34 Matching Annotations
  1. Oct 2026
    1. To determine the role of SPACR in the pathological mechanisms leading to RP and VMD, we generated a knockout mouse model lacking Impg1, the mouse ortholog. Impg1-deficient mice show abnormal accumulation of autofluorescent deposits visible by fundus imaging and spectral-domain optical coherence tomography (SD-OCT) and attenuated electroretinogram responses from 9 months of age. Furthermore, SD-OCT of Impg1-/- mice shows a degeneration of the photoreceptor layer, and transmission electron microscopy shows a disruption of the IPM and the retinal pigment epithelial cells. The decrease in the concentration of the chromophore 11-cis-retinal supports this loss of photoreceptors. In conclusion, our results demonstrate the essential role of SPACR in maintaining photoreceptors.

      ExperimentName: Knockout mouse model of Impg1

      NonHumanModel: Mus musculus

      GeneAlteration: The mouse model harbors a deletion of exon 6, resulting in disruption of reading frame and loss of Impg1 protein either in the heterozygous or homozygous state.

      ModelPhenotype: HP:0025158 (Hyperautofluorescent retinal lesion), HP:0000512 (Abnormal electroretinogram, specifically attenuated responses), HP:0030609 (Photoreceptor layer loss on macular OCT, described as degeneration with loss of 11-cis-retinal signal), HP:0007703 (Abnormality of retinal pigmentation, specifically disruption of RPE cells and the IPM)

      HumanPhenotype: HP:0007754 (Macular dystrophy), HP:0007769 (Peripheral retinal degeneration), HP:0032037 (Mildly reduced visual acuity, progressive), HP:0008179 (Decreased Arden ratio of electrooculogram), HP:0030505 (Nummular pigmentation of the fundus)

      ModelEvidence: The model exhibits phenotypes consistent with a critical role of Impg1 in photoreceptor maintenance. Phenotypes included hyperpigmented and sometimes autofluorescent subretinal deposits that were present at 9 months of age (Figure 2B) and increased by 14 months of age (Figure 2C) that were localized between the photoreceptor outer segment and the RPE (Figure 2D). Some images showed nummular pigmentation of the fundus (Figure 2E). Interestingly, attenuation of ERG response was first noted at 9 months and pronounced at 14 months (Figure 3A), which is consistent with the findings from an independent mouse model that showed less dramatic findings at earlier 5 month and 8 month time points (PMID: 32265257). Scotopic ERG was more affected than photopic ERG (Figure 3B). Retinal thickness was also reduced in the outer layer relative to the inner layer (Figure 3C). Retinoid generation was also progressively abnormal (Figure 4), indicating that photoreceptors might be lost. The IPM was also disorganized at 14 months (Figure 5), with cellular material accumulating in the IPM consistent with cell death (Figure 6).

      ModelVariant: The model harbors a knockout allele disrupting Impg1, rather than a specific variant from a human patient.

    2. SPACR Encoded by IMPG1 Is Essential for Photoreceptor Survival by Interplaying between the Interphotoreceptor Matrix and the Retinal Pigment Epithelium

      PMID: 36140676

      Gene: IMPG1

      HGNC: 6055

      Disease: vitelliform macular dystrophy 4

      MONDO: 0014508

      InheritancePattern: semi-dominant

      Prevalence: Vitelliform macular dystrophy in general is estimated to have a prevalence of 1 in 5,500 (PMID: 27120116).

      Penetrance: The penetrance of the phenotype among homozygous cases appears to be complete, while heterozygous carriers of deleterious variants show incomplete penetrance and variable expressivity.

    1. Exome sequencing of a family with RP revealed a splice variant in IMPG1.

      FamilyLabel: Olivier_2021_Family_A

      Family#PresentingHPOs: HP:0030629 (Perifoveal ring of hyperautofluorescence), HP:0011510 (Drusen),

      FamilyPresentingHPOFreeText: The affected family members have been diagnosed with retinitis pigmentosa, with severity ranging from mild to severe, depending on the family member.

      FamilyNotHPOs: N/A

      FamilyNotHPOFreeText: Younger family members were thought to be "pre-clinical", with only mild symptoms such as a subtle non-physiological autofluorescence ring and some drusen-like lesions in the posterior pole.

      CountryOrigin: The family is reportedly French.

      Ethnicity: Not specifically described

      Race: N/A

      Family#PreviousTesting: Panel-based genetic testing was performed, focusing on retinitis pigmentosa-associated genes. Subsequent testing used whole exome sequencing of four affected and one unaffected patient (II:1, II:2, II:3, III:3 and III:4).

      Family#Method1: whole-exome sequencing

      Family#Method2: Sanger sequencing of the candidate genes is assumed but not described.

      Family#GenotypingMethod: Panel-based genetic testing was performed, focusing on retinitis pigmentosa-associated genes. Subsequent testing used whole exome sequencing of four affected and one unaffected patient (II:1, II:2, II:3, III:3 and III:4). Sanger sequencing of the candidate genes is assumed but not described.

      Affected: 10 genotyped

      Unaffected: 4 genotyped

      Segregations: 9 segregations are shown by the pedigree in Figure 1.

      PublishedLOD: N/A

      eLOD: 2.7

      AddSegregationInfo: All genotype-positive individuals were phenotype-positive in this family.

      ProbandLabel: Olivier_2021_Family_Proband_IV-8

      Variant: The affected family members harbor the NM_001563.4:c.1824+1G>A variant in the heterozygous state.

      CAID: CA3898050

      gnomAD: This variant is found in gnomAD v2.1.1 at a frequency of 0.00002980 (1 / 33554 alleles total in the Latino / Admixed American population. https://gnomad.broadinstitute.org/variant/6-76660278-C-T

      VariantEvidence: NM_001563.4:c.1824+1G>A is a canonical splice site variant predicted to have a severe impact on the gene product.

      FamilyAddInfo: The family's national origin has been reported as French.

      FamilyPMIDs: N/A

    2. retrospective study

      Case#: Olivier_2021_Family_D_Proband_II:2, male, age 58 years at the time of report, national origin reported as Spanish

      CasePresentingHPOs: HP:0007737 (Bone spicule pigmentation of the retina), HP:0007843 (Attenuation of retinal blood vessels), HP:0030629 (Perifoveal ring of hyperautofluorescence)

      CaseHPOFreeText: The proband and his sibling have been diagnosed with autosomal recessive retinitis pigmentosa, with clinical signs in the fundus reportedly consistent with this diagnosis.

      CaseNotHPOs: HP:0040049 (Macular edema), HP:0030500 (Yellow/white lesions of the macula)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: It is not clear whether previous testing methods included systematic genotyping of loci associated with VMD or RP.

      CaseMethod1: Screening of IMPG1 using either gene panel testing or exome sequencing

      CaseMethod2: Sanger sequencing-based confirmation

      CaseGenotypingMethod: Genotyping is not entirely clear but has at least included panel-based analysis of the IMPG1 locus and Sanger sequencing-based confirmation.

