10,000 Matching Annotations
  1. Oct 2026
    1. 49

      Case#: 49, male, 56 years old, Chinese

      DiseaseAssertion: Hemophilia A, mild

      FamilyInfo: Noted Family History

      ParentalTesting: Maternity confirmed

      CasePresentingHPOs: HP:0003125

      CaseHPOFreeText: FVIII:C = 5.1%

      CaseNotHPOs: NA

      CaseNotHPOFreeText: NA

      CasePreviousTesting: F8 gene variants were identified using next-generation sequencing (NGS), inverse shifting PCR and MLPA

      Gene: F8

      Variant: NM_000132.3:c.1660A>C

      LegacyVariant:

      ClinVar: No

      CAID: CA414911810

      gnomAD:

    2. 168

      Case#: 168, male, 7 years old, Chinese

      DiseaseAssertion: Hemophilia A, moderate

      FamilyInfo: Noted Family History

      ParentalTesting: Maternity confirmed

      CasePresentingHPOs: HP:0003125

      CaseHPOFreeText: FVIII:C = 1.6%

      CaseNotHPOs: NA

      CaseNotHPOFreeText: NA

      CasePreviousTesting: F8 gene variants were identified using next-generation sequencing (NGS), inverse shifting PCR and MLPA

      Gene: F8

      Variant: NM_000132.3:c.5480delA

      LegacyVariant:

      ClinVar: No

      CAID: No

      gnomAD:

    3. 105

      Case#: 105, male, 8 years old, Chinese

      DiseaseAssertion: Hemophilia A, mild

      FamilyInfo: Noted Family History

      ParentalTesting: Maternity confirmed

      CasePresentingHPOs: HP:0003125

      CaseHPOFreeText: FVIII:C = 49%

      CaseNotHPOs: NA

      CaseNotHPOFreeText: NA

      CasePreviousTesting: F8 gene variants were identified using next-generation sequencing (NGS), inverse shifting PCR and MLPA

      Gene: F8

      Variant: NM_000132.3:c.6683G>A

      LegacyVariant:

      ClinVar: 10098

      CAID: CA255016

      gnomAD:

    4. 98

      Case#: 98, male, 31 years old, Chinese

      DiseaseAssertion: Hemophilia A, moderate

      FamilyInfo: Noted Family History

      ParentalTesting: Maternity confirmed

      CasePresentingHPOs: HP:0003125

      CaseHPOFreeText: FVIII:C = 1.7%

      CaseNotHPOs: NA

      CaseNotHPOFreeText: NA

      CasePreviousTesting: F8 gene variants were identified using next-generation sequencing (NGS), inverse shifting PCR and MLPA

      Gene: F8

      Variant: NM_000132.3:c.6544C>T

      LegacyVariant:

      ClinVar: 10321

      CAID: CA255214

      gnomAD:

    5. 172

      Case#: 172, male, 32 years old, Chinese

      DiseaseAssertion: Hemophilia A, severe

      FamilyInfo: NA

      ParentalTesting: NA

      CasePresentingHPOs: HP:0003125

      CaseHPOFreeText: FVIII:C < 1%, Inhibitor present

      CaseNotHPOs: NA

      CaseNotHPOFreeText: NA

      CasePreviousTesting: F8 gene variants were identified using next-generation sequencing (NGS), inverse shifting PCR and MLPA

      Gene: F8

      Variant: NM_000132.3:c.del exons1_25

      LegacyVariant:

      ClinVar: No

      CAID: No

      gnomAD:

    6. 163

      Case#: 163, male, 30 years old, Chinese

      DiseaseAssertion: Hemophilia A, severe

      FamilyInfo: NA

      ParentalTesting: Maternity confirmed

      CasePresentingHPOs: HP:0003125

      CaseHPOFreeText: FVIII:C < 1%

      CaseNotHPOs: NA

      CaseNotHPOFreeText: NA

      CasePreviousTesting: F8 gene variants were identified using next-generation sequencing (NGS), inverse shifting PCR and MLPA

      Gene: F8

      Variant: NM_000132.3:c.3931_3932delinsTTT

      LegacyVariant:

      ClinVar: No

      CAID: No

      gnomAD:

    7. 58

      Case#: 58, male, 8 years old, Chinese

      DiseaseAssertion: Hemophilia A, moderate

      FamilyInfo: NA

      ParentalTesting: NA

      CasePresentingHPOs: HP:0003125

      CaseHPOFreeText: FVIII:C = 1.1%

      CaseNotHPOs: NA

      CaseNotHPOFreeText: NA

      CasePreviousTesting: F8 gene variants were identified using next-generation sequencing (NGS), inverse shifting PCR and MLPA

      Gene: F8

      Variant: NM_000132.3:c.1909A>G

      LegacyVariant:

      ClinVar: No

      CAID: CA414909856

      gnomAD:

    8. 91

      Case#: 91, male, 7 years old, Chinese

      DiseaseAssertion: Hemophilia A, mild

      FamilyInfo: Noted Family History

      ParentalTesting: Maternity confirmed

      CasePresentingHPOs: HP:0003125

      CaseHPOFreeText: FVIII:C = 22%

      CaseNotHPOs: NA

      CaseNotHPOFreeText: NA

      CasePreviousTesting: F8 gene variants were identified using next-generation sequencing (NGS), inverse shifting PCR and MLPA

      Gene: F8

      Variant: NM_000132.3:c.6437T>C

      LegacyVariant:

      ClinVar: 627110

      CAID: CA414908033

      gnomAD:

    9. 129

      Case#: 129, male, 20 years old, Chinese

      DiseaseAssertion: Hemophilia A, severe

      FamilyInfo: Noted Family History

      ParentalTesting: Maternity confirmed

      CasePresentingHPOs: HP:0003125

      CaseHPOFreeText: FVIII:C < 1%

      CaseNotHPOs: NA

      CaseNotHPOFreeText: NA

      CasePreviousTesting: F8 gene variants were identified using next-generation sequencing (NGS), inverse shifting PCR and MLPA

      Gene: F8

      Variant: NM_000132.3:c.3637dupA

      LegacyVariant:

      ClinVar: No

      CAID: CA10568191

      gnomAD:

    10. 118

      Case#: 118, male, 55 years old, Chinese

      DiseaseAssertion: Hemophilia A, moderate

      FamilyInfo: Noted Family History

      ParentalTesting: Maternity confirmed

      CasePresentingHPOs: HP:0003125

      CaseHPOFreeText: FVIII:C = 1.3%

      CaseNotHPOs: NA

      CaseNotHPOFreeText: NA

      CasePreviousTesting: F8 gene variants were identified using next-generation sequencing (NGS), inverse shifting PCR and MLPA

      Gene: F8

      Variant: NM_000132.3:c.5219+3A>G

      LegacyVariant:

      ClinVar: No

      CAID: CA873340051

      gnomAD:

    1. Leu-23Pro

      Case#: HB-KHF-04 (Male, Korean)

      DiseaseAssertion: Severe Hemophilia B

      FamilyInfo: Among the 33 patients, 13 had a family history (39%), while the rest of the patients did not (sporadic, 61%). 27 patients (82%) had the severe form of the disease, while 6 patients (18%) had the moderate form

      ParentalTesting: N/A

      CasePresentingHPOs: HP:0003645, HP:0011858

      CaseHPOsFreeText: Prolonged partial thromboplastin time, reduced factor IX activity

      CaseNotHPOs: None

      CasePreviousTesting: aPTT and one-stage clotting assay at labs where patients were ascertained: FIX-deficient plasma (STA®-Deficient IX; Diagnostica Stago, Asnieres-sur-Seine, France; reference range, 60–150%) at Samsung Medical Center or HemosIL™ (Instrumentation Laboratory, Milan, Italy; reference range, 50–145%) at the Korea Hemophilia Foundation.

      Gene: F9

      Variant: NM_000133.4:c.68T>C (p.Leu23Pro)

      ClinVar: Absent

      CAID: CA414434403

      gnomAD: Absent/Not Reported

    1. 26.

      Case#: 26

      DiseaseAssertion: Hemophilia B, severe

      FamilyInfo: NA

      ParentalTesting: NA

      CasePresentingHPOs: HP:0011858

      CaseHPOFreeText: FIX:C < 1%

      CaseNotHPOs: NA

      CaseNotHPOFreeText: NA

      CasePreviousTesting: All relevant sequences of F9 were PCR amplified and analyzed by DNA sequencing

      Gene: F9

      Variant: NM_000133.3:c.1234G>T

      LegacyVariant:

      ClinVar: No

      CAID: CA414446705

      gnomAD:

    2. 42.

      Case#: 42

      DiseaseAssertion: Hemophilia B, severe

      FamilyInfo: NA

      ParentalTesting: NA

      CasePresentingHPOs: HP:0011858

      CaseHPOFreeText: FIX:C < 1%

      CaseNotHPOs: NA

      CaseNotHPOFreeText: NA

      CasePreviousTesting: All relevant sequences of F9 were PCR amplified and analyzed by DNA sequencing

      Gene: F9

      Variant: NM_000133.3:c.252+2T>G

      LegacyVariant:

      ClinVar: No

      CAID: CA414436440

      gnomAD:

    1. p.Ala37Thr

      Case#: Tamura_Case (male, 49 y/o)

      DiseaseAssertion: Severe Hemophilia B

      FamilyInfo: No family history of stroke, thrombosis or bleeding episodes

      ParentalTesting: N/A

      CasePresentingHPOs: HP:0012233, HP:0011858

      CaseHPOsFreeText: cerebral infarction, prolonged APTT (58.4 s), elevated diluted Russell viper venom time ratio (2.68), and anti-β2 glycoprotein I antibody (9.7 U/mL) and anticardiolipin antibody IgG (39 U/mL), antiphospholipid antibody syndrome (APS), intramuscular hemorrhage, reduced factor IX activity (<0.5%)

      CasePreviousTesting: N/A

      Gene: F9

      Variant: NM_000133.4:c.109G>A (p.Ala37Thr)

      ClinVar: 804089

      CAID: CA10529736

      gnomAD: Allele Frequency in population where variant was found in the highest (South Asian population): 0.0001128

  2. www-thieme-connect-de.libproxy.lib.unc.edu www-thieme-connect-de.libproxy.lib.unc.edu
    1. 005–1002

      Case#: 005-1002

      DiseaseAssertion: Hemophilia A, severe

      FamilyInfo: NA

      ParentalTesting: NA

      CasePresentingHPOs: HP:0003125

      CaseHPOFreeText: FVIII:C < 1%, Inhibitor present

      CaseNotHPOs: NA

      CaseNotHPOFreeText: NA

      CasePreviousTesting: The 26 exons and their flanking regions of F8 were amplified by PCR using specific primers with a simple modification

      Gene: F8

      Variant:

      LegacyVariant:

      ClinVar: No

      CAID: No

      gnomAD:

    2. 084–2003

      Case#: 084-2003

      DiseaseAssertion: Hemophilia A, severe

      FamilyInfo: NA

      ParentalTesting: NA

      CasePresentingHPOs: HP:0003125

      CaseHPOFreeText: FVIII:C < 1%, Inhibitor present

      CaseNotHPOs: NA

      CaseNotHPOFreeText: NA

      CasePreviousTesting: The 26 exons and their flanking regions of F8 were amplified by PCR using specific primers with a simple modification

      Gene: F8

      Variant: NM_000132.3:c.209_212delTTGT

      LegacyVariant:

      ClinVar: No

      CAID: CA255050

      gnomAD:

    3. 020–2065

      Case#: 020-2065

      DiseaseAssertion: Hemophilia A, mild

      FamilyInfo: NA

      ParentalTesting: NA

      CasePresentingHPOs: HP:0003125

      CaseHPOFreeText: 5% < FVIII:C < 40%

      CaseNotHPOs: NA

      CaseNotHPOFreeText: NA

      CasePreviousTesting: The 26 exons and their flanking regions of F8 were amplified by PCR using specific primers with a simple modification

      Gene: F8

      Variant: NM_000132.3:c.1834C>T

      LegacyVariant:

      ClinVar: No

      CAID: CA255129

      gnomAD:

    4. 004–2019

      Case#: 004-2019

      DiseaseAssertion: Hemophilia A, severe

      FamilyInfo: NA

      ParentalTesting: NA

      CasePresentingHPOs: HP:0003125

      CaseHPOFreeText: FVIII:C < 1%

      CaseNotHPOs: NA

      CaseNotHPOFreeText: NA

      CasePreviousTesting: The 26 exons and their flanking regions of F8 were amplified by PCR using specific primers with a simple modification

      Gene: F8

      Variant: NM_000132.3:c.3637delA

      LegacyVariant:

      ClinVar: No

      CAID: CA255146

      gnomAD:

    5. 060–2006

      Case#: 060-2006

      DiseaseAssertion: Hemophilia A, moderate

      FamilyInfo: NA

      ParentalTesting: NA

      CasePresentingHPOs: HP:0003125

      CaseHPOFreeText: 1% < FVIII:C < 5%

      CaseNotHPOs: NA

      CaseNotHPOFreeText: NA

      CasePreviousTesting: The 26 exons and their flanking regions of F8 were amplified by PCR using specific primers with a simple modification

      Gene: F8

      Variant: NM_000132.3:c.1618C>A

      LegacyVariant:

      ClinVar: No

      CAID: CA414911950

      gnomAD:

    6. 001–2026

      Case#: 001-2026

      DiseaseAssertion: Hemophilia A, severe

      FamilyInfo: NA

      ParentalTesting: NA

      CasePresentingHPOs: HP:0003125

      CaseHPOFreeText: FVIII:C < 1%

      CaseNotHPOs: NA

      CaseNotHPOFreeText: NA

      CasePreviousTesting: The 26 exons and their flanking regions of F8 were amplified by PCR using specific primers with a simple modification

      Gene: F8

      Variant: NM_000132.3:c.986G>A

      LegacyVariant:

      ClinVar: No

      CAID: CA255089

      gnomAD:

    7. 047–2002

      Case#: 047-2002

      DiseaseAssertion: Hemophilia A, moderate

      FamilyInfo: NA

      ParentalTesting: NA

      CasePresentingHPOs: HP:0003125

      CaseHPOFreeText: 1% < FVIII:C < 5%

      CaseNotHPOs: NA

      CaseNotHPOFreeText: NA

      CasePreviousTesting: The 26 exons and their flanking regions of F8 were amplified by PCR using specific primers with a simple modification

      Gene: F8

      Variant: NM_000132.3:c.6011C>A

      LegacyVariant:

      ClinVar: No

      CAID: CA414905140

      gnomAD:

    1. 6 months of age, the proband (male, born on 20 February 2008)

      Case2: 6-month-old Male, China

      DiseaseAssertion: Hemophilia B (Factor IX-deficient)

      FamilyInfo: Mother and maternal grandmother are HB carriers due to a novel mutation in intron 3. Pedigree shown in Figure 1.

      ParentalTesting: The F9 exons were amplified (RT-PCR) and exons 1 to 8 of the F9 gene were analyzed with the ABI 3130 Genetic Analyzer, Sequenced intron 3 of the F9 gene

      CasePresentingHPOs: HP:0011858 (Reduced factor IX activity)

      CaseHPOFreeRext: FIX:C 1%, Pelioma, Cyanotic bumps, Subcutaneous bleeding, knee swelling from crawling

      CasePreviousTesting: Prenatal testing at 20 weeks

      Gene: F9

      Variant: NM_000133.3(F9):c.278-3A>G

      ClinVar: 92225 https://www.ncbi.nlm.nih.gov/clinvar/variation/92225/#id_first

      CAID: CA285284

      gnomAD: Not Reported

    1. The p.Pro521Leu substitution (patient P3)

      Case#: P3 (female)

      DiseaseAssertion: Carrier

      FamilyInfo: N/A

      ParentalTesting: Father was tested; has mild HA

      CasePresentingHPOs: HP:0003125, HP:0001928

      CaseHPOFreeText: Low FVIII levels (significant decrease in FVIII:C (48.4% ± 6.1, P < 0.01) and FVIII:Ag (36.6% ± 2.7, P < 0.01)), abnormal blood coagulation

      CaseNotHPOs: N/A

      CaseNotHPOsFreeText: N/A

      CasePreviousTesting: Molecular Analysis included a southern blot assay, PCR, dHPLC and a multiplex ligation-dependent probe amplification analysis. Plasmid mutagenesis, plasmid transfection and in silico analysis were also performed.

      Gene: F8

      Variant: NM_000132.4:c.1562C>T

      CAID: CA414912242

      gnomAD: Absent/Not Reported

    1. B32 – B44

      Case#: B32 - B44

      DiseaseAssertion: NA

      FamilyInfo: NA

      ParentalTesting: NA

      CasePresentingHPOs: HP:0003125

      CaseHPOFreeText: FVIII:C Chr = 94, FVIII:AG = 88, inverse assay discrepancy present (OSA<CSA)

      CaseNotHPOs: NA

      CaseNotHPOFreeText: NA

      CasePreviousTesting: Coding region and intron/exon bound-aries of the F8 gene were amplified from all patient samples and directly sequenced using primers

      Gene: F8

      Variant: NM_000132.4:c.2215G>A

      LegacyVariant:

      ClinVar: No

      CAID: CA255139

      gnomAD:

    2. A5 – A8

      Case#: A5 - A8

      DiseaseAssertion: Hemophilia A, mild

      FamilyInfo: NA

      ParentalTesting: NA

      CasePresentingHPOs: HP:0003125

      CaseHPOFreeText: FVIII:C = 26, FVIII:AG = 60, assay discrepancy present (OSA>CSA)

      CaseNotHPOs: NA

      CaseNotHPOFreeText: NA

      CasePreviousTesting: Coding region and intron/exon bound-aries of the F8 gene were amplified from all patient samples and directly sequenced using primers

      Gene: F8

      Variant: NM_000132.4:c.1649G>A

      LegacyVariant:

      ClinVar: No

      CAID: CA255115

      gnomAD:

    1. c.2545 A > G (p.T849A) was observed in family 087

      Case#: Jiang_2015_Family_087_Patient_III:2, male, age 28 at time of report, national origin listed as Chinese

      CasePresentingHPOs: HP:0011463 (Childhood onset), HP:0025573 (Mild myopia), HP:0032037 (Mildly reduced visual acuity), HP:0007703 (Abnormality of retinal pigmentation), HP:0008275 (Abnormal light-adapted electroretinogram), HP:0000642 (Red-green dyschromatopsia)

      CaseHPOFreeText: N/A

      CaseNotHPOs: HP:0000662 (Nyctalopia), HP:0000639 (Nystagmus)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous testing included mapping the disease locus in this family to the region of chr17p13.1-2 containing AIPL1, PITPNM3, and GUCY2D (PMID: 23734073).

      CaseMethod1: Sanger sequencing of PCR products from all exons and flanking regions of the GUCY2D, AIPL1, and PITPNM3 loci.

      CaseMethod2: Allele-specific PCR analysis to genotype the proband and family members

      CaseGenotypingMethod: The proband was genotyped by linkage mapping of the phenotype within affected and unaffected members of his family, followed by Sanger sequencing of PCR products from all exons and flanking regions of the 3 candidate loci, and finally allele-specific PCR analysis to genotype the proband and family members.

      Variant: The proband harbors the NM_000180.4(GUCY2D)):c.2545A>G (p.Thr849Ala) variant in the heterozygous state.

      CAID: CA397953755

      gnomAD: The variant was not found in gnomAD.

      VariantEvidence: NM_000180.4(GUCY2D)):c.2545A>G (p.Thr849Ala) is a missense variant located within the coiled-coil domain that mediates dimerization. Missense variants at the nearby Codon 838 have proven to constitute a hot spot disrupted in other families similarly affected with autosomal dominant cone-rod dystrophy (PMID: 11115851, PMID: 12552567, PMID: 26298565). Cases from this family appear to be less severely affected than those.

      CaseAddInfo: The proband has two older family members who are similarly affected and who harbor the variant.

      CasePMIDs: PMID: 23734073

    2. p.R838H

      Case#: Jiang_2015_Patient_010043, female, age 28 at time of report, national origin listed as Chinese

      CasePresentingHPOs: HP:0011463 (Childhood onset), HP:0011003 (High myopia), HP:0007663 (Reduced visual acuity), HP:0007703 (Abnormality of retinal pigmentation), HP:0030329 (Retinal thinning), HP:0008275 (Abnormal light-adapted electroretinogram)

      CaseHPOFreeText: N/A

      CaseNotHPOs: HP:0000662 (Nyctalopia), HP:0000639 (Nystagmus)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous testing appears to have been limited to clinical phenotyping.

      CaseMethod1: Sanger sequencing of PCR products from all exons and flanking regions of the GUCY2D locus

      CaseMethod2: HhaI restriction digest of the PCR-amplified exon 13

      CaseGenotypingMethod: The proband was genotyped by Sanger sequencing of PCR products from all exons and flanking regions of the GUCY2D locus. Parents were implied to have been genotyped as well. The patient and family members were subjected to additional genotyping through restriction fragment length polymorphism analysis, then confirmation by HhaI restriction endonuclease digestion of PCR products from the relevant exon 13.

      Variant: The proband harbors the NM_000180.4(GUCY2D):c.2513G>A (p.Arg838His) variant in the heterozygous state.

      ClinVar: 9357

      gnomAD: The variant was not found in gnomAD.

      VariantEvidence: NM_000180.4(GUCY2D):c.2513G>A (p.Arg838His) is a missense variant located within the coiled-coil domain that mediates dimerization. Codon 838 has proven to be a hot spot disrupted in other families similarly affected with autosomal dominant cone-rod dystrophy (PMID: 11115851, PMID: 12552567, PMID: 26298565). The variant has been reported in an apparently unrelated family from this same publication. The p.Arg838His substitution has been shown to disrupt the calcium sensitivity of GUCY2D and to trigger the inability to inactivate cyclase activity at high physiological calcium ion concentrations (PMID: 11115851).

      CaseAddInfo: The proband's parents are unaffected and negative for the variant, indicating that this may be a de novo case. It is uncertain whether genotyping methods were sufficient to confirm paternity and maternity.

      CasePMIDs: N/A

    1. Genotype-phenotype correlation in British families with X linked congenital stationary night blindness

      PMID: 14609846

      Gene: NYX

      HGNC: 8082

      Disease: Congenital stationary night blindness 1A

      MONDO: 0010690

      InheritancePattern: X-linked recessive

      Prevalence: Congenital stationary night blindness has an estimated prevalence between 1 in 6,000 (PMID: 31427709) and 1 in 300,000 (PMID: 3487908). However, the prevalence of congenital stationary night blindness 1A specifically is unknown.

      Penetrance: Penetrance is thought to be complete.

    2. nonsense mutation found in family X08

      Case#: Allen_2003_Familly_X08_Proband, male, age not mentioned, British national origin

      CasePresentingHPOs: HP:0007642 (Congenital stationary night blindness), HP:0007663 (Reduced visual acuity), HP:0031624 (Moderate myopia), HP:0007984 (Electronegative electroretinogram)

      CaseHPOFreeText: ERG with absent scotopic oscillatory potential, subnormal ON response

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: Normal OFF response

      CasePreviousTesting: N/A

      CaseMethod1: Sanger sequencing of PCR-amplified exons from NYX and CACNA1F

      CaseMethod2: Haplotype analysis using microsatellite markers surrounding the NYX locus

      CaseGenotypingMethod: The proband and family members were subjected to Sanger sequencing of NYX to identify the variant, followed by microsatellite-based haplotype analysis of families sharing the same variant.

      Variant: The proband harbors the NM_022567.2(NYX):c.895C>T (p.Gln299Ter) variant on the X chromosome.

      CAID: CA412991558

      gnomAD: NM_022567.2(NYX):c.895C>T (p.Gln299Ter) was not found in gnomAD.

      VariantEvidence: NM_022567.2(NYX):c.895C>T (p.Gln299Ter) is a nonsense variant in exon 3/3 that is not predicted to trigger NMD but truncates the C-terminal 38% of the protein product. A separate publication (PMID: 14507859) indicates that variants (such as this one) that remove the C-terminal GPI anchor disrupt NYX function by triggering its mislocalization to and accumulation in the ER and Golgi and its absence from its normal destination at the cell surface.

      CaseAddInfo: N/A

      CasePMIDs: N/A

    1. missense

      Case#: Mykykyn_2002_Proband_PR1-1, gender not specified, age not described, family origin reported as from Puerto Rico

      CasePresentingHPOs: N/A

      CaseHPOFreeText: The proband has been previously diagnosed with Bardet-Biedl syndrome based on at least three of the following features; obesity, polydactyly, renal anomalies, retinopathy, hypogonadism, and/or mental retardation.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The proband and their affected and unaffected family members were subjected to mapping of the disease-associated locus to chromosome 11, followed by PCR- and Sanger sequencing-based genotyping of chromosome 11 markers.

      CaseMethod1: linkage mapping

      CaseMethod2: Sanger sequencing of BBS1

      CaseGenotypingMethod: The proband and their affected and unaffected family members were subjected to linkage mapping of the disease-associated locus to chromosome 11, followed by PCR- and Sanger sequencing-based genotyping of chromosome 11 markers. Sanger sequencing of BBS1 was subsequently used to identify the variant.

      Variant: The proband harbors the NM_024649.5(BBS1):c.1169T>G (p.Met390Arg) variant in the homozygous state.

      ClinVar ID: 12143

      gnomAD: The variant is found in gnomAD v2.1.1 at a frequency of 0.002773 in the European (non-Finnish) population, with 358 alleles / 129114 total alleles (0 homozygotes) https://gnomad.broadinstitute.org/variant/11-66293652-T-G?dataset=gnomad_r2_1

      VariantEvidence: NM_024649.5(BBS1):c.1169T>G (p.Met390Arg) is a missense variant with mouse knock-in evidence of a similar disease-causing effect in the homozygous state (PMID: 18032602). This has not been taken into account in scoring, as the mouse model has been scored separately. However, it has provided a rationale not to down-score for the relatively high gnomAD frequency of this variant.

      CaseAddInfo: The proband's family is described as consanguineous.

      CasePMIDs: N/A

    1. 15 year old boy (patient II‐1)

      Case#: Moore_2006_Family_1_Patient_II-1, male, 15 years old at time of report, national origin not mentioned

      CasePresentingHPOs: HP:0011463 (Childhood onset), HP:0011109 (Chronic sinusitis), HP:0031353 (Otitis media with effusion), HP:0002837 (Recurrent bronchitis), HP:0100750 (Atelectasis), HP:0002110 (Bronchiectasis), HP:0006536 (Airway obstruction), HP:0005101 (High-frequency hearing impairment), HP:0012263 (Immotile cilia), HP:0012258 (Abnormal axonemal organization of respiratory motile cilia), HP:0012264 (Absent central microtubular pair morphology of respiratory motile cilia), HP:0012256 (Absent outer dynein arms), HP:0012257 (Absent inner dynein arms)

      CaseHPOFreeText: The patient received a diagnosis of primary ciliary dyskinesia in early childhood, followed by retinitis pigmentosa diagnosed later in childhood. Atelectasis was severe and led to partial lobectomy at age 14 years. Microbiology detected Haemophilus influenzae. Biopsies showed both motile and immotile cilia.

      CaseNotHPOs: HP:0002643 (Neonatal respiratory distress), HP:0012418 (Hypoxemia), HP:0030853 (Heterotaxy)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Based on a family history consistent with X-linked inheritance, the patient and family members were subjected to segregation analysis using 4 microsatellite markers on the X chromosome. Genome-wide methods were not used for genotyping.

      CaseMethod1: Sanger sequencing of PCR products from each of the 19 coding exons of RPGR, including the flanking intronic sequences

      CaseMethod2: N/A

      CaseGenotypingMethod: The patient and family members were subjected to segregation analysis using 4 microsatellite markers on the X chromosome. Sanger sequencing of PCR products from each of the 19 coding exons of RPGR, including the flanking intronic sequences, was then performed. Genome-wide methods were not used for genotyping.

      Variant: The patient harbors the NM_001034853.2(RPGR):c.572_619+9del variant in the hemizygous state.

