Rachel L Taylor1, Neil R A Parry2, Stephanie J Barton3, Christopher Campbell3, Claire M Delaney2, Jamie M Ellingford1, Georgina Hall1, Claire Hardcastle3, Jiten Morarji4, Elisabeth J Nichol4, Lindsi C Williams4, Sofia Douzgou1, Jill Clayton-Smith1, Simon C Ramsden1, Vinod Sharma4, Susmito Biswas4, I Chris Lloyd5, Jane L Ashworth6, Graeme C Black7, Panagiotis I Sergouniotis8. 1. Division of Evolution and Genomic Sciences, Neuroscience and Mental Health Domain, School of Health Sciences, Faculty of Biology, Medicines and Health, University of Manchester, Manchester, United Kingdom; Manchester Centre for Genomic Medicine, Saint Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom. 2. Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom; Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicines and Health, University of Manchester, Manchester, United Kingdom. 3. Manchester Centre for Genomic Medicine, Saint Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom. 4. Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom. 5. Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom; Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom. 6. Division of Evolution and Genomic Sciences, Neuroscience and Mental Health Domain, School of Health Sciences, Faculty of Biology, Medicines and Health, University of Manchester, Manchester, United Kingdom; Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom. 7. Division of Evolution and Genomic Sciences, Neuroscience and Mental Health Domain, School of Health Sciences, Faculty of Biology, Medicines and Health, University of Manchester, Manchester, United Kingdom; Manchester Centre for Genomic Medicine, Saint Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom. Electronic address: graeme.black@manchester.ac.uk. 8. Division of Evolution and Genomic Sciences, Neuroscience and Mental Health Domain, School of Health Sciences, Faculty of Biology, Medicines and Health, University of Manchester, Manchester, United Kingdom; Manchester Centre for Genomic Medicine, Saint Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom; Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom.
Abstract
PURPOSE: To assess the clinical usefulness of genetic testing in a pediatric population with inherited retinal disease (IRD). DESIGN: Single-center retrospective case series. PARTICIPANTS: Eighty-five unrelated children with a diagnosis of isolated or syndromic IRD who were referred for clinical genetic testing between January 2014 and July 2016. METHODS: Participants underwent a detailed ophthalmic examination, accompanied by electrodiagnostic testing (EDT) and dysmorphologic assessment where appropriate. Ocular and extraocular features were recorded using Human Phenotype Ontology terms. Subsequently, multigene panel testing (105 or 177 IRD-associated genes) was performed in an accredited diagnostic laboratory, followed by clinical variant interpretation. MAIN OUTCOME MEASURES: Diagnostic yield and clinical usefulness of genetic testing. RESULTS: Overall, 78.8% of patients (n = 67) received a probable molecular diagnosis; 7.5% (n = 5) of these had autosomal dominant disease, 25.4% (n = 17) had X-linked disease, and 67.2% (n = 45) had autosomal recessive disease. In a further 5.9% of patients (n = 5), a single heterozygous ABCA4 variant was identified; all these participants had a spectrum of clinical features consistent with ABCA4 retinopathy. Most participants (84.7%; n = 72) had undergone EDT and 81.9% (n = 59) of these patients received a probable molecular diagnosis. The genes most frequently mutated in the present cohort were CACNA1F and ABCA4, accounting for 14.9% (n = 10) and 11.9% (n = 8) of diagnoses respectively. Notably, in many cases, genetic testing helped to distinguish stationary from progressive IRD subtypes and to establish a precise diagnosis in a timely fashion. CONCLUSIONS: Multigene panel testing pointed to a molecular diagnosis in 84.7% of children with IRD. The diagnostic yield in the study population was significantly higher compared with that in previously reported unselected IRD cohorts. Approaches similar to the one described herein are expected to become a standard component of care in pediatric ophthalmology. We propose the introduction of genetic testing early in the diagnostic pathway in children with clinical and/or electrophysiologic findings, suggestive of IRD.