      Variant: The proband harbors the NM_001563.4(IMPG1):c.1875A>G (p.Ile625Met) variant in the homozygous state.

      CAID: CA364775681

      gnomAD: This variant is not found in gnomAD v2.1.1.

      VariantEvidence: NM_001563.4(IMPG1):c.1875A>G (p.Ile625Met) is a missense variant that lacks evidence of a functional impact on the protein product.

      CaseAddInfo: The patient's sister is similarly affected with the same homozygous genotype, while an unaffected sister harbored the variant in the heterozygous state. Parental consanguinity is not reported but family origin is from a small village.

      CasePMIDs: N/A

    3. patients

      Case#: Olivier_2021_Family_K_Proband_II:3, male, age 43 years at the time of onset, national origin reported as Spanish

      CasePresentingHPOs: HP:0000662 (Nyctalopia), HP:0001099 (Fundus atrophy), HP:0007737 (Bone spicule pigmentation of the retina)

      CaseHPOFreeText: The proband has onset of retinitis pigmentosa at the age of 43 years.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: It is not clear whether previous testing methods included systematic genotyping of loci associated with VMD or RP.

      CaseMethod1: Screening of IMPG1 using either gene panel testing or exome sequencing

      CaseMethod2: Sanger sequencing-based confirmation

      CaseGenotypingMethod: Genotyping is not entirely clear but has at least included panel-based analysis of the IMPG1 locus and Sanger sequencing-based confirmation.

      Variant: The proband harbors the NM_001563.4(IMPG1):c.1982G>A (p.Arg661His) variant in the homozygous state.

      ClinVar ID: 1056230

      gnomAD: The NM_001563.4(IMPG1):c.1982G>A (p.Arg661His) variant is found in gnomAD v2.1.1 at a frequency of 0.00004006 (1/24964) in the African / African-American population, with 0 homozygotes https://gnomad.broadinstitute.org/variant/6-76657093-C-T

      VariantEvidence: NM_001563.4(IMPG1):c.1982G>A (p.Arg661His) is a missense variant, which does not have experimental evidence of a functional effect on the protein product.

      CaseAddInfo: The patient's affected sister shares the same homozygous genotype.

      CasePMIDs: N/A

    4. RP

      Case#: Olivier_2021_Family_H_Proband_II:1, male, age 53 years at the time of diagnosis, national origin reported as French

      CasePresentingHPOs: HP:0007401 (Macular atrophy), HP:0007737 (Bone spicule pigmentation of the retina)

      CaseHPOFreeText: The proband has been diagnosed with maculopathy at the age of 53 years, and exhibits retinal discoloration.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: It is not clear whether previous testing methods included systematic genotyping of loci associated with VMD or RP.

      CaseMethod1: Screening of IMPG1 using either gene panel testing or exome sequencing

      CaseMethod2: Sanger sequencing-based confirmation

      CaseGenotypingMethod: Genotyping is not entirely clear but has at least included panel-based analysis of the IMPG1 locus and Sanger sequencing-based confirmation.

      Variant: The proband harbors the NM_001563.4:c.2083G>T (p.Glu695Ter) variant in the heterozygous state.

      CAID: CA364770054

      gnomAD: This variant is not found in gnomAD v2.1.1.

      VariantEvidence: NM_001563.4:c.2083G>T (p.Glu695Ter) is a nonsense variant in exon 15 of 17, which is predicted to trigger nonsense-mediated decay or to at least truncate the C-terminal 13% of the protein product.

      CaseAddInfo: The patient's brother is an unaffected carrier of the variant.

      CasePMIDs: N/A

    5. RP

      Case#: Olivier_2021_Family_C_Proband_II:1, female, age 48 years at the time of diagnosis, national origin reported as Spanish

      CasePresentingHPOs: HP:0000543 (Optic disc pallor), HP:0007843 (Attenuation of retinal blood vessels), HP:0030329 (Retinal thinning), HP:0007737 (Bone spicule pigmentation of the retina)

      CaseHPOFreeText: The proband was diagnosed with moderate retinitis pigmentosa at age 48 years.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: It is not clear whether previous testing methods included systematic genotyping of loci associated with VMD or RP.

      CaseMethod1: Screening of IMPG1 using gene panel testing and Sanger sequencing-based confirmation

      CaseMethod2: Haplotype analysis using the microsatellite markers D6S1622, D6S456, D6S1589 and D6S251, spanning a 7.2-Mb region surrounding IMPG1.

      CaseGenotypingMethod: Genotyping is not entirely clear but has at least included panel-based analysis of the IMPG1 locus, Sanger sequencing-based confirmation, and haplotype analysis of the multiple families harboring the variant.

      Variant: The affected family members harbor the NM_001563.4:c.1824+1G>A variant in the heterozygous state.

      ClinVar ID: 1240018

      gnomAD: This variant is found in gnomAD v2.1.1 at a frequency of 0.00002980 (1 / 33554 alleles total in the Latino / Admixed American population. https://gnomad.broadinstitute.org/variant/6-76660278-C-T

      VariantEvidence: NM_001563.4:c.1824+1G>A is an intronic variant disrupting a canonical splice site in intron 13 (of the 17-exon gene), with unknown consequences for IMPG1 splicing.

      CaseAddInfo: This family helps establish the incomplete penetrance of the variant, as the patient's carrier mother was clinically asymptomatic with no retinal vessel abnormalities, despite the presence of hard drusen-like deposits in the macula.

      CasePMIDs: N/A

    6. VMD

      Case#: Olivier_2021_Family_B_Proband_II:2, female, age not specified, ethnic origin reported as French

      CasePresentingHPOs: HP:0007663 (Reduced visual acuity), HP:0030643 (Vitelliform-like retinal lesions), HP:0011506 (Choroidal neovascularization),

      CaseHPOFreeText: The patient has a diagnosis of vitelliform macular dystrophy, and reportedly has a hyperreflective deposit in one eye.

      CaseNotHPOs: HP:0000512 (Abnormal electroretinogram), HP:0030454 (Abnormal electrooculogram)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: It is not clear whether previous testing methods included systematic genotyping of loci associated with VMD or RP.

      CaseMethod1: Screening of IMPG1 using gene panel testing and Sanger sequencing-based confirmation

      CaseMethod2: Haplotype analysis using the microsatellite markers D6S1622, D6S456, D6S1589 and D6S251, spanning a 7.2-Mb region surrounding IMPG1.

      CaseGenotypingMethod: Genotyping is not entirely clear but has at least included panel-based analysis of the IMPG1 locus, Sanger sequencing-based confirmation, and haplotype analysis of the multiple families harboring the variant.

      Variant: The affected family members harbor the NM_001563.4:c.1824+1G>A variant in the heterozygous state.