      CAID: CA2573131867

      gnomAD: This variant was not found in gnomAD v.2.1.1.

      VariantEvidence: NM_001034853.2(RPGR):c.572_619+9del is a deletion variant spanning the function between exon 6 and intron 6. It has been shown to yield a shorter mRNA generated by the use of a cryptic splice donor site in exon 6 (Figure 4) that is predicted to trigger a frameshift and nonsense-mediated decay or disruption of the C-terminal 84% of the protein product.

      CaseAddInfo: The proband is a member of Family 1, which has a pedigree shown in Figure 1. The patient's family includes a similarly affected brother and a mother diagnosed with retinitis pigmentosa, both harboring the RPGR variant of interest. Parents are reportedly non-consanguineous.

      CasePMIDs: N/A

    1. A novel GPR143 duplication mutation in a Chinese family with X-linked congenital nystagmus

      PMID: 19390656

      Gene: GPR143

      HGNC: 20145

      Disease: X-linked recessive ocular albinism

      MONDO: 0021019

      InheritancePattern: X-linked recessive

      Prevalence: Ocular albinism has an estimated prevalence between 1 in 111,000 and 1 in 1,000,000 live births (PMID: 35495622)

      Penetrance: Fully penetrant in males, with onset in infancy. Most female carriers appear to be unaffected.

    2. In this study, we present a four-generation Chinese family with X-linked CN. All affected individuals exhibited nystagmus but without any typical signs of OA1. Upon genetic analysis, we characterized the underlying molecular defect as a novel 19 base pair (bp) duplication in exon 1 of GPR143, causing a frame-shift in all affected males.

      Case#: Peng_2009_Patient_IV:3, male, age of onset not reported, family origin reported to be from China

      CasePresentingHPOs: HP:0006934 (Congenital nystagmus)

      CaseHPOFreeText: The proband has been diagnosed with congenital nystagmus, with family members showing an X-linked pattern of inheritance.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: The affected individuals are described as lacking the typical signs of ocular albinism 1, but details have not been described.

      CasePreviousTesting: Genotyping was initially performed by linkage mapping using markers on the X chromosome.

      CaseMethod1: linkage analysis

      CaseMethod2: Sanger sequencing

      CaseGenotypingMethod: Genotyping was initially performed by linkage mapping using markers on the X chromosome, followed by Sanger sequencing of PCR products from each exon of the GPR143 gene. Family members were subsequently genotyped by allele-specific PCR.

      Variant: The proband harbors the NM_000273.3:c.291_309dup (p.Asp104PhefsTer3) variant in the hemizygous state.

      CAID: CA2573320693

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

      VariantEvidence: NM_000273.3:c.291_309dup (p.Asp104PhefsTer3) is a frameshift variant in exon 2 of 9, and is predicted to trigger nonsense-mediated decay or to at least truncate the C-terminal 75% of the protein product.

      CaseAddInfo: The proband is from a family with at least three other affected males who also harbor the variant.

      CasePMIDs: N/A

    1. Unique Variants in OPN1LW Cause Both Syndromic and Nonsyndromic X-Linked High Myopia Mapped to MYP1

      PMID: 26114493

      Gene: OPN1LW

      HGNC: 9936

      Disease: protan color blindness

      MONDO: 0010565

      InheritancePattern: X-linked

      Prevalence: The overall prevalence of protan color blindness is approximately 1% in males, which is higher than that of blue cone monochromacy (~1 in 100,000, PMID: 35759666).

      Penetrance: Known disease-causing alleles appear to be almost completely penetrant in males (PMID: 21167193).

    2. Analysis of data from WES on other probands with early-onset high myopia detected the two variants (c.532A > G and c.538T > G) in OPN1LW in one proband from a large family (HM346) and a frameshift mutation (c.617_620dup, p.Phe208Argfs*51) in OPN1LW in one proband from a small family (HM429). The long-range and second PCR also confirmed that the two variants in HM346 were present in the first OPN1LW gene and formed the unique haplotype (LVAVA) with other adjacent polymorphisms (Fig. 1A). The unique haplotype cosegregated with high myopia in the large family with a maximum logarithm of the odds (LOD) score of 2.31 at theta = 0 (Fig. 1C; Supplementary Table S2). Sanger sequencing confirmed the frameshift mutation in HM429 (Fig. 2). Segregation analysis was not available from the proband with the frameshift mutation.

      Case#: Li_2015_Proband_HM429III3, onset before age 7 years, male, seen at a medical center in Guangzhou

      CasePresentingHPOs: Abnormal optic disc morphology HP:0012795, Abnormal morphology of the choroidal vasculature HP:0025568, Abnormal light-adapted electroretinogram HP:0008275, Protanopia HP:0011522

      CaseHPOFreeText: The proband has a diagnosis of early onset high myopia, yet also shows protanopia. He exhibits myopic fundus changes, with temporal crescent of optic nerve head and tigroid appearance of posterior retina. Rod ERG responses are normal, while cone responses are mildly to moderately reduced.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Genotyping of the proband was performed by whole exome sequencing.

      CaseMethod1: whole exome sequencing

      CaseMethod2: Sanger sequencing of OPN1LW

      CaseGenotypingMethod: Genotyping of the proband was performed by whole exome sequencing, followed by Sanger sequencing of OPN1LW.

      Variant: The individual harbors the NM_020061.6(OPN1LW):c.617_620dup (p.Phe208ArgfsTer51) variant in the hemizygous state.

      CAID: CA2739290587

      gnomAD: The variant was not found in gnomAD version 4.1.0.

      VariantEvidence: NM_020061.6(OPN1LW):c.617_620dup (p.Phe208ArgfsTer51) is a nonsense variant in exon 4 of 6 that is predicted to undergo nonsense-mediated decay.

      CaseAddInfo: The proband was seen at a medical center in Guangzhou. 4 other male family members are similarly affected but ungenotyped.

      CasePMIDs: N/A

    1. Identification of Novel RPGR ORF15 Mutations in X-linked Progressive Cone-Rod Dystrophy (XLCORD) Families

      PMID: 15914600

      Gene: RPGR

      HGNC: 10295

      Disease: RPGR-related retinopathy

      MONDO: MONDO:0100437

      InheritancePattern: X-linked

      Prevalence: The prevalence of RPGR-related retinopathy is calculated to be approximately 1 in 214,000, based on the known incidence of retinitis pigmentosa at 1 in 3,000, the proportion of retinitis pigmentposa that is X-linked at 20%, and the proportion of X-linked retinitis pigmentosa that is RPGR-associated at 70% (PMID: 34985506).

      Penetrance: Penetrance is nearly 100% in hemizygous males but is incomplete and dependent upon the variant in heterozygous female carriers.

    1. Background

      Case: Lin_FamilyA_II:2

      CasePresentingHPOsFreeText: Ophthalmic examination notes were retrospectively reviewed in patients. Best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, fundus examination, spectral-domain optical coherence tomography (SD-OCT) scans through the fovea, and short-wavelength fundus autofluorescence (SW-AF, 488 nm), were obtained in all four affected patients with Spectralis HRA+OCT (Heidelberg Engineering, Heidelberg, Germany). Full-field electroretinogram (ERG) testing was performed according to the International Society for Clinical Electrophysiology of Vision (ISCEV) standards. The patients in this study exhibited chorioretinal phenotypes characteristic of RP (Figure 1). All patients initially presented with night blindness followed by progressive constriction of their visual field. ERG recordings were collected from three patients (A-II:2, B-II:1, and D-II:5) (Figure 3). For A-II:2 at 60 years of age and D-II:5 at age 37 years of age, ERG rod responses of the right eyes were almost undetectable.

      CasePreviousTesting: WES

      CaseGenotypingMethod: Genetic testing was performed in all four patients in this study, using either whole exome sequencing (WES, A-II:2, B-II:1, and D-II:5)

      Variant: c.226C>T (p.Arg76Ter)

      ClinVarID: or CAID: CA151548

      gnomAD: allele frequency of 0.001173 in the Latino population

      AddCaseInfo:

      PreviouslyPublished:

      VariantEvidence:

    1. The A187K mutation was found in three families from Sweden sharing a common haplotype.

      Case#: Pusch_2000_Family_9069_proband, male, 18 years of age, Swedish family origin

      CasePresentingHPOs: HP:0007642 (Congenital stationary night blindness), HP:0007663 (Reduced visual acuity), HP:0031624 (Moderate myopia), HP:0007984 (Electronegative electroretinogram)

      CaseHPOFreeText: ERG with absent oscillatory-potential wavelets

      CaseNotHPOs: HP:0001098 (Abnormal fundus morphology), HP:0030473 (Abnormal light-adapted flicker electroretinogram)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Linkage analysis and haplotype analysis were performed using RFLP X-chromosomal markers and SSCP.

      CaseMethod1: Sanger sequencing of PCR amplified exons from NYX

      CaseMethod2: N/A

      CaseGenotypingMethod: Linkage analysis and haplotype analysis were performed using RFLP X-chromosomal markers and SSCP. This was followed by Sanger sequencing of PCR products to identify the variant.

      Variant: The proband harbors the NM_022567.2(NYX):c.559_560delinsAA (p.Ala187Lys) variant in his X-chromosome.

      ClinVar: 11423

      gnomAD: NM_022567.2(NYX):c.559_560delinsAA (p.Ala187Lys) was not found in gnomAD.

      VariantEvidence: This is missense variant does not have experimental evidence of impact on the protein product, but is a recurrent variant observed in this paper in multiple Swedish families (2996, 9069, and 2999) with a shared haplotype.

      CaseAddInfo: Phenotype information is found in PMID: 12397430.

      CasePMIDs: 12397430

    2. 8 missense mutations

      Case#: Pusch_2000_Family_2438B_proband, male, 36 years of age, origin not mentioned (PMID: 12397430)

      CasePresentingHPOs: HP:0007642 (Congenital stationary night blindness), HP:0007663 (Reduced visual acuity), HP:0031624 (Moderate myopia), HP:0007984 (Electronegative electroretinogram)

      CaseHPOFreeText: ERG with absent oscillatory-potential wavelets

      CaseNotHPOs: HP:0001098 (Abnormal fundus morphology), HP:0030473 (Abnormal light-adapted flicker electroretinogram)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Linkage analysis and haplotype analysis were performed using RFLP X-chromosomal markers and SSCP.

      CaseMethod1: Sanger sequencing of PCR amplified exons from NYX

      CaseMethod2: N/A

      CaseGenotypingMethod: Linkage analysis and haplotype analysis were performed using RFLP X-chromosomal markers and SSCP. This was followed by Sanger sequencing of PCR products to identify the variant.

      Variant: The proband harbors the NM_001378477.3(NYX):c.77G>C (p.Cys26Ser) variant in his X-chromosome.

      ClinVar: 99843

      gnomAD: NM_001378477.3(NYX):c.77G>C (p.Cys26Ser) was not found in gnomAD.

      VariantEvidence: This is missense variant does not have experimental evidence of impact on the protein product, but is a recurrent variant observed in multiple apparently unrelated families (2438B, 5886, and 5884) from this paper.

      CaseAddInfo: Phenotype information is found in PMID: 12397430.

      CasePMIDs: 12397430

    1. In contrast, at P12, retinal sections of C57BL/6J-Pde6anmf363/nmf363 mutants and controls are indistinguishable (Fig. 2C and D). By P14, an ∼30% reduction in ONL thickness is observed in mutant mice. The thickness of the IS and OS is almost comparable to that of C57BL/6J-Pde6anmf363/+ controls until P16. Degeneration of OS is clearly seen in C57BL/6J-Pde6anmf363/nmf363 mutants at P19. However, even at P36, a single layer of cell bodies still remained in the ONL of the mutant mice. Therefore, the photoreceptor degeneration while rapid has a later onset and is prolonged in C57BL/6J-Pde6anmf363/nmf363 mutants compared to A.B6-Tyr+/J-Pde6anmf282/nmf282 mutant mice. Functional analyses by ERG are consistent with these histological observations (Fig. 2E). While the ERG response is extinguished in A.B6-Tyr+/J-Pde6anmf282/nmf282 mutants at P14, some residual activity is still observed in C57BL/6J-Pde6anmf363/nmf363 mutants at P21.

      ExperimentName: Murine model of PDE6A loss-of-function (Pde6Anmf363/nmf363)

      NonHumanModel: Mus musculus

      GeneAlteration: Mice were found to develop retinal degeneration due to a homozygous missense variant (2159G>A) at codon 670 substituting glycine for aspartic acid.

      ModelPhenotype: HP:0030609 (Photoreceptor layer loss on macular OCT), HP:0030478 (Abnormal amplitude of dark-adapted bright flash electroretinogram)

      HumanPhenotype: HP:0011463 (Childhood onset), HP:0000662 (Nyctalopia), HP:0007994 (Peripheral visual field loss), HP:0000543 (Optic disc pallor), HP:0007843 (Attenuation of retinal blood vessels), HP:0007737 (Bone spicule pigmentation of the retina), HP:0000654 (Decreased light- and dark-adapted electroretinogram amplitude), HP:0007984 (Electronegative electroretinogram)

      ModelEvidence: This mutation caused photoreceptor outer nuclear layer outer segment thinning (Figures 2C, 2D, 7), decreased dark-adapted bright flash ERG amplitude (Figure 2E), and decreased cGMP/PDE activity (Figure 3C).

      ModelVariant: The model does not harbor a variant equivalent to one from the human patients, but rather has a mutagenesis-induced missense variant disrupting Pde6a leading to partial loss-of-function.

    2. New mouse models for recessive retinitis pigmentosa caused by mutations in the Pde6a gene

      PMID: 18849587

      Gene: PDE6A

      HGNC: 8785

      Disease: retinitis pigmentosa 43

      MONDO: MONDO:0013437

      InheritancePattern: autosomal recessive

      Prevalence: The overall prevalence of retinitis pigmentosa is between 1 in 3,000 and 1 in 4,000 individuals, while the proportion of retinitis pigmentosa with a recessive mode of inheritance is estimated to be 65-85% (between 1 in 3,500 and 1 in 6,200). Retinitis pigmentosa 43 is considered to be make up 2-5% of these cases, with an overall prevalence estimated between 1 in 70,000 and 1 in 310,000.

      Penetrance: Known disease-causing alleles appear to be completely penetrant.

    1. mice with a targeted disruption of Lrp5 develop a low bone mass phenotype. In vivo and in vitro analyses indicate that this phenotype becomes evident postnatally, and demonstrate that it is secondary to decreased osteoblast proliferation and function in a Cbfa1-independent manner. Lrp5 is expressed in osteoblasts and is required for optimal Wnt signaling in osteoblasts. In addition, Lrp5-deficient mice display persistent embryonic eye vascularization due to a failure of macrophage-induced endothelial cell apoptosis. These results implicate Wnt proteins in the postnatal control of vascular regression and bone formation, two functions affected in many diseases. Moreover, these features recapitulate human osteoporosis-pseudoglioma syndrome, caused by LRP5 inactivation.

      ExperimentName: Targeted disruption of Lrp5 in mice

      NonHumanModel: Mus musculus

      GeneAlteration: Model animals were subjected to targeted disruption of Lrp5 by inserting an IRES-LacZ-Neomycin cassette to replace the region encoding the extracellar domain, starting at amino acid 373.

      ModelPhenotype: HP:0004349 (Reduced bone mineral density), HP:0410280 (Pediatric onset), decreased osteoblast proliferation, HP:0007968 (Remnants of the hyaloid vascular system), failure of macrophage-mediated endothelial cell apoptosis

      HumanPhenotype: HP:0000939 (Osteoporosis), HP:0011463 (Childhood onset), HP:0000541 (Retinal detachment), HP:0007968 (Remnants of the hyaloid vascular system), HP:0008046 (Abnormal retinal vascular morphology), HP:0000618 (Blindness), HP:0001249 (Intellectual disability), HP:0020110 (Bone fracture), HP:0000938 (Osteopenia), HP:0000926 (Platyspondyly)

      ModelEvidence: Model animals subjected to targeted disruption of Lrp5 resembled human patients in that they exhibited reduced bone mineral density in the post-natal stage (Figs. S2, 3A), decreased osteoblast proliferation (Fig. 4), delayed ossification (Fig. 5), and remnants of the hyaloid vascular system due to failure of macrophage-mediated endothelial cell apoptosis (Fig. 8).

      ModelVariant: The model features disruption of the wild-type Lrp5 gene, but not a mutation equivalent to a human variant.

    1. Heterozygous 'null allele' mutation in the human peripherin/RDS gene

      PMID: 8111389

      Gene: PRPH2

      HGNC: 9942

      Disease: retinitis pigmentosa 7

      MONDO: 0011974

      InheritancePattern: semi-dominant

      Prevalence: The incidence of PRPH2-related cases among inherited retinal dystrophies is reported to range from 3.5% in North America to 10.3% in France (PMID: 36010202).

      Penetrance: The penetrance among biallelic cases appears to be complete, while the monoallelic cases exhibit incomplete penetrance (PMID: 36609934).

    1. Landscape of pathogenic variants in six pre-mRNA processing factor genes for retinitis pigmentosa based on large in-house data sets and database comparisons

      PMID: 35138024

      Gene: PRPF4

      HGNC: 17349

      Disease: retinitis pigmentosa 70

      MONDO: 0014400

      InheritancePattern: autosomal dominant

      Prevalence: The overall prevalence of retinitis pigmentosa is between 1 in 3,000 and 1 in 4,000 individuals, while the proportion of retinitis pigmentosa with a dominant mode of inheritance is estimated to be 15-35% (between 1 in 8,500 and 1 in 27,000). The proportion of that incidence made up by the specific form caused by variants in PRPF4 is not clear.

      Penetrance: Known disease-causing alleles appear to be incompletely penetrant (PMID: 25383878).

    1. The affected 11-year-old female

      Case#: Case report, 11 year old, female, Korean

      CaseHPOs: HP:0007663, HP:0000603, HP:0025010, HP:0000551 (reduced visual acuity, bilateral central scotoma, foveal atrophy, severe color vision deficiency)

      CaseHPOsFreeText: Onset at 4 years old. BCVA in both eyes were 20/40, 20/50, and 20/100 at 4, 10, and 11 years, respectively. Cycloplegic refraction showed –0.5 D spherical error with astigmatism of –3.0 D cylindrical error in the right eye, and –1.0 D spherical error with astigmatism of –3.5 D cylindrical error in the left eye. The fundus examination showed slightly atrophic fovea (Figure 1A). Fundus autofluorescence showed hyperfluorescent fovea in both eyes, which may be an artifact (Figure 1A). SD-OCT showed an ellipsoid zone defect in both macular areas with an intact periphery (Figure 1A). Light-adapted 3 ERG and 30 Hz flicker ERG showed almost extinguished wave, while dark-adapted 0.01 ERG and 3 ERG also showed reduced amplitude (Figure 1B). Diagnosis – Cone Rod dystrophy

      CasePreviousTesting: As part of this study - No pathogenic variants were identified in the other 97 genes associated with retinal degeneration, including 8 genes known to be associated with AR-CRD (ABCA4, ADAM9, C8orf37, CERKL, EYS, PROM1, RPGRIP1, and TULP1).

      CaseMethod1: NGS

      CaseGenotypingMethod: NGS of 98 genes known to be associated with inherited retinal degenerations (including cone-rod dystrophy), with confirmation of the identified variant by Sanger sequencing.

      Variant: NM_004249.3:c.68C>T (p.Ser23Phe), homozygous

      ClinVar: N/A

      CAID: CA2860239

      gnomAD: The highest population minor allele frequency in gnomAD v2.1.1 is 0.0004158 in the East Asian population; no homozygotes in any population.

      VariantEvidence: 3D structures of the wild type and mutated RAB28 proteins, predicted using SWISS-MODEL, showed the p.Ser23Phe variant is located in the GTP binding region. Multiple in silico predictors, including SIFT, PolyPhen, CADD, suggest that the variant is damaging.

      CaseAddInfo: Parents are not related. Parents and male sibling had normal vision and fundus findings and all were heterozygous for the RAB28 variant.

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

      PMID: 28644393

      Gene: IMPG2

      HGNC: 18362

      Disease: retinitis pigmentosa 56

      MONDO: 0013314

      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. Molecular cloning of a retina-specific membrane guanylyl cyclase

      PMID: 1356371

      Gene: GUCY2D

      HGNC: 4689

      Disease: Leber congenital amaurosis 1

      MONDO: 0008764

      InheritancePattern: Autosomal Recessive

      Prevalence: The overall prevalence of Leber congenital amaurosis is between 1 in 33,000 and 1 in 100,000 newborns, while the proportion of Leber congenital amaurosis caused by GUCY2D variants is between 10% and 20% (PMID: 10951519). Thus, the prevalence of Leber congenital amaurosis 1 is between 1 in 165,000 and 1 in 1,000,000.

      Penetrance: Fully penetrant, with onset in neonates or in infancy

    2. Like other membrane guanylyl cyclases, the 1101 aa retGC is predicted to have a hydrophobic amino-terminal signal sequence followed by a large extracelluiar domain, a single membrane spanning domain, a kinase homology domain, and a guanylyl cyclase catalytic domain. In contrast to other membrane guanylyl cylases, such as natriuretic peptide receptors, retGC has a relatively high basal level of activity when expressed in human 293 cells. cGMP production by retGC is unaffected by any of the known natriuretic peptides. In situ hybridization analysis of a variety of rhesus monkey tissues showed retGC transcripts to be localized exclusively along the retinal outer nuclear layer, corresponding to the nuclei of the rod and cone photoreceptor cells. Our results suggest that retGC may synthesize cGMP required for recovery of the dark state after phototransduction.

      Selection B - Gene function is consistent with phenotype.

      GOterm: GO:0007168 (receptor guanylyl cyclase signaling pathway)

      FunctionalEvidence: Exogenous expression of the gene product in 293 cells exhibits a high level of cGMP production activity. When combined with the in situ hybridization evidence showing its expression along the retinal outer nuclear layer (coinciding with the rod and cone photoreceptor cell nuclei), this biochemical evidence indicates a function in synthesizing cGMP to promote recovery of the dark state following phototransduction.

      FunctionalHPO: HP:0000662 (Nyctalopia), HP:0007663 (Reduced visual acuity), HP:0007688 (Undetectable light- and dark-adapted electroretinogram), HP:0007703 (Abnormality of retinal pigmentation)

      PhenotypeEvidence: The ability of the exogenously expressed enzyme to efficiently catalyze cGMP production (Figure) is consistent with the loss of photoreceptor function that is characteristic of the disease, as abnormalities in cGMP levels have long been associated with photoreceptor degeneration (PMID: 4369896).

    1. out-of-frame

      Case#: Xin_Patient_4, sex not mentioned, age 12 at time of study, U.S. nationality, ethnicity listed as Hispanic

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous testing for mutations in the CLN1, CLN2, CLN3, CLN6, and CLN8 had already occurred, using PCR amplification and Sanger sequencing to exclude the possibility of variants in the exons and surrounding noncoding regions. Genome-wide analysis methods were not used, as NCL had already been diagnosed based on clinical phenotypes.

      CaseMethod1: PCR amplification of the coding and surrounding non-coding regions of each gene, followed by bidirectional Sanger sequencing

      CaseMethod2: as mentioned

      CaseGenotypingMethod: CLN5 genotyping was performed by PCR amplification of the four exons and surrounding non-coding regions was performed, followed by bi-directional Sanger sequencing. Synthetic multiplex ligation-dependent probe amplification (MLPA) was then used to calculate average gene dosage ratio for each ratio, in order to detect large deletions.

      Variant: The patient is believed to be homozygous for the NM_006493.4(CLN5):c.936del (p.Phe312LeufsTer4) variant as well as the NM_006493.4(CLN5):c.956A>G (p.Lys319Arg) variant (considered likely benign). The proband is also apparently homozygous for two non-coding variants (an intron 1 variant referred to as "Int1, c.320+8C>T" and a 3'UTR variant referred to as "3'UTR c.1224+33A>G").

      ClinVar: 56528 and 128778 (in cis, homozygous)

      gnomAD: Maximum allele frequency for the NM_006493.4(CLN5):c.936del (p.Phe312LeufsTer4) variant is 0.0001159 (Latino / Admixed American population, no homozygotes). https://gnomad.broadinstitute.org/variant/13-77574958-AT-A Maximum allele frequency for NM_006493.4(CLN5):c.956A>G (p.Lys319Arg) is 0.4186 (in the African / African-American population, 2136 homozygotes). https://gnomad.broadinstitute.org/variant/13-77574983-A-G

      VariantEvidence: NM_006493.4(CLN5):c.936del (p.Phe312LeufsTer4) is a frameshift variant predicted to disrupt ~13% of the protein product. The C-terminal region disrupted has been shown to be glycosylated and is important for proper localization of the protein (PMID:19309691).

      CaseAddInfo: Parents are not available for genotyping, so homozygosity of variants is assumed. This conclusion was supported by failure to detect a deletion.

      CasePMIDs: N/A

    1. Mutational screening of splicing factor genes in cases with autosomal dominant retinitis pigmentosa

      PMID: 24959063

      Gene: PRPF4

      HGNC: 17349

      Disease: retinitis pigmentosa 70

      MONDO: 0014400

      InheritancePattern: autosomal dominant

      Prevalence: The overall prevalence of retinitis pigmentosa is between 1 in 3,000 and 1 in 4,000 individuals, while the proportion of retinitis pigmentosa with a dominant mode of inheritance is estimated to be 15-35% (between 1 in 8,500 and 1 in 27,000). The proportion of that incidence made up by the specific form caused by variants in PRPF4 is not clear.

      Penetrance: Known disease-causing alleles appear to be incompletely penetrant (PMID: 25383878).

    1. Improving the management of Inherited Retinal Dystrophies by targeted sequencing of a population-specific gene panel

      PMID: 27032803

      Gene: BBS1

      HGNC: 966

      Disease: Bardet-Biedl syndrome 1

      MONDO: 0008854

      InheritancePattern: autosomal recessive

      Prevalence: The prevalence of BBS1 variants among Bardet-Biedl syndrome cohorts has been reported as at least 20% (PMID: 19402160), while the prevalence of Bardet-Biedl syndrome overall has been estimated between 1 in 13,500 and 1 in 160,000 live births, depending on the population (PMID: 22713813).

      Penetrance: The penetrance of the phenotype among homozygous cases appears to be complete.

    1. Lack of Interphotoreceptor Retinoid Binding Protein Caused by Homozygous Mutation of RBP3 Is Associated With High Myopia and Retinal Dystrophy

      PMID: 25766589

      Gene: RBP3

      HGNC: 9921

      Disease: retinitis pigmentosa 66

      MONDO: 0014093

      InheritancePattern: autosomal recessive

      Prevalence: RBP3-related cases are believed to be very rare (possibly with estimated prevalence of less than 1 in 1,000,000), however, it is believed that there may be under-diagnosis (PMID: 37806543).

      Penetrance: RBP3 disease-causing variants appear to have complete penetrance.

    1. Using the RPE-specific monoclonal antibody RPE9, raised against human RPE cells, we have identified a novel 65 kD protein, conserved in mammals, birds, and frogs.

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

      ExperimentName: RPE65 expression is highly specific to the retinal pigment epithelium

      TissueExpression: pigmented layer of retina (also known as retinal pigment epithelium, UBERON:0001782)

      ExpressionEvidence: RPE65 protein was first detected using an RPE-specific monocolonal antibody raised against human retinal pigment epithelium (RPE) cells. Retina-specific gene expression data from a separate publication (PMID: 30239781, https://eyeintegration.nei.nih.gov/) confirm that RPE65 expression is highly specific to the retina relative to other tissues within the eye or the human body in general. Note where the evidence is found in the article.

    1. Germline Mutations in CTNNB1 Associated With Syndromic FEVR or Norrie Disease

      PMID: 30640974

      Gene: CTNNB1

      HGNC: 2514

      Disease: severe intellectual disability-progressive spastic diplegia syndrome

      MONDO: 0014035

      InheritancePattern: autosomal dominant

      Prevalence: The incidence is unknown but estimated to be between 1 in 30,000 and 1 in 40,000 births (PMID: 32168371).

