A cross-sectional and longitudinal study of retinal sensitivity in RPE65-associated leber congenital amaurosis

Neruban Kumaran, Gary S. Rubin, Angelos Kalitzeos, Kaoru Fujinami, James W.B. Bainbridge, Richard Weleber, Michel Michaelides

Research output: Contribution to journalArticle

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Abstract

PURPOSE. RPE65-associated Leber congenital amaurosis (RPE65-LCA) is an early-onset severe retinal dystrophy associated with progressive visual field loss. Phase I/II and III gene therapy trials have identified improved retinal sensitivity but little is known about the natural history of retinal sensitivity in RPE65-LCA. METHODS. A total of 19 subjects (aged 9 to 23 years) undertook monocular full-field static perimetry of which 13 subjects were monitored longitudinally. Retinal sensitivity was measured as mean sensitivity (MS) and volumetrically quantified (in decibel-steradian) using visual field modeling and analysis software for the total (VTOT), central 30° (V30) and central 15° (V15) visual field. Correlation was evaluated between retinal sensitivity and age, best-corrected visual acuity (BCVA), contrast sensitivity, vision-related quality of life, and genotype. Test-retest reliability was also investigated. RESULTS. V30 was identified to have a strong, weak, and moderate correlation with age, BCVA and contrast sensitivity respectively. Furthermore, V30 was identified as having a weak linear relationship with the mobility and independence domains of the vision-related quality of life questionnaire. Longitudinal analysis demonstrated a slow loss of retinal sensitivity in this cohort. Subjects with at least one RPE65 nonsense variant appeared to show greater progressive loss of retinal sensitivity in the second decade of life than those without. CONCLUSIONS. Volumetric assessment of central 30° visual field sensitivity, V30, is a useful independent measure of retinal function and, in our data, represented the best metric to monitor deterioration of retinal sensitivity in RPE65-LCA. Furthermore, functional correlation with genotype may enable more informed prognostic counseling.

Original languageEnglish (US)
Pages (from-to)3330-3339
Number of pages10
JournalInvestigative Ophthalmology and Visual Science
Volume59
Issue number8
DOIs
StatePublished - Jul 1 2018

Fingerprint

Leber Congenital Amaurosis
Visual Fields
Longitudinal Studies
Cross-Sectional Studies
Contrast Sensitivity
Visual Acuity
Genotype
Quality of Life
Visual Field Tests
Natural History
Reproducibility of Results
Genetic Therapy
Counseling
Software

Keywords

  • Clinical trials
  • Endpoints
  • LCA
  • LCA2
  • Leber congenital amaurosis
  • Perimetry
  • Retina
  • Retinal sensitivity
  • Visual field

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

A cross-sectional and longitudinal study of retinal sensitivity in RPE65-associated leber congenital amaurosis. / Kumaran, Neruban; Rubin, Gary S.; Kalitzeos, Angelos; Fujinami, Kaoru; Bainbridge, James W.B.; Weleber, Richard; Michaelides, Michel.

In: Investigative Ophthalmology and Visual Science, Vol. 59, No. 8, 01.07.2018, p. 3330-3339.

Research output: Contribution to journalArticle

Kumaran, Neruban ; Rubin, Gary S. ; Kalitzeos, Angelos ; Fujinami, Kaoru ; Bainbridge, James W.B. ; Weleber, Richard ; Michaelides, Michel. / A cross-sectional and longitudinal study of retinal sensitivity in RPE65-associated leber congenital amaurosis. In: Investigative Ophthalmology and Visual Science. 2018 ; Vol. 59, No. 8. pp. 3330-3339.
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abstract = "PURPOSE. RPE65-associated Leber congenital amaurosis (RPE65-LCA) is an early-onset severe retinal dystrophy associated with progressive visual field loss. Phase I/II and III gene therapy trials have identified improved retinal sensitivity but little is known about the natural history of retinal sensitivity in RPE65-LCA. METHODS. A total of 19 subjects (aged 9 to 23 years) undertook monocular full-field static perimetry of which 13 subjects were monitored longitudinally. Retinal sensitivity was measured as mean sensitivity (MS) and volumetrically quantified (in decibel-steradian) using visual field modeling and analysis software for the total (VTOT), central 30° (V30) and central 15° (V15) visual field. Correlation was evaluated between retinal sensitivity and age, best-corrected visual acuity (BCVA), contrast sensitivity, vision-related quality of life, and genotype. Test-retest reliability was also investigated. RESULTS. V30 was identified to have a strong, weak, and moderate correlation with age, BCVA and contrast sensitivity respectively. Furthermore, V30 was identified as having a weak linear relationship with the mobility and independence domains of the vision-related quality of life questionnaire. Longitudinal analysis demonstrated a slow loss of retinal sensitivity in this cohort. Subjects with at least one RPE65 nonsense variant appeared to show greater progressive loss of retinal sensitivity in the second decade of life than those without. CONCLUSIONS. Volumetric assessment of central 30° visual field sensitivity, V30, is a useful independent measure of retinal function and, in our data, represented the best metric to monitor deterioration of retinal sensitivity in RPE65-LCA. Furthermore, functional correlation with genotype may enable more informed prognostic counseling.",
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AU - Kumaran, Neruban