      ClinVar ID: 1240018

      gnomAD: This variant is found in gnomAD v2.1.1 at a frequency of 0.00002980 (1 / 33554 alleles total in the Latino / Admixed American population. https://gnomad.broadinstitute.org/variant/6-76660278-C-T

      VariantEvidence: NM_001563.4:c.1824+1G>A is an intronic variant disrupting a canonical splice site in intron 13 (of the 17-exon gene), with unknown consequences for IMPG1 splicing.

      CaseAddInfo: This family has helped establish the incomplete penetrance of the variant, as the patient's two sisters were asymptomatic carriers with normal fundus findings at ages 45 and 50 years respectively. The patient's 70-year-old mother was also a carrier and exhibited low vision.

      CasePMIDs: N/A

    7. Using morpholino-mediated ablation of Impg1 and its paralog Impg2 in medaka fish, we confirmed a phenotype consistent with that observed in the families, including a decreased length of rod and cone photoreceptor outer segments.

      ExperimentName: Morpholino-based disruption of Impg1 in medaka fish

      NonHumanModel: Oryzias latipes

      GeneAlteration: Model animals were subjected to targeted disruption of Impg1 by morpholino-based silencing.

      ModelPhenotype: HP:0030610 (Photoreceptor outer segment loss on macular OCT).

      HumanPhenotype: HP:0007754 (Macular dystrophy), HP:0007769 (Peripheral retinal degeneration), HP:0032037 (Mildly reduced visual acuity, progressive), HP:0008179 (Decreased Arden ratio of electrooculogram)

      ModelEvidence: Morpholino-injected animals exhibit decreased photoreceptor outer segment length, especially for cones (Figures 4I, 4J).

      ModelVariant: The model does not introduce a variant previously observed in human patients, but rather disrupts the expression of the Impg1 ortholog using a morpholino.

    8. Pathogenic variants in IMPG1 cause autosomal dominant and autosomal recessive retinitis pigmentosa

      PMID: 32817297

      Gene: IMPG1

      HGNC: 6055

      Disease: vitelliform macular dystrophy 4

      MONDO: 0014508

      InheritancePattern: semi-dominant

      Prevalence: Vitelliform macular dystrophy in general is estimated to have a prevalence of 1 in 5,500 (PMID: 27120116).

      Penetrance: The penetrance of the phenotype among homozygous cases appears to be complete, while heterozygous carriers of deleterious variants show incomplete penetrance and variable expressivity.

    1. The Benign Concentric Annular Macular Dystrophy Locus Maps to 6p12.3-q16

      PMID: 14691150

      Gene: IMPG1

      HGNC: 6055

      Disease: vitelliform macular dystrophy 4

      MONDO: 0014508

      InheritancePattern: semi-dominant

      Prevalence: Vitelliform macular dystrophy in general is estimated to have a prevalence of 1 in 5,500 (PMID: 27120116).

      Penetrance: The penetrance of the phenotype among homozygous cases appears to be complete, while heterozygous carriers of deleterious variants show incomplete penetrance and variable expressivity.

    2. Linkage analysis established complete segregation of the BCAMD phenotype (maximum multipoint LOD score, 3.8) with DNA markers at chromosome 6, region p12.3-q16. Recombination events defined a critical interval spanning 30.7 cM at the long arm of chromosome 6 between markers D6S269 and D6S300. This interval encompasses several retinal dystrophy loci, including the ELOVL4 gene, mutated in autosomal dominant Stargardt disease, and the RIM1 gene, mutated in autosomal dominant cone-rod dystrophy, as well as the retinally expressed GABRR1 and -2 genes. Mutation screening of these four genes revealed no mutations. Sequence analysis of the interphotoreceptor matrix proteoglycan 1 gene IMPG1, also residing in the BCAMD locus, revealed a single base-pair change (T-->C) of nucleotide 1866 in exon 13, resulting in a Leu579Pro amino acid substitution

      FamilyLabel: van_Lith-Verhoeven_2004_Family

      Family#PresentingHPOs: HP:0007754 (Macular dystrophy), HP:0007769 (Peripheral retinal degeneration), HP:0032037 (Mildly reduced visual acuity, progressive), HP:0008179 (Decreased Arden ratio of electrooculogram)

      FamilyPresentingHPOFreeText: The affected family members have been diagnosed with benign concentric annular macular dystrophy (BCAMD), segregating with an autosomal dominant mode of inheritance. Visual acuity was initially normal but progressed to phenotype similar to retinitis pigmentosa, including peripheral retinal involvement and photoreceptor cell dysfunction (shown by ERG).

      FamilyNotHPOs: HP:0000613 (Photophobia), HP:0000551 (severe Color vision defect)

      FamilyNotHPOFreeText: N/A

      CountryOrigin: The family is reportedly Dutch.

      Ethnicity: Not specifically described

      Race: N/A

      Family#PreviousTesting: Linkage analysis was performed using a combination of a whole genome scan and microsatellite markers within candidate retinal loci.

      Family#Method1: Genome-wide and candidate-focused linkage analyses

      Family#Method2: Sanger sequencing of the candidate genes ELOVL4, GABR1, GABR2 and IMPG1

      Family#GenotypingMethod: Linkage analysis was performed using a genome-wide scan as well as microsatellite markers from candidate loci. Sanger sequencing then analyzed the candidate retina genes from the linkage region; ELOVL4, GABR1, GABR2 and IMPG1

      Affected: 11 genotyped

      Unaffected: 5 genotyped

      Segregations: 10 segregations are shown by the pedigree in Figure 1.

      PublishedLOD: 3.8

      eLOD: N/A

      AddSegregationInfo: N/A

      ProbandLabel: van_Lith-Verhoeven_2004_Family_Proband_II-4

      Variant: The affected family members harbor the NM_001563.4(IMPG1):c.1736T>C (p.Leu579Pro) variant in the heterozygous state.

      ClinVar: 1008228

      gnomAD: This variant was not found in gnomAD v2.1.1.

      VariantEvidence: NM_001563.4(IMPG1):c.1736T>C (p.Leu579Pro) is a missense variant that does not have evidence confirming an impact on the gene product.

      FamilyAddInfo: The family's national origin has been reported as Dutch.

      FamilyPMIDs: N/A

    1. An additional IMPG1 variant was found in a simplex case of the French family NAX1. This female individual had a small vitelliform disk and was heterozygous for the splice-site mutation c.1824+1G>A in intron 13; this mutation was absent from the human SNP databases (Figure 4A). No other mutation was found in this proband. Her two unaffected sisters and her mother were also heterozygous for the mutation. However, the two unaffected sisters shared a paternal allele different from the paternal allele of the affected sister (Figure 4A), suggesting that the proband could harbor an unidentified paternal mutation located in the noncoding regions of IMPG1. An incomplete penetrance or a mutation in a different gene could also be considered.