      Penetrance: The penetrance of the cognitive impairment phenotype among cases appears to be near-complete, while the exudative vitreoretinopathy phenotype reportedly has a prevalence of ~39% among affected individuals with a syndromic diagnosis.

    1. To study the function of GPR143, we investigated the phenotypic effect of overexpression of GPR143 in pheochromocytoma (PC12) cells treated with nerve growth factor. Overexpression of mouse GPR143 inhibited neurite outgrowth, and the effect was mitigated by l-DOPA cyclohexylester, an antagonist for l-DOPA. Furthermore, knockdown of G-protein Gα13 attenuated mouse GPR143 induced inhibition of neurite outgrowth. Human wild-type (wt) GPR143 also inhibited neurite outgrowth, but its mutants did not mimic the effect of wt GPR143. Our results provide a mechanism for axon guidance phenotype in ocular albinism 1.

      ExperimentName: GPR143 over-expression in neuroendocrine tumor cells

      NonPatientCell: CL:0000336 (adrenal medulla chromaffin cell, specifically the PC-12 cell line)

      GeneFunction: GO:0031175 (neuron projection development)

      GeneAlteration: Over-expression of GPR143 was accomplished by stable transfection of PC-12 cells with mCherry-tagged wild-type or mutant GPR143.

      FunctionalEvidence: Figure 4C indicates that GPR143 over-expression decreases the # of neurites longer than 100 microns, and that this occurs through a mechanism that is dependent on the G-protein Galpha13. Figure 5E shows that this effect of wild-type GPR143 is particularly pronounced for neurites longer than 150 microns, and is not mimicked by GPR143 missense variants reported in patients.

      FAVariants: Patient-associated variants were p.Asp78Asn (ClinVar: 98620), p.Trp133Arg (ClinVar: 10516 or 10519), p.Ile261Asn (CAID: CA411996177), and p.Trp292Gly (ClinVar: 98647).

    2. Overexpression of the gene product of ocular albinism 1 (GPR143/OA1) but not its mutant forms inhibits neurite outgrowth in PC12 cells

      PMID: 31606330

      Gene: GPR143

      HGNC: 20145

      Disease: X-linked recessive ocular albinism

      MONDO: 0021019

      InheritancePattern: X-linked recessive

      Prevalence: Ocular albinism has an estimated prevalence between 1 in 111,000 and 1 in 1,000,000 live births (PMID: 35495622)

      Penetrance: Fully penetrant in males, with onset in infancy. Most female carriers appear to be unaffected.

    1. c.136C>T (p.Arg46*)

      Case#: Khan_2016_Proband_2, male, age 4 months at time of referral, national origin indicated as Saudi

      CasePresentingHPOs: Abnormal visual fixation HP:0025404, Nystagmus HP:0000639, Infantile onset HP:0003593, Visual impairment HP:0000505, Deeply set eye HP:0000490, Esotropia HP:0000565, High hypermetropia HP:0008499, Undetectable electroretinogram HP:0000550,

      CaseHPOFreeText: The proband has been diagnosed with Leber congenital amaurosis, with poor visual fixation and nystagmus as the presenting features. Staring at lights was a phenotype.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous testing in the proband consisted of a 44-gene next generation sequencing-based panel for retinal dystrophy showing no other potential cause of retinal features.

      CaseMethod1: next-generation sequencing panel (44 genes)

      CaseMethod2: Sanger sequencing of PRPH2

      CaseGenotypingMethod: Previous testing in the proband consisted of a 44-gene next generation sequencing-based panel for retinal dystrophy showing no other potential cause of retinal features. The presence of the variant was confirmed by Sanger sequencing of PRPH2.

      Variant: The proband harbors the NM_000322.5(PRPH2):c.136C>T (p.Arg46Ter) variant in the homozygous state.

      ClinVar ID: 13179

      gnomAD: The NM_000322.5(PRPH2):c.136C>T (p.Arg46Ter) variant is found in gnomAD v4.0.0 at a frequency of 0.00004005 (3 alleles / 74906 total alleles, with 0 homozygotes) in the African / African-American population https://gnomad.broadinstitute.org/variant/6-42722199-G-A?dataset=gnomad_r4

      VariantEvidence: NM_000322.5(PRPH2):c.136C>T (p.Arg46Ter) is a nonsense variant in exon 1 of 3 that is predicted to trigger nonsense-mediated decay or at least to truncate the C-terminal 87% of the protein product.

      CaseAddInfo: The proband is the child of first cousin parents who appeared sub-clinically affected but were not genotyped. A second, similarly affected sibling shares the same genotype.

      CasePMIDs: N/A

    1. We have studied two Japanese families with SFD, the first report from the Eastern world, and identified a novel 3’ splice site mutation in the TIMP3 gene, namely a single base insertion at the intron 4/exon 5 junction which converts the consensus sequence CAG to CAAG in the splice acceptor site.

      GroupName: Tabata_1998_Group

      GroupPresentingHPOs: HP:0007663 (Reduced visual acuity), HP:0025094 (Disciform macular scar)

      GroupHPOFreeText: Relatively late onset of phenotypes during the 6th, 7th, or 8th decade of life.

      GroupNotHPOs: N/A

      GroupNotHPOFreeText: N/A

      GroupDemographics

      NumberMales: 4

      NumberFemales: 5

      CountryOrigin: Japan

      Ethnicity: Not mentioned

      Race: Not mentioned

      AgeRange: The individuals mentioned range in age from 52 to 75.

      TotalNumber: 9

      FamilyInfo: 9

      NoFamily: 0

      VariantCount: 5

      NonVariant: 4

      OtherVariant: N/A

      GroupPreviousTesting: Sanger sequencing of PCR-amplified exon 5

      GroupGenotypingMethod: PCR-based heteroduplex analysis using gel electophoresis, as well as SSCP analysis of exon 5.

    1. A core complex of BBS proteins cooperates with the GTPase Rab8 to promote ciliary membrane biogenesis

      PMID: 17574030

      Gene: BBS7

      HGNC: 18758

      Disease: Bardet-Biedl syndrome 7

      MONDO: 0014435

      InheritancePattern: autosomal recessive

      Prevalence: The prevalence of BBS7 variants among Bardet-Biedl syndrome cohorts has been reported at 4.2% (PMID: 19402160), while the prevalence of Bardet-Biedl syndrome overall has been estimated between 1 in 13,500 and 1 in 160,000 live births, depending on the population (PMID: 22713813).

      Penetrance: The penetrance of the phenotype among homozygous cases appears to be complete.

    2. Here we identify a complex composed of seven highly conserved BBS proteins. This complex, the BBSome, localizes to nonmembranous centriolar satellites in the cytoplasm but also to the membrane of the cilium. Interestingly, the BBSome is required for ciliogenesis but is dispensable for centriolar satellite function. This ciliogenic function is mediated in part by the Rab8 GDP/GTP exchange factor, which localizes to the basal body and contacts the BBSome. Strikingly, Rab8(GTP) enters the primary cilium and promotes extension of the ciliary membrane. Conversely, preventing Rab8(GTP) production blocks ciliation in cells and yields characteristic BBS phenotypes in zebrafish. Our data reveal that BBS may be caused by defects in vesicular transport to the cilium.

      ExperimentName: BBS7 interacts with other components of the BBSome.

      InteractingGene: BBS4 (HGNC:969)

      InteractionType: Physical

      InteractionMethod: co-immunoprecipitation

      InteractionEvidence: Antibody-based isolation of BBS4 results in co-purification of BBS7, as well as BBS1, BBS2, BBS5, BBS8, and BBS9 in stoichiometric quantities. The co-purifying proteins are shown separated by gel electrophoresis in Figure 1F and were identified and quantified by mass spectrometry in Table S1. All 8 proteins are encoded by genes linked to Bardet-Biedl syndrome.

    1. Identification of a novel RPGR mutation associated with X-linked cone-rod dystrophy in a Chinese family

      PMID: 34800980

      Gene: RPGR

      HGNC: 10295

      Disease: RPGR-related retinopathy

      MONDO: MONDO:0100437

      InheritancePattern: X-linked

      Prevalence: The prevalence of RPGR-related retinopathy is calculated to be approximately 1 in 214,000, based on the known incidence of retinitis pigmentosa at 1 in 3,000, the proportion of retinitis pigmentposa that is X-linked at 20%, and the proportion of X-linked retinitis pigmentosa that is RPGR-associated at 70% (PMID: 34985506).

      Penetrance: Penetrance is nearly 100% in hemizygous males but is incomplete and dependent upon the variant in heterozygous female carriers.

    2. In this study, we reported a Chinese family with four male CORD patients carrying a novel nonsense mutation in the exon ORF15 (c.2383G > T, p.E795X) of RPGR gene, which broaden the spectrum of RPGR mutations associated with X-linked CORD.

      Case#: Wang_2021_Patient_III-1, male, 32 years old, ethnicity described as Chinese

      CasePresentingHPOs: HP:0000533 (Chorioretinal atrophy), HP:0007754 (Macular dystrophy), HP:0025158 (Hyperautofluorescent retinal lesion), HP:0001123 (Visual field defect), HP:0007994 (Peripheral visual field loss), HP:0030474 (Undetectable dark-adapted electroretinogram), HP:0008275 (Abnormal light-adapted electroretinogram), HP:0000662 (Nyctalopia), HP:0000529 (Progressive visual loss), HP:0000551 (Color vision defect), HP:0030534 (Abnormal best corrected visual acuity test), HP:0007737 (Bone spicule pigmentation of the retina),

      CaseHPOFreeText: The proband has been diagnosed with cone-rod dystrophy, with the family exhibiting X-linked pattern of inheritance.

      CaseNotHPOs: HP:0012632 (Abnormal intraocular pressure)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The proband and was subjected to whole-exome sequencing.

      CaseMethod1: Whole-exome sequencing

      CaseMethod2: Sanger sequencing to confirm candidate variants within the RPGR locus

      CaseGenotypingMethod: The proband and was subjected to whole-exome sequencing, followed by Sanger sequencing to confirm candidate variants within the RPGR locus and to genotype family members.

      Variant: The proband harbors the NM_001034853.2(RPGR):c.2383G>T (p.Glu795Ter) variant in the hemizygous state.

      ClinVar: 975145

      gnomAD: The variant was not found in gnomAD v.2.1.1.

      VariantEvidence: NM_001034853.2(RPGR):c.2383G>T (p.Glu795Ter) is a nonsense variant in the final exon (exon 15) that is not predicted to trigger nonsense-mediated decay but truncates ~31% of the C-terminus of the protein product. In HEK-293T cells, truncation was confirmed by western blotting (Figure 3b), yet immunocytochemistry showed normal (cytoplasmic) localization (Figure 3c).

      CaseAddInfo: The proband is a member of a family with three other affected males and three carrier females described as unaffected.

      CasePMIDs: N/A

    1. Next-Generation Sequencing and Novel Variant Determination in a Cohort of 92 Familial Exudative Vitreoretinopathy Patients

      PMID: 25711638

      Gene: LRP5

      HGNC: 6697

      Disease: osteoporosis-pseudoglioma syndrome

      MONDO: 0009820

      InheritancePattern: autosomal recessive

      Prevalence: osteoporosis-pseudoglioma syndrome is estimated to occur in 1 out of every 2,000,000 live births.

      Penetrance: The penetrance of the phenotype among homozygous or compound heterozygous cases appears to be complete, while heterozygous carriers of deleterious variants appear to be mildly affected.

    1. c.-114_-97del in a simplex RP patient

      Case#: Chen_2014_Proband_S01, male, age 20 years at onset, age 53 years at time of report, family origin reported as Chinese

      CasePresentingHPOs: Nyctalopia HP:0000662, Constriction of peripheral visual field HP:0001133, Severely reduced visual acuity HP:0001141, Undetectable electroretinogram HP:0000550, Retinal degeneration HP:0000546, Macular degeneration HP:0000608, Optic disc pallor HP:0000543, Attenuation of retinal blood vessels HP:0007843, Pigmentary retinopathy HP:0000580

      CaseHPOFreeText: The proband has been diagnosed with retinitis pigmentosa. Patient fibroblasts showed 92.58% decreased expression of PRPF4.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous testing in the proband included next-generation sequencing targeted to a large number of known variants in all known retinal disease-related genes.

      CaseMethod1: next-generation sequencing

      CaseMethod2: Sanger sequencing of PRPF4

      CaseGenotypingMethod: Genotyping of the proband included next-generation sequencing targeted to a large number of known variants in all known retinal disease-related genes, followed by Sanger sequencing analysis of all coding regions of PRPF4.

      Variant: The proband harbors the NM_004697.4(PRPF4):c.-114_-97del variant in the heterozygous state.

      ClinVar ID: 143058

      gnomAD: The NM_004697.4(PRPF4):c.-114_-97del variant is found in gnomAD v4.1.0 at a frequency of 0.0003297 (13 alleles / 39430 total alleles, with 0 homozygotes) in the East Asian population https://gnomad.broadinstitute.org/variant/9-113275629-TTGTCAGTGACGCACTTCC-T?dataset=gnomad_r4

      VariantEvidence: NM_004697.4(PRPF4):c.-114_-97del is a deletion variant within the 5' UTR that disrupts the beginning of the transcribed region. Luciferase assay indicates that the ability of the PRPF4 promoter to activate transcription of the reporter gene was significantly decreased by the variant, which disrupted binding sites for the c-Ets-1 and GR-alpha transcription factors and matched the 93% decrease in PRPF4 expression seen in the patient blood cells (Figure 3).

      CaseAddInfo: The proband has an unaffected son who does not harbor the variant.

      CasePMIDs: N/A

    1. proband

      Case#: proband, F, Age of Report: 11 y.o., Ethnicity: European ancestry.

      CasePresentingHPOs: HP:0000510 (Rod-cone dystrophy/Retinitis pigmentosa), HP:0000662 (Nyctalopia), HP:0007737 (Bone spicule pigmentation of the retina), HP:0001250 (Seizure)

      CaseHPOFreeText: The proband of European ancestry was referred at the age of 11 yr for a recent diagnosis of retinitis pigmentosa (II:3). She reported a several-year history of nyctalopia. At her initial visit, her VA was 20/20 in both eyes [oculus uterque (OU)]. GVF testing was unreliable at this visit, and results are not shown. ERG testing showed barely recordable responses in both eyes. Fundus examination showed early optic nerve pallor and surface gliosis, vascular attenuation, depressed foveal reflex, and fine retinal pigment epithelium (RPE) granularity. Peripheral retina showed a few areas of bone spicule-like pigmentation and a coarse RPE granularity. When re-evaluated at the age of 17 yr, her vision was reduced to 20/30 OU and visual fields were constricted (Fig. 1D, i and ii). Testing at the age of 24 yr demonstrated further reduction of VA to 20/50 right eye [oculus dexter (OD)] and 20/30 left eye [oculus sinister (OS)] with greatly constricted visual field (Fig. 1D, iii and iv). Fundus examination showed heavy bone spicule pigmentation in the equatorial region OU (Fig. 1C). Medical history was significant for a history of petit mal seizures beginning at the age of 8 yr, which were controlled with medication.

      CaseNotHPOs: N/A.

      CaseNotHPOFreeText: N/A.

      CasePreviousTesting: N/A.

      CaseMethod1: N/A.

      CaseMethod2: N/A.

      CaseGenotypingMethod: WGS.

      Variant: Variant 1: NM_021831.6:c.841C>T (p.Arg281Cys). Variant 2: NM_021831.6:c.1459C>T (p.Arg487Ter).

      ClinVar: Variant 1: 1036269. Variant 2: N/A.

      CAID: Variant 1: CA1567739. Variant 2: CA1567876.

      gnomAD: Variant 1: Frequency: 0. Link: https://gnomad.broadinstitute.org/variant/chr2-27055186-C-T?dataset=gnomad_r4. Variant 2: Frequency: 0.000003590. Link: https://gnomad.broadinstitute.org/variant/chr2-27056716-C-T?dataset=gnomad_r4.

      VariantEvidence: N/A.

      CaseAddInfo: The proband's brother (II:2) was initially evaluated at the age of 15 yr. He also reported a history of impaired night vision. His visual acuities were 20/15 OD and 20/20 OS. GVF testing showed full fields with the V4e isopter, but constriction to 30 degrees centrally with the I4e isopter. The scotopic ERG was barely recordable and photopic responses showed 50% reduction of amplitude and normal waveform. Fundus examination showed slight optic disc pallor and gliosis. Vessels were attenuated. The foveal reflex was intact in both eye, and the RPE was intact in both maculae. The peripheral retina showed fine bone spicule pigmentation and fine granularity to the RPE. Aside from the history of seizures as a child in the proband, these patients reported no other ocular or nonocular abnormalities and had a diagnosis of recessive retinitis pigmentosa.

      CasePMIDs: N/A.

    1. Patient F1-IV:3

      Case#: Patient F1-IV:3, M, Age of Report: 32 y.o., Ethnicity: N/A.

      CasePresentingHPOs: HP:0000510 (Rod-cone dystrophy/Retinitis pigmentosa), HP:0011505 (Cystoid macular edema/cystoid maculopathy), HP:0007663 (Reduced visual acuity), HP:0500081 (Pseudophakia),

      CaseHPOFreeText: Patient F1-IV:3 was referred to the Rotterdam Eye Hospital at age 32 with end-stage RP complicated by cystoid maculopathy. Visual acuity at presentation was hand movements in the right and light perception in the left eye. He was pseudophakic (cataract extraction performed at age 29), and retrospective data on visual acuity and visual fields were not available. The cystoid maculopathy was responsive to subcutaneous octreotide, but visual acuity did not improve. Through the years the cysts disappeared and atrophy of the macular region developed (Figs. 2A, 2B). He was also suffering from Behcet's disease, but did not have a history of recurring uveitis.

      Stratus OCT of the right eye in F1-IV:3 (B) at age 34 showed large cysts at the macula comprising several retinal layers with cysts in the inner nuclear layer of the paramacular region (upper). In the lower scan (at 39 years), complete atrophy of retinal layers at the fovea can be observed.

      All patients had midperipheral reduced autofluorescence in keeping with regions of RPE atrophy and increased pigmentation.

      All patients had midperipheral reduced autofluorescence in keeping with regions of RPE atrophy and increased pigmentation.

      All patients developed posterior subcapsular cataract.

      CaseNotHPOs: N/A.

      CaseNotHPOFreeText:N/A.

      CasePreviousTesting: N/A.

      CaseMethod1: N/A.

      CaseMethod2: N/A.

      CaseGenotypingMethod: WES.

      Variant: NM_021831.6:c.1775G>A (p.Trp592Ter).

      ClinVar: N/A.

      CAID: CA1567964.

      gnomAD: Frequency: 2.800e-7. Link: https://gnomad.broadinstitute.org/variant/chr2-27058503-G-A?dataset=gnomad_r4.

      VariantEvidence: N/A.

      CaseAddInfo: His older sister (F1-IV:2) was examined only once, at the age of 43. She also presented with end-stage RP. She was pseudophakic, and visual acuity was hand movement and counting fingers. Her fundus examination revealed optic disc pallor, attenuated vessels, macular atrophy, midperipheral and peripheral RPE atrophy, and heavy bone spicule pigmentation but no cystoid macular edema (not shown). The DNA sample of this patient was not available.

      CasePMIDs: N/A.

    2. F3-II.1

      Case#: F3-II.1, F, Age of Report: N/A, Ethnicity: N/A.

      CasePresentingHPOs: HP:0000662 (Nyctalopia), HP:0007994 (Peripheral visual field loss), HP:0032037 (Mildly reduced visual acuity),

      CaseHPOFreeText: Very limited photoreceptor preservation for F3-II.1

      Patients from families 2 and 3 initially developed nyctalopia, with a range of onset from 9 to 30 years before subsequent development of peripheral visual field loss. At last review (age range, 24–45 years), there was mild visual acuity loss with best-corrected visual acuity mean 0.34 logMAR (range, 0.30–0.48). There were fundus abnormalities consistent with RP including attenuated vessels, macular and midperipheral RPE mottling/atrophy, and peripheral intraretinal pigment migration, most prominent in the proband of family 3 (Fig. 2I). A partial ring of reduced autofluorescence in F3-II:1 (Figs. 2D, 2G, 2J).

      All patients had midperipheral reduced autofluorescence in keeping with regions of RPE atrophy and increased pigmentation.

      All patients had midperipheral reduced autofluorescence in keeping with regions of RPE atrophy and increased pigmentation.

      All patients developed posterior subcapsular cataract.

      CaseNotHPOs: N/A.

      CaseNotHPOFreeText: N/A.

      CasePreviousTesting: N/A.

      CaseMethod1: N/A.

      CaseMethod2: N/A.

      CaseGenotypingMethod: WGS.

      Variant: Variant 1: NM_021831.6:c.752T>G (p.Val251Gly). Variant 2: NM_021831.6:c.1504dup (p.Ala502GlyfsTer15).

      ClinVar: Variant 1: N/A. Variant 2: N/A.

      CAID: Variant 1: CA346174950. Variant 2: CA2586968850.

      gnomAD: Variant 1: Frequency: 2.800e-7. Link: https://gnomad.broadinstitute.org/variant/chr2-27053509-C-G?dataset=gnomad_r4. Variant 2: N/A.

      VariantEvidence: N/A.

      CaseAddInfo: N/A.

      CasePMIDs: N/A.

    1. We have identified a homozygous 4-bp deletion (485delAAGA) in putative exon 5 of the canine Rpe65 gene in affected animals of a highly inbred kinship of Swedish briard/briard-beagle dogs, in which an autosomal recessive, early-onset, and progressive retinal dystrophy segregates. The deletion results in a frameshift and leads to a premature stop codon after inclusion of 52 canine RPE65-unrelated amino acids from residue 153 onward. More than two-thirds of the wildtype polypeptide chain will be missing, and the mutant protein is most likely nonfunctional (null allele).

      ExperimentName: Retinal dystrophy in dogs is caused by Rpe65 loss of function.

      NonHumanModel: Canis familiaris

      GeneAlteration: Swedish Briard / Briard Beagle dogs exhibit a biallelic 485delAAGA variant in the RPE65 locus that triggers a frameshift predicted to disrupt ~71% of the protein product.

      ModelPhenotype: HP:0007642 (Congenital stationary night blindness), HP:0007663 (Reduced visual acuity), HP:0000618 (Blindness), HP:0007703 (Abnormality of retinal pigmentation), HP:0000556 (Retinal dystrophy), HP:0030483 (Reduced amplitude of dark-adapted bright flash electroretinogram a-wave), HP:0007984 (Electronegative electroretinogram), HP:0030479 (Abnormal amplitude of light-adapted flicker electroretinogram)

      HumanPhenotype: HP:0000662 (Nyctalopia), HP:0000529 (Progressive visual loss), HP:0000618 (Blindness), HP:0030479 (Abnormal amplitude of light-adapted flicker electroretinogram), HP:0030474 (Undetectable dark-adapted electroretinogram)

      ModelEvidence: The model system recapitulates the human phenotype in that the dogs exhibit severe vision loss (Table 1 in PMID: 2804031, describing the same animal model), structural abnormalities of the RPE (PMID: 7851218, studying the same animal model), and similar ERG abnormalities (Figures 2 and 3 in PMID: 2804031). Similar to the human patient families, the heterozygous individuals are unaffected (Figure 1 in this publication).

      ModelVariant: The dogs harbor a spontaneously occurring frameshift variant in exon 5 of 14 (485delAAGA), rather than a targeted mutation equivalent to a particular human patient variant.

    1. Rpe65-deficient mice exhibit changes in retinal physiology and biochemistry. Outer segment discs of rod photoreceptors in Rpe65–/– mice are disorganized compared with those of Rpe65+/+ and Rpe65+/– mice. Rod function, as measured by electroretinography, is abolished in Rpe65–/– mice, although cone function remains. Rpe65–/– mice lack rhodopsin, but not opsin apoprotein. Furthermore, all-trans-retinyl esters over-accumulate in the RPE of Rpe65–/– mice, whereas 11-cis-retinyl esters are absent. Disruption of the RPE-based metabolism of all-trans-retinyl esters to 11-cis-retinal thus appears to underlie the Rpe65-/- phenotype, although cone pigment regeneration may be dependent on a separate pathway.

      ExperimentName: Rpe65 homozygous knockout abolishes rod photoreceptor function and disrupts RPE metabolism in mice.

      NonHumanModel: Mus musculus

      GeneAlteration: Rpe65 homozygous knockout was generated by replacing the 5' flanking region and the first three exons of Rpe65 with a PGK-Neo cassette.

      ModelPhenotype: HP:0000479 (Abnormal retinal morphology), HP:0030469 (Abnormal dark-adapted electroretinogram), HP:0030483 (Reduced amplitude of dark-adapted bright flash electroretinogram a-wave), HP:0007984 (Electronegative electroretinogram)

      HumanPhenotype: HP:0000662 (Nyctalopia), HP:0007688 (Undetectable light- and dark-adapted electroretinogram), HP:0001098 (Abnormal fundus morphology), HP:0000529 (Progressive visual loss)

      ModelEvidence: The model system recapitulates the human phenotype in that the mice exhibit progressive onset of abnormalities in retinal morphology (specifically photoreceptor outer segment loss, Figures 2a-2e), accompanied by reduced responses in dark-adapted (Figure 4) but not light-adapted (Figure 5) ERG. These ERG results are characteristic of abolished rod function. The mice also recapitulate the molecular features of the human patients in that retinal esters accumulate in the retinal pigment epithelium of the mice (HPLC data in Figures 8a-8c).

      ModelVariant: The model disrupts the entire Rpe65 locus rather than introducing a mutation equivalent to a human patient variant.

    1. Unusual OCT findings in a patient with CABP4-associated cone-rod synaptic disorder

      PMID: 38206458

      Gene: CABP4

      HGNC: 1386

      Disease: cone-rod synaptic disorder, congenital nonprogressive

      MONDO: 0012490

      InheritancePattern: autosomal recessive

      Prevalence: The prevalence of the Åland eye disease or incomplete congenital stationary night blindness phenotype was estimated at 1 in 22,000 based on a Danish male cohort, with CABP4 variants specifically responsible for 1 out of 35 cases (PMID: 28002560).

      Penetrance: Penetrance appears to be 100% among the reported individuals harboring biallelic disease-causing CABP4 variants.

    1. The retinal degeneration slow (rds) gene product is a photoreceptor disc membrane-associated glycoprotein

      PMID: 1986774

      Gene: PRPH2

      HGNC: 9942

      Disease: retinitis pigmentosa 7

      MONDO: 0011974

      InheritancePattern: semi-dominant

      Prevalence: The incidence of PRPH2-related cases among inherited retinal dystrophies is reported to range from 3.5% in North America to 10.3% in France (PMID: 36010202).

      Penetrance: The penetrance among biallelic cases appears to be complete, while the monoallelic cases exhibit incomplete penetrance (PMID: 36609934).

    2. The developmental appearance of the rds protein coincides with outer segment disc formation. We propose that the rds protein functions as an adhesion molecule for stabilization of the outer segment discs.

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

      ExperimentName: Wild-type Prph2 expression in the developing mouse retina begins on day postnatal day 6.

      TissueExpression: photoreceptor outer segment layer (UBERON:0003926)

      ExpressionEvidence: Immunohistochemistry indicates that wild-type Prph2 expression in the developing mouse retina begins on day postnatal day 6 (Figure 3C). This time point coincides with the timing of the formation of the photoreceptor outer segment discs, and is consistent with a proposed function of PRPH2 as an adhesion molecule that acts to stabilize the outer segment discs.

    1. Hprp3p and Hprp4p have been shown to interact with each other and the first 100 amino acids of Hprp3p are not essential for this interaction. These experiments suggest that both Hprp3p and Hprp4p are components of human spliceosomes.

      ExperimentName: PRPF4 physically interacts with PRPF3.