PURPOSE: To assess the clinical usefulness of genetic testing in a pediatric population with inherited retinal disease (IRD). DESIGN: Single-center retrospective case series. PARTICIPANTS: Eighty-five unrelated children with a diagnosis of isolated or syndromic IRD who were referred for clinical genetic testing between January 2014 and July 2016. METHODS:Participants underwent a detailed ophthalmic examination, accompanied by electrodiagnostic testing (EDT) and dysmorphologic assessment where appropriate. Ocular and extraocular features were recorded using Human Phenotype Ontology terms. Subsequently, multigene panel testing (105 or 177 IRD-associated genes) was performed in an accredited diagnostic laboratory, followed by clinical variant interpretation. MAIN OUTCOME MEASURES: Diagnostic yield and clinical usefulness of genetic testing. RESULTS: Overall, 78.8% of patients (n = 67) received a probable molecular diagnosis; 7.5% (n = 5) of these had autosomal dominant disease, 25.4% (n = 17) had X-linked disease, and 67.2% (n = 45) had autosomal recessive disease. In a further 5.9% of patients (n = 5), a single heterozygous ABCA4 variant was identified; all these participants had a spectrum of clinical features consistent with ABCA4 retinopathy. Most participants (84.7%; n = 72) had undergone EDT and 81.9% (n = 59) of these patients received a probable molecular diagnosis. The genes most frequently mutated in the present cohort were CACNA1F and ABCA4, accounting for 14.9% (n = 10) and 11.9% (n = 8) of diagnoses respectively. Notably, in many cases, genetic testing helped to distinguish stationary from progressive IRD subtypes and to establish a precise diagnosis in a timely fashion. CONCLUSIONS: Multigene panel testing pointed to a molecular diagnosis in 84.7% of children with IRD. The diagnostic yield in the study population was significantly higher compared with that in previously reported unselected IRD cohorts. Approaches similar to the one described herein are expected to become a standard component of care in pediatric ophthalmology. We propose the introduction of genetic testing early in the diagnostic pathway in children with clinical and/or electrophysiologic findings, suggestive of IRD.
Authors: Virginia Miraldi Utz; Wanda Pfeifer; Susannah Q Longmuir; Richard John Olson; Kai Wang; Arlene V Drack Journal: JAMA Ophthalmol Date: 2018-04-01 Impact factor: 7.389
Authors: Sebastian Köhler; Leigh Carmody; Nicole Vasilevsky; Julius O B Jacobsen; Daniel Danis; Jean-Philippe Gourdine; Michael Gargano; Nomi L Harris; Nicolas Matentzoglu; Julie A McMurry; David Osumi-Sutherland; Valentina Cipriani; James P Balhoff; Tom Conlin; Hannah Blau; Gareth Baynam; Richard Palmer; Dylan Gratian; Hugh Dawkins; Michael Segal; Anna C Jansen; Ahmed Muaz; Willie H Chang; Jenna Bergerson; Stanley J F Laulederkind; Zafer Yüksel; Sergi Beltran; Alexandra F Freeman; Panagiotis I Sergouniotis; Daniel Durkin; Andrea L Storm; Marc Hanauer; Michael Brudno; Susan M Bello; Murat Sincan; Kayli Rageth; Matthew T Wheeler; Renske Oegema; Halima Lourghi; Maria G Della Rocca; Rachel Thompson; Francisco Castellanos; James Priest; Charlotte Cunningham-Rundles; Ayushi Hegde; Ruth C Lovering; Catherine Hajek; Annie Olry; Luigi Notarangelo; Morgan Similuk; Xingmin A Zhang; David Gómez-Andrés; Hanns Lochmüller; Hélène Dollfus; Sergio Rosenzweig; Shruti Marwaha; Ana Rath; Kathleen Sullivan; Cynthia Smith; Joshua D Milner; Dorothée Leroux; Cornelius F Boerkoel; Amy Klion; Melody C Carter; Tudor Groza; Damian Smedley; Melissa A Haendel; Chris Mungall; Peter N Robinson Journal: Nucleic Acids Res Date: 2019-01-08 Impact factor: 16.971
Authors: Eva Lenassi; Jill Clayton-Smith; Sofia Douzgou; Simon C Ramsden; Stuart Ingram; Georgina Hall; Claire L Hardcastle; Tracy A Fletcher; Rachel L Taylor; Jamie M Ellingford; William D Newman; Cecilia Fenerty; Vinod Sharma; I Chris Lloyd; Susmito Biswas; Jane L Ashworth; Graeme C Black; Panagiotis I Sergouniotis Journal: Genet Med Date: 2019-12-18 Impact factor: 8.822
Authors: Jacque L Duncan; Eric A Pierce; Amy M Laster; Stephen P Daiger; David G Birch; John D Ash; Alessandro Iannaccone; John G Flannery; José A Sahel; Donald J Zack; Marco A Zarbin Journal: Transl Vis Sci Technol Date: 2018-07-18 Impact factor: 3.283
Authors: Patrick Campbell; Jamie M Ellingford; Neil R A Parry; Tracy Fletcher; Simon C Ramsden; Theodora Gale; Georgina Hall; Katherine Smith; Dalia Kasperaviciute; Ellen Thomas; I Chris Lloyd; Sofia Douzgou; Jill Clayton-Smith; Susmito Biswas; Jane L Ashworth; Graeme C M Black; Panagiotis I Sergouniotis Journal: Sci Rep Date: 2019-11-12 Impact factor: 4.379