      Case#: Manes_2013_Family_NAX1_Proband_II:2, female, age unreported, national origin reported as French

      CasePresentingHPOs: HP:0007677 (Vitelliform-like macular lesions), HP:0032037 (Mildly reduced visual acuity), HP:0030469 (Abnormal dark-adapted electroretinogram, specifically reduced)

      CaseHPOFreeText: The patient has been diagnosed with vitelliform macular dystrophy.

      CaseNotHPOs: HP:0008179 (Decreased Arden ratio of electrooculogram), HP:0008275 (Abnormal light-adapted electroretinogram)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous testing appears to have been limited to Sanger sequencing-based screening of exon 7 of IMPG1.

      CaseMethod1: Sanger sequencing of the 17 exons and flanking intronic sequences

      CaseMethod2: N/A

      CaseGenotypingMethod: Genotyping appears to have included Sanger-based sequencing of the 17 exons and intronic flanking sequences of the IMPG1 locus.

      Variant: The proband harbors the NM_001563.4(IMPG1):c.1824+1G>A variant in the heterozygous state.

      ClinVar: 1240018

      gnomAD: The NM_001563.4(IMPG1):c.1824+1G>A variant was found in gnomAD v2.1.1 at a frequency of 0.00002980 (1/33554) in the Latino / Admixed American population, with 0 homozygotes https://gnomad.broadinstitute.org/variant/6-76660278-C-T?dataset=gnomad_r2_1

      VariantEvidence: NM_001563.4(IMPG1):c.1824+1G>A is a canonical splice site variant in intron 13 that does not have evidence confirming an impact on the gene product, however, it has been reported by the same researchers in a proband with retinitis pigmentosa (PMID: 32817297).

      CaseAddInfo: The proband has two unaffected sisters and an unaffected mother who share the same genotype. Consanguinity is not reported in this family. It is possible that the proband harbors a second unidentified variant in trans, inherited from the father.

      CasePMIDs: N/A

    2. Mutations in IMPG1 Cause Vitelliform Macular Dystrophies

      PMID: 23993198

      Gene: IMPG1

      HGNC: 6055

      Disease: vitelliform macular dystrophy 4

      MONDO: 0014508

      InheritancePattern: semi-dominant

      Prevalence: Vitelliform macular dystrophy in general is estimated to have a prevalence of 1 in 5,500 (PMID: 27120116).

      Penetrance: The penetrance of the phenotype among homozygous cases appears to be complete, while heterozygous carriers of deleterious variants show incomplete penetrance and variable expressivity.

    3. In the consanguineous Italian family NA1863, we found that the affected brother II:1 and the affected sister II:2 were homozygous for the splice-site mutation c.807+1G>T in intron 7, which was absent from the human SNP databases, whereas the asymptomatic parents were each heterozygous for the mutation (Figure 4A). In affected individuals of families NAL69 and NA1863, the EOG Arden ratio was moderately decreased (Table 1). During fundus examination, some asymptomatic heterozygous carriers were found to have minor changes. In family NAL69, although the daughter, III:2, was normal, the son, III:1, showed a slight defect in the line between the inner and outer segments in the nasal parafovea of the left eye. In family NA1863, fundus examination showed that the parents had tiny extramacular deposits (Figure 2). This suggests that the c.461T>C and c.807+1G>T changes could be sufficient to cause subclinical retinal abnormalities and exert a mild pathogenic effect at the heterozygous state. Yet, because the macular vitelliform disc with decreased visual acuity (Table 1) was present only in the individuals who were either compound heterozygous (family NAL69) or homozygous (family NA1863), it is likely that the disease in these two families segregated as an autosomal-recessive trait.

      Case#: Manes_2013_Family_NA1863_Proband_II:1, male, age between 25 and 45 years at time of report, national origin reported as Italian

      CasePresentingHPOs: HP:0007677 (Vitelliform-like macular lesions), HP:0030631 (Hyperautofluorescent macular lesion), HP:0008179 (Decreased Arden ratio of electrooculogram, specifically 1.53 and 1.61 in each eye), HP:0000654 (Decreased light- and dark-adapted electroretinogram amplitude)

      CaseHPOFreeText: The patient has been diagnosed with vitelliform macular dystrophy, and has very mildly reduced visual acuity (20/22).

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous testing appears to have been limited to Sanger sequencing-based screening of exon 7 of IMPG1.

      CaseMethod1: Sanger sequencing of the 17 exons and flanking intronic sequences

      CaseMethod2: N/A

      CaseGenotypingMethod: Genotyping appears to have included Sanger-based sequencing of the 17 exons and intronic flanking sequences of the IMPG1 locus.

      Variant: The proband harbors the NM_001563.4(IMPG1):c.807+1G>T variant in the homozygous state.

      ClinVar: 162134

      gnomAD: The NM_001563.4(IMPG1):c.807+1G>T variant was found in gnomAD v2.1.1 at a frequency of 0.000008855 (1/112932) in the European non-Finnish population, with 0 homozygotes https://gnomad.broadinstitute.org/variant/6-76728434-C-A

      VariantEvidence: NM_001563.4(IMPG1):c.807+1G>T is a canonical splice site variant in intron 7 that does not have evidence confirming an impact on the gene product.

      CaseAddInfo: The proband has a similarly affected younger sister who shares the same genotype. Parents are clinically unaffected heterozygous carriers but each harbor tiny extramacular deposits in the fundus. Consanguinity is reported in this family.

      CasePMIDs: N/A

    4. Members of a large French family (MTP327) were identified as having autosomal-dominant VMD. The disease was assessed with visual-acuity testing, funduscopy, and autofluorescence imaging. A full-fields electroretinogram (ERG) was recorded with a ganzfeld apparatus (Metrovision, Pérenchies, France) with a bipolar contact lens electrode on maximally dilated pupils according to the international ISCEV protocol. Dim blue stimulation after 20 min of dark adaptation was used for eliciting rod responses, and 30 Hz flicker stimulation after 10 min of light adaptation was used for eliciting cone responses. Electrooculography (EOG) was also performed, and the Arden ratio, defined as the ratio of the amplitude of the light peak over that of the dark trough, was calculated (normal value ≥ 1.80). There were eight affected individuals in six generations examined (Figure 1A). The age of onset ranged from 20 to 45 years, and the mean visual acuity was 20/30 (Table 1). Six of eight individuals had a single subfoveal vitelliform lesion, and two individuals, V:2 and V:5, had several small vitelliform deposits in both eyes (Figure 2). In most individuals, the ERG rod responses were above the lower limit (except IV:4, who had moderately decreased responses), and the cone responses were either normal or moderately decreased. All individuals except IV:6 had a normal or a slightly decreased (V:5) EOG Arden ratio (Table 1).

      FamilyLabel: Manes_2013_Family_MTP327

      Family#PresentingHPOs: HP:0007677 (Vitelliform-like macular lesions), HP:0030469 (Abnormal dark-adapted electroretinogram, specifically reduced)

      FamilyPresentingHPOFreeText: The affected family members have been diagnosed with vitelliform macular dystrophy.