      InteractingGene: PRPF3 (HGNC:17348)

      InteractionType: Physical

      InteractionMethod: Co-immunoprecipitation

      InteractionEvidence: Immunoprecipitation of endogenous PRPF3 from HeLa cell nuclear extracts pulled down PRPF4 (Figures 5 and 6).

    1. AAV-mediated expression of human L-opsin promoted cone outer segment regeneration and rescued cone-mediated function when mice were injected subretinally at 2 months of age or younger. Cone-mediated function and visually guided behavior were maintained for at least 8 months post-treatment. However, when mice were treated at 5 and 7 months of age, the chance and effectiveness of rescue was significantly reduced, although cones were still present in the retina. Crossing Opn1mw−/−/Opn1sw−/− mice with proteasomal activity reporter mice (UbG76V–GFP) did not reveal GFP accumulation in Opn1mw−/−/Opn1sw−/− cones eliminating impaired degradation of ubiquitinated proteins as stress factor contributing to cone loss. Our results demonstrate that AAV-mediated gene augmentation therapy can rescue cone structure and function in a mouse model with a congenital opsin deletion

      Selection B- Gene function is consistent with phenotype.

      ExperimentName: OPN1LW encodes a long-wave-sensitive opsin and can rescue cone-mediated function when subretinally injected in Opn1mw−/−/Opn1sw−/− mice.

      GOterm: GO:0007602 (phototransduction)

      FunctionalEvidence: Subretinal injection of AAV carrying the OPN1LW gene encoding human L-opsin into mice at age 2 months or younger promoted cone outer segment regeneration () and rescued cone functions such as the b-wave amplitude of the long wavelength-mediated electroretinogram response (Figures 2A, 2B, 4D) and visually guided behavior (Figure 4E).

      FunctionalHPO: Protanopia HP:0011522

    1. Identifying core biological processes distinguishing human eye tissues with precise systems-level gene expression analyses and weighted correlation networks

      PMID: 30239781

      Gene: GUCY2D

      HGNC: 4689

      Disease: Leber congenital amaurosis 1

      MONDO: 0008764

      InheritancePattern: Autosomal Recessive

      Prevalence: The overall prevalence of Leber congenital amaurosis is between 1 in 33,000 and 1 in 100,000 newborns, while the proportion of Leber congenital amaurosis caused by GUCY2D variants is between 10% and 20% (PMID: 10951519). Thus, the prevalence of Leber congenital amaurosis 1 is between 1 in 165,000 and 1 in 1,000,000.

      Penetrance: Fully penetrant, with onset in neonates or in infancy

    1. family A

      FamilyInfo: Family A, German, Pedigree in Fig 1

      FamilyHPOs: HP:0007663, HP:0011003, HP:0008001, HP:0030602, HP:0000551, HP:0000603, HP:0000512 (reduced visual acuity, high myopia, foveal hyperpigmentation, hyperfluorescent fovea, color vision defect, central scotoma, abnormal ERG)

      FamilyHPOFreeText: All 3 affected family members were diagnosed with CRD in the second decade of life. Optical coherence tomography (OCT) displayed altered photoreceptors in the fovea, whereas the peripheral photoreceptors are intact (Figure 2C, and 2A, 2B). On ERG photopic responses were nondetectable and scotopic responses reduced in all three siblings.

      FamilyMethod1: Homozygosity mapping

      FamilyMethod2: WES

      FamilyGenotypingMethod: Homozygosity mapping, using Affymetrix GeneChip Human Mapping 250K SNP arrays, in 3 affected siblings revealed a shared homozygous region of 4.68 Mb on chromosome 4 containing 15 genes. Subsequently, exome sequencing was performed in 2 of the affected sibling, A-II:1 and A-II:2. No pathogenic variants in the genes known to be mutated in arCRD (ABCA4, ADAM9, C8orf37, CERKL, EYS, RPGRIP1, and TULP1) were observed among the shared variants. RAB28 variant confirmed by Sanger sequencing.

      Variant: NM_001017979.2:c.565C>T (p.Glu189Ter), homozygous, (all 3 affected individuals are homozygous, parents not tested)

      ClinVar: 60754

      gnomAD: Not in gnomAD.

      Proband: A-II:1, 14 years at diagnosis, 28 years at last visit, German

      CaseHPOsFreeText: Refractive error OD -16D SE, OS -15.5D SE; visual acuity OD 20/320 OS 20/200; hyperpigmented foveal region; autofluorescence showed hyperfluorescent area at foveal region; OCT showed irregular inner and outer segments in fovea, thinning of other retinal layers of fovea; color vision using D-15 Panel showed tritan and defects in scotopic lines; visual field showed concentric reduction to 15–20 degrees (III/4); ERG at age 16 revealed nondetectable cone function and reduced rod responses.

    1. Especially convincing are the data from family 7828 (Fig. 2A) indicating that individuals with RP resulting from three separate parental pairs carry the same mutations. This family is from the Dominican Republic, and it is likely that the Leu341Ser allele is fortuitously present in the two unrelated individuals (I-1 and I-8) in the first generation of the pedigree who do not report any consanguinity with their spouses who presumably carry either the same allele (individual I-7) or the mutation Glu404(4-bp ins) (individual I-2). Although family 7828 was originally categorized as showing a recessive inheritance pattern, it was only through analysis of RPE65 that the possibility of different genetic loci causing RP in the three branches was ruled out.

      FamilyLabel: Morimura_1998_Family_7828

      FamilyPresentingHPOs: HP:0000546 (Retinal degeneration)

      FamilyPresentingHPOFreeText: While specific phenotypes are not provided, the diagnosis of retinitis pigmentosa indicates that the affected family members maintained central vision during the first decade of life and subsequently experienced severe vision loss.

      FamilyNotHPOs: N/A

      FamilyNotHPOFreeText: N/A

      CountryOrigin: The Dominican Republic

      Ethnicity: Not mentioned

      Race: Not mentioned

      Family#PreviousTesting: All 14 RPE65 exons and flanking sequences were PCR-amplified and subjected to single-strand conformation polymorphism analysis (SSCA).

      Family#GenotypingMethod: PCR-amplified exons identified by SSCA as candidates to harbor variants were subjected to Sanger sequencing in the probands and their family members.

      Affected: 5

      Unaffected: 5

      Segregations: The pedigree (Figure 2A) shows 10 segregations, with none inconsistent.

      PublishedLOD: N/A

      eLOD: 3.03

      AddSegregationInfo: While four of the affected family members are compound heterozygotes at the RPE65 locus, one harbors homozygous variants.

      ProbandLabel: Morimura_1998_Patient_III-4

      Variant: Four affected individuals are compound heterozygotes harboring the NM_000329.3(RPE65):c.1022T>C (p.Leu341Ser) and NM_000329.3(RPE65):c.1207_1210dup (p.Glu404fs) variants, while one affected individual is homozygous for the NM_000329.3(RPE65):c.1022T>C (p.Leu341Ser) variant.

      ClinVar: 13118, 98831

      gnomAD: Neither the NM_000329.3(RPE65):c.1022T>C (p.Leu341Ser) variant nor the NM_000329.3(RPE65):c.1207_1210dup (p.Glu404fs) variant is found within gnomAD.

      FamilyAddInfo: The two variants were confirmed to be in trans, and heterozygous carriers were found to be unaffected. Potential consanguinity between the parents was not reported, at least within the first generation of the pedigree.

      FamilyPMIDs: N/A

    1. Silencing of Prpf4, a splicing factor hitherto unrelated to RP, evoked the same defects in vision, photoreceptor morphology and retinal gene expression. Hence, various routes affecting the tri-snRNP can elicit tissue-specific gene expression defects and lead to the RP phenotype.

      ExperimentName: "Prpf4 silencing in zebrafish causes defects in visual function."

      NonHumanModel: Danio rerio

      GeneAlteration: The model animals have been subjected to morpholino-based knockdown of Prpf4, the zebrafish ortholog of human PRPF4.

      ModelPhenotype: Nystagmus HP:0000639, Abnormality of ocular smooth pursuit HP:0000617

      HumanPhenotype: Constriction of peripheral visual field HP:0001133, Reduced visual acuity HP:0007663,, Decreased light- and dark-adapted electroretinogram amplitude HP:0000654. Retinal degeneration HP:0000546, Macular degeneration HP:0000608, Optic disc pallor HP:0000543, Attenuation of retinal blood vessels HP:0007843, Pigmentary retinopathy HP:0000580

      ModelEvidence: Morpholino-based incomplete knockdown of the Prpf4 gene circumvents the lethality of complete silencing and causes optokinetic nystagmus with a significantly reduced number of saccades (Fig. 5B, 5C, 5D). Immunohistochemistry showed that retinal morphology showed mostly normal retinal layering but decreased rhodopsin staining in the photoreceptor cell layer (Figs. 5E–5H). Photoreceptor outer segments were primarily affected, but with unaffected cell body morphology (Figs. 5I and 5J). This phenotype was a complete match for the zebrafish with Prpf31 loss/. Semi-quantitative RT–PCR analysis of the RP-relevant transcripts opn1lw1, opn1mw1, gnat2, irx6a, rx3, crx and rhodopsin as well as the controls gapdh and lsm7 showed a very similar pattern of down-regulation in both Prpf31- and Prpf4-deficient animals (Fig. 5W). The phenotype was dose-dependent and could be rescued by co-injection of Prpf4 mRNA (Fig. S2).

      ModelVariant: This model did not introduce a disease-associated variant known from an affected human patient, but rather studied the effects of heterozygous loss of the gene product.

    1. All nine exons of the OA1 gene, as well as the 5' and 3' untranslated regions, were scanned for point mutations in PCR-amplified DNA from 60 OA1 patients. The mutations identified include: two frameshifts

      Case#: Schiaffino_1995_Family_2948_Patient_BA442, male, age not reported, family origin reported as British in two previous publications

      CasePresentingHPOs: N/A

      CaseHPOFreeText: The proband has been diagnosed with ocular albinism 1.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The patient's family was included in two previous linkage mapping studies (PMID: 1355560, PMID: 8301646).

      CaseMethod1: Linkage mapping

      CaseMethod2: Sanger sequencing

      CaseGenotypingMethod: The patient's family was included in two previous linkage mapping studies (PMID: 1355560, PMID: 8301646), and the proband was genotyped in this study by Sanger sequencing of PCR products from the 9 exons of GPR143.

      Variant: The proband harbors the NM_000273.3(GPR143):c.216_232del (p.Ala73fs) variant in the hemizygous state.

      ClinVar: 98619

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

      VariantEvidence: NM_000273.3(GPR143):c.216_232del (p.Ala73fs) is a frameshift variant in exon 1 of 9, and is predicted to trigger nonsense-mediated decay or to at least truncate the C-terminal 82% of the protein product.

      CaseAddInfo: The variant observed in this proband has been previously reported in two other studies (PMID: 1355560, PMID: 8301646).

      CasePMIDs: PMID: 1355560, PMID: 8301646

    1. A posterior subcapsular cataract could be observed in patient II-1 of family A (age 53)

      Case#: Collin_2008_Family_A_Patient_II-1, male, 61 years of age at time of study, 12 years of age at onset, family ethnicity likely to be of Dutch origin based on the description of the majority of the cohort as Dutch

      CasePresentingHPOs: Nyctalopia HP:0000662, Bone spicule pigmentation of the retina HP:0007737, Attenuation of retinal blood vessels HP:0007843, Constriction of peripheral visual field HP:0001133, Undetectable electroretinogram HP:0000550, Posterior subcapsular cataract HP:0007787, Optic disc pallor HP:0000543, Peripheral retinal atrophy HP:0200070, Reduced visual acuity HP:0007663

      CaseHPOFreeText: The patient has been diagnosed with retinitis pigmentosa and has been described as displaying abnormalities characteristic of this diagnosis. Night blindness was the initial symptom.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Because of the autosomal recessive pattern of inheritance in the patient's family, he and his family members were subjected to homozygosity mapping, identifying a homozygous region on chromosome 6 shared by affected members.

      CaseMethod1: Homozygosity mapping within the family

      CaseMethod2: Sanger sequencing of 44 PCR-amplified exons from the EYS locus

      CaseGenotypingMethod: The proband was genotyped by homozygosity mapping of family members, followed by Sanger sequencing of 44 PCR-amplified exons from the EYS locus.

      Variant: The proband harbors the NM_001142800.2(EYS):c.9405T>A (p.Tyr3135Ter) variant in the homozygous state.

      ClinVar: 538

      gnomAD: NM_001142800.2(EYS):c.9405T>A (p.Tyr3135Ter) is found in gnomAD v2.1.1 at a frequency of 0.00004991 (1/20038) in the Latino / Admixed American population https://gnomad.broadinstitute.org/variant/6-64430522-A-T

      VariantEvidence: NM_001142800.2(EYS):c.9405T>A (p.Tyr3135Ter) is a nonsense variant in exon 44 of 44 that is not predicted to trigger nonsense-mediated decay but rather to disrupt the C-terminal 1% of the protein product.

      CaseAddInfo: The proband is a member of Family A and has a similarly affected sister sharing the same genotype, as well as four unaffected siblings who are either heterozygous carriers or non-carriers of the variant.

      CasePMIDs: N/A

    1. NAP1

      Case#: Bandah-Rozenfeld_2010_NAP1_proband, female, age 30 years at time of diagnosis, in the 6th decade of life at the time of report, national origin reported as Italian

      CasePresentingHPOs: HP:0007401 (Macular atrophy), HP:0032122 (Very low visual acuity), HP:0000577 (Exotropia), HP:0000639 (Nystagmus), HP:0007787 (Posterior subcapsular cataract), HP:0000550 (Undetectable electroretinogram)

      CaseHPOFreeText: The patient has been diagnosed with advanced retinitis pigmentosa.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping consisted of autozygosity mapping.

      CaseMethod1: Homozygosity mapping

      CaseMethod2: Sanger sequencing of the 19 exons of the IMPG2 gene

      CaseGenotypingMethod: Genotyping consisted of autozygosity mapping followed by Sanger sequencing of the 19 exons of the IMPG2 gene.

      Variant: The patient harbors the NM_016247.4(IMPG2):c.2890C>T (p.Arg964Ter) variant in the homozygous state.

      ClinVar: 3549

      gnomAD: The NM_016247.4(IMPG2):c.2890C>T (p.Arg964Ter) variant is found in gnomAD v2.1.1 at a maximum allele frequency of 0.00006152 (1/16256, with 0 homozygotes) in the African / African-American population. https://gnomad.broadinstitute.org/variant/3-100961664-G-A

      VariantEvidence: NM_016247.4(IMPG2):c.2890C>T (p.Arg964Ter) is a nonsense variant in exon 14 of 19 that is predicted to lead to nonsense mediated decay or at least to C-terminal truncation of 22% of the protein product.

      CaseAddInfo: The family is consanguineous, with the parents being second cousins.

      CasePMIDs: N/A

    1. Autozygome-guided exome sequencing in retinal dystrophy patients reveals pathogenetic mutations and novel candidate disease genes

      PMID: 23105016

      Gene: IMPG2

      HGNC: 18362

      Disease: retinitis pigmentosa 56

      MONDO: 0013314

      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. Lysosomal localization of the neuronal ceroid lipofuscinosis CLN5 protein

      PMID: 11971870

      Gene: CLN5

      HGNC: 2076

      Disease: Ceroid lipofuscinosis, neuronal, 5 (also known as Finnish variant late infantile neuronal ceroid lipofuscinosis, neuronal ceroid lipofuscinosis late infantile Finnish variant, or Finnish vLINCL)

      MONDO: 0009745

      InheritancePattern: Autosomal Recessive

      Prevalence: Unknown, but part of a larger group of NCL disorders with a collective prevalence between 1 in 12,500 (PMID:9662406) and 1 in 100,000 (PMID:23374165)

      Penetrance: Fully penetrant, with onset often in the late infantile period but in some cases during early adulthood or even as late as in the 6th decade of life

    1. It has been demonstrated previously that localization of cone α-transducin is perturbed in Gucy2e–/– cone photoreceptors, with α-transducin localized to the inner segments and synaptic regions of cones (Coleman and Semple-Rowland, 2005). Our results are consistent with these findings; we observed weak and mislocalized cone α-transducin staining in untreated Gucy2e–/– eyes. In the treated eyes, however, immunohistochemical staining revealed increased levels of cone α-transducin, correctly localized to the cone outer segments (Fig. 3a). It has also been reported previously that localization of cone arrestin is perturbed in Gucy2e–/– cone photoreceptors (Coleman and Semple-Rowland, 2005), and that cone arrestin remains in the outer segments and synaptic terminals regardless of light conditions. However, we did not observe a major difference in cone arrestin staining in C57BL/6J wild-type and untreated Gucy2e–/– mice (Fig. 3b). Although there was faint immunostaining throughout Gucy2e–/– cones that was not seen in wild-type cones, in light-adapted animals the bulk of the signal, as in wild-type animals, was present in cone outer segments and synaptic terminals. Furthermore, after dark adaptation, arrestin translocated normally throughout cone photoreceptor cells. The localization and translocation of cone arrestin was not altered after administration of vector (Fig. 3b).

      ExperimentName: Rescue of mouse Gucy2e homozygous knockout model by AAV-borne human GUCY2D transgene

      NonHumanModel: Mus musculus

      GeneAlteration: The mouse Gucy2e gene was disrupted by the introduction of a neomycin-resistance gene cassette into exon 5, resulting in a truncated protein lacking its transmembrane domain (PMID: 10407028). The effects of this knockout were studied in the homozygous state.

      RescueVariant: Rescue was performed with the wild-type human GUCY2D and mouse Gucy2e genes but not with a patient-derived variant.

      RescuePhenotype: HP:0030465 (Undetectable light-adapted electroretinogram), HP:0030483 (Reduced amplitude of dark-adapted bright flash electroretinogram a-wave), HP:0030469 (Abnormal dark-adapted electroretinogram), HP:0000479 (Abnormal retinal morphology), HP:0008020 (Cone dystrophy)

      RescueMethod: Human GUCY2D or mouse Gucy2e was cloned into an overexpression construct under the control of the human rhodopsin kinase promoter and packaged into adeno-associated (AAV2/8) viral particles for 2 subretinal injections on postnatal day 10. Efficacy was measured by ERG recordings every two weeks.

      RescueEvidence: Treatment with the human GUCY2D gene restored proper localization of alpha-transducin (Figs. 3a-3b), which was first reported by PMID: 15623748 to be abnormal in this model. Treatment corrected the defect in scotopic b-wave amplitude by 65-100% (Figs. 4a-4b). Cone amplitude was corrected from 20% of wild-type to 65% of wild-type (Fig. 4c). Similar results were obtained with the mouse Gucy2e transgene (Fig. 5). Head-tracking behavior (measure of visual acuity and contrast sensitivity) was fully corrected by treatment (Fig. 6). Moderate cone preservation was also demonstrated by normalization of alpha-transducin staining, showing a 20% increase in cone numbers relative to the untreated control (Fig. 7r).

      ModelVariant: The mouse model disrupts the expression of the endogenous GC1 protein product but does not feature knock-in of a variant from a human patient.

    1. family 10, JU1426

      Case#: JU1426 (Family 10, II:3), Japanese male, 59 years (report)

      CaseHPOsFreeText: Best-corrected visual acuity of zero in both eyes; fundus exam - inconspicuous, partial white dots at peripheral retina, and macular degeneration in both eyes; reduced fundus autofluorescence, and irregular autofluorescence around fovea in both eyes; Optical coherence tomography - diffuse disruption of ellipsoid zone and interdigitation zone with foveal sparing in both eyes; 30 min dark adapted ERG showed extinguished b-waves, and with dark adaptation of 2-3 hours there was partial recovery of b-waves.

      CaseGenotypingMethod: WES

      Variant: NM_002905.4:c.259C>T (p.Gln87Ter) homozygous

      ClinVar: N/A

      CAID: CA385200238

      gnomAD: Not in gnomAD

      CaseAddInfo: Estimated age (based on years of follow up)

      Score: 2 points. This individual, with a diagnosis of fundus albipunctatus is homozygous for a nonsense variant in RDH5. This variant is absent in gnomAD.

    1. The RPGR gene nonsense mutation G-->T at open reading frame (ORF)15+1164 cosegregated with the disease and may create a donor splice site. Identification of an RPGR mutation in atrophic maculardegeneration expands the phenotypic range associated with this gene

      Case#: Ayyagari_2002_Family_UM:F1088_Patient_III-16, male, 48 years old, ethnicity not descibed

      CasePresentingHPOs: HP:0007401 (Macular atrophy), HP:0007663 (Reduced visual acuity), HP:0000529 (Progressive visual loss), HP:0007722 (Retinal pigment epithelial atrophy), HP:0003596 (Middle age onset), HP:0031624 (Moderate myopia), HP:0000603 (Central scotoma)

      CaseHPOFreeText: Onset of symptoms was approximately at age 43. The proband has been diagnosed with atrophic macular degeneration, with the family exhibiting X-linked pattern of inheritance.

      CaseNotHPOs: HP:0000580 (Pigmentary retinopathy), HP:0030491 (Choriocapillaris atrophy), HP:0008046 (Abnormal retinal vascular morphology), HP:0000512 (Abnormal electroretinogram)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The proband and family members were subjected to linkage analysis using microsatellite markers along the length of the X chromosome (LOD score of 4.17 associated with marker DXS1058.

      CaseMethod1: Sanger sequencing of the PCR-amplified exons from the NYX locus

      CaseMethod2: Sanger sequencing of the PCR-amplified exons from the RPGR locus

      CaseGenotypingMethod: The proband and his family members were subjected to linkage analysis using microsatellite markers along the length of the X chromosome, followed by Sanger sequencing of the PCR-amplified exons from the NYX and RPGR loci.

      Variant: The proband harbors the NM_001034853.2(RPGR):c.2917G>T (p.Glu973Ter) variant in the hemizygous state.

      ClinVar: 866129

      gnomAD: The variant was not found in gnomAD v.2.1.1.

      VariantEvidence: NM_001034853.2(RPGR):c.2917G>T (p.Glu973Ter) is a nonsense variant in the final exon (exon 15) that is not predicted to trigger nonsense-mediated decay but truncates ~16% of the C-terminus of the protein product.

      CaseAddInfo: The proband is a member of Family UM:F1088, shown in Figure 1 from this study. Ten other genotype-positive affected males are present in his extended family, as well as carrier females affected with mild perimacular RPE depigmentation and tapetal reflex.

      CasePMIDs: N/A

    1. affected member

      Case#: Kelsell_1998_CORD6_Family_Proband, male, age 48 at time of report, nationality listed as British

      CasePresentingHPOs: HP:0000548 (Cone/cone-rod dystrophy), HP:0007663 (Reduced visual acuity), HP:0007994 (Peripheral visual field loss), HP:0000613 (Photophobia), HP:0011504 (Bull's eye maculopathy), HP:0030465 (Undetectable light-adapted electroretinogram), HP:0030469 (Abnormal dark-adapted electroretinogram)

      CaseHPOFreeText: The text asserts that In all members of the proband's family, central vision was lost before age 7, while peripheral field vision was lost by the fourth decade of life. Cone ERG was undetectable early on in the disease, while rod ERG abnormalities later developed progressively.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: In a previous publication (PMID: 9097965), the family was subjected to (genome-wide) linkage analysis mapping the affected phenotype to chromosome 17p12-p13. The LOD score associated with marker locus D17S1844 was 5.93 (with no recombination).

      CaseMethod1: Sanger sequencing of PCR products from each of the 18 exons of the GUCY2D locus

      CaseMethod2: HhaI restriction digest of the PCR-amplified exon 13

      CaseGenotypingMethod: The proband and his family members were subjected to sequencing of PCR products from each of the 18 exons of the GUCY2D locus. The PCR-amplified product from exon 13 was then subjected to HhaI restriction digest and resolved by agarose gel electrophoresis.

      Variant: The proband harbors the NM_000180.3(GUCY2D):c.[2511G>C;2512C>A] variant in the heterozygous state.

      ClinVar: 453243

      gnomAD: The variant was not found in gnomAD.

      VariantEvidence: NM_000180.3(GUCY2D):c.[2511G>C;2512C>A] is a missense variant that causes two adjacent substitutions at the protein level (p.Glu837Asp;Arg838Ser), located within the coiled-coil domain that mediates dimerization. Codon 838 has proven to be a hot spot disrupted in other families similarly affected with autosomal dominant cone-rod dystrophy (PMID: 11115851, PMID: 12552567, PMID: 26298565). The p.Arg838Ser substitution has also been shown to disrupt the calcium-dependent regulation of GUCY2D by GUCA1A (PMID: 15504042), decrease sensitivity to inhibition by RD3 (PMID: 27703005), and trigger blindness in a transgenic mouse model (PMID: 27703005).

      CaseAddInfo: The family's variant was not comprehensively genotyped in this publication but was later identified in PMID: 10647719.

      CasePMIDs: PMID: 9097965, PMID: 10647719, PMID: 11565546

    1. variants

      Case#: Family_11864_Proband_II-2, onset before age 7 years, male, seen at a medical center in Guangzhou

      CasePresentingHPOs: High myopia HP:0011003, Blurred vision HP:0000622, Childhood onset HP:0011463, Protanopia HP:0011522

      CaseHPOFreeText: The proband is part of a cohort in which all patients had a diagnosis of early onset high myopia, with onset in early childhood and either high myopia or axial length >25 mm before age 7, or refractive errors <-10 as an adult.

      CaseNotHPOs: Nystagmus HP:0000639, Photophobia HP:0000613, Nyctalopia HP:0000662

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Genotyping of the proband was performed by either targeted exome sequencing or whole exome sequencing.

      CaseMethod1: targeted exome or whole exome sequencing

      CaseMethod2: Sanger sequencing of OPN1LW

      CaseGenotypingMethod: Genotyping of the proband was performed by either targeted exome sequencing or whole exome sequencing, followed by Sanger sequencing of OPN1LW.

      Variant: The individual harbors the NM_020061.6(OPN1LW):c.427_433dup (p.Ala145ValfsTer23) variant in the hemizygous state.

      CAID: CA2695237718

      gnomAD: The variant was not found in gnomAD version 4.1.0.

      VariantEvidence: NM_020061.6(OPN1LW):c.427_433dup (p.Ala145ValfsTer23) is a nonsense variant in exon 3 of 6 that is predicted to undergo nonsense-mediated decay.

      CaseAddInfo: The proband was seen at a medical center in Guangzhou. The variant was inherited from the proband's unaffected mother.

      CasePMIDs: N/A

    1. Human retinal organoids harboring IMPG2 mutations exhibit a photoreceptor outer segment phenotype that models advanced retinitis pigmentosa

      PMID: 36206764

      Gene: IMPG2

      HGNC: 18362

      Disease: retinitis pigmentosa 56

      MONDO: 0013314

      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 index patient of family 3 (III.5; Fig. 5) presented with a widespread chorioretinal atrophy extending substantially beyond the vascular arcades (Figs. 6A–D). The family history was compatible with a dominant inheritance, but the very advanced disease stage was not immediately suggestive for SFD. Targeted NGS for a retinal dystrophy gene panel identified a heterozygous c.452A>G (p.Tyr174Cys) missense mutation in exon 5 of the TIMP3 gene

      FamilyLabel: Gliem_2015_Family_3

      Family#PresentingHPOs: HP:0007663 (Reduced visual acuity), HP:0011510 (Drusen), HP:0000533 (Chorioretinal atrophy), HP:0011506 (Choroidal neovascularization)

      FamilyHPOFreeText: Onset of symptoms in the early fourth or fifth decade of life, with dark adaptation problems being the first symptoms, central and/or midperipheral chorioretinal atrophy, and central fibrosis or focal fibrotic changes, thinning of choroid

      FamilyNotHPOs: N/A

      FamilyNotHPOFreeText: N/A

      CountryOrigin: Germany

      Family#PreviousTesting: Targeted next-generation sequencing of the proband (for a 74-gene panel of retinal dystrophy genes), identifying the TIMP3 variant as well as a heterozygous c.1107G>A (p.Trp369) variant in RP1L1*

      Family#GenotypingMethod: Sanger sequencing of PCR products from the TIMP3 and RP1L1 genes, confirming that the TIMP3 variant co-segregated with the disease.

