학술논문

Expanding the FDXR-Associated Disease Phenotype: Retinal Dystrophy Is a Recurrent Ocular Feature
Document Type
article
Source
Investigative Ophthalmology & Visual Science. 62(6)
Subject
Rare Diseases
Clinical Research
Genetics
Biotechnology
Neurosciences
Eye Disease and Disorders of Vision
Human Genome
2.1 Biological and endogenous factors
Aetiology
Eye
Adolescent
Adult
Child
Child
Preschool
Electroretinography
Female
Ferredoxin-NADP Reductase
Humans
Male
Mutation
Missense
Pedigree
Phenotype
Retina
Retinal Dystrophies
Retrospective Studies
Visual Acuity
Exome Sequencing
Young Adult
FDXR
ferredoxin reductase
syndromic optic neuropathy
retinal dystrophy
neurodegenerative disorder
iron accumulation
Genomics England Research Consortium
Biological Sciences
Medical and Health Sciences
Ophthalmology & Optometry
Language
Abstract
PurposeThe purpose of this study was to report retinal dystrophy as a novel clinical feature and expand the ocular phenotype in patients harboring biallelic candidate FDXR variants.MethodsPatients carrying biallelic candidate FDXR variants were identified by whole genome sequencing (WGS) as part of the National Institute for Health Research BioResource rare-disease and the UK's 100,000 Genomes Project (100KGP) with an additional case identified by exome sequencing. Retrospective clinical data were collected from the medical records. Haplotype reconstruction was performed in families harboring the same missense variant.ResultsTen individuals from 8 unrelated families with biallelic candidate variants in FDXR were identified. In addition to bilateral optic atrophy and variable extra-ocular findings, 7 of 10 individuals manifested retinal dystrophy comprising dysfunction and degeneration of both rod and cone photoreceptors. Five of 10 subjects had sensorineural hearing loss. The previously unreported missense variant (c.1115C > A, p.(Pro372His)) was found in 5 of 8 (62.5%) study families. Haplotype reconstruction using WGS data demonstrated a likely ancestral haplotype.ConclusionsFDXR-associated disease is a phenotypically heterogeneous disorder with retinal dystrophy being a major clinical feature observed in this cohort. In addition, we hypothesize that a number of factors are likely to drive the pathogenesis of optic atrophy, retinal degeneration, and perhaps the associated systemic manifestations.