A Korean Patient With Leber Congenital Amaurosis and a Homozygous RPE65 Variant Originating From a Paternal Uniparental Isodisomy

ABSTRACT Background Leber congenital amaurosis (LCA), the most severe form of inherited retinal dystrophy, is a rare, heterogeneous, genetic eye disease associated with severe congenital visual impairment. RPE65, one of the causative genes for LCA, encodes retinoid isomerohydrolase, an enzyme that p...

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Main Authors: Hane Lee, Dongseok Moon, Rin Khang, Go Hun Seo, Chang Ki Yoon, Un Chul Park, Kyu Hyung Park, Eun Kyoung Lee
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Molecular Genetics & Genomic Medicine
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Online Access:https://doi.org/10.1002/mgg3.70060
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author Hane Lee
Dongseok Moon
Rin Khang
Go Hun Seo
Chang Ki Yoon
Un Chul Park
Kyu Hyung Park
Eun Kyoung Lee
author_facet Hane Lee
Dongseok Moon
Rin Khang
Go Hun Seo
Chang Ki Yoon
Un Chul Park
Kyu Hyung Park
Eun Kyoung Lee
author_sort Hane Lee
collection DOAJ
description ABSTRACT Background Leber congenital amaurosis (LCA), the most severe form of inherited retinal dystrophy, is a rare, heterogeneous, genetic eye disease associated with severe congenital visual impairment. RPE65, one of the causative genes for LCA, encodes retinoid isomerohydrolase, an enzyme that plays a critical role in regenerating visual pigment in photoreceptor cells. Methods Exome sequencing (ES) was performed on a patient with suspected LCA. Results Here, we report a 33‐year‐old male patient diagnosed with RPE65‐related LCA caused by uniparental isodisomy (UPiD) who received gene therapy as treatment, fourth patient to receive it in Korea. His fundus examinations showed salt‐and‐pepper retinal dystrophy, with diffuse extinguished signal on fundus autofluorescence and attenuated amplitude on electroretinogram. A homozygous frameshift variant NM_000329.3:c.1067del (p.Asn356MetfsTer17) in RPE65 was identified by ES with the entire chromosome 1 proving to be paternal UPiD. Within 5 months after the molecular diagnosis, the patient was treated with subretinal voretigene neparvovec (VN) therapy and is being followed up for prognosis. Conclusions To our knowledge, this patient is the first UPiD case to receive VN treatment. Performing ES as a first‐tier test was favourable because it allowed to identify UPiD that needed to be detected in addition to the disease‐causing variant.
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spelling doaj-art-af10e99042fe4888b7a15d8b5e95c9362025-01-24T08:16:42ZengWileyMolecular Genetics & Genomic Medicine2324-92692025-01-01131n/an/a10.1002/mgg3.70060A Korean Patient With Leber Congenital Amaurosis and a Homozygous RPE65 Variant Originating From a Paternal Uniparental IsodisomyHane Lee0Dongseok Moon1Rin Khang2Go Hun Seo3Chang Ki Yoon4Un Chul Park5Kyu Hyung Park6Eun Kyoung Lee7Division of Medical Genetics 3billion Inc Seoul KoreaDivision of Medical Genetics 3billion Inc Seoul KoreaDivision of Medical Genetics 3billion Inc Seoul KoreaDivision of Medical Genetics 3billion Inc Seoul KoreaDepartment of Ophthalmology Seoul National University College of Medicine, Seoul National University Hospital Seoul KoreaDepartment of Ophthalmology Seoul National University College of Medicine, Seoul National University Hospital Seoul KoreaDepartment of Ophthalmology Seoul National University College of Medicine, Seoul National University Hospital Seoul KoreaDepartment of Ophthalmology Seoul National University College of Medicine, Seoul National University Hospital Seoul KoreaABSTRACT Background Leber congenital amaurosis (LCA), the most severe form of inherited retinal dystrophy, is a rare, heterogeneous, genetic eye disease associated with severe congenital visual impairment. RPE65, one of the causative genes for LCA, encodes retinoid isomerohydrolase, an enzyme that plays a critical role in regenerating visual pigment in photoreceptor cells. Methods Exome sequencing (ES) was performed on a patient with suspected LCA. Results Here, we report a 33‐year‐old male patient diagnosed with RPE65‐related LCA caused by uniparental isodisomy (UPiD) who received gene therapy as treatment, fourth patient to receive it in Korea. His fundus examinations showed salt‐and‐pepper retinal dystrophy, with diffuse extinguished signal on fundus autofluorescence and attenuated amplitude on electroretinogram. A homozygous frameshift variant NM_000329.3:c.1067del (p.Asn356MetfsTer17) in RPE65 was identified by ES with the entire chromosome 1 proving to be paternal UPiD. Within 5 months after the molecular diagnosis, the patient was treated with subretinal voretigene neparvovec (VN) therapy and is being followed up for prognosis. Conclusions To our knowledge, this patient is the first UPiD case to receive VN treatment. Performing ES as a first‐tier test was favourable because it allowed to identify UPiD that needed to be detected in addition to the disease‐causing variant.https://doi.org/10.1002/mgg3.70060exome sequencinggene therapyLeber congenital amaurosisRPE65uniparental Isodisomy
spellingShingle Hane Lee
Dongseok Moon
Rin Khang
Go Hun Seo
Chang Ki Yoon
Un Chul Park
Kyu Hyung Park
Eun Kyoung Lee
A Korean Patient With Leber Congenital Amaurosis and a Homozygous RPE65 Variant Originating From a Paternal Uniparental Isodisomy
Molecular Genetics & Genomic Medicine
exome sequencing
gene therapy
Leber congenital amaurosis
RPE65
uniparental Isodisomy
title A Korean Patient With Leber Congenital Amaurosis and a Homozygous RPE65 Variant Originating From a Paternal Uniparental Isodisomy
title_full A Korean Patient With Leber Congenital Amaurosis and a Homozygous RPE65 Variant Originating From a Paternal Uniparental Isodisomy
title_fullStr A Korean Patient With Leber Congenital Amaurosis and a Homozygous RPE65 Variant Originating From a Paternal Uniparental Isodisomy
title_full_unstemmed A Korean Patient With Leber Congenital Amaurosis and a Homozygous RPE65 Variant Originating From a Paternal Uniparental Isodisomy
title_short A Korean Patient With Leber Congenital Amaurosis and a Homozygous RPE65 Variant Originating From a Paternal Uniparental Isodisomy
title_sort korean patient with leber congenital amaurosis and a homozygous rpe65 variant originating from a paternal uniparental isodisomy
topic exome sequencing
gene therapy
Leber congenital amaurosis
RPE65
uniparental Isodisomy
url https://doi.org/10.1002/mgg3.70060
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