      Affected: 2

      Unaffected: 2

      Segregations: 2

      PublishedLOD: N/A

      eLOD: N/A

      AddSegregationInfo: The number of affected individuals / segregations was insufficient to estimate a LOD score.

      ProbandLabel: Gliem_2000_Family_3_patient_III.5

      Variant: Patients harbor the NM_000362.5(TIMP3):c.452A>G (p.Tyr151Cys) missense variant.

      CAID: CA411540149

      gnomAD: Variant is absent from gnomAD.

      FamilyAddInfo: N/A

      FamilyPMIDs: N/A

    1. Functional characterization of missense mutations at codon 838 in retinal guanylate cyclase correlates with disease severity in patients with autosomal dominant cone–rod dystrophy

      PMID: 11115851

      Gene: GUCY2D

      HGNC: 4689

      Disease: Cone-rod dystrophy 6

      MONDO: 0011143

      InheritancePattern: Autosomal Dominant

      Prevalence: The overall prevalence of cone-rod dystrophy is between 1 in 30,000 and 1 in 40,000 (PMID: 17270046), while the proportion of cone-rod dystrophy caused by GUCY2D variants is between 19% and 23% (PMID: 22183351, PMID: 25515582). Thus, the prevalence of cone-rod dystrophy 6 is between 1 in 130,000 and 1 in 215,000.

      Penetrance: Penetrance is age-dependent, with onset between the 1st and 6th decades of life.

    1. one from Denmark and Sweden (family D)

      Case#: Delvallée_2021_Proband_D.II-2, female, age not described, family origin reported as from Denmark and Sweden, ancestry reported as European

      CasePresentingHPOs: HP:0000556 (Retinal dystrophy), HP:0001162 (Postaxial hand polydactyly), HP:0030084 (Clinodactyly), HP:0001513 (Obesity), HP:0000119 (Abnormality of the genitourinary system)

      CaseHPOFreeText: The proband additionally exhibits slow ideation.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The proband was subjected to targeted exome sequencing to detect variants in BBS-related loci.

      CaseMethod1: targeted exome sequencing

      CaseMethod2: Sanger sequencing of BBS1

      CaseGenotypingMethod: The proband was subjected to targeted exome sequencing to detect variants in BBS-related loci, followed by Sanger sequencing of BBS1 to identify the variant and perform segregation analysis within the family.

      Variant: The proband harbors the NM_024649.5(BBS1):c.1169T>G (p.Met390Arg) and NM_024649.5(BBS1):c.1214_1215insSVA variants in the compound heterozygous state.

      ClinVar ID: 12143, 981241

      gnomAD: The NM_024649.5(BBS1):c.1169T>G (p.Met390Arg) variant is found in gnomAD v2.1.1 at a frequency of 0.002773 in the European (non-Finnish) population, with 358 alleles / 129114 total alleles (0 homozygotes) https://gnomad.broadinstitute.org/variant/11-66293652-T-G?dataset=gnomad_r2_1 The NM_024649.5(BBS1):c.1214_1215insSVA was not found in gnomAD v2.1.1.

      VariantEvidence: NM_024649.5(BBS1):c.1169T>G (p.Met390Arg) is a missense variant with mouse knock-in evidence of a similar disease-causing effect in the homozygous state (PMID: 18032602). This has not been taken into account in scoring, as the mouse model has been scored separately. However, it has provided a rationale not to down-score for the relatively high gnomAD frequency of this variant. NM_024649.5(BBS1):c.1214_1215insSVA is an indel in exon 13 of 17 that is reported to shift the reading frame and trigger nonsense-mediated decay. Figure 3 confirms the likely occurrences of NMD by indicating that the compound heterozygous probands have approximately 50% of wild-type levels of both BBS1 mRNA and protein.

      CaseAddInfo: The proband's family indicates segregation of the two variants from the two heterozygous unaffected carrier parents.

      CasePMIDs: N/A

    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.

    1. In a sibling pair from a consanguineous marriage (family B) and in a sibling pair from a nonconsanguineous family (family A), we identified large homozygous regions on chromosome 10 (11 Mb and 26 Mb, respectively) (Figure 1A). The common 26 Mb homozygous region in the sibs from family A was the largest homozygous region (SNP boundaries SNP_A-2260521 and SNP_A-1892358); the second, third, and fourth largest regions measured 8, 4.3, and 4.2 Mb. The overlapping 11 Mb homozygous region in the affected sibs of family B was the second largest homozygous region (SNP boundaries SNP_A-2003359 and SNP_A-1804692). The largest region in this family spanned 25 Mb; the third and fourth largest regions measured 10 and 6 Mb. The overlapping homozygous region in both families spanned the PDE6C gene but no other obvious candidate genes (Figure 1A; see also Table S1 available online). These regions were not found in other patients.

      Case#: Thiadens_2009_Family_A_Proband_AII-2, male, age 6 years at onset and 51 years at the time of report, sites of treatment listed as the Netherlands, Belgium, U.K., or Canada

      CasePresentingHPOs: HP:0030534 (Abnormal best corrected visual acuity test), HP:0000613 (Photophobia), HP:0000639 (Nystagmus), HP:0011003 (High myopia), HP:0000551 (Color vision defect, described as severe), HP:0030825 (Absent foveal reflex), HP:0007703 (Abnormality of retinal pigmentation, described as mild), HP:0030465 (Undetectable light-adapted electroretinogram)

      CaseHPOFreeText: The proband and affected family member were previously diagnosed with early onset autosomal recessive cone dystrophy. The proband had onset by age 6 years.

      CaseNotHPOs: HP:0007769 (Peripheral retinal degeneration)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Affected and unaffected family members were initially subjected to homozygosity mapping based on Affymetrix GeneChIP SNP analysis, identifying an 11-Mb region of homozygosity shared with another unrelated family.

      CaseMethod1: homozygosity mapping

      CaseMethod2: screening of the 22 exons and flanking regions of PDE6C (the only strong candidate gene) using Sanger sequencing

      CaseGenotypingMethod: Affected and unaffected family members were initially subjected to homozygosity mapping based on Affymetrix GeneChIP SNP analysis, identifying an 11-Mb region of homozygosity shared with another unrelated family. The clear candidate gene, PDE6C, was then subjected to Sanger sequencing-based screening of the 22 exons and flanking regions.

      Variant: The proband harbors the NM_006204.4(PDE6C):c.85C>T (p.Arg29Trp) variant in the homozygous state.

      ClinVar ID: 8763

      gnomAD: The NM_006204.4(PDE6C):c.85C>T (p.Arg29Trp) variant is found in gnomAD v2.1.1 at a frequency of 0.00008009 (2/24972) in the African / African-American population, with 0 homozygotes https://gnomad.broadinstitute.org/variant/10-95372567-C-T

      VariantEvidence: NM_006204.4(PDE6C):c.85C>T (p.Arg29Trp) is a missense variant that does not have experimental evidence of a functional effect on the protein product. However, it has been reported in similarly affected individuals in other studies (PMID: 21127010, PMID: 30080950).

      CaseAddInfo: The patient's affected sibling shares the same homozygous genotype, while the parents are unaffected and unrelated at least during the last 3 generations.

      CasePMIDs: N/A

    1. Visual and ocular findings in a family with X-linked cone dysfunction and protanopia

      PMID: 34287097

      Gene: OPN1LW

      HGNC: 9936

      Disease: red color blindness

      MONDO: MONDO:0010565

      InheritancePattern: X-linked

      Prevalence: Protanomaly and protanopia are common disorders with peak frequencies (among the males of certain populations) of 1.94% and 1.28%, respectively (PMID: 30258865).

      Penetrance: The penetrance of the phenotype among hemizygous cases appears to be complete or near-complete.

    1. hot spots

      Case#: Weigell-Weber_2000_adCRD_Family_Proband, age and gender not specified, nationality listed as Swiss

      CasePresentingHPOs: HP:0000548 (Cone/cone-rod dystrophy), HP:0007663 (Reduced visual acuity), HP:0000512 (Abnormal electroretinogram), HP:0000529 (Progressive visual loss), HP:0001123 (Visual field defect), HP:0000613 (Photophobia)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The proband and family members were subjected to linkage analysis excluding linkage to candidate loci at chr19q13, chr6q13-q15, and chr6p21, and confirming linkage to chr17p (using the microsatellite

      CaseMethod1: Sanger sequencing of PCR products from each of the GUCY2D locus

      CaseMethod2: HhaI restriction digest of the PCR-amplified exon 13

      CaseGenotypingMethod: The proband and his family members were subjected to sequencing of PCR products from each of the 18 exons of the GUCY2D locus. The PCR-amplified product from exon 13 was then subjected to HhaI restriction digest and resolved by agarose gel electrophoresis.

      Variant: The proband harbors the NM_000180.4(GUCY2D):c.2513G>A (p.Arg838His) variant in the heterozygous state.

      ClinVar: 9357

      gnomAD: The variant was not found in gnomAD.

      VariantEvidence: NM_000180.4(GUCY2D):c.2513G>A (p.Arg838His) is a missense variant located within the coiled-coil domain that mediates dimerization. Codon 838 has proven to be a hot spot disrupted in other families similarly affected with autosomal dominant cone-rod dystrophy (PMID: 11115851, PMID: 12552567, PMID: 26298565). The p.Arg838His substitution has been shown to disrupt the calcium sensitivity of GUCY2D and to trigger the inability to inactivate cyclase activity at high physiological calcium ion concentrations (PMID: 11115851).

      CaseAddInfo: N/A

      CasePMIDs: N/A

    1. Codon-Optimized RPGR Improves Stability and Efficacy of AAV8 Gene Therapy in Two Mouse Models of X-Linked Retinitis Pigmentosa

      PMID: 28549772

      Gene: RPGR

      HGNC: 10295

      Disease: RPGR-related retinopathy

      MONDO: MONDO:0100437

      InheritancePattern: X-linked

      Prevalence: The prevalence of RPGR-related retinopathy is calculated to be approximately 1 in 214,000, based on the known incidence of retinitis pigmentosa at 1 in 3,000, the proportion of retinitis pigmentposa that is X-linked at 20%, and the proportion of X-linked retinitis pigmentosa that is RPGR-associated at 70% (PMID: 34985506).

      Penetrance: Penetrance is nearly 100% in hemizygous males but is incomplete and dependent upon the variant in heterozygous female carriers.

    1. A Tyr368His RPE65 founder mutation is associated with variable expression and progression of early onset retinal dystrophy in 10 families of a genetically isolated population

      PMID: 12960219

      Gene: RPE65

      HGNC: 10294

      Disease: Leber congenital amaurosis 2

      MONDO: 0008765

      InheritancePattern: Autosomal Recessive

      Prevalence: The overall prevalence of Leber congenital amaurosis is between 1 in 33,000 and 1 in 100,000 newborns, while the proportion of Leber congenital amaurosis caused by RPE65 variants is between 1% and 16.7%. Thus, the prevalence of Leber congenital amaurosis 2 is between 1 in 200,000 and 1 in 10,000,000.

      Penetrance: Fully penetrant, with onset typically by 1 year of age

    1. LRP5 variants may contribute to ADPKD

      PMID: 25920554

      Gene: LRP5

      HGNC: 6697

      Disease: osteoporosis-pseudoglioma syndrome

      MONDO: 0009820

      InheritancePattern: autosomal recessive

      Prevalence: osteoporosis-pseudoglioma syndrome is estimated to occur in 1 out of every 2,000,000 live births.

      Penetrance: The penetrance of the phenotype among homozygous or compound heterozygous cases appears to be complete, while heterozygous carriers of deleterious variants appear to be mildly affected.

    1. Patient-iPSC-Derived Kidney Organoids Show Functional Validation of a Ciliopathic Renal Phenotype and Reveal Underlying Pathogenetic Mechanisms

      PMID: 29706353

      Gene: IFT140

      HGNC: 29077

      Disease: Short-rib thoracic dysplasia 9 with or without polydactyly

      MONDO: 0009964

      InheritancePattern: autosomal recessive

      Prevalence: Within the lumped disease entity for this curation, the most prevalent form may be retinitis pigmentosa. The prevalence of Saldino-Mainzer syndrome (one of the synonyms of Short-rib thoracic dysplasia 9) is less than 1 in 1,000,000. The prevalence of Leber congenital amaurosis cases caused by IFT140 variants (PMID: 26216056) is calculated to be less than 1 in 3,000,000. Although IFT140 variants are estimated to be responsible for less than 2% of RP, the prevalence of the overall disorder at 1 in 3,000 or 1 in 4,000 means the frequency of these cases could potentially be higher than 1 in 1,000,000.

      Penetrance: Known variants for this lumped disease entity appear to be completely penetrant, with highly variable phenotypes and age of onset. On the other hand, the split disease entity caused by monoallelic IFT140 variants appears to have incomplete penetrance.

    1. Cone Dystrophy Associated with a Novel Variant in the Terminal Codon of the RPGR-ORF15

      PMID: 33805381

      Gene: RPGR

      HGNC: 10295

      Disease: RPGR-related retinopathy

      MONDO: MONDO:0100437

      InheritancePattern: X-linked

      Prevalence: The prevalence of RPGR-related retinopathy is calculated to be approximately 1 in 214,000, based on the known incidence of retinitis pigmentosa at 1 in 3,000, the proportion of retinitis pigmentposa that is X-linked at 20%, and the proportion of X-linked retinitis pigmentosa that is RPGR-associated at 70% (PMID: 34985506).

      Penetrance: Penetrance is nearly 100% in hemizygous males but is incomplete and dependent upon the variant in heterozygous female carriers.

    1. The mGluR6 ligand-binding domain, but not the C-terminal domain, is required for synaptic localization in retinal ON-bipolar cells

      PMID: 34793838

      Gene: TRPM1

      HGNC: 7146

      Disease: congenital stationary night blindness 1C

      MONDO: MONDO:0013183

      InheritancePattern: autosomal recessive

      Prevalence: Congenital stationary night blindness has an estimated prevalence between 1 in 6,000 (PMID: 31427709) and 1 in 300,000 (PMID: 3487908). However, the prevalence of congenital stationary night blindness 1C specifically is unknown.

      Penetrance: Penetrance is thought to be complete.

    1. The Chlamydomonas reinhardtii BBSome is an IFT cargo required for export of specific signaling proteins from flagella

      PMID: 20038682

      Gene: BBS1

      HGNC: 966

      Disease: Bardet-Biedl syndrome 1

      MONDO: 0008854

      InheritancePattern: autosomal recessive

      Prevalence: The prevalence of BBS1 variants among Bardet-Biedl syndrome cohorts has been reported as at least 20% (PMID: 19402160), while the prevalence of Bardet-Biedl syndrome overall has been estimated between 1 in 13,500 and 1 in 160,000 live births, depending on the population (PMID: 22713813).

      Penetrance: The penetrance of the phenotype among homozygous cases appears to be complete.

    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

    1. In-frame deletion in a novel centrosomal/ciliary protein CEP290/NPHP6 perturbs its interaction with RPGR and results in early-onset retinal degeneration in the rd16 mouse

      PMID: 16632484

      Gene: RPGR

      HGNC: 10295

      Disease: RPGR-related retinopathy

      MONDO: MONDO:0100437

      InheritancePattern: X-linked

      Prevalence: The prevalence of RPGR-related retinopathy is calculated to be approximately 1 in 214,000, based on the known incidence of retinitis pigmentosa at 1 in 3,000, the proportion of retinitis pigmentposa that is X-linked at 20%, and the proportion of X-linked retinitis pigmentosa that is RPGR-associated at 70% (PMID: 34985506).

      Penetrance: Penetrance is nearly 100% in hemizygous males but is incomplete and dependent upon the variant in heterozygous female carriers.

    1. One such family of Middle-Eastern origin (family A), including two affected family members, aged 34 (subject A-2; V-3 in Figure 1A) and 32 (subject A-3; V-4 in Figure 1A), is the basis of this report. The study was approved by the local research ethics committee, and all investigations were conducted in accordance with the principles of the Declaration of Helsinki; informed consent was obtained from all participating individuals. Both affected siblings in family A were noticed to have nystagmus and were diagnosed with LCA shortly after birth. Poor night vision and difficulty reading print from an early age was reported for both patients A-2 and A-3; gradual progression of visual problems affecting central and peripheral vision was also noted. Both had bilateral cataract surgery in their 20s. No other family history of retinal disease was reported. Visual acuities were 2.0 logMAR (logarithm of the minimal angle of resolution) in each eye of patient A-2 and 1.78 logMAR for the right and 1.48 for the left eye of patient A-3. Fundoscopy revealed significant pigment at the level of the retinal pigment epithelium (RPE) and in a configuration unlike that of typical RP (A-2 and A-3, Figure 2A).

      Case#: Sergouniotis_2011_Proband_A-2, female, age 34 years, family ethnic origin described as Middle Eastern

      CasePresentingHPOs: Congenital nystagmus HP:0006934, Presenile cataracts HP:0007819, Reduced visual acuity HP:0007663, Nyctalopia HP:0000662, Constriction of peripheral visual field HP:00011

      CaseHPOFreeText: The proband received a diagnosis of Leber congenital amaurosis shortly after birth. Fundoscopy results were described as "significant pigment at the level of the retinal pigment epithelium and in a configuration unlike that of typical RP".

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The proband was initially genotyped by a combination of homozygosity mapping and exome sequencing.

      CaseMethod1: homozygosity mapping and exome sequencing

      CaseMethod2: Sanger sequencing of the proband and family members to confirm the presence of the variant and to test segregation

      CaseGenotypingMethod: The proband was initially genotyped by a combination of homozygosity mapping and exome sequencing. Sanger sequencing of the proband and family members was then performed to confirm the presence of the variant and to test segregation.

      Variant: The individual is homozygous for the NM_002242.4(KCNJ13):c.496C>T (p.Arg166Ter) variant.

      ClinVar: 30331

      gnomAD: The variant was not found in gnomAD version 4.1.0.

      VariantEvidence: NM_002242.4(KCNJ13):c.496C>T (p.Arg166Ter) is a nonsense variant in exon 3 of 3 that is not predicted to trigger nonsense-mediated decay but rather to truncate the C-terminal 54% of the protein product.

      CaseAddInfo: The proband's family history includes consanguinity and a sibling similarly diagnosed with LCA.

      CasePMIDs: N/A

    1. However, during this study, we had the opportunity to identify IFT140 mutations in a child affected with Jeune syndrome (FVII1, Table S1). The child was compound heterozygous for a splice-site mutation and the c.634G>A (p.Gly212Arg) change identified in Family V. These data suggest that mutations in IFT140 may be a rare cause of Jeune syndrome and that there is no clear correlation between the IFT140 genotype and the severity of the disease.

      Case#: Perrault_2012_Patient_FVII1, male, 18 months of age at time of study, ethnicity not specified

      CasePresentingHPOs: HP:0001252 (Hypotonia), HP:0011968 (Feeding difficulties), HP:0003577 (Congenital onset), HP:0000639 (Nystagmus), HP:0010306 (Short thorax), HP:0000773 (Short ribs), HP:0010230 (Cone-shaped epiphyses of the phalanges of the hand), HP:0000093 (Proteinuria), HP:0001970 (Tubulointerstitial nephritis), HP:0004719 (Hyperechogenic kidneys)

      CaseHPOFreeText: This proband was diagnosed with Jeune syndrome, unlike the other probands in this study who were diagnosed with Mainzer-Saldino syndrome. Limbs are described as trident. Elevated urea listed as a kidney-related phenotype.

      CaseNotHPOs: HP:0025404 (Abnormal visual fixation), HP:0004322 (Short stature), HP:0000929 (Abnormal skull morphology)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      CaseMethod1: Ciliome resequencing of a customized target enrichment library (consisting of 1,666 genes)

      CaseMethod2: Sanger sequencing of the 29 coding exons of IFT140

      CaseGenotypingMethod: The patient was genotyped by ciliome resequencing of a customized target enrichment library (consisting of 1,666 genes), confirmed by Sanger sequencing of the 29 coding exons of IFT140

      Variant: The patient is a compound heterozygote harboring the NM_014714.4(IFT140):c.634G>A (p.Gly212Arg) and NM_014714.4(IFT140):c.2399+1G>T variants in IFT140.

      ClinVar: 31683, 31680

      gnomAD: The NM_014714.4(IFT140):c.634G>A (p.Gly212Arg) variant is present in gnomAD at a frequency of 0.00009295 in the European (non-Finnish) population (12/129100, with no homozygotes) https://gnomad.broadinstitute.org/variant/16-1642177-C-T The NM_014714.4(IFT140):c.2399+1G>T variant is present in gnomAD at a frequency of 0.0001231 in the European (non-Finnish) population (14/113764, with no homozygotes) https://gnomad.broadinstitute.org/variant/16-1607935-C-A

      VariantEvidence: Exogenous expression of the FLAG-tagged p.Gly212Arg variant in the RPE1 (retinal pigment epithelial) cell line revealed an inability to co-localize with gamma-tubulin, indicating a defect in localization to the basal body in most cells that is less severe than one of the other suspected pathogenic missense variants (Figure 3A). The NM_014714.4(IFT140):c.2399+1G>T variant disrupts a canonical splice donor site and is predicted but not confirmed to trigger skipping of exon 18/31.

      CaseAddInfo: The proband's parents are reportedly non-consanguineous.

      CasePMIDs: N/A

    1. Finnish

      Case#: Holmberg_Patient_1, male, age 3 at onset and age 15 at time of study, Finnish origin

      CasePresentingHPOs: HP:0003208 (Fingerprint intracellular accumulation of autofluorescent lipopigment storage material), HP:0011463 (Childhood onset), HP:0001268 (Mental deterioration), HP:0000572 (Visual loss), HP:0001251 (Ataxia), HP:0002540 (Inability to walk), HP:0001250 (Seizure), HP:0000550 (Undetectable electroretinogram), HP:0012018 (EEG with temporal focal spikes), HP:0100952 (Enlarged sylvian cistern), HP:0006855 (Cerebellar vermis atrophy), HP:0002198 (Dilated fourth ventricle), HP:0033725 (Thin corpus callosum), HP:0030891 (Periventricular white matter hyperdensities), HP:0012690 (T2 hypointense thalamus), HP:0001312 (Giant somatosensory evoked potentials)

      CaseHPOFreeText: Age of onset was 3, while mental decline was present at age 3 and both visual deterioration and abolished ERG at age 6. The patient had progressive cerebral atrophy starting between the ages of 6 and 7. Ataxia and seizures were found at age 8. Loss of independent walking occurred at age 9. Posterior EEG spikes in response to low-frequency photic stimuli were observed. T2-weighted images showed increased signal intensity of the periventricular white matter and posterior limb of the capsula interna. The thalamus had abnormally low signal intensity compared to the putamen, caudate nuclei, and white matter. Giant flash visual evoked potentials were found at age 10.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Other than clinical phenotype characterization, it is not clear what genotype tests preceded CLN5 sequencing.

      CaseMethod1: N/A

      CaseMethod2: N/A

      CaseGenotypingMethod: Each exon of CLN5 was PCR-amplified and Sanger sequenced in both directions.

      Variant: The patient is homozygous for the NM_006493.4(CLN5):c.1028_1029del (p.Thr342_Tyr343insTer) variant.

      ClinVar: 2564 (homozygous)

      gnomAD: The maximum allele frequency of the NM_006493.4(CLN5):c.1028_1029del (p.Thr342_Tyr343insTer) variant is 0.0008137 (within the European Finnish population, with no homozygous occurrences). https://gnomad.broadinstitute.org/variant/13-77575052-CAT-C

      VariantEvidence: NM_006493.4(CLN5):c.1028_1029del (p.Thr342_Tyr343insTer) is a recurring frameshift variant that is predicted to disrupt approximately 5% of CLN5 at the C-terminus and has been shown to disturb its localization to the lysosome (PMID:20052765).

      CaseAddInfo: N/A

      CasePMIDs: N/A

    1. P9-CH

      Case#: P9-CH, M, Age of Report: 39 y.o., Ethnicity: Switzerland.

      CasePresentingHPOs: HP:0000510 (Rod-cone dystrophy/Retinitis pigmentosa), HP:0008527 (Congenital sensorineural hearing impairment/congenital hearing loss/bilateral sensorineural hearing loss), HP:0000667 (Phthisis bulbi), HP:0001105 (Retinal atrophy), HP:0000523 (Subcapsular cataract),

      CaseHPOFreeText: P9-CH is a 39-year-old male patient diagnosed with RP and congenital hearing loss.

      At the time of the first referral to the clinic, the patient presented with a monocular situation after enucleation of the right eye due to painful phthisis bulbi, which he developed after multiple surgeries to treat retinal detachment when he was 18 and 20 years old. Fundus examination of the left eye revealed typical RP with waxy optic nerve head pallor, attenuated arteries, and peripheral BSP and retinal atrophy (Fig. 2f). No CME was observed at the most recent visit or previously described in his medical history. The patient had a visual field of <10° as assessed with a microperimetry device (Nidek MP3), which corresponds well to the margins of the retinal degeneration. He also presented subcapsular cataract and received cataract surgery. Following the surgery, his BCVA in the left eye increased from 0.3 D to 1.5 D. The patient reported hearing impairment since childhood (Fig. 3). Audiological testing indicated a bilateral sensorineural hearing loss with a flat audiogram.

      CaseNotHPOs: N/A.

      CaseNotHPOFreeText: N/A.

      CasePreviousTesting: N/A.

      CaseMethod1: N/A.

      CaseMethod2: N/A.

      CaseGenotypingMethod: WES.

      Variant: NM_021831.6:c.908G>A (p.Arg303His).

      ClinVar: 1044022.

      CAID: CA1567753.

      gnomAD: Frequency: 0.00001995. Link: https://gnomad.broadinstitute.org/variant/chr2-27055253-G-A?dataset=gnomad_r4.

      VariantEvidence: N/A.

      CaseAddInfo: The proband has an affected brother and an unaffected sister (Fig. 1f). The brother (II.1) was not available for the study, but the proband mentioned that his brother was less severely affected than him despite being 15 years older.

      CasePMIDs: N/A.

    1. The youngest (III:4) had unilateral vision loss, with his left eye showing no signs of CNV and maintaining good visual acuity.

      Case: Saihan_2009_Family_patient_III:4, male, British (of Welsh origin), 47 years old at presentation

      DiseaseAssertion: Sorsby's fundus dystrophy

      FamilyInfo: The mother of the proband and affected siblings was unaffected and negative for the variant, while the father was affected but not genotyped.

      CasePresentingHPOs: HP:0000662 (Nyctalopia), HP:0000529 (Progressive visual loss), HP:0000572 (Visual loss), HP:0011510 (Drusen), HP:0031239 (Extrafoveal choroidal neovascularization), HP:0031528 (Subretinal deposits),

      CaseHPOFreeText: First presenting phenotypes were reduction of night vision and slow dark adaptation (with onset in fifth decade, 1 year prior to vision loss). Nyctalopia was progressive, with onset in the fifth decade of life (age 47). Vision loss in one eye occurred suddenly at age 48, but had not occurred in the other eye by age 51. Occasional drusen-like deposits were present at the posterior pole. Choroidal neovascularization was hemorrhagic and initiated loss of central vision. A large tear was observed in the retinal pigment epithelium. RPE-choroid complex showed increased reflectivity in both eyes. Left eye had signs of retinal atrophy.

      CaseNotHPOs: HP:0004328 (Abnormal anterior eye segment morphology), HP:0000518 (Cataract)

      CaseNotHPOFreeText: No history of renal disease or systemic disease was consistently observed among the affected family members. Left eye was largely unaffected at the time of evaluation.

      CasePreviousTesting: Family history (indicating autosomal dominant inheritance of retinal degeneration) and ophthalmic exams (including LogMAR visual acuities, slit-lamp biomicroscopy, color fundus photography, optical coherence tomography scans of the fovea, and autofluorescent imaging of the fundus).

