference Zawadzki RJ, Fuller AR, Wiley DF et al (2007) Adaptation of a support vector machine algorithm for segmentation and visualization of retinal structures in volumetric optical coherence tomography data sets. J Biomed Opt 12:041206. doi:10.1117/1.2772658 PubMedCrossRef Zawadzki RJ, Fuller AR, Wiley DF et al (2007) Adaptation of a support vector machine algorithm for segmentation and visualization of retinal structures in volumetric optical coherence tomography data sets. J Biomed Opt 12:041206. doi:10.​1117/​1.​2772658 PubMedCrossRef
11.
go back to reference Wabbels B, Preising MN, Kretschmann U et al (2006) Genotype-phenotype correlation and longitudinal course in ten families with Best vitelliform macular dystrophy. Graefes Arch Clin Exp Ophthalmol 244:1453–1466. doi:10.1007/s00417-006-0286-6 PubMedCrossRef Wabbels B, Preising MN, Kretschmann U et al (2006) Genotype-phenotype correlation and longitudinal course in ten families with Best vitelliform macular dystrophy. Graefes Arch Clin Exp Ophthalmol 244:1453–1466. doi:10.​1007/​s00417-006-0286-6 PubMedCrossRef
13.
go back to reference Weingeist TA, Kobrin JL, Watzke RC (1982) Histopathology of Best’s macular dystrophy. Arch Ophthalmol 100:1108–1114PubMed Weingeist TA, Kobrin JL, Watzke RC (1982) Histopathology of Best’s macular dystrophy. Arch Ophthalmol 100:1108–1114PubMed
14.
go back to reference Frangieh GT, Green WR, Fine SL (1982) A histopathologic study of Best’s macular dystrophy. Arch Ophthalmol 100:1115–1121PubMed Frangieh GT, Green WR, Fine SL (1982) A histopathologic study of Best’s macular dystrophy. Arch Ophthalmol 100:1115–1121PubMed
17.
go back to reference Marmorstein AD, Marmorstein LY, Rayborn M et al (2000) Bestrophin, the product of the Best vitelliform macular dystrophy gene (VMD2), localizes to the basolateral plasma membrane of the retinal pigment epithelium. Proc Natl Acad Sci USA 97:12758–12763. doi:10.1073/pnas.220402097 PubMedCrossRef Marmorstein AD, Marmorstein LY, Rayborn M et al (2000) Bestrophin, the product of the Best vitelliform macular dystrophy gene (VMD2), localizes to the basolateral plasma membrane of the retinal pigment epithelium. Proc Natl Acad Sci USA 97:12758–12763. doi:10.​1073/​pnas.​220402097 PubMedCrossRef
19.
go back to reference Rosenthal R, Bakall B, Kinnick T et al (2006) Expression of bestrophin-1, the product of the VMD2 gene, modulates voltage-dependent Ca2+ channels in retinal pigment epithelial cells. FASEB J 20:178–180PubMed Rosenthal R, Bakall B, Kinnick T et al (2006) Expression of bestrophin-1, the product of the VMD2 gene, modulates voltage-dependent Ca2+ channels in retinal pigment epithelial cells. FASEB J 20:178–180PubMed
20.
go back to reference Wachtmeister L, Dowling JE (1978) The oscillatory potentials of the mudpuppy retina. Invest Ophthalmol Vis Sci 17:1176–1188PubMed Wachtmeister L, Dowling JE (1978) The oscillatory potentials of the mudpuppy retina. Invest Ophthalmol Vis Sci 17:1176–1188PubMed
21.
go back to reference King-Smith PE, Loffing DH, Jones R (1986) Rod and cone ERGs and their oscillatory potentials. Invest Ophthalmol Vis Sci 27:270–273PubMed King-Smith PE, Loffing DH, Jones R (1986) Rod and cone ERGs and their oscillatory potentials. Invest Ophthalmol Vis Sci 27:270–273PubMed
22.
go back to reference Hood DC, Frishman LJ, Saszik S, Viswanathan S (2002) Retinal origins of the primate multifocal ERG: implications for the human response. Invest Ophthalmol Vis Sci 43:1673–1685PubMed Hood DC, Frishman LJ, Saszik S, Viswanathan S (2002) Retinal origins of the primate multifocal ERG: implications for the human response. Invest Ophthalmol Vis Sci 43:1673–1685PubMed
Metadata
Title
Detailed analysis of retinal function and morphology in a patient with autosomal recessive bestrophinopathy (ARB)
Authors
Christina Gerth
Robert J. Zawadzki
John S. Werner
Elise Héon
Publication date
01-06-2009
Publisher
Springer-Verlag
Published in
Documenta Ophthalmologica / Issue 3/2009
Print ISSN: 0012-4486
Electronic ISSN: 1573-2622
DOI
https://doi.org/10.1007/s10633-008-9154-5

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