      FamilyNotHPOs: N/A

      FamilyNotHPOFreeText: N/A

      CountryOrigin: The family is reportedly French.

      Ethnicity: Not specifically described

      Race: Not specifically described

      Family#PreviousTesting: Previous genotyping included Sanger sequencing of BEST1 and PRPH2, followed by genome-wide scan using a 250K SNP Affymetrix array, which identified a shared 95.2 Mb haplotype on chromosome 6p12.1-q24.3 (encompassing 705 genes) in all affected family members. The candidate loci ELOVL4 and MCDR1 were then subjected to Sanger sequencing.

      Family#Method1: Whole-exome sequencing of seven affected family members

      Family#Method2: Sanger sequencing of IMPG1 to confirm the presence of the variant.

      Family#GenotypingMethod: Whole-exome sequencing of seven affected family members was performed, followed by Sanger sequencing of IMPG1 to confirm the presence of the variant.

      Affected: 8 genotyped

      Unaffected: 4 genotyped

      Segregations: 11 segregations are shown by the pedigree in Figure 1A.

      PublishedLOD: 3.02 (for the D6S1622 marker on chromosome 6q13)

      eLOD: N/A

      AddSegregationInfo: All genotype-positive individuals were phenotype-positive in this family.

      ProbandLabel: Manes_2013_Family_MTP327_Proband

      Variant: The affected family members harbor the NM_001563.4(IMPG1):c.713T>G (p.Leu238Arg) variant in the heterozygous state.

      ClinVar ID: 162133

      gnomAD: This variant was not found in gnomAD v2.1.1.

      VariantEvidence: NM_001563.4(IMPG1):c.713T>G (p.Leu238Arg) is a missense site variant lacking evidence of a deleterious impact on the gene product.

      FamilyAddInfo: The family's national origin has been reported as French. Age of onset ranged from 20 to 45 years.

      FamilyPMIDs: N/A

    5. In the French family NAL69, we found that the proband (II:4) and his affected sister (II:2) were compound heterozygous for the paternal c.1519C>T mutation in exon 13, leading to the nonsense change p.Arg507∗, and for the maternal c.461T>C mutation in exon 3, leading to the missense change p.Leu154Pro (Figure 4A).

      Case#: Manes_2013_Family_NAL69_Proband_II:4, male, age 43 years at time of report, national origin reported as French

      CasePresentingHPOs: HP:0007677 (Vitelliform-like macular lesions), HP:0030631 (Hyperautofluorescent macular lesion), HP:0008179 (Decreased Arden ratio of electrooculogram, specifically 1.58 and 1.68 in each eye), HP:0008275 (Abnormal light-adapted electroretinogram, slightly decreased)

      CaseHPOFreeText: The patient has been diagnosed with vitelliform macular dystrophy.

      CaseNotHPOs: HP:0007663 (Reduced visual acuity), HP:0030469 (Abnormal dark-adapted electroretinogram)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous testing appears to have been limited to Sanger sequencing-based screening of exon 7 of IMPG1.

      CaseMethod1: Sanger sequencing of the 17 exons and flanking intronic sequences

      CaseMethod2: N/A

      CaseGenotypingMethod: Genotyping appears to have included Sanger-based sequencing of the 17 exons and intronic flanking sequences of the IMPG1 locus.

      Variant: The proband harbors the NM_001563.4(IMPG1):c.461T>C (p.Leu154Pro) and NM_001563.4(IMPG1):c.1519C>T (p.Arg507Ter) variants in the compound heterozygous state.

      ClinVar: 162136, 162135

      gnomAD: The NM_001563.4(IMPG1):c.461T>C (p.Leu154Pro) variant was found in gnomAD v2.1.1 at a frequency of 0.00007924 (9/113576) in the European non-Finnish population, with 0 homozygotes https://gnomad.broadinstitute.org/variant/6-76744345-A-G The NM_001563.4(IMPG1):c.1519C>T (p.Arg507Ter) variant was found in gnomAD v2.1.1 at a frequency of 0.00004007 (1/24958) in the African / African-American population, with 0 homozygotes https://gnomad.broadinstitute.org/variant/6-76660584-G-A?dataset=gnomad_r2_1

      VariantEvidence: NM_001563.4(IMPG1):c.461T>C (p.Leu154Pro) is a missense variant that does not have evidence confirming an impact on the gene product. However, another study has reported an apparently unrelated affected patient harboring this variant in the heterozygous state (PMID: 30688845). The NM_001563.4(IMPG1):c.1519C>T (p.Arg507Ter) variant is a nonsense variant in exon 13 of 17 and is predicted to trigger nonsense-mediated decay or to at least truncate the C-terminal 37% of the protein product.

      CaseAddInfo: The proband has a similarly affected older sister who shares the same genotype. One carrier child is unaffected while the other has a slight defect in one eye within the line separating the inner and outer segments, consistent with incomplete penetrance in the heterozygous state. Consanguinity is not reported in this family.

      CasePMIDs: N/A

    1. To describe a case of symptomatic outer retinal disruption in a patient heterozygous for the p.Leu154Pro interphotoreceptor matrix proteoglycan-1 (IMPG1) mutation implicated in adult-onset foveomacular vitelliform dystrophy. Methods: Observational case report. Results: We describe a case of a 25-year-old female patient with symptomatic scotoma and vision decrease who exhibited bilateral small foveal yellow spots. Optical coherence tomography revealed disorganization and decreased reflectance of the foveal ellipsoid and interdigitation zones in the left eye more than in the right eye. Fundus autofluorescence imaging showed minimal findings, and dye angiography was unrevealing. Multifocal electroretinogram revealed slightly decreased retinal sensitivity in the central retina of the left eye. Genetic testing identified a heterozygous p.Leu154Pro mutation in the IMPG1 gene.

      Case#: Gupta_2021_Proband_1, female, age 25 years at time of report, ethnic origin not reported

      CasePresentingHPOs: HP:0000575 (Scotoma), HP:0007663 (Reduced visual acuity), HP:0030500 (Yellow/white lesions of the macula, specifically small foveal yellow spots), HP:0030627 (Foveal hyporeflective spaces on macular OCT), HP:0008323 (Abnormal light- and dark-adapted electroretinogram, specifically reduced response in the center of one retina)

      CaseHPOFreeText: The patient has been diagnosed with foveomacular vitelliform dystrophy with adult onset.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous testing appears to have included genotyping of the

      CaseMethod1:

      CaseMethod2:

      CaseGenotypingMethod: Genotyping appears to have included

      Variant: The proband harbors the NM_001563.4(IMPG1):c.461T>C (p.Leu154Pro) variant in the heterozygous state.