      GenotypingMethod: Mutational screening of TIMP3 by bidirectional Sanger sequencing

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: The Variant used was NM_000362.5(TIMP3):c.484G>A (p.Glu162Lys) (CAID:CA411540222). The variant is referred to in this publication as "Glu139Lys" (due to the removal of a 23-amino acid N-terminal signal peptide from the polypeptide sequence) but encodes Glu162Lys in the full/updated polypeptide sequence.

      CAID: CA411540222

      gnomAD: Variant is absent from gnomAD.

      VariantEvidence: When the missense variant was exogenously expressed in a retinal epithelial cell line, reverse zymographs of the extracellular matrix revealed the presence of both monomeric and dimeric species for the variant but only the monomeric species for the wild-type. This indicated that the free cysteine present in the variant did not compromise metalloproteinase inhibitory activity, but likely facilitated an intramolecular disfulfide bonding interaction with another TIMP3 molecule. This gain-of-function interpretation of the variant effect would be consistent with the autosomal dominant mechanism of inheritance.

    1. Seven novel variants expand the spectrum of RPE65-related Leber congenital amaurosis in the Chinese population

      PMID: 30996589

      Gene: RPE65

      HGNC: 10294

      Disease: Leber congenital amaurosis 2

      MONDO: 0008765

      InheritancePattern: Autosomal Recessive

      Prevalence: The overall prevalence of Leber congenital amaurosis is between 1 in 33,000 and 1 in 100,000 newborns, while the proportion of Leber congenital amaurosis caused by RPE65 variants is between 1% and 16.7%. Thus, the prevalence of Leber congenital amaurosis 2 is between 1 in 200,000 and 1 in 10,000,000.

      Penetrance: Fully penetrant, with onset typically by 1 year of age

    1. patients II2

      Case: Langton_2000_Family_1_patient_II2, female, country of origin northeast England (PMID:11734514), onset at 25 years of age

      DiseaseAssertion: Sorsby's fundus dystrophy

      FamilyInfo: Variant inherited by the proband rather than acquired de novo, although parents were not genotyped.

      CasePresentingHPOs: HP:0000662 (Nyctalopia), HP:0007663 (Reduced visual acuity), HP:0032284 (Ultra-low vision with retained motion projection), HP:0000533 (Chorioretinal atrophy), HP:0007843 (Attenuation of retinal blood vessels), HP:0007703 (Abnormality of retinal pigmentation)

      CaseHPOFreeText: Presentation at age 25 was with nyctalopia and loss of central vision. At age of 72, remaining visual acuity was limited to retained motion projection, and chorioretinal atrophy was complete in each macula. Pigmentation was observed in the retinal periphery.

      CaseNOTHPOs: N/A

      CaseNOTHPOFreeText: Rheumatological exam and renal function were both normal.

      CasePreviousTesting: Phenotypic characterization only

      GenotypingMethod: PCR of TIMP3 exon 5 followed by Sanger sequencing of the PCR product

      PreviouslyPublished: PMID:11734514

      SupplementalData: N/A

      Variant: The NM_000362.5(TIMP3):c.484G>T, p.Glu139X variant converts the GAG codon to a TAG, resulting in early termination of the transcript. This nonsense substitution affects the final exon 5, so that truncation of the protein product is predicted but not nonsense-mediated decay of the transcript.

      ClinVar: 12680

      gnomAD: Variant is absent from gnomAD.

      VariantEvidence: This nonsense variant may result in an unpaired Cys residue (with the potential to mediate dimerization). However, unlike some other variants (missense), this nonsense variant forms dimers that are difficult to distinguish from full-length TIMP3 when exogenously expressed in COS-7 cells (Figure 5). Reverse zymography also indicates retained activity as a metalloproteinase inhibitor. The molecular weight is consistent with the prediction that the premature stop codon removes the C-terminal site for N-glycosylation. This lower molecular weight (unglycosylated) species is unique to the variant and is not seen in the wild-type condition (Fig. 5).

    1. Retinitis Pigmentosa GTPase Regulator (RPGR)-interacting Protein Is Stably Associated with the Photoreceptor Ciliary Axoneme and Anchors RPGR to the Connecting Cilium

      PMID: 11104772

      Gene: RPGR

      HGNC: 10295

      Disease: RPGR-related retinopathy

      MONDO: MONDO:0100437

      InheritancePattern: X-linked

      Prevalence: The prevalence of RPGR-related retinopathy is calculated to be approximately 1 in 214,000, based on the known incidence of retinitis pigmentosa at 1 in 3,000, the proportion of retinitis pigmentposa that is X-linked at 20%, and the proportion of X-linked retinitis pigmentosa that is RPGR-associated at 70% (PMID: 34985506).

      Penetrance: Penetrance is nearly 100% in hemizygous males but is incomplete and dependent upon the variant in heterozygous female carriers.

    1. Two novel CLN5 mutations in a Portuguese patient with vLINCL: Insights into molecular mechanisms of CLN5 deficiency

      PMID: 16814585

      Gene: CLN5

      HGNC: 2076

      Disease: Ceroid lipofuscinosis, neuronal, 5 (also known as Finnish variant late infantile neuronal ceroid lipofuscinosis, neuronal ceroid lipofuscinosis late infantile Finnish variant, or Finnish vLINCL)

      MONDO: 0009745

      InheritancePattern: Autosomal Recessive

      Prevalence: Unknown, but part of a larger group of NCL disorders with a collective prevalence between 1 in 12,500 (PMID:9662406) and 1 in 100,000 (PMID:23374165)

      Penetrance: Fully penetrant, with onset often in the late infantile period but in some cases during early adulthood or even as late as in the 6th decade of life

    1. Neuronal Ceroid Lipofuscinoses Are Connected at Molecular Level: Interaction of CLN5 Protein with CLN2 and CLN3

      PMID: 12134079

      Gene: CLN5

      HGNC: 2076

      Disease: Ceroid lipofuscinosis, neuronal, 5 (also known as Finnish variant late infantile neuronal ceroid lipofuscinosis, neuronal ceroid lipofuscinosis late infantile Finnish variant, or Finnish vLINCL)

      MONDO: 0009745

      InheritancePattern: Autosomal Recessive

      Prevalence: Unknown, but part of a larger group of NCL disorders with a collective prevalence between 1 in 12,500 (PMID:9662406) and 1 in 100,000 (PMID:23374165)

      Penetrance: Fully penetrant, with onset often in the late infantile period but in some cases during early adulthood or even as late as in the 6th decade of life

    1. To determine if LRP-5 has any effect on the canonical Wnt signaling pathway in mammalian cells, we coexpressed LRP-5 with Wnt-1 in NIH 3T3 cells. In these cells, Wnt-1 has been shown to elevate the levels of cytosolic β-catenin and activate LEF-1-dependent transcriptional activity (Li et al. 1999aLi L Yuan H Weaver C Mao J Farr III, G.H Sussman D.J Jonkers J Kimelman D Wu D Axin and Frat-1 interact with Dvl and GSK, bridging Dvl to GSK in Wnt-mediated regulation of LEF-1.EMBO J. 1999; 18 (a): 4233-4240Crossref PubMed Scopus (358) Google Scholar, Li et al. 1999bLi L Yuan H Xie W Mao J McMahon E Sussman D Wu D Dishevelled proteins lead to two different signaling pathways; regulation of the JNK and b-catenin pathways.J. Biol. Chem. 1999; 274 (b): 129-134Crossref PubMed Scopus (255) Google Scholar). Expression of LRP-5 alone had no effect on LEF-1 activity (Figure 1A), as determined using a LEF-1-dependent luciferase reporter gene assay (Hsu et al. 1998Hsu S.C Galceran J Grosschedl R Modulation of Transcriptional Regulation By Lef-1 in Response to Wnt-1 Signaling and Association With Beta-Catenin.Mol. Cell. Biol. 1998; 18: 4807-4818Crossref PubMed Scopus (338) Google Scholar), but enhanced the effect of Wnt-1 (Figure 1A) or Wnt-3a (data not shown). To confirm that LRP-5 acted with secreted Wnt-1 protein, a paracrine coculture approach was used (Li et al. 1999aLi L Yuan H Weaver C Mao J Farr III, G.H Sussman D.J Jonkers J Kimelman D Wu D Axin and Frat-1 interact with Dvl and GSK, bridging Dvl to GSK in Wnt-mediated regulation of LEF-1.EMBO J. 1999; 18 (a): 4233-4240Crossref PubMed Scopus (358) Google Scholar), in which LRP-5 and the reporter luciferase were transfected into one group of cells and Wnt-1 was transfected into a separate group of cells. These two groups were combined after transfection, and luciferase activities were determined after the cells were cocultured for 24 hr. Since Wnt-1 and the reporter gene were produced in different cells, any effect of Wnt-1 could be attributed only to the interaction of secreted Wnt-1 protein with cells expressing LRP-5 and containing the reporter gene. As shown in Figure 1B, LRP-5 and Wnt-1 acted synergistically in the activation of LEF-1-dependent transcription in the paracrine assay, demonstrating that LRP-5 potentiates the signaling of secreted Wnt-1. The same results were also observed for Wnt-3a in similar coculture assays (data not shown).

      Selection B - Gene function is consistent with phenotype.

      Title: LRP5 is a canonical Wnt signaling pathway co-receptor.

      GOterm: GO:0060070 (canonical Wnt signaling pathway)

      FunctionalEvidence: Exogenous LRP5 expression in NIH3T3 cells increases the activity of the canonical Wnt signaling transcription factor LEF1 only when combined with exogenous expression of the Wnt-1 ligand in a separate population of cells grown in co-culture (Figure 1). This function is related to the phenotype in that canonical Wnt signaling is known to mediate bone formation.

      FunctionalHPO: HP:0004349 (reduced bone mineral density), osteoporosis (HP:0000939), HP:0020110 (bone fracture)

    1. Leber's congenital amaurosis

      Case#: Marlhens_1997_Patient_III-2, female, age 20 years at time of report, unspecified ethnicity

      CasePresentingHPOs: HP:0030506 (Yellow/white lesions of the retina), HP:0000580 (Pigmentary retinopathy), HP:0007843 (Attenuation of retinal blood vessels), HP:0000543 (Optic disc pallor), HP:0001141 (Severely reduced visual acuity)

      CaseHPOFreeText: Pigmentary deposits, Attenuation of retinal blood vessels, and Optic disc pallor were all mild/moderate.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: All RPE65 coding exons and flanking sequences were PCR-amplified and subjected to single-strand conformation analysis. Exon 10 was identified as a likely candidate to harbor a variant.

      CaseMethod1: Sanger sequencing of all 14 exons of RPE65

      CaseMethod2: Screening of PCR products using SSCA for the maternal variant and AlwNI restriction digest for the paternal variant

      CaseGenotypingMethod: All 14 exons of RPE65 were PCR-amplified and subjected to Sanger sequencing. Screening of PCR products was also performed using SSCA for the maternal variant and AlwNI restriction digest for the paternal variant.

      Variant: Affected individuals are compound heterozygous for the NM_000329.3(RPE65):c.1067del (p.Asn356fs) (maternal) and NM_000329.3(RPE65):c.700C>T (p.Arg234Ter) (paternal) variants.

      ClinVar: 98821, 13114

      gnomAD: The maximum allele frequency for the NM_000329.3(RPE65):c.1067del (p.Asn356fs) variant is 0.00005458 (within the East Asian population, with no homozygotes). https://gnomad.broadinstitute.org/variant/1-68903930-AT-A The maximum allele frequency for the NM_000329.3(RPE65):c.700C>T (p.Arg234Ter) variant is 0.00008676 (within the Latino / Admixed American population, with no homozygotes). https://gnomad.broadinstitute.org/variant/1-68905269-G-A

      VariantEvidence: The maternal frameshift variant occurs in exon 10 of 14 and is predicted to either trigger NMD or disrupt 33% of the protein product. The paternal nonsense variant occurs in exon 7 of 14 and is predicted to either trigger NMD or truncate 56% of the protein product. Both are likely to be null variants.

      CaseAddInfo: The two variants were confirmed to be in trans, and heterozygous carriers were found to be unaffected. Potential parental consanguinity was not mentioned.

      CasePMIDs: N/A

    1. In our Kcnj13W53X/+ΔR mice, we used ABE8e mRNA, sgRNA packaged in SNC-PEG-ATRA, and administered subretinally to edit the mutant allele. Full-field ERG measurements were performed at weeks 2, 6, and 10 to monitor longitudinal rescue in phenotype (Figure 6F). At week 10, multifocal ERG (mfERG) was performed on injected eyes to determine whether functional recovery was regionalized based on localized delivery of the base-editor complex. For the control group, Kcnj13W53X/+ΔR was injected with a base editor and a nontargeting guide. The nontargeted guide–injected mice exhibited a progressive decrease in c wave amplitude as well as depressed mfERG waveforms in almost the entire retina. On the other hand, the base-edited eyes showed an increase in the c wave amplitude at all measured time points (Figure 6, G–J). mfERG showed localized waveforms (Figure 6H and Supplemental Figure 11A) that perhaps correlated with the site of injection (Figure 6C). On the second week following the injection, the normalized c wave amplitude (to that before the therapy) in eyes receiving the nontargeted guide was 0.8 ± 0.1, practically indistinguishable to that of the eyes injected with the targeted guide, 0.9 ± 0.2 (P = 0.9). At 10 weeks after injection, the c wave was reduced (0.7 ± 0.1) for the nontargeted retina compared with an increasing trend (1.6 ± 0.1, P = 0.01) (Figure 6K) for the targeted guide–delivered retina. This increase of 55% in amplitude and intact retinal structure, as evaluated by OCT (Figure 6, H and J), demonstrates that inherited retinal channelopathies could be mitigated using base editors. As a further preclinical validation, we determined whether the SNC used to deliver the base editor triggers an immune response. The RPE cells in culture were transduced with either lentivirus, AAV7m8, or AAV5 or were incubated with SNC. Expression of inflammatory cytokines, including IFN-γ, IL-1α, IL-1β, IL-6, CD-8, and Iba1, was assessed by quantitative PCR (qPCR). CD8 and Iba1 showed increased expression in virally transduced RPE cells, but not in cells exposed to SNCs (Supplemental Figure 11B).

      ExperimentName: CRISPR/Cas9-based rescue of patient variant in the mouse RPE

      RescueModel: Mus musculus

      GeneAlteration: The Kcnj13W53X/+ΔR model has been generated from Kcnj13W53X/+ mice by retinal pigment epithelium-specific introduction of the variant encoding the p.Trp53Ter nonsense variant.

      RescueVariant: Rescue was performed by editing the variant to restore wild-type KCNJ13, not by introducing an additional human variant.

      RescuePhenotype: The rescued phenotypes are full-field electroretinogram responses measured at week 10 post-injection and retinal thickness by optical coherence tomography.

      RescueMethod: This rescue model has subretinally injected sgRNA to edit the W53X allele and restore the wild-type by CRISPR/Cas9 base editing.

      RescueEvidence: The ERG c-wave from the RPE layer shows 55% higher amplitude for the edited/targeted retina relative to the non-targeted control (Figures 6J and 6K) and is accompanied by intact retinal structure by OCT (Figures 6H and 6I).

      ModelVariant: NM_002242.4(KCNJ13):c.158G>A (p.Trp53Ter), ClinVarID: 224857

    1. We studied a large Chinese family with nystagmus as a prominent and consistent manifestation phenotype in nine patients to map and identify a disease-causing gene for nystagmus. X-linked recessive inheritance was observed in the family, and foveal hypoplasia was detected in some of the nine patients. The disease gene was mapped to an approximately 10.6 Mb region flanked by DXS996 and DXS7593 on Xp22 with a significant peak multipoint LOD score. Analysis of 21 candidate genes in the region revealed a novel p.S89F mutation in the second transmembrane domain of GPR143, a G protein-coupled receptor which causes ocular albinism when mutated. All male patients in the family were hemizygous for the mutation; the female carriers were heterozygous for the mutation.

      FamilyLabel: Liu_2007_Family

      Family#PresentingHPOs: HP:0006934 (Congenital nystagmus), HP:0007750 (Hypoplasia of the fovea), HP:0000483 (Astigmatism), HP:0007663 (Reduced visual acuity)

      FamilyPresentingHPOFreeText: The affected family members have been diagnosed with congenital nystagmus segregating with an X-linked mode of inheritance. While all members exhibit nystagmus, some members have foveal hypoplasia (4 out of 5 affected males), myopia, amblyopia, and/or mottling of the retinal pigmentation as well.

      FamilyNotHPOs: HP:0001000 (Abnormality of skin pigmentation), HP:0009887 (Abnormality of hair pigmentation), HP:0012805 (Iris transillumination defect), HP:0007894 (Hypopigmentation of the fundus)

      FamilyNotHPOFreeText: One family member was subjected to functional MRI and did not show abnormalities of the optic nerve head.

      CountryOrigin: China

      Ethnicity: Chinese

      Race: Not specifically described

      Family#PreviousTesting: Linkage mapping has been performed in affected and unaffected family members using 33 polymorphic markers along the entire X chromosome. Haplotype analysis identified a shared region of approximately 10.6 Mb in all affected males.

      Family#Method1: Linkage mapping and haplotype analysis

      Family#Method2: Sanger sequencing of 21 candidate genes in the linkage region

      Family#GenotypingMethod: Linkage mapping has been performed in affected and unaffected family members using 33 polymorphic markers along the entire X chromosome. Haplotype analysis identified a shared region of approximately 10.6 Mb in all affected males. Sanger sequencing was then performed for 21 candidate genes in the linkage region, followed by RFLP analysis in a subset of affected and unaffected family members.

      Affected: 4 fully genotyped, 9 total

      Unaffected: 7 fully genotyped

      Segregations: 8 segregations are shown by the pedigree in Figure 2B.

      PublishedLOD: 8.89 (associated with the DXS987 marker on chromosome Xp22)

      eLOD: N/A

      AddSegregationInfo: N/A

      ProbandLabel: Liu_2007_Family_Patient_V-10

      Variant: The affected male family members harbor the NM_000273.3(GPR143):c.266C>T (p.Ser89Phe) variant in the hemizygous state.

      ClinVar: 10522

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

      VariantEvidence: NM_000273.3(GPR143):c.266C>T (p.Ser89Phe) is a missense variant in exon 2 of 9 total, and is located in a transmembrane domain but does not have experimental evidence of gene impact.

      FamilyAddInfo: The family is not reported to be consanguineous.

      FamilyPMIDs: N/A

    1. Pro363Thr

      Case#: Gu_1997_Family_PMK30_Patient_V-5, male, unknown age, Indian ethnicity

      CasePresentingHPOs: HP:0410280 (Pediatric onset), HP:0000662 (Nyctalopia), HP:0000505 (Visual impairment), HP:0008047 (Abnormality of the vasculature of the eye), HP:0000648 (Optic atrophy), HP:0007737 (Bone spicule pigmentation of the retina)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous testing consisted of linkage analysis using microsatellite repeat markers.

      CaseMethod1: PCR products were screened by single-strand conformation polymorphism (SSCP) analysis.

      CaseMethod2: Sanger sequencing of all RPE65 exons

      CaseGenotypingMethod: After discovery of a band shift for exon 10, the patient sample was subjected to PCR and Sanger sequencing of all RPE65 exons.

      Variant: Affected individuals are homozygous for the NM_000329.3(RPE65):c.1087C>A (p.Pro363Thr) variant.

      ClinVar: 13117 (homozygous)

      gnomAD: The maximum allele frequency for the NM_000329.3(RPE65):c.1087C>A (p.Pro363Thr) variant is 0.0001307 (within the South Asian population, with no homozygotes). https://gnomad.broadinstitute.org/variant/1-68903911-G-T

      VariantEvidence: A different publication (PMID: 16828753) later used QBI-293A cells to establish that this variant decreases the stability of the RPE65 protein, shifts its localization from predominantly in the membrane fraction to predominantly in the cytosolic fraction, and abolishes its isomerohydrolase activity.

      CaseAddInfo: The family pedigree shows consanguinity in the parents of all affected individuals.

      CasePMIDs: N/A

    1. In vitro stem cell modelling demonstrates a proof-of-concept for excess functional mutant TIMP3 as the cause of Sorsby fundus dystrophy

      PMID: 32666594

      Gene: TIMP3

      HGNC: 11822

      Disease: Sorsby fundus dystrophy (SFD), also known as Sorsby's fundus dystrophy, Sorsby pseudoinflammatory fundus dystrophy, or hemorrhagic macular dystrophy

      MONDO: 0007640

      InheritancePattern: Autosomal Dominant

      Prevalence: Estimated at 1 in 220,000 (PMID: 28847738)

      Penetrance: Fully penetrant, onset between the third and sixth decades of life

    1. More recent genetic testing of the patients identified a novel c.410A>G; p.Tyr137Cys variant of uncertain clinical significance in the Tissue Inhibitor of Metalloproteinase-3 (TIMP3) gene.

      Case#: DiBenedetto_Patient_1, male, age 74 at time of evaluation, Dutch ancestry on maternal (affected) side and North Irish / English on paternal (unaffected) side

      CasePresentingHPOs: HP:0000575 (Scotoma), HP:0000662 (Nyctalopia), HP:0000518 (Cataract), HP:0000964 (Eczema), HP:0000822 (Hypertension), HP:0001342 (Cerebral hemorrhage), HP:0001397 (Hepatic steatosis), HP:0009726 (Renal neoplasm), HP:0007663 (Reduced visual acuity), HP:0011510 (Drusen), HP:0007703 (Abnormality of retinal pigmentation), HP:0007737 (Bone spicule pigmentation of the retina), HP:0007894 (Hypopigmentation of the fundus)

      CaseHPOFreeText: Onset in 5th decade of life, anterior chamber intraocular lenses in both eyes (shown by slit lamp examination), bilateral cataract surgery at age 60, stroke at age 71, renal tumor at age 74, visual acuity limited to hand motion at age 74, initial diagnosis not with SFD but with retinitis pigmentosa.

      CaseNotHPOs: HP:0012632 (Abnormal intraocular pressure), HP:0025574 (Macular hemorrhage), HP:0030496 (Macular exudate),

      CaseNotHPOFreeText: Features of syndromic retinal dystrophy

      CasePreviousTesting: Limited (non genome-wide) genetic testing confirming absence of pathogenic variants in 13 different genes; RHO, PRPH2/RDS, RP1, IMPDH1, PRPF31, PRPF, PRPF8, NR2E3, SNRNP200, TOPORS, KLHL7, RPGR, and RP2.

      CaseMethod1: Limited genetic testing for 13 candidate genes

      CaseMethod2: N/A

      CaseGenotypingMethod: next-generation sequencing analysis of an 856-gene retinal dystrophy panel

      Variant: NM_000362.5(TIMP3):c.410A>G (p.Tyr137Cys)

      CAID: CA411539826

      gnomAD: The variant is not found in gnomAD.

      VariantEvidence: The variant is a missense substitution at a conserved amino acid. A homology model (based on an available TIMP2 crystal structure) indicates that the variant is a more hydrophobic substitution at a surface-exposed site. This may disrupt protein-protein interactions, particularly with EFEMP1, which is known to interact with the region.

      CaseAddInfo: The proband has a number of family members diagnosed with retinitis pigmentosa (son, sister, brother, mother, maternal grandmother, and maternal great-uncle ). The pattern was consistent with autosomal dominant inheritance. His sister underwent treatment for choroidal neovascularization at age 73.

      CasePMIDs: N/A

    1. Thirty-year follow-up of a patient with leber congenital amaurosis and novel RPE65 mutations

      PMID: 14962443

      Gene: RPE65

      HGNC: 10294

      Disease: Leber congenital amaurosis 2

      MONDO: 0008765

      InheritancePattern: Autosomal Recessive

      Prevalence: The overall prevalence of Leber congenital amaurosis is between 1 in 33,000 and 1 in 100,000 newborns, while the proportion of Leber congenital amaurosis caused by RPE65 variants is between 1% and 16.7%. Thus, the prevalence of Leber congenital amaurosis 2 is between 1 in 200,000 and 1 in 10,000,000.

      Penetrance: Fully penetrant, with onset typically by 1 year of age

    1. A diagnosis was made in patient 22018

      Case#: Yzer_2006_Patient_22018, male, age 2 months at diagnosis, Dutch or Belgian family origin

      CasePresentingHPOs: HP:0003593 (Infantile onset), HP:0001483 (Eye poking), HP:0002457 (Abnormal head movements), HP:0030553 (Visual acuity no light perception), HP:0000543 (Optic disc pallor), HP:0000639 (Nystagmus), HP:0000550 (Undetectable electroretinogram)

      CaseHPOFreeText: The individual is described as having Leber congenital amaurosis. No perception of light was detected at age 2.5 years. Pupils were wide and minimally responsive to bright light.

      CaseNotHPOs: HP:0000662 (Nyctalopia), HP:0000613 (Photophobia), HP:0001098 (Abnormal fundus morphology)

      CaseNotHPOFreeText: Most recent fundus examination was relatively normal at 3 years of age.

      CasePreviousTesting: An LCA-specific microarray ChIP was used for initial genotyping, using antisense oligos to screen for 301 known disease-associated variants 6 LCA genes (AIPL1, CRB1, CRX, GUCY2D, RPE65, and RPGRIP1) and two early-onset RP genes (LRAT and MERTK).

      CaseMethod1: Sanger sequencing of PCR products from the relevant exon of GUCY2D.

      CaseMethod2: N/A

      CaseGenotypingMethod: The individual was initially screened using an LCA-specific microarray ChIP with antisense oligos to detect 301 known disease-associated variants 6 LCA genes (AIPL1, CRB1, CRX, GUCY2D, RPE65, and RPGRIP1) and two early-onset RP genes (LRAT and MERTK). Subsequent genotyping was performed by Sanger sequencing of PCR products from the relevant exon of the GUCY2D locus.

      Variant: The individual is homozygous for the NM_000180.4(GUCY2D):c.2302C>T (p.Arg768Trp) variant.

      ClinVar: 98563

      gnomAD: The NM_000180.4(GUCY2D):c.2302C>T (p.Arg768Trp) variant exhibits a maximum allele frequency of 0.0002943 in gnomAD version 2.1.1 (in the European non-Finnish population, with no homozygotes). https://gnomad.broadinstitute.org/variant/17-7917236-C-T

      VariantEvidence: Multiple publications have found functional defects in the NM_000180.4(GUCY2D):c.2302C>T (p.Arg768Trp) variant. PMID: 25477517 shows defective binding to its interacting partner RD3, while PMID: 20050595 and PMID: 23035049 show reduced basal enzymatic activity and inability to interact with the activity-stimulating binding partner GCAP1.

      CaseAddInfo: Parents were not reported to be consanguineous. Segregation / phasing of two variants was not confirmed by parental genotyping.

      CasePMIDs: N/A

    1. one nonsense mutation (p.R1534X)

      Case#: Narumi_2010_patient_3, male, age 10 years at report, national origin listed as Japanese

      CasePresentingHPOs: HP:0000939 (Osteoporosis), HP:0011463 (Childhood onset), HP:0000572 (Visual loss), HP:0000639 (Nystagmus), HP:0000541 (Retinal detachment), HP:0004327 (Abnormal vitreous humor morphology, vascular remnants), HP:0008046 (Abnormal retinal vascular morphology), HP:0000618 (Blindness), HP:0001249 (Intellectual disability), HP:0020110 (Bone fracture), HP:0001388 (Joint laxity), HP:0001252 (Hypotonia), HP:0007083 (Hyperactive patellar reflex), HP:0000938 (Osteopenia), HP:0000926 (Platyspondyly)

      CaseHPOFreeText: The patient has been diagnosed with osteoporosis-pseudoglioma syndrome. In one eye, peripheral retinal vessel was insufficiently developed and optic disc traction was observed. Complete blindness occurred at age 3 due to deterioration of abnormal vascular growth in one eye.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: No deformity of long bones was observed.

      CasePreviousTesting: Genotyping appears to have been limited to the LRP5 locus.