AU - Rubin, Gary S.

AU - Kalitzeos, Angelos

AU - Fujinami, Kaoru

AU - Bainbridge, James W.B.

AU - Weleber, Richard

AU - Michaelides, Michel

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N2 - PURPOSE. RPE65-associated Leber congenital amaurosis (RPE65-LCA) is an early-onset severe retinal dystrophy associated with progressive visual field loss. Phase I/II and III gene therapy trials have identified improved retinal sensitivity but little is known about the natural history of retinal sensitivity in RPE65-LCA. METHODS. A total of 19 subjects (aged 9 to 23 years) undertook monocular full-field static perimetry of which 13 subjects were monitored longitudinally. Retinal sensitivity was measured as mean sensitivity (MS) and volumetrically quantified (in decibel-steradian) using visual field modeling and analysis software for the total (VTOT), central 30° (V30) and central 15° (V15) visual field. Correlation was evaluated between retinal sensitivity and age, best-corrected visual acuity (BCVA), contrast sensitivity, vision-related quality of life, and genotype. Test-retest reliability was also investigated. RESULTS. V30 was identified to have a strong, weak, and moderate correlation with age, BCVA and contrast sensitivity respectively. Furthermore, V30 was identified as having a weak linear relationship with the mobility and independence domains of the vision-related quality of life questionnaire. Longitudinal analysis demonstrated a slow loss of retinal sensitivity in this cohort. Subjects with at least one RPE65 nonsense variant appeared to show greater progressive loss of retinal sensitivity in the second decade of life than those without. CONCLUSIONS. Volumetric assessment of central 30° visual field sensitivity, V30, is a useful independent measure of retinal function and, in our data, represented the best metric to monitor deterioration of retinal sensitivity in RPE65-LCA. Furthermore, functional correlation with genotype may enable more informed prognostic counseling.

AB - PURPOSE. RPE65-associated Leber congenital amaurosis (RPE65-LCA) is an early-onset severe retinal dystrophy associated with progressive visual field loss. Phase I/II and III gene therapy trials have identified improved retinal sensitivity but little is known about the natural history of retinal sensitivity in RPE65-LCA. METHODS. A total of 19 subjects (aged 9 to 23 years) undertook monocular full-field static perimetry of which 13 subjects were monitored longitudinally. Retinal sensitivity was measured as mean sensitivity (MS) and volumetrically quantified (in decibel-steradian) using visual field modeling and analysis software for the total (VTOT), central 30° (V30) and central 15° (V15) visual field. Correlation was evaluated between retinal sensitivity and age, best-corrected visual acuity (BCVA), contrast sensitivity, vision-related quality of life, and genotype. Test-retest reliability was also investigated. RESULTS. V30 was identified to have a strong, weak, and moderate correlation with age, BCVA and contrast sensitivity respectively. Furthermore, V30 was identified as having a weak linear relationship with the mobility and independence domains of the vision-related quality of life questionnaire. Longitudinal analysis demonstrated a slow loss of retinal sensitivity in this cohort. Subjects with at least one RPE65 nonsense variant appeared to show greater progressive loss of retinal sensitivity in the second decade of life than those without. CONCLUSIONS. Volumetric assessment of central 30° visual field sensitivity, V30, is a useful independent measure of retinal function and, in our data, represented the best metric to monitor deterioration of retinal sensitivity in RPE65-LCA. Furthermore, functional correlation with genotype may enable more informed prognostic counseling.

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KW - LCA2

KW - Leber congenital amaurosis

KW - Perimetry

KW - Retina

KW - Retinal sensitivity

KW - Visual field

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