      ClinVar: 162136

      gnomAD: This variant was found in gnomAD v2.1.1 at a frequency of 0.00007924 (9/113576) in the European non-Finnish population, with 0 homozygotes https://gnomad.broadinstitute.org/variant/6-76744345-A-G

      VariantEvidence: NM_001563.4(IMPG1):c.461T>C (p.Leu154Pro) is a missense variant that does not have evidence confirming an impact on the gene product. However, another study has reported apparently unrelated affected patients harboring this variant in the compound heterozygous state (PMID: 23993198), in trans with the NM_001563.4(IMPG1):c.1519C>T (p.Arg507Ter) variant.

      CaseAddInfo: The variant is paternally inherited in this case, and the patient's father has been diagnosed with central serous chorioretinopathy but lacks other features of vitelliform macular dystrophy. This indicates that central serous chorioretinopathy is part of the spectrum of monoallelic disease.

      CasePMIDs: N/A

    2. UNUSUAL EARLY-ONSET VITELLIFORM DYSTROPHY POSSIBLY LINKED TO THE INTERPHOTORECEPTOR MATRIX PROTEOGLYCAN-1 P.LEU154PRO MUTATION

      PMID: 30688845

      Gene: IMPG1

      HGNC: 6055

      Disease: vitelliform macular dystrophy 4

      MONDO: 0014508

      InheritancePattern: semi-dominant

      Prevalence: Vitelliform macular dystrophy in general is estimated to have a prevalence of 1 in 5,500 (PMID: 27120116).

      Penetrance: The penetrance of the phenotype among homozygous cases appears to be complete, while heterozygous carriers of deleterious variants show incomplete penetrance and variable expressivity.

    1. Extracellular matrix component expression in human pluripotent stem cell-derived retinal organoids recapitulates retinogenesis in vivo and reveals an important role for IMPG1 and CD44 in the development of photoreceptors and interphotoreceptor matrix

      PMID: 29777959

      Gene: IMPG1

      HGNC: 6055

      Disease: vitelliform macular dystrophy 4

      MONDO: 0014508

      InheritancePattern: semi-dominant

      Prevalence: Vitelliform macular dystrophy in general is estimated to have a prevalence of 1 in 5,500 (PMID: 27120116).

      Penetrance: The penetrance of the phenotype among homozygous cases appears to be complete, while heterozygous carriers of deleterious variants show incomplete penetrance and variable expressivity.

    2. Blocking the action of CD44 and IMPG1 in pluripotent stem cell derived retinal organoids affected the development of photoreceptors, their inner/outer segments and connecting cilia and disrupted IPM formation, with IMPG1 having an earlier and more significant impact. Together, our data suggest an important role for IMPG1 and CD44 in the development of photoreceptors and IPM formation during human retinogenesis.

      ExperimentName: Blocking IMPG1 in retinal organoids disrupts early development of IPM, photoreceptors and inner/outer segments, and connecting cilia.

      NonPatientCell: UBERON:0000966 (retina, specifically IPSC-derived retinal organoids) or CL:0009004 (retinal cell)

      GeneFunction: GO:0033165 (interphotoreceptor matrix)

      GeneAlteration: Alteration was not performed at the genetic level, but rather a blocking antibody to IMPG1 protein was added to the culture media of the developing retinal organoid at days 90 and 150 of the differentiation process. After incubation, the effects were assessed by IHC and qRT-PCR detecting key markers of differentiation (Figure 6, Figures S12-S15).

      FunctionalEvidence: Expression of RCVRN (a marker of photoreceptor and bipolar cells) and proportion of recoverin-positive cells were reduced (Figs. 6B, S12B, S14B, S14C, S15B). Expression of ARL13B (marker of photoreceptor connecting cilia) was reduced (Figs. 6B, S15B). Expression of RBP3 (marker of IPM formation) was changed only at the later time point (Figs. 6B, S12B, S15B). Expression of OPN1LW/OPN1MW (cone marker) was down-regulated (Fig. S14B). Expression of RHO (rod cell marker) and proportion of rhodopsin-positive cells were reduced, and the typical pattern of staining was replaced with a punctate pattern at the surface of the organoids (Fig. 6B, 6C). Staining for WGA (rod inner/outer segment marker) was reduced, indicating disrupted development of these structures (Fig. 6B, 6C). The authors conclude that IMPG1 is important for development of photoreceptors, inner and outer segments, connecting cilia, and IPM.

      FAVariants: No variant in IMPG1 was used, but rather an inhibitory antibody.

    1. Proteoglycan IMPG2 Shapes the Interphotoreceptor Matrix and Modulates Vision

      PMID: 32265257

      Gene: IMPG1

      HGNC: 6055

      Disease: vitelliform macular dystrophy 4

      MONDO: 0014508

      InheritancePattern: semi-dominant

      Prevalence: Vitelliform macular dystrophy in general is estimated to have a prevalence of 1 in 5,500 (PMID: 27120116).

      Penetrance: The penetrance of the phenotype among homozygous cases appears to be complete, while heterozygous carriers of deleterious variants show incomplete penetrance and variable expressivity.

    2. Interestingly, mice lacking both IMPG1 and IMPG2, regardless of sex, showed normal retinal structure and function, demonstrating that the aberrant IMPG1 distribution is the main cause of the visual alterations observed in the absence of IMPG2. In conclusion, our results show the dependence of secreted proteoglycans such as IMPG1 on the extracellular environment to properly integrate into the matrix, demonstrate the role of IMPG2 in shaping the IPM, and shed light on the potential mechanisms leading to the development of subretinal lesions and vision loss.

      ExperimentName: CRISPR/Cas9-based disruption of mouse Impg1

      NonHumanModel: Mus musculus

      GeneAlteration: Model animals were subjected to CRISPR/Cas9-based deletion of 10bp from exon 2 of Impg1, and analyzed in the homozygous state. Absence of Impg1 signal was confirmed by immunofluorescent staining. Mice were studied at ages 5 months and 8 months.

      ModelPhenotype: HP:0030612 (Abnormal retinal morphology, specifically mislocalization of chondroitin sulfate in the IPM, with none in the outer segment and more in the inner segment)

      HumanPhenotype: HP:0007754 (Macular dystrophy), HP:0007769 (Peripheral retinal degeneration), HP:0032037 (Mildly reduced visual acuity, progressive), HP:0008179 (Decreased Arden ratio of electrooculogram)

      ModelEvidence: This is the first mouse model of Impg1 disruption, with confirmed absence of Impg1 in the homozygous animals. The only observed abnormality is mislocalization of chondroitin sulfate in the IPM, with none in the outer segment and more in the inner segment (Figure 7). A mild disruption was observed in the localization of PNA, a cone-specific marker, to the outer segment (Fig. 2F). Impg2 appears to be normally localized (Figure 2C). ERG responses were normal (data not shown). Please note that an independent study generating a different model of homozygous Impg1 disruption reported different findings (PMID: 36140676).

      ModelVariant: The model does not introduce a variant previously observed in human patients, but rather disrupts the expression of the Impg1 ortholog.

