Article
作者: Bevers, Roel ; Rogers, Tim ; Sieghart, Alexander ; Scott, Richard H. ; Kousathanas, Athanasios ; Ambrose, John C. ; Poulter, James A. ; O’Donovan, Peter ; Rendon, Augusto ; Arno, Gavin ; Hardcastle, Alison J. ; Chan, Georgia C. ; Siddiq, Afshan ; Kayikci, Melis ; Pullinger, John ; Stuckey, Alexander ; Henderson, Shirley ; Smith, Samuel C. ; Ali, Manir ; Taylor, Rachel ; Tucci, Arianna ; Caulfield, Mark J. ; Murugaesu, Nirupa ; Tanguy, Mélanie ; Downes, Susan ; Ellingford, Jamie ; Williams, Eleanor ; Moutsianas, Loukas ; Witkowska, Katarzyna ; Castle, Bruce ; Cheetham, Michael ; Toomes, Carmel ; Taylor Tavares, Ana Lisa ; McKibbin, Martin ; Minneci, Federico ; Manson, Forbes ; Ingram, Stuart ; Webster, Andrew R. ; Smith, Claire E.L. ; Odhams, Chris A. ; Leong, Ivonne U.S. ; Hamblin, Angela ; Kasperaviciute, Dalia ; Pereira, Mariana Buongermino ; Welland, Matthew J. ; Jackson, Rob ; Broadgate, Suzanne ; Lahnstein, Lea ; Yu, Jing ; Khan, Muhammad I. ; Elgar, Greg ; Hubbard, Tim J.P. ; Mueller, Michael ; van Heyningen, Veronica ; Patch, Christine ; Thomas, Ellen R.A. ; Arumugam, Prabhu ; Boardman-Pretty, Freya ; McEntagart, Meriel ; Fiorentino, Alessia ; Boustred, Christopher R. ; Inglehearn, Chris F. ; Yahya, Samar ; Brittain, Helen ; Fowler, Tom ; Giess, Adam ; Kämpjärvi, Kati ; Steel, David H.W. ; Sosinsky, Alona ; Savage, Kevin ; Sawant, Kushmita ; Bleda, Marta ; Rahim, Tahrima ; El-Asrag, Mohammed E. ; Thompson, Simon R. ; Jones, Louise J. ; Pontikos, Nikolas ; Sergouniotis, Panagiotis ; Halford, Stephanie ; Lopez, Javier F. ; Perez-Gil, Daniel ; Cremers, Frans P.M. ; Need, Anna C. ; Black, Graeme C. ; Leigh, Sarah E.A. ; Wood, Suzanne M. ; Maleady-Crowe, Fiona
PURPOSETo characterize the phenotype observed in a case series with macular disease and determine the cause.DESIGNMulticenter case series.PARTICIPANTSSix families (7 patients) with sporadic or multiplex macular disease with onset at 20 to 78 years, and 1 patient with age-related macular degeneration.METHODSPatients underwent ophthalmic examination; exome, genome, or targeted sequencing; and/or polymerase chain reaction (PCR) amplification of the breakpoint, followed by cloning and Sanger sequencing or direct Sanger sequencing.MAIN OUTCOME MEASURESClinical phenotypes, genomic findings, and a hypothesis explaining the mechanism underlying disease in these patients.RESULTSAll 8 cases carried the same deletion encompassing the genes TPRX1, CRX, and SULT2A1, which was absent from 382 control individuals screened by breakpoint PCR and 13 096 Clinical Genetics patients with a range of other inherited conditions screened by array comparative genomic hybridization. Microsatellite genotypes showed that these 7 families are not closely related, but genotypes immediately adjacent to the deletion breakpoints suggest they may share a distant common ancestor.CONCLUSIONSPrevious studies had found that carriers for a single defective CRX allele that was predicted to produce no functional CRX protein had a normal ocular phenotype. Here, we show that CRX whole-gene deletion in fact does cause a dominant late-onset macular disease.