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Choroideremia: variability of clinical and electrophysiological characteristics and first report of a negative electroretinogram.

Abstract：

PURPOSE:To analyze the variability of clinical and electrophysiological characteristics in X-linked choroideremia and provide the first report of a negative electroretinogram in choroideremia. DESIGN:Retrospective study. PARTICIPANTS:The records of 18 male patients with choroideremia and 8 female carriers were evaluated. METHODS:The data were reviewed regarding visual acuity (VA), color vision, perimetry, fundus autofluorescence, and full-field electroretinography (according to standards of the International Society for Clinical Electrophysiology of Vision). MAIN OUTCOME MEASURES:Morphological and functional phenotype characteristics, fundus autofluorescence, electroretinography, and Rab escort protein 1 (REP-1) mutations. RESULTS:Four unrelated families with choroideremia (9 affected males, 7 carriers) and 10 unrelated individuals (9 affected males, 1 carrier) were included. Mutational analysis, performed in 2 families and 3 individual males, revealed REP-1 mutations in all except 1 male. The age of the males ranged from 5.9 to 63.0 years (mean, 33.9), and VA ranged from hand movements to 1.0 (median, 0.7). Fundus autofluorescence (n = 7) showed defects in the retinal pigment epithelium in all males. Electroretinography (n = 13) was almost undetectable in 6 males and reduced in 6, indicating a rod-cone dystrophy. A further male showed a negative electroretinogram, with a b:a wave ratio of 0.5. Visual acuity of the 8 carriers (age, 4.8-56.8 years [mean, 24.0]) ranged from light perception to 1.2 (median, 1.0). Light perception was present in 1 carrier manifesting choroideremia with distinct chorioretinal atrophy. Pigmentary stippling, seen in the other carriers, was seen in fundus autofluorescence (n = 1) with a distinct speckled pattern. Electroretinograms were normal in 6 of 7 and reduced in the manifesting carrier. Defects in color vision and visual field were found in affected males and in the female carriers. CONCLUSIONS:The phenotype of choroideremia presents with high variability. In addition to the previously reported findings, we observed a negative electroretinogram, indicating a postreceptoral retinal dysfunction, in 1 affected male; severe course of choroideremia with early blindness in 1 manifesting carrier; color vision deficits in the majority of affected males and carriers; and characteristic alterations in fundus autofluorescence.

journal_name

Ophthalmology

journal_title

Ophthalmology

authors

Renner AB,Kellner U,Cropp E,Preising MN,MacDonald IM,van den Hurk JA,Cremers FP,Foerster MH

doi

10.1016/j.ophtha.2006.05.045

subject

Has Abstract

pub_date

2006-11-01 00:00:00

pages

2066.e1-10

issue

eissn

0161-6420

issn

1549-4713

pii

S0161-6420(06)00730-5

journal_volume

113

pub_type

杂志文章

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Choroideremia: variability of clinical and electrophysiological characteristics and first report of a negative electroretinogram.