    1. Expression and characterization of the IPM 150 gene (IMPG1) product, a novel human photoreceptor cell-associated chondroitin-sulfate proteoglycan

      PMID: 10601738

      Gene: IMPG1

      HGNC: 6055

      Disease: vitelliform macular dystrophy 4

      MONDO: 0014508

      InheritancePattern: semi-dominant

      Prevalence: Vitelliform macular dystrophy in general is estimated to have a prevalence of 1 in 5,500 (PMID: 27120116).

      Penetrance: The penetrance of the phenotype among homozygous cases appears to be complete, while heterozygous carriers of deleterious variants show incomplete penetrance and variable expressivity.

    2. In situ hybridization analyses indicate that, in the eye, IPM 150 mRNA is expressed specifically by cone and rod photoreceptor cells.

      Selection A - Gene is expressed in tissues relevant to disease:

      ExperimentName: IMPG1 protein ("IPM150") expression within eye tissues is localized to cone and rod photoreceptor cells in the outer nuclear layer.

      TissueExpression: UBERON:0001789 (outer nuclear layer of retina)

      ExpressionEvidence: In situ hybridization within eye tissues detects IMPG1 expression in the cone and rod photoreceptor cells, specifically in the outer nuclear layer (Figure 8).

    3. The interphotoreceptor matrix (IPM) occupies the extracellular space between the apical surface of the retinal pigmented epithelium and the external limiting membrane of the neural retina. This space contains two chondroitin sulfate proteoglycans, designated IPM 150 and IPM 200

      Selection B- Gene function is consistent with phenotype.

      GOterm: GO:0033165 (interphotoreceptor matrix)

      FunctionalEvidence: IMPG1 protein can be purified as a component of an insoluble extracellular layer that is located between apical side of the RPE and the external limiting membrane of the neural retina, known as the interphotoreceptor matrix (Figure 1). This layer is known to support the function and maintenance of photoreceptor cells (PMID: 7344830).

      FunctionalHPO: HP:0030612 (Abnormal retinal morphology on macular OCT, specifically photoreceptor outer segment elongation), HP:0007677 (Vitelliform-like macular lesions)

      PhenotypeEvidence: The article provides an example of the function of IMPG1 (here referred to as IPM150) as a component of the interphotoreceptor matrix, an insoluble extracellular layer that is located between apical side of the RPE and the external limiting membrane of the neural retina, and which supports the adhesion, function, and maintenance of photoreceptor cells.

    1. Interphotoreceptor matrix proteoglycans IMPG1 and IMPG2 proteolyze in the SEA domain and reveal localization mutual dependency

      PMID: 36109576

      Gene: IMPG1

      HGNC: 6055

      Disease: vitelliform macular dystrophy 4

      MONDO: 0014508

      InheritancePattern: semi-dominant

      Prevalence: Vitelliform macular dystrophy in general is estimated to have a prevalence of 1 in 5,500 (PMID: 27120116).

      Penetrance: The penetrance of the phenotype among homozygous cases appears to be complete, while heterozygous carriers of deleterious variants show incomplete penetrance and variable expressivity.

    1. Mutations in the Genes for Interphotoreceptor Matrix Proteoglycans, IMPG1 and IMPG2, in Patients with Vitelliform Macular Lesions

      PMID: 28644393

      Gene: IMPG1

      HGNC: 6055

      Disease: vitelliform macular dystrophy 4

      MONDO: 0014508

      InheritancePattern: semi-dominant

      Prevalence: Vitelliform macular dystrophy in general is estimated to have a prevalence of 1 in 5,500 (PMID: 27120116).

      Penetrance: The penetrance of the phenotype among homozygous cases appears to be complete, while heterozygous carriers of deleterious variants show incomplete penetrance and variable expressivity.

    2. A second IMPG1 mutation, c.807 + 5G > A, was found in patient #2 of the consanguineous Turkish family 11-151 in a homozygous state (Table 1). Homozygosity was confirmed by segregation analysis in the genomic DNA of the parents. The intronic c.807 + 5G > A nucleotide substitution resides within in the conserved 5’ splice site of exon 7 and is predicted to weaken the donor splice site by 20%. The analysis of cDNA derived from HEK293 cells transfected with a construct containing the c.807 + 5G > A mutation, revealed aberrant pre-mRNA splicing; exon 7 was skipped in about half of the transcripts leading to a 194 bp as well as the 335 bp reverse transcription (RT)-PCR product amplified in controls (Figure 1). An additional faint band of ~270 bp of unknown origin was seen in cells transfected with the mutant construct. The in vitro splice assay thus confirms the bioinformatic prediction of missplicing due to the c.807 + 5G > A variant that likely leads to nonsense-mediated mRNA decay (NMD) of the aberrant mRNA.

      Case#: Brandl_2017_Family_11-151_Proband_#2, male, age 10 years at time of report, national origin reported as Turkish

      CasePresentingHPOs: HP:0007677 (Vitelliform-like macular lesions), HP:0007663 (Reduced visual acuity, 0.2 logMAR), HP:0000493 (Abnormal foveal morphology, specifically bilateral central foveal detachment of neurosensory retina), HP:0008179 (Decreased Arden ratio of electrooculogram), HP:0030612 (Abnormal retinal morphology on macular OCT)

      CaseHPOFreeText: The patient has been diagnosed with vitelliform macular dystrophy with onset in early childhood. The abnormal foveal morphology refers specifically to foveal detachment. Photoreceptor outer segments were elongated.

      CaseNotHPOs: HP:0000512 (Abnormal electroretinogram)

      CaseNotHPOFreeText: RPE and Bruch's membrane appeared normal.

      CasePreviousTesting: Previous testing appears to have been limited to Sanger sequencing of the BEST1 and PRPH2 loci.

      CaseMethod1: Sanger sequencing of the exons and flanking intronic sequences of IMPG1 and IMPG2.

      CaseMethod2: N/A

      CaseGenotypingMethod: Previous testing appears to have been limited to Sanger sequencing of the BEST1 and PRPH2 loci, while subsequent genotyping included Sanger sequencing of the exons and flanking intronic sequences of IMPG1 and IMPG2.

      Variant: The proband harbors the NM_001563.4(IMPG1):c.807+5G>A variant in the homozygous state.

      ClinVar: 1240016

      gnomAD: The NM_001563.4(IMPG1):c.807+5G>A variant was not found in gnomAD v2.1.1.

      VariantEvidence: NM_001563.4(IMPG1):c.807+5G>A is an intron 7 variant that has mini-gene assay evidence from this article (Figure 1) confirming a partial deleterious impact on the splicing of the transcript. The variant triggers skipping of exon 7 in approximately half of the transcripts. This partial defect appears to lead to in-frame loss of 141 bp (47 amino acids) corresponding to ~6% of the protein product.

      CaseAddInfo: The parents of the proband are consanguineous and are clinically asymptomatic at ages 35 and 40 years, respectively.