      CaseMethod1: Sanger sequencing of 23 PCR-amplified exons and flanking regions of the LRP5 locus

      CaseMethod2: N/A

      CaseGenotypingMethod: Genotyping appears to have been limited to Sanger sequencing of 23 PCR-amplified exons and flanking regions of the LRP5 locus.

      Variant: The patient harbors the NM_002335.4(LRP5):c.1145C>T (p.Pro382Leu) and NM_002335.4(LRP5):c.4600C>T (p.Arg1534Ter) variants in the compound heterozygous state.

      ClinVar: 40288, 40290

      gnomAD: The NM_002335.4(LR5P5):c.1145C>T (p.Pro382Leu) variant is found in gnomAD v2.1.1 at a frequency of 0.000008800 (1/113634) in the European non-Finnish population https://gnomad.broadinstitute.org/variant/11-68153913-C-T The NM_002335.4(LRP5):c.4600C>T (p.Arg1534Ter) variant was not found in gnomAD v2.1.1.

      VariantEvidence: NM_002335.4(LR5P5):c.1145C>T (p.Pro382Leu) is a missense variant that does not have evidence of impact on the protein product, although it has been observed in the compound heterozygous state in an apparently unrelated proband from this same study. NM_002335.4(LRP5):c.4600C>T (p.Arg1534Ter) is a nonsense variant in exon 23 of 23 and is predicted not to trigger nonsense-mediated decay but rather to truncate the C-terminal 5% of the protein product.

      CaseAddInfo: The patient has 2 apparently unaffected parents, one of whom carries the p.Arg1534Ter variant (mother), and one of whom carries the p.Pro382Leu variant (father)

      CasePMIDs: N/A

    1. index case

      Case#: Weisschuh_2018_Patient_8, sex unreported, age 35 years at time of report, likely from Europe or of European descent

      CasePresentingHPOs: HP:0030465 (Undetectable light-adapted electroretinogram), HP:0030534 (Abnormal best corrected visual acuity test), HP:0000551 (Color vision defect), HP:0000613 (Photophobia)

      CaseHPOFreeText: The proband has been previously diagnosed with achromatopsia.

      CaseNotHPOs: HP:0030469 (Abnormal dark-adapted electroretinogram)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The patient was previously genotyped by Sanger sequencing of CNGB3, CNGA3, and GNAT2.

      CaseMethod1: next-generation sequencing of PDE6C and possibly other loci

      CaseMethod2: screening of the 22 exons and flanking regions of PDE6C (the only strong candidate gene) using Sanger sequencing

      CaseGenotypingMethod: The proband has been genotyped by Sanger sequencing of CNGB3, CNGA3, GNAT2, and PDE6C, as well as next-generation sequencing of PDE6C and possibly other loci.

      Variant: The proband harbors the NM_006204.4(PDE6C):c.78del (p.Lys27fs) and NM_006204.4(PDE6C):c.775C>T (p.Arg259Ter) variants in the compound heterozygous state.

      ClinVar ID: 487693, 487691

      gnomAD: The NM_006204.4(PDE6C):c.78del (p.Lys27fs) variant was not found in gnomAD v2.1.1. The NM_006204.4(PDE6C):c.775C>T (p.Arg259Ter) variant is found in gnomAD v2.1.1 at a frequency of 0.00001759 (2/113724) in the European (non-Finnish) population, with 0 homozygotes https://gnomad.broadinstitute.org/variant/10-95381740-C-T

      VariantEvidence: NM_006204.4(PDE6C):c.775C>T (p.Arg259Ter) is a nonsense variant in exon 4 of 22 that is predicted to trigger nonsense mediated decay or to at least truncate the C-terminal 70% of the protein product. NM_006204.4(PDE6C):c.78del (p.Lys27fs) is a frameshift variant in exon 1 of 12 that is predicted to trigger nonsense mediated decay or to at least truncate the C-terminal 97% of the protein product.

      CaseAddInfo: N/A

      CasePMIDs: N/A

    1. The retinas of the retinal degeneration (rd) chicken are fully developed and possess normal morphology at hatching but fail to respond to light stimulation. Analyses of retinal cGMP, the internal messenger of phototransduction, show that the amount of cGMP in predegenerate, fully developed rd/rd photoreceptors is 5–10 times less than that seen in normal photoreceptor cells. We show that the low levels of cGMP in rd chicken retina are a consequence of a null mutation in the photoreceptor guanylate cyclase (GC1) gene. Thus, the rd chicken is a model for human Leber’s congenital amaurosis. Absence of GC1 in rd retina prevents phototransduction and affects survival of rods and cones but does not interfere with normal photoreceptor development.

      ExperimentName: Homozygous disruption of the chicken ortholog of GUCY2D

      NonHumanModel: Gallus gallus domesticus

      GeneAlteration: The null allele of the chicken Rd gene (orthologous to human GUCY2D) exhibits a rearrangement in which a 723-bp region corresponding to exons 4-7 has been replaced by an in-frame insertion of 81-bp fragment likely derived from exon 9. This deletes the transmembrane domain and is predicted to result in complete inactivation of the enzyme. This variant has been studied in the homozygous state.

      ModelPhenotype: HP:0007875 (Congenital blindness), HP:0000654 (Decreased light- and dark-adapted electroretinogram amplitude), Optokinetic reflex,

      HumanPhenotype: HP:0007663 (Reduced visual acuity), HP:0007688 (Undetectable light- and dark-adapted electroretinogram), HP:0007703 (Abnormality of retinal pigmentation)

      ModelEvidence: Chickens harboring the null variant in a homozygous state have dramatically lower levels of cGMP in the retina (Figure 1) and absent expression of GC1, the GUCY2D ortholog (Figure 2). Rod and cone photoreceptor cells develop normally, but have little to no function according to ERG. This is similar to the normal fundus appearance in LCA patients, despite severe early vision loss.

      ModelVariant: The mouse model disrupts the expression of the endogenous GC1 protein product but does not feature knock-in of a variant from a human patient.

    1. Retinal Phenotype in the rd9 Mutant Mouse, a Model of X-Linked RP

      PMID: 31607844

      Gene: RPGR

      HGNC: 10295

      Disease: RPGR-related retinopathy

      MONDO: MONDO:0100437

      InheritancePattern: X-linked

      Prevalence: The prevalence of RPGR-related retinopathy is calculated to be approximately 1 in 214,000, based on the known incidence of retinitis pigmentosa at 1 in 3,000, the proportion of retinitis pigmentposa that is X-linked at 20%, and the proportion of X-linked retinitis pigmentosa that is RPGR-associated at 70% (PMID: 34985506).

      Penetrance: Penetrance is nearly 100% in hemizygous males but is incomplete and dependent upon the variant in heterozygous female carriers.

    1. Different RPGR exon ORF15 mutations in Canids provide insights into photoreceptor cell degeneration

      PMID: 11978759

      Gene: RPGR

      HGNC: 10295

      Disease: RPGR-related retinopathy

      MONDO: MONDO:0100437

      InheritancePattern: X-linked

      Prevalence: The prevalence of RPGR-related retinopathy is calculated to be approximately 1 in 214,000, based on the known incidence of retinitis pigmentosa at 1 in 3,000, the proportion of retinitis pigmentposa that is X-linked at 20%, and the proportion of X-linked retinitis pigmentosa that is RPGR-associated at 70% (PMID: 34985506).

      Penetrance: Penetrance is nearly 100% in hemizygous males but is incomplete and dependent upon the variant in heterozygous female carriers.

    1. Here we report a 2-basepair deletion in codon 25 of the human gene in a family with autosomal dominant retinitis punctata albescens

      Case#: Kajiwara_1993_Proband_III-1, male, age 59 years at time of report, family origin not reported

      CasePresentingHPOs: Adult onset HP:0003581, Nyctalopia HP:0000662, Reduced visual acuity, HP:0007663, Foveal hyperpigmentation HP:0008001, Foveal atrophy HP:0025010, Subretinal deposits HP:0031528, Uveitis HP:0000554, Cataract HP:0000518, Corneal opacity HP:0007957, Central scotoma HP:0000603, Chorioretinal atrophy HP:0000533, Optic disc pallor HP:0000543

      CaseHPOFreeText: The proband has been diagnosed with autosomal dominant retinitis pigmentosa albescens, with age of reported onset after 40 years.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous testing consisted of screening of the RHO locus for disease-causing variants.

      CaseMethod1: SSCP

      CaseMethod2: Sanger sequencing of PRPH2

      CaseGenotypingMethod: Previous testing of this family consisted of screening of the RHO locus for variants causing RP, with negative results. Genotyping started with single strand conformation polymorphism analysis of PCR-amplified products from the PRPH2 gene, followed by Sanger sequencing of the relevant PCR product to identify the variant. SSCP was subsequently performed to genotype family members..

      Variant: The proband harbors the NM_000322.5(PRPH2):c.73_74del (p.Trp25fs) variant in the heterozygous state.

      ClinVar ID: 98707

      gnomAD: The NM_000322.5(PRPH2):c.73_74del (p.Trp25fs) variant was not found in gnomAD v4.0.0.

      VariantEvidence: NM_000322.5(PRPH2):c.73_74del (p.Trp25fs) is a frameshift variant in exon 1 of 3 that is predicted to trigger nonsense-mediated decay or to at least truncate the C-terminal 93% of the protein product.

      CaseAddInfo: The proband's family includes a daughter who is an "unaffected" (subclinically affected) carrier of the variant with an elevated dark-adapted threshold and numerous yellow/white subretinal flecks in the periphery of the fundus with macular sparing.

      CasePMIDs: N/A

    1. 4/m

      Case#: 4, Male, Han Chinese

      DiseaseAssertion: Hurler Syndrome

      FamilyInfo: Not Provided

      CasePresentingHPOs: HP:0001249, HP:0007957, HP:0001433 (Mental Retardation (severe), Corneal Clouding, Hepatosplenomegaly)

      CaseHPOFreeText: Skeletal Deformities

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: 0 Leukocyte IDUA activity (nmol/h/mg protein) (isolated leukocytes in the latter)

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      GenotypingMethod: Using the artificial substrate 4-methyl-umbelliferyl α-L-iduronide (Sigma)

      Variant1: c.792+1G>T

      Variant1ClinVarID: N/A

      Variant1CAID: CA355962278

      Variant2: c.792+1G>T

      Variant2ClinVarID: N/A

      Variant2CAID: CA355962278

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. Case#: Patient 4, 11 years old, Iranian

      DiseaseAssertion: MPS1-H (Severe)

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: IDUA activity not detected

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.1029C>A (p.Y343X)

      Variant1ClinVarID: 222997

      Variant1CAID: CA356984

      Variant2: c.1029C>A (p.Y343X)

      Variant2ClinVarID: 222997

      Variant2CAID: CA356984

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. P13

      Case#: P13, Female, 2.7 years (diagnosed), 5.1 (report), 18 kg (weight), 96 cm (height), Algerian

      DiseaseAssertion: Hurler Syndrome

      FamilyInfo: Parents are not consanguineous

      CasePresentingHPOs: HP:0001249, HP:0001999, HP:0000943, HP:0001387, HP:0002240, HP:0001387, HP:0007957, HP:0000238 (Mental Retardation, Facial Dysmorphic Features, Multiple Dysostosis, Joint Stiffness, Hepatomegaly, Hernia(Ombelical), Corneal Opacity, Hydrocephalus)

      CaseHPOFreeText: Chronic Rhinorrhea

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: Cardiac Manifestations

      CaseEnzymeAssay: IDUA Enzyme activity 2 (% to the reference range mean)

      CaseUrineGAGs: GAG quantitation 19.6 (fold change to the reference range mean according to age)

      CaseERT: N/A

      CaseBMT: N/A

      GenotypingMethod: Direct DNA Fragments Sequencing

      Variant1: c.501C>G (p.Tyr167*)

      Variant1ClinVarID: 92644

      Variant1CAID: CA220511

      Variant2: c.501C>G (p.Tyr167*)

      Variant2ClinVarID: 92644

      Variant2CAID: CA220511

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. 17

      Case#: Patient 17 (see Table 2), 40 weeks (Gestational age)

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.1205G>A (p.W402X)

      Variant1ClinVarID: 11908

      Variant1CAID: CA220498

      Variant2: c.1205G>A (p.W402X)

      Variant2ClinVarID: 11908

      Variant2CAID: CA220498

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    2. 2

      Case#: Patient 2 (see Table 2), 38 weeks, 1 day (Gestational age)

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: Inguinal hernia (HP:0000023)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: Upper respiratory tract involvement

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.1205G>A (p.W402X)

      Variant1ClinVarID: 11908

      Variant1CAID: CA220498

      Variant2: c.208C>T (p.Q70X)

      Variant2ClinVarID: 11909

      Variant2CAID: CA204563

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    3. 7

      Case#: Patient 7 (see Table 2), 33 weeks, 1 day (Gestational age)

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: 0.44 nmol x mg-1 × hr-1

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.208C>T (p.Q70X)

      Variant1ClinVarID: 11909

      Variant1CAID: CA204563

      Variant2: c.653T>C (p.L218P)

      Variant2ClinVarID: 222995

      Variant2CAID: CA356986

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. 1

      Case#: Subject 1, female, in her 30s (age at enrollment), died during extension study from pneumonia and respiratory failure sixty-five days after her first dose in the extension study.

      DiseaseAssertion: MPS1-HS

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0002093, HP:0002540, HP:0002090, HP:0002176 (Chronic respiratory insufficiency, inability to walk, pneumonia, spinal cord compression)

      CaseHPOFreeText: Hemidiaphragmatic paralysis, improved strength and range of motion

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: Yes - Enzyme replacement therapy with laronidase

      CaseBMT: N/A

      Variant1: N/A

      Variant1ClinVarID: N/A

      Variant1CAID: N/A

      Variant2: N/A

      Variant2ClinVarID: N/A

      Variant2CAID: N/A

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. the patient (II‐2)

      Case#: II-2, Female, 2 years (onset), Chinese

      DiseaseAssertion: MPS 1

      FamilyInfo: I-1 and I-2 are the parents, II-4 is a full sibling of II-2 and a full child of I-1 and I-2. II-4 also carries the disease. (pedigree is figure # 1).

      CasePresentingHPOs: HP:0001367, HP:0000622, HP:0007663, HP:0001718, HP:0001643, HP:0001698, HP:0000238, (Abnormal joints, Blurred vision, Decreased vision, Mitral stenosis (severe), Patent ductus arteriosus (tubular), Pericardial effusion (moderate), Hydrocephalus)

      CaseHPOFreeText: Abnormal mitral valve development, Anterior mitral valve prolapses and insufficiency (moderate), Pulmonary hypertension (moderate), Bilateral temporal arachnoid cyst, Congenital spinal stenosis, Congenital glaucoma, Corneal gray degeneration, Corneal staphyloma

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      GenotypingMethod: Sanger Sequencing

      Variant1: c.1037T>G

      Variant1ClinVarID: 11927

      Variant1CAID: CA256128

      Variant2: c.18115dupT

      Variant2ClinVarID: 1454082

      Variant2CAID: CA2573137507

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

    1. D4

      Case#: Patient D4, Druze religious group, located in lower Galilee.

      DiseaseAssertion: N/A

      FamilyInfo: May have relation with Patient D5 due to being located in the same village. Parents were found to be heterozygous for the mutation.

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.1096A>C (p.T366P)

      Variant1ClinVarID: 11916

      Variant1CAID: CA:256117

      Variant2: N/A

      Variant2ClinVarID: N/A

      Variant2CAID: N/A

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. 19/F

      Case#: 19, Female, infancy (onset), 3 years (diagnosed), 17 years (report)

      DiseaseAssertion: Hurler Syndrome

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0004322, HP:0001387, HP:0002240, HP:0001744, HP:0001537, HP:0001007, HP:0000158, HP:0000280, HP:0000943, HP:0007957 (Short Stature, Joint Stiffness, Hepatomegaly (severe), Splenomegaly(severe), Umbilical Hernia, Hirsutism, Large Tongue, Coarse Facial Features, Dysostosis Multiplex, Corneal Clouding)

      CaseHPOFreeText: (Mental Development (delayed), Systolic murmur 3/6/combined defect of mitral valve)

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      GenotypingMethod: Not Provided

      Variant1: p.H539T (fsX21)

      Variant1ClinVarID: N/A

      Variant1CAID: N/A

      Variant2: c.1650+5G>A (splicing error)

      Variant2ClinVarID: 92634

      Variant2CAID: CA220504

      AdditionalVariants: p.A8, p.A20, p.Q33H

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    2. 18/M

      Case#: 18, Male, 15 years (onset), 15 years (diagnosed), 15 years (report)

      DiseaseAssertion: Scheie Syndrome

      FamilyInfo: Patients 17 and 18 are siblings

      CasePresentingHPOs: HP:0004322, HP:0001387, HP:0002240, HP:0001744, HP:0001537, HP:0000280, HP:0000943 (Short Stature, Joint Stiffness, Hepatomegaly (moderate), Splenomegaly(mild), Umbilical Hernia, Coarse Facial Features (mild), Dysostosis Multiplex)

      CaseHPOFreeText: (Mental Development (developmental quotient 93 at 15y, Verbal IQ 77; CIQ 79), Umbilical/Carpal Tunnel Syndrome)

      CaseNotHPOs: HP:0000256 (Macrocephaly)

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      GenotypingMethod: Not Provided

      Variant1: p.Q380R

      Variant1ClinVarID: 550799

      Variant1CAID: CA2802202

      Variant2: p.Q380R

      Variant2ClinVarID: 550799

      Variant2CAID: CA2802202

      AdditionalVariants: p.A8/A8, p.A20/A20

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    3. 7/F

      Case#: 7, Female, 8 months (onset), 10 months (diagnosed), 5 years (report)

      DiseaseAssertion: Hurler Syndrome

      FamilyInfo: Not Provided

      CasePresentingHPOs: HP:0000256, HP:0001387, HP:0002240, HP:0001537, HP:0000486, HP:0002857, HP:0012185, HP:0000280, HP:0000943, HP:0007957 (Macrocephaly (at 8m), Joint Stiffness (at 8m), Hepatomegaly (Severe before HSCT, mild after HSCT), Umbilical Hernia, Strabismus, genua valga, carpal tunnel syndrome, Coarse Facial Features (very mild), Dysostosis Multiplex, Corneal Clouding)

      CaseHPOFreeText: Mental Development (developmental quotient 110 at 1y, Developmental quotient 115 at 5y), Normal psychomotor development, Hearing problems,

      CaseNotHPOs: HP:0004322, HP:0001744 (Short Stature, Splenomegaly)

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: normal IDUA activity in leucocytes (4 years after HSCT)

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: Hematopoietic Stem Cell Transplantation at 1y

      GenotypingMethod: Not Provided

      Variant1: p.W402X

      Variant1ClinVarID: 11908

      Variant1CAID: CA220498

      Variant2: c.1650 + 5G > A

      Variant2ClinVarID: 92634

      Variant2CAID: CA220504

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    4. 8/M

      Case#: 8, Male, 2, 5 years (onset), 3,5 months (diagnosed), 16 years (report)

      DiseaseAssertion: Hurler-Scheie Syndrome

      FamilyInfo: Not Provided

      CasePresentingHPOs: HP:0000256, HP:0001387, HP:0002240, HP:0001744, HP:0001537, HP:001285, HP:0000280, HP:0000943, HP:0007957 (Macrocephaly, Joint Stiffness, Hepatomegaly (mild before HSCT), Splenomegaly (mild before HSCT), Umbilical Hernia, Carpal tunnel syndrome, Coarse Facial Features, Dysostosis Multiplex, Corneal Clouding)

      CaseHPOFreeText: Mental Development (Borderline developmental quotient at 3y, IQ 117 at 12y)

      CaseNotHPOs: HP:0004322, HP:0002240, HP:0001744 (Short Stature, Hepatomegaly (after HSCT), Splenomegaly (after HSCT))

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: normal IDUA activity at 16 years

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: Hematopoietic Stem Cell Transplantation at 5y

      GenotypingMethod: Not Provided

      Variant1: p.W402X

      Variant1ClinVarID: 11908

      Variant1CAID: CA220498

      Variant2: p.E640fs

      Variant2ClinVarID: 558359

      Variant2CAID: CA355966048

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. Hurler disease

      Case#: Patient 55, 6 months old (age at report), female, Indian

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: Coarse facial features, hepatosplenomegaly, dysostosis multiplex (HP:0000280, HP:0001433, HP:0000943)

      CaseHPOFreeText: Cardiac disease

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: 2.7% (Range of residual enzyme activity: 0.0%-4.8%)

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.589G>A (p.Gly197Ser)

      Variant1ClinVarID: 1526094

      Variant1CAID: CA355961839

      Variant2: c.1091C>T (p.Thr364Met)

      Variant2ClinVarID: 11925

      Variant2CAID: CA256126

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    2. Hurler disease

      Case#: Patient 16, 2 years old (age at report), male, Indian

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: Coarse facial features, hepatosplenomegaly, joint contractures, corneal clouding, recurrent infections, dysostosis multiplex, intellectual disability, hernia (HP:0000280, HP:0001433, HP:0002828, HP:0007957, HP:0002719, HP:0000943, HP:0001249, HP:0100790)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: 3.3% (Range of residual enzyme activity: 0.0%-4.8%)

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.568_581del (p.Asn190Hisfs*204)

      Variant1ClinVarID: 3639714

      Variant1CAID: CA2801994

      Variant2: c.568_581del (p.Asn190Hisfs*204)

      Variant2ClinVarID: 3639714

      Variant2CAID: CA2801994

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    3. Hurler disease

      Case#: Patient 5, 2 years old (age at report), male, Indian

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: Coarse facial features, hepatosplenomegaly, corneal clouding, recurrent infections, dysostosis multiplex (HP:0000280, HP:0001433, HP:0007957, HP:0002719, HP:0000943)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: 2.2% (Range of residual enzyme activity: 0.0%-4.8%)

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.343G>T (p.Asp115Tyr)

      Variant1ClinVarID: N/A

      Variant1CAID: CA355961128

      Variant2: c.343G>T (p.Asp115Tyr)

      Variant2ClinVarID: N/A

      Variant2CAID: CA355961128

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. siblings

      Case#: Case 2, proband was an 2-year-old female of Mexican origin. She was born at full term via cesarian section at 7 lbs and 6 oz.

      DiseaseAssertion: MPS1-H

      FamilyInfo: Proband came from a consanguineous union (uncle-niece). Case 1 is the proband's brother.

      CasePresentingHPOs: Recurrent otitis media (HP:0000403)

      CaseHPOFreeText: She also had more than 10 ear infections, and was diagnosed with bilateral moderate to severe hearing loss. She was mildly delayed, mainly in language.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: Her physical growth was not impaired.

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: Given the conclusion to discontinue enzyme replacement therapy in her brother, the decision was made, again with the participation of the patient's mother, not to initiate ERT unless she developed somatic symptoms that could be alleviated with treatment.

      CaseBMT: N/A

      Variant1: c.923T>C (p.L308P)

      Variant1ClinVarID: 502243

      Variant1CAID: CA2802119

      Variant2: c.923T>C (p.L308P)

      Variant2ClinVarID: 502243

      Variant2CAID: CA2802119

      AdditionalVariants: Shee also had a homozygous variant (c.268G>A) in the SGSH gene, and additionally diagnosed with Sanfilippo syndrome type A.

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    2. siblings

      Case#: Case 1, proband was an 8-year-old male of Mexican origin. He was born at 32 weeks gestational age; 3 lbs and 12 oz. He was diagnosed at 1.5 years old.

      DiseaseAssertion: MPS1-H

      FamilyInfo: Proband came from a consanguineous union (uncle-niece). Case 2 is the proband's sister.

      CasePresentingHPOs: Developmental delay, coarse facial features, gastroesophageal reflux, hiatal hernia, umbilical hernia, recurrent otitis media, hepatomegaly, dysostosis multiplex, joint stiffness (HP:0001263, HP:0000280, HP:0002020, HP:0002036, HP:0001537, HP:0000403, HP:0002240, HP:0000943, HP:0001387)

      CaseHPOFreeText: He had bilateral moderate to severe hearing loss. He had a normal ophthalmologic examination at 3 years of age, and at age 8 has not developed corneal clouding. He had contractures at the knees as well.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: Enzyme analysis on fibroblasts showed 10% residual alpha-l-iduronidase activity and no detectable activity for heparan N-sulfatase.

      CaseUrineGAGs: Urinary quantitation of glycosaminoglycans showed 127 mg/g creatinine of uronic acid by the orcinol reaction (nl. 10.7 ± 8.0) and 449 mg/g creatinine by the carbazole reaction (nl. 16.9 ± 9.9), giving a carbazole to orcinol ratio of almost 3, which is indicative of excess heparan sulfate as compared with dermatan sulfate. The electrophoresis which revealed a strong band of heparan sulfate and slightly less chondroitin sulfate was confirmatory of this conclusion. N-sulfated hexosamine was 126 mg/g creatinine (nl. 15.8 ± 12).

      CaseERT: He was started on enzyme replacement therapy (ERT) for iduronidase deficiency at age 3 years. However, his severe hyperactivity often precluded therapy as he could not sit still during the infusions, and the intravenous access catheter infiltrated on numerous occasions. Given his mild somatic symptoms, the concurrent diagnosis of Sanfilippo syndrome, a lethal condition, as well as the difficulty his family had with his complex medical care, the decision was made with the family's participation and accord to discontinue ERT and to treat only those problems that would improve his quality of life. He was on ERT for a total of 3 years.

      CaseBMT: He was evaluated for a bone marrow transplant but was determined to be ineligible due to his low developmental quotient.

      Variant1: c.923T>C (p.L308P)

      Variant1ClinVarID: 502243

      Variant1CAID: CA2802119

      Variant2: c.923T>C (p.L308P)

      Variant2ClinVarID: 502243

      Variant2CAID: CA2802119

      AdditionalVariants: He also had a homozygous variant (c.268G>A) in the SGSH gene, and additionally diagnosed with Sanfilippo syndrome type A.

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. 50/M

      Case#: Patient 50, male, Han origin, 5 years 6 months old (age at diagnosis)

      DiseaseAssertion: MPS1-H/S

      FamilyInfo: N/A

      CasePresentingHPOs: Macrocephaly, Joint stiffness, Hepatosplenomegaly, Hernia, Airway obstruction (HP:0000256, HP:0001387, HP:0001433, HP:0100790, HP:0006536)

      CaseHPOFreeText: N/A

      CaseNotHPOs: Global Developmental Delay, Mongolian macula (HP:0001263, HP:0011369)

      CaseNotHPOFreeText: Cardiac disease

      CaseEnzymeAssay: IDUA activity 0.8 nmol/h/mg protein. The normal range in Chinese controls was found to be 27.2–52 nmol/h/mg protein.

      CaseUrineGAGs: Diagnosis was confirmed biochemically by the demonstration of an increased excretion of urinary dermatan sulfate and heparan sulfate.

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.1898C>T (p.S633L)

      Variant1ClinVarID: 556406

      Variant1CAID: CA355966010

      Variant2: N/A

      Variant2ClinVarID: N/A

      Variant2CAID: N/A

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    2. 55/F

      Case#: Patient 55, female, Han origin, 2 years 3 months old (age at diagnosis)

      DiseaseAssertion: MPS1-H/S

      FamilyInfo: N/A

      CasePresentingHPOs: Global Developmental Delay, Macrocephaly, Joint stiffness, Hepatosplenomegaly (HP:0001263, HP:0000256, HP:0001387, HP:0001433)

      CaseHPOFreeText: Cardiac disease

      CaseNotHPOs: Mongolian macula, Hernia, Airway obstruction (HP:0011369, HP:0100790, HP:0006536)

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: IDUA activity 1.0 nmol/h/mg protein. The normal range in Chinese controls was found to be 27.2–52 nmol/h/mg protein.

      CaseUrineGAGs: Diagnosis was confirmed biochemically by the demonstration of an increased excretion of urinary dermatan sulfate and heparan sulfate.