      CasePMIDs: N/A

    3. Patient #1 of the German family 13-501 carries a heterozygous c.713T > C nucleotide change in exon 7 of the IMPG1 gene that leads to a p.(Leu238Pro) amino acid substitution in the SEA I domain (Sperm protein, Enterokinase and Agrin) of the IMPG1 protein and is predicted to be pathogenic by all three algorithms used in the in silico analysis. At the age of 13, patient #1 showed reduced visual acuity with 0.2 and 0.1 logMAR on the right and left eye, respectively. The fundus of both eyes revealed central RPE abnormalities with foveal detachment (images not available). Patient #1 is the only affected member in the family. Data on ophthalmological examination or genetic testing of the parents of patient #1 were not available.

      Case#: Brandl_2017_Family_13-501_Proband_#1, male, age 13 years at time of report, national origin reported as German

      CasePresentingHPOs: HP:0007677 (Vitelliform-like macular lesions), HP:0007663 (Reduced visual acuity, 0.1 to 0.2 logMAR), HP:0007703 (Abnormality of retinal pigmentation, particularly in the center), HP:0000493 (Abnormal foveal morphology, specifically foveal detachment)

      CaseHPOFreeText: The patient has been diagnosed with vitelliform macular dystrophy with onset in early childhood. The abnormal foveal morphology refers specifically to foveal detachment.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous testing appears to have been limited to Sanger sequencing of the BEST1 and PRPH2 loci.

      CaseMethod1: Sanger sequencing of the exons and flanking intronic sequences of IMPG1 and IMPG2.

      CaseMethod2: N/A

      CaseGenotypingMethod: Previous testing appears to have been limited to Sanger sequencing of the BEST1 and PRPH2 loci, while subsequent genotyping included Sanger sequencing of the exons and flanking intronic sequences of IMPG1 and IMPG2.

      Variant: The proband harbors the NM_001563.4(IMPG1):c.713T>C (p.Leu238Pro) variant in the heterozygous state.

      ClinVar: 865770

      gnomAD: The NM_001563.4(IMPG1):c.713T>C (p.Leu238Pro) variant was found in gnomAD v2.1.1 at a frequency of 0.00006598 (2/30310) in the South Asian population, with 0 homozygotes https://gnomad.broadinstitute.org/variant/6-76728530-G-A?dataset=gnomad_r2_1

      VariantEvidence: NM_001563.4(IMPG1):c.713T>C (p.Leu238Pro) is a missense variant that does not have evidence confirming an impact on the gene product. However, it has been reported by an independent group of researchers in multiple families with vitelliform macular dystrophy (PMID: 23993198).

      CaseAddInfo: The proband is the only family member affected, with clinical and genetic testing data on the parents unavailable.

      CasePMIDs: N/A

    1. panel-based NGS

      Case#: Weisschuh_2020_Patient_BVMD_75, male, age 61 years at diagnosis, age 66 years at report, national origin reported as German

      CasePresentingHPOs: N/A

      CaseHPOFreeText: The patient has been diagnosed with best vitelliform macular dystrophy.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping consisted of next generation sequencing-based RET.6 panel.

      CaseMethod1: next generation sequencing-based RET.6 panel

      CaseMethod2: N/A

      CaseGenotypingMethod: Genotyping was performed using a next-generation sequencing-based RET.6 panel.

      Variant: The patient harbors the NM_001563.4(IMPG1):c.807+1G>C variant in the homozygous state.

      ClinVar: 813048

      gnomAD: The NM_001563.4(IMPG1):c.807+1G>C variant was not found in gnomAD v2.1.1.

      VariantEvidence: NM_001563.4(IMPG1):c.807+1G>T is a canonical splice site variant in intron 7 that does not have evidence confirming an impact on the gene product.

      CaseAddInfo: Segregation confirmation in family members is not available. The patient has a genotype that has been reported elsewhere in an apparently separate proband (PMID: 23993198, apparently of Italian national origin).

      CasePMIDs: N/A

    2. European

      Case#: Weisschuh_2020_Patient_MDS_342, male, age 73 years at diagnosis, age 75 years at report, national origin reported as German

      CasePresentingHPOs: N/A

      CaseHPOFreeText: The patient has been diagnosed with macular dystrophy.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping consisted of next generation sequencing-based RET.8 panel.

      CaseMethod1: next generation sequencing-based RET.8 panel

      CaseMethod2: N/A

      CaseGenotypingMethod: Genotyping was performed using a next-generation sequencing-based RET.8 panel.

      Variant: The patient harbors the NM_001563.4(IMPG1):c.378G>A (p.Trp126Ter) variant in the heterozygous state.

      ClinVar: 493439

      gnomAD: The NM_001563.4(IMPG1):c.378G>A (p.Trp126Ter) variant is found in gnomAD v2.1.1 at a maximum allele frequency of 0.00006533 (2/30616) in the South Asian population, with no homozygotes https://gnomad.broadinstitute.org/variant/6-76744428-C-T

      VariantEvidence: NM_001563.4(IMPG1):c.378G>A (p.Trp126Ter) is a nonsense variant in exon 3 of 17, and is predicted to trigger nonsense-mediated decay or to at least truncate the C-terminal 84% of the protein product.

      CaseAddInfo: Segregation confirmation in family members is not available.

      CasePMIDs: N/A

    3. Genetic architecture of inherited retinal degeneration in Germany: A large cohort study from a single diagnostic center over a 9-year period

      PMID: 32531858

      Gene: IMPG1

      HGNC: 6055

      Disease: vitelliform macular dystrophy 4

      MONDO: 0014508

      InheritancePattern: semi-dominant

      Prevalence: Vitelliform macular dystrophy in general is estimated to have a prevalence of 1 in 5,500 (PMID: 27120116).

      Penetrance: The penetrance of the phenotype among homozygous cases appears to be complete, while heterozygous carriers of deleterious variants show incomplete penetrance and variable expressivity.

    4. IRD

      Case#: Weisschuh_2020_Patient_ARRP_339, male, age 32 years at diagnosis, age 34 years at report, national origin reported as German

      CasePresentingHPOs: N/A

      CaseHPOFreeText: The patient has been diagnosed with autosomal recessive retinitis pigmentosa.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping consisted of next generation sequencing-based RET.8 panel.

      CaseMethod1: next generation sequencing-based RET.8 panel

      CaseMethod2: N/A

      CaseGenotypingMethod: Genotyping was performed using a next-generation sequencing-based RET.8 panel.

      Variant: The patient harbors the NM_001563.4(IMPG1):c.1291+1G>T variant in the homozygous state.

      ClinVar: 547007

      gnomAD: The NM_001563.4(IMPG1):c.1291+1G>T variant was not found in gnomAD v2.1.1.

      VariantEvidence: NM_001563.4(IMPG1):c.1291+1G>T is a canonical splice site variant in intron 12 of the 17-exon locus, and does not have evidence of impact on the protein product.

      CaseAddInfo: Segregation confirmation in family members is not available.

      CasePMIDs: N/A