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.236C>T (p.A79V)

      Variant1ClinVarID: 1458769

      Variant1CAID: CA356987

      Variant2: c.503G>T (p.G168V)

      Variant2ClinVarID: 4069658

      Variant2CAID: CA355961655

      AdditionalVariants: N/A

      ParentalGenotype: The transmission of sequence variations found in each patient was inferred by sequencing the corresponding exons of the patient's parents - confirmed in trans by parental testing.

      PreviouslyPublished N/A

    3. 42/M

      Case#: Patient 42, male, Han origin, 2 years old (age at diagnosis)

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: Global Developmental Delay, Macrocephaly, Joint stiffness, Mongolian macula, Hepatosplenomegaly, Hernia (HP:0001263, HP:0000256, HP:0001387, HP:0011369, HP:0001433, HP:0100790)

      CaseHPOFreeText: Cardiac disease

      CaseNotHPOs: Airway obstruction (HP:0006536)

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: IDUA activity 1.0 nmol/h/mg protein. The normal range in Chinese controls was found to be 27.2–52 nmol/h/mg protein.

      CaseUrineGAGs: Diagnosis was confirmed biochemically by the demonstration of an increased excretion of urinary dermatan sulfate and heparan sulfate.

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.1402+1G>T

      Variant1ClinVarID: 1323099

      Variant1CAID: CA355964387

      Variant2: c.1402+1G>T

      Variant2ClinVarID: 1323099

      Variant2CAID: CA355964387

      AdditionalVariants: N/A

      ParentalGenotype: The transmission of sequence variations found in each patient was inferred by sequencing the corresponding exons of the patient's parents - confirmed by parental testing.

      PreviouslyPublished N/A

    1. P1

      Case#: P1, male, 1.1 years (age at HCT - hematopoietic cell transplantation), 2 iPS colonies per 100,000 cells (KC)

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: Yes - Donor cells were received from KC, keratinocytes. Study was conducted 0.2 years after HCT.

      Variant1: c.501C>G (p.Y167X)

      Variant1ClinVarID: 92644

      Variant1CAID: CA220511

      Variant2: c.1205G>A (p.W402X)

      Variant2ClinVarID: 11908

      Variant2CAID: CA220498

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. c.536C > A

      Case#: No additional case information provided

      DiseaseAssertion: MPSI-H/S

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: 0.07 umol/g hr, reference range 10–50 umol/g hr.

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.536C>A (p.T179K)

      Variant1ClinVarID: 2734636

      Variant1CAID: CA355961717

      Variant2: c.536C>A (p.T179K)

      Variant2ClinVarID: 2734636

      Variant2CAID: CA355961717

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. Abnormal

      Case#: No additional case information provided

      DiseaseAssertion: Not specified

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: Abnormal

      CaseUrineGAGs: Normal

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.1054T>C (p.F352L)

      Variant1ClinVarID: 2432790

      Variant1CAID: CA2802178

      Variant2: c.1112T>A (p.V371D)

      Variant2ClinVarID: 1470032

      Variant2CAID: CA355963356

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    2. Abnormal

      Case#: No additional case information provided

      DiseaseAssertion: MPSI-H/S

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: Abnormal

      CaseUrineGAGs: Normal

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.1205G>A (p.W402X)

      Variant1ClinVarID: 11909

      Variant1CAID: CA220498

      Variant2: c.1577T>C (p.L526P)

      Variant2ClinVarID: 567566

      Variant2CAID: CA2802300

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. older sibling

      Case#: OS of sibship 2, male, 1.3 years old (age at diagnosis), 3.3 years old (age at ERT enrollment), 11.7 years (duration of ERT)

      DiseaseAssertion: MPS1-HS

      FamilyInfo: Affected female YS (YS of sibship 2)

      CasePresentingHPOs: HP:0007957, HP:0000943, HP:0002828, HP:0002650 (Corneal opacity, dysostosis, joint contractures, scoliosis)

      CaseHPOFreeText: Cardiac disease, mild organomegaly, learning difficulties, progression of musculoskeletal symptoms,

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: Yes - Motor development remained normal while learning difficulties present at onset of ERT persisted. After 5 years of ERT, showed significant scoliosis and other spinal deformities

      CaseBMT: N/A

      Variant1: c.1598C>G (p.P533R)

      Variant1ClinVarID: 11910

      Variant1CAID: CA256112

      Variant2: c.1598C>G (p.P533R)

      Variant2ClinVarID: 11910

      Variant2CAID: CA256112

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    2. older sibling

      Case#: OS of sibship 8, male, 6.8 years old (age at diagnosis), 7 years old (age at ERT enrollment), 6.0 years (duration of ERT)

      DiseaseAssertion: MPS1-HS

      FamilyInfo: Affected YS (YS of sibship 8)

      CasePresentingHPOs: HP:0007957, HP:0000943, HP:0002828 (Corneal opacity, dysostosis, joint contracture)

      CaseHPOFreeText: Cardiac disease

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: Yes - Had progression of cardiac symptoms at T2 and dysostosis multiplex stabilized. Had behavioral issues and required an aide for 1-on-1 schooling.

      CaseBMT: N/A

      Variant1: N/A

      Variant1ClinVarID: N/A

      Variant1CAID: N/A

      Variant2: N/A

      Variant2ClinVarID: N/A

      Variant2CAID: N/A

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. 8

      Case#: Patient 8 (see Table 2), male, 22.3 years old (age at report), 12.5 years (duration of treatment), 8 surgeries

      DiseaseAssertion: MPS1-HS

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: HP:0000238, HP:0002176, HP:0002360 (Hydrocephalus, spinal cord compression, sleep abnormality)

      CaseNotHPOFreeText: Shunt placement, psychiatric problems

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: Yes

      CaseBMT: N/A

      Variant1: c.793G>C (p.G265R)

      Variant1ClinVarID: 638074

      Variant1CAID: CA2802098

      Variant2: c.979G>C (p.A327P)

      Variant2ClinVarID: 167190

      Variant2CAID: CA234128

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    2. 2

      Case#: Patient 2 (see Table 2), male, 18.3 years old (age at report), 9.1 years (duration of treatment), 7 surgeries

      DiseaseAssertion: MPS1-HS

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0000238, HP:0002176, HP:0002360 (Hydrocephalus, spinal cord compression, sleep abnormality)

      CaseHPOFreeText: Shunt placement, psychiatric problems

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: Yes

      CaseBMT: N/A

      Variant1: c.712T>A (p.L238Q) CDNA and protein change do not match. Known variant p.L238Q has a CDNA change of c.713T>A.

      Variant1ClinVarID: 265418

      Variant1CAID: CA2802065

      Variant2: c.1205G>A (p.W402X)

      Variant2ClinVarID: 11908

      Variant2CAID: CA220498

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    3. 4

      Case#: Patient 4 (see Table 2), female, 19.8 years old (age at report), 9.7 years (duration of treatment), 8 surgeries

      DiseaseAssertion: MPS1-HS

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0000238, HP:0002360 (Hydrocephalus, sleep abnormality)

      CaseHPOFreeText: Shunt placement, psychiatric problems

      CaseNotHPOs: HP:0002176 (Spinal cord compression)

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: Yes

      CaseBMT: N/A

      Variant1: c.712T>A (p.L238Q) CDNA and protein change do not match. Known variant p.L238Q has a CDNA change of c.713T>A.

      Variant1ClinVarID: 265418

      Variant1CAID: CA2802065

      Variant2: c.1205G>A (p.W402X)

      Variant2ClinVarID: 11908

      Variant2CAID: CA220498

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. Patient 5

      Case#: Patient 5, Male, 1 year 4 months (diagnosed), 4 years (report), Djerba Island (Tunisian origin)

      DiseaseAssertion: N/A

      FamilyInfo: Parents are consanguineous between 3rd cousins

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: Leukocyte IDUA activity 0.2% (% normal) ; determined in sonicated leukocyte pellets using the artificial substrate 4-methylumbellifery IDUA

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      GenotypingMethod: Sequencing exons and intro-exon junctions; Phenol/chloroform procedure

      Variant1: p.P533R

      Variant1ClinVarID: 11910

      Variant1CAID: CA256112

      Variant2: p.P533R

      Variant2ClinVarID: 11910

      Variant2CAID: CA256112

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. Patient F

      Case#: Patient F, female, 25 years old (age at report), 61 kg of weight (50th percentile), height of 154 cm (10th percentile). She is now working as an office secretary and also practices aerobic activity three times a week. She drives a car autonomously with her driving license which is renewed every 2 years. Her quality of life was measured with EQ-5D-Y and resulted good (100/100). Overall cognitive abilities are in the lower average expected for age (IQ:80), with difficulties in executive functioning, working memory, and arithmetic reasoning.

      DiseaseAssertion: attenuated form of MPS-1

      FamilyInfo: Affected younger sibling (Patient M), born to non-consanguineous Italian parents.

      CasePresentingHPOs: Moderate facial coarseness, moderately severe dysostosis multiplex, scoliosis, hyperlordosis, genua valga, corneal clouding, hyperopia, astigmatism, otitis media (completely corrected by eyeglasses), hearing impairment, mild obstructive sleep apnea (since 16 years old), mild thickened skin (HP:0000280, HP:0000943, HP:0002650, HP:0003307, HP:0002857, HP:0007957, HP:0000540, HP:0000483, HP:0000388, HP:0000365, HP:0010535, HP:0001072)

      CaseHPOFreeText: Liver and spleen volumes were normalized within the first year of ERT and remained within normal limits at clinical examination, claw feet, stiffness of the tibio-tarsal joint, ROM of hip and knees were within the normal ranges, improved stiffness of the trunk, movements of shoulders, elbows and wrists were within the normal range, limited flexion of fingers due to mild rigidity, normal cerebral MRI, a mild–moderate tricuspid insufficiency with pulmonary artery pressure (PAP) within the upper normal range (25 mmHG) was reported (at 16 years old), cardiac involvement.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: Total urinary GAG excretion was slightly above the upper limit of the normal range (47 μg/mg creatinine with normal values < 26) with the qualitative assay showing a band of DS.

      CaseERT: Yes - Began ERT and 5 years old. Laronidase infusions were started delivering weekly (at the dose of 0.5 mg/kg) using implanted venous access devices. Laronidase infusion generally lasted approximately 4 h, without the need for any premedication.

      CaseBMT: N/A

      Variant1: c.1205G>A (p.W402X)

      Variant1ClinVarID: 11908

      Variant1CAID: CA220498

      Variant2: c.1603C>T (p.L535F)

      Variant2ClinVarID: 638076

      Variant2CAID: CA355865038

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished Yes (PMID: 20026495) and (PMID:26965916)

    2. Patient M

      Case#: Patient M, male, 19 years of age (age at report), 71 kg of weight (50th percentile), height of 171 cm (25th percentile). He attended the last year of high school Institute of Art and practices aerobic activity three times a week. He is intellectually normal (IQ: 108) with a good quality of life (100/100 assessed by EQ-5D-Y).

      DiseaseAssertion: attenuated form of MPS 1

      FamilyInfo: Affected older sibling (Patient F), born to non-consanguineous Italian parents.

      CasePresentingHPOs: Mild facial coarseness, temporomandibular joint dislocation, hypoplasia of the odontoid process, severe worsening of corneal clouding (noted at 12 months), mild hyperopia (noted at 7 years), astigmatism (noted at 7 years but completely corrected by eyeglasses), minimal multiplex dysostosis, mild joint stiffness, kyphosis, initial signs of carpal tunnel syndrome (HP:0000280, HP:6000814, HP:0003311, HP:0007957, HP:0000540, HP:0000483, HP:0000943, HP:0001387, HP:0002808, HP:0012185)

      CaseHPOFreeText: Mild shoulder stiffness was present with limited forward elevation up to 120° and in abduction up to 100°, mild scoliosis with Cobb angle of 17°, triangular shape of cervical and thoracic vertebres (C4, C5, C6, D6, and D7), several dorsal herniated discs, normal brain MRI, mild heart involvement, stabilization of the cardiac valvulopathy, normal hearing.

      CaseNotHPOs: Hepatosplenomegaly (HP:0001433)

      CaseNotHPOFreeText: Respiratory or sleep disturbances, no recurrent infections.

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: Total urinary glycosaminoglycans (GAG) determination on samples collected just before infusion remained within normal ranges (20,8 μg/mg creatinine with normal values < 42) but at the qualitative assay was present a band of DS.

      CaseERT: Yes - Began ERT at 5 months old (pre symptomatically). Laronidase infusions were started delivering weekly (at the dose of 0.5 mg/kg) using implanted venous access devices. Laronidase infusion generally lasted approximately 4 h, without the need for any premedication.

      CaseBMT: N/A

      Variant1: c.1205G>A (p.W402X)

      Variant1ClinVarID: 11908

      Variant1CAID: CA220498

      Variant2: c.1603C>T (p.L535F)

      Variant2ClinVarID: 638076

      Variant2CAID: CA355865038

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished Yes (PMID: 20026495) and (PMID:26965916)

    1. Case#: Patient 9, 4 years old, Iranian

      DiseaseAssertion: MPS1-S (Attenuated)

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: 0.19 µmol/g.h (Normal ranges: 10-50 µmol/g.h)

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.903C>G (p.D301E)

      Variant1ClinVarID: 1458511

      Variant1CAID: CA355962528

      Variant2: c.903C>G (p.D301E)

      Variant2ClinVarID: 1458511

      Variant2CAID: CA355962528

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. 50.198 (3.0)9.2DS 4.6heterozygous pathogenic: c.1029C>G; p.Y343*Normal examinationHS 6.1heterozygous PD: c.235G>A; p.A79TCarrierheterozygous PD: c.296C>T; p.T99I

      Case#:Patient Sample unique ID 5, Infant screened positive at birth (specimens with activity ≤15% of the DMA for enzyme activity and a CLIR screening algorithm result of indeterminate or MPS I)

      DiseaseAssertion:Carrier

      FamilyInfo:None

      CasePresentingHPOs:None

      CaseHPOFreeText:None

      CaseNotHPOs:None

      CaseNotHPOFreeText: Normal examination at follow up after screening positive at birth (specimens with activity ≤15% of the DMA for enzyme activity and a CLIR screening algorithm result of indeterminate or MPS I)

      CaseEnzymeAssay: IDUA activity 0.198 (9.2) umol/L/h (%DMA) during new born screening through dried blood spot (plasma) and 9.2 pmol/punch/h Confirmatory IDUA enzyme measured at follow-up appointment

      CaseUrineGAGs: DS 4.6 g/mol creatinine and HS 6.1 g/mol creatinine (Normal)

      CaseERT:No

      CaseBMT:No

      Variant1:heterozygous pathogenic: c.1029C>G; p.Y343* (Normal examination)

      Variant1ClinVarID: 560781

      Variant1CAID: CA352049896

      Variant2: heterozygous PD: c.235G>A; p.A79T (Carrier)

      Variant2ClinVarID:41682

      Variant2CAID:CA000358

      AdditionalVariants:heterozygous PD: c.296C>T; p.T99I (ClinVarID:53610, CAID:CA326991)

      ParentalGenotype:N/A

      PreviouslyPublished:N/A

    1. MPS IH patients

      Case#: Patient 2

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.208C>T (p.Q70X)

      Variant1ClinVarID: 11909

      Variant1CAID: CA204563

      Variant2: c.398_403del (p.Met133_Gly134del)

      Variant2ClinVarID: 863830

      Variant2CAID: CA2801912

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. Case#: Patient 5, male, 7.5 months (age at HSCT), 5.3 months (age at ERT).

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: Pneumonia (HP:0002090)

      CaseHPOFreeText: Adenovirus, gastrointestinal and skin (GVHD)

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: 0.2 (at diagnosis), 38.3 (after HSCT) Units not provided.

      CaseUrineGAGs: N/A

      CaseERT: Yes - 87 days duration

      CaseBMT: Yes - MUD (matched unrelated donor) with stem cells sourcing from the CB (cord blood)

      Variant1: c.208C>T (p.Q70X)

      Variant1ClinVarID: 11909

      Variant1CAID: CA204563

      Variant2: c.1205G>A (p.W402X)

      Variant2ClinVarID: 11908

      Variant2CAID: CA220498

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. 2

      Case#: Patient 2: Enrolled in study at 9.9 years, female, onset at 0.3 years, diagnosed at 5.2 years, ERT started 7.9 years DiseaseAssertion:MPS1 H FamilyInfo:No consanguinity, Sister similarly affected CasePresentingHPOs:Corneal opacity (HP:0007957), Joint stiffness (HP:0001387), Macrocephaly (HP:0000256), CaseHPOFreeText: CaseNotHPOs: Hepatosplenomegaly (HP:0001433) CaseNotHPOFreeText: CaseEnzymeAssay: CaseUrineGAGs: 0.36(min)-4.55(max) mg GAG/mmol creatinine while on ERT CaseERT: Laronidase dose-optimization trial : standard regimen – 0.58 mg/kg/week; biweekly regimen – 1.2 mg/kg every two weeks CaseBMT:Nil Variant1:P533R Variant1ClinVarID:11910 Variant1CAID:CA256112 Variant2:P533R Variant2ClinVarID:11910 Variant2CAID:CA256112 AdditionalVariants:Nil ParentalGenotype:NA PreviouslyPublishedNA

    1. Case#: Variant not associated with a proband. Variant listed in supplementary materials in Supplementary Table 4

      DiseaseAssertion: Mucopolysaccharidosis type I, MPS I

      FamilyInfo: N/A

      CasePresentingHPOs:

      CaseHPOFreeText:

      CaseNotHPOs:

      CaseNotHPOFreeText:

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: L218P

      Variant1ClinVarID: 222995

      Variant1CAID:CA356986

      Variant2: N/A

      Variant2ClinVarID: N/A

      Variant2CAID: N/A

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

    1. 19

      Case#: Patient 19, born in 2004 (paper published in 2017), 11 months (age at first treatment)

      DiseaseAssertion: MPSI-H

      FamilyInfo: N/A

      CasePresentingHPOs: Corneal clouding (HP:0007957)

      CaseHPOFreeText: N/A

      CaseNotHPOs: Retinopathy, cataract (HP:0000488, HP:0000518)

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: 66 ng/mol (56 weight matched enzyme reference assay)

      CaseUrineGAGs: 0.55 DS/CS

      CaseERT: Yes

      CaseBMT: Yes, Cord

      Variant1: c.1205G>A (p.W402X)

      Variant1ClinVarID: 11908

      Variant1CAID: CA220498

      Variant2: c.1205G>A (p.W402X)

      Variant2ClinVarID: 11908

      Variant2CAID: CA220498

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    2. 1

      Case#: Patient 1, born in 2007 (paper published in 2017), 9 months (age at first treatment)

      DiseaseAssertion: MPSI-H

      FamilyInfo: N/A

      CasePresentingHPOs: Corneal clouding (HP:0007957)

      CaseHPOFreeText: N/A

      CaseNotHPOs: Retinopathy, cataract (HP:0000488, HP:0000518)

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: 44.29 ng/mol (33.09 weight matched enzyme reference assay)

      CaseUrineGAGs: 0.4 DS/CS

      CaseERT: Yes

      CaseBMT: Yes, cord

      Variant1: c.208C>T (p.Q70X)

      Variant1ClinVarID: 11909

      Variant1CAID: CA204563

      Variant2: c.979G>C (p.A327P)

      Variant2ClinVarID: 167190

      Variant2CAID: CA234128

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. R628X

      Case#: Family 4, Middle East

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: The paper states that "Hurler form is characterized by skeletal abnormalities, hepatosplenomegaly and severe mental retardation" but is not specific to this patient.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: The α-L-iduronidase enzyme activities in leucocytes from all patients in the study was measured using the artificial substrate 4-methylumbelliferyl α-L iduronide (Sigma). Values ranged from 0 to 2.47 nmol/h/mg protein (reference range: 28–92 nmol/h/mg protein) and did not correlate to the clinical phenotype.

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.1882C>T (p.R628X)

      Variant1ClinVarID: 550421

      Variant1CAID: CA2802462

      Variant2: c.1882C>T (p.R628X)

      Variant2ClinVarID: 550421

      Variant2CAID: CA2802462

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    2. G208V

      Case#: Family 1, Middle East

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: The paper states that "Hurler form is characterized by skeletal abnormalities, hepatosplenomegaly and severe mental retardation" but is not specific to this patient.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: The α-L-iduronidase enzyme activities in leucocytes from all patients in the study was measured using the artificial substrate 4-methylumbelliferyl α-L iduronide (Sigma). Values ranged from 0 to 2.47 nmol/h/mg protein (reference range: 28–92 nmol/h/mg protein) and did not correlate to the clinical phenotype.

      α-L-iduronidase activity in COS-7 cells transiently transfected with wild-type or mutagenised cDNAs. α-L-iduronidase activity: 4.5 nmol/h/mg cell protein; values are the means of two experiments.

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.623G>T (p.G208V)

      Variant1ClinVarID: 3591555

      Variant1CAID: CA355961949

      Variant2: c.623G>T (p.G208V)

      Variant2ClinVarID: 3591555

      Variant2CAID: CA355961949

      AdditionalVariants: N/A

      ParentalGenotype: Parental testing conducted, each parent was shown to carry one of the sequence changes found in their affected child.

      PreviouslyPublished N/A

    1. Case#: Pt 1, age is 20 months (proband can be found in Table 1)

      DiseaseAssertion: Hurler syndrome, mucopolysaccharidosis type IH, MPS IH, MPS type I

      FamilyInfo: No family information provided

      CasePresentingHPOs:

      CaseHPOFreeText:

      CaseNotHPOs:

      CaseNotHPOFreeText:

      CaseEnzymeAssay: In methods it is stated that an IDUA activity assay was conducted on cartilaginous pellets generated from patient-derived bone marrow stromal cells at 5 weeks. However, results of the IDUA activity assays are not stated.

      CaseUrineGAGs: "Significantly higher levels of GAGs in MPS IH compared with HD pellets at.1 week of chondrogenic differentiation, thus indicating that GAG accumulation in MPS IH can be seen during cell condensation and early differentiation stages." Total GAG content for each sample in ug GAG/ug DNA shown in Figure 4 graphs.

      CaseERT: Don't know

      CaseBMT: Don't know

      Variant1: p.Q70X

      Variant1ClinVarID:

      Variant1CAID: PA3044620172

      Variant2: p.P496R

      Variant2ClinVarID: 496861

      Variant2CAID: CA2802275

      AdditionalVariants: No additional variants mentioned

      ParentalGenotype: No parental information provided

      PreviouslyPublished: No mention of previously being published

    1. Patient of family F

      Case#: Family F proband, male, 1 year old (age of onset), Tunisia.

      DiseaseAssertion: MPS1-H

      FamilyInfo: Seven unaffected brothers with MPS1 (See results), parents were 2nd degree relatives (See Table 1)

      CasePresentingHPOs: HP:0001433, HP:0001744, HP:0001999, (Hepatosplenomegaly, splenomegaly, abnormal facial shape)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: IDUA activity (0.1 nmol/h/mg) (usual values: 1-5).

      CaseUrineGAGs: glycosaminoglycans (102 mg/g of creatinine) (usual values: 9-46), abnormal electrophoresis profile with dermatan sulfate and heparan sulfate

      CaseERT: N/A

      CaseBMT: Yes

      Variant1: c.1598C>G (p.P533R)

      Variant1ClinVarID: 11910

      Variant1CAID: CA256112

      Variant2: c.1598C>G (p.P533R)

      Variant2ClinVarID: 11910

      Variant2CAID: CA256112

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. 6

      Case#: 6, Male, 0.9 years (diagnosed), 13.0 years (report), 15 kg (weight), 102 cm (height), Iranian

      DiseaseAssertion: Hurler Syndrome

      FamilyInfo: Parents are consanguineous

      CasePresentingHPOs: HP:0001249, HP:0001999, HP:0000943, HP:0001387, HP:0100790, HP:0000365, HP:0000238 (Mental Retardation, Facial Dysmorphic Features, Multiple Dysostosis, Joint Stiffness, Hernia, Deafness, Hydrocephalus)

      CaseHPOFreeText: HM/HSM, Chronic Rhinorrhea

      CaseNotHPOs: HP:0007957 (Corneal Capacity)

      CaseNotHPOFreeText: Cardiac Manifestations

      CaseEnzymeAssay: IDUA activity 1.3 (μmol/spot.20h)

      CaseUrineGAGs: Quantitative urinary GAG 11.54 (mg/gCr)

      CaseERT: N/A

      CaseBMT: N/A

      GenotypingMethod: Sanger Sequencing

      Variant1: p.D301E

      Variant2: N/A

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished: N/A

  3. watermark.silverchair.com watermark.silverchair.com
    1. Case#: No additional case information provided.

      DiseaseAssertion: MPS1-H

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.653T>C (p.L218P)

      Variant1ClinVarID: 222995

      Variant1CAID: CA356986

      Variant2: c.653T>C (p.L218P)

      Variant2ClinVarID: 222995

      Variant2CAID: CA356986

      AdditionalVariants: In the paper an additional variant is listed on the same allele as "G387 + 6c->t". It seems that the current nomenclature for this variant is "c.299+6C>T". This variant is classified as benign by the LD VCEP.

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. c.1081G>A

      Case#: Functional assay variant with a clinical significance of clinically benign.

      DiseaseAssertion: MPS-I

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.1081G>A (p.A361T)

      Variant1ClinVarID: 92624

      Variant1CAID: CA145865

      Variant2: N/A

      Variant2ClinVarID: N/A

      Variant2CAID: N/A

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A

    1. Pt3

      Case#: Pt3, Male, 38 months (diagnosis), 4 months (onset)

      DiseaseAssertion: Hurler Syndrome

      FamilyInfo: N/A Pedigree (Figure 4Pt3)

      CasePresentingHPOs: HP:0000280, HP:0007957, HP:0001387, HP:0001654, HP:0100814, (Coarse face, Cornea clouding, Joint stiffness, Valvular heart disease, Dermal melanocytosis)

      CaseHPOFreeText: Spinal Deformation, Inguinal or Umbilical hernia

      CaseNotHPOs: HP:0001433 (Hepatosplenomegaly)

      CaseNotHPOFreeText: Long bone deformation

      CaseEnzymeAssay: α-L-iduronidase 0.13 (dried blood spots, normal >1.32 µM/h)

      CaseUrineGAGs: Urine heparan sulfate 8.18 (mg/mmol creatinine) {<0.76}

      CaseERT: N/A

      CaseBMT: N/A

      GenotypingMethod: Not Provided.

      Variant1: c.1190-10C>A

      Variant1ClinVarID: 950888

      Variant1CAID: CA1139658405

      Variant2: c.1046A>G

      Variant2ClinVarID: 950889

      Variant2CAID: CA2802173

      AdditionalVariants: N/A

      ParentalGenotype: Both parents are homozygous for not having the c.1190-10C>A and c.1046A>G variants (figure 4 Pt3)

      PreviouslyPublished: N/A

    1. A second patient

      Case#: Second patient

      DiseaseAssertion: MPS-I

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.299+6C>T

      Variant1ClinVarID: 92640

      Variant1CAID: CA145880

      Variant2: c.653T>C (p.L218P)

      Variant2ClinVarID: 222995

      Variant2CAID: CA356986

      AdditionalVariants: c.1205G>A (p.W402X), ClinVarID: 11908, CAID:CA220498

      ParentalGenotype: Parental studies demonstrated that the c.299+6C>T and p.L218P changes are in cis.

      PreviouslyPublished N/A

    1. splicing mutations

      Case#: Patient 81, Turkey

      DiseaseAssertion: MPS1-H/S

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CaseEnzymeAssay: N/A

      CaseUrineGAGs: N/A

      CaseERT: N/A

      CaseBMT: N/A

      Variant1: c.494-1G>A

      Variant1ClinVarID: 557942

      Variant1CAID: CA355961634

      Variant2: c.494-1G>A

      Variant2ClinVarID: 557942

      Variant2CAID: CA355961634

      AdditionalVariants: N/A

      ParentalGenotype: N/A

      PreviouslyPublished N/A