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    1. 21-year-old professional soccer player

      Case1: 21, Male

      DiseaseAssertion: To be found

      FamilyInfo: No remarkable family history.

      CasePresentingHPOs: HP:0003401, HP:0410173, HP:0001688

      CaseHPOFreeText: "arietal ischemic lesions, elevated high-sensitivity I troponin, left ventricle (LV) dilation, apical hypokinesia, apical thrombus, and multifocal nonischemic late gadolinium enhancement with edema" " elevated N-terminal pro–B-type natriuretic peptide and low c-reactive protein"

      CaseNotHPOs: HP:0001297, HP:0012819

      CaseNotHPOFreeText: "A cardioembolic stroke due to myocarditis with an LV thrombus was assumed" “Ischemic heart disease was considered unlikely at presentation” “Cardiac sarcoidosis was considered but was not supported” “Autoimmune myocarditis and other systemic inflammatory causes were also considered” “Giant cell myocarditis was considered to be unlikely”

      CasePreviousTesting:

      Genotyping Method: Whole genome sequencing

      Variant: c.1484G>A; p.Arg495Gln

      ClinVar: CA010464

      gnomAD: To be found

    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

    3. mutation c.2513G > C (p.R838P) in one family and one sporadic case

      Case#: Jiang_2015_Family_010153_Patient_III:1, female, age 37 at time of report, national origin listed as Chinese

      CasePresentingHPOs: HP:0003621 (Juvenile onset), HP:0007663 (Reduced visual acuity), HP:0000639 (Nystagmus), HP:0030329 (Retinal thinning), HP:0011516 (Achromatopsia), HP:0030465 (Undetectable light-adapted electroretinogram), HP:0030469 (Abnormal dark-adapted electroretinogram), HP:0007703 (Abnormality of retinal pigmentation)

      CaseHPOFreeText: N/A

      CaseNotHPOs: HP:0000662 (Nyctalopia)

      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 and her 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>C (p.Arg838Pro) variant in the heterozygous state.

      ClinVar: 811743

      gnomAD: The variant was not found in gnomAD.

      VariantEvidence: NM_000180.4(GUCY2D):c.2513G>C (p.Arg838Pro) 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).

      CaseAddInfo: The proband is a member of a family with several other affected family members who carry the variant.

      CasePMIDs: N/A

    4. p.R838P

      Case#: Jiang_2015_Patient_010097, female, age 4 at time of report, national origin listed as Chinese

      CasePresentingHPOs: HP:0011463 (Childhood onset), HP:0025573 (Mild myopia), HP:0007663 (Reduced visual acuity), HP:0030329 (Retinal thinning), HP:0000654 (Decreased light- and dark-adapted electroretinogram amplitude), HP:0007401 (Macular atrophy)

      CaseHPOFreeText: N/A

      CaseNotHPOs: HP:0000662 (Nyctalopia), HP:0000639 (Nystagmus), HP:0000551 (Color vision defect)

      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>C (p.Arg838Pro) variant in the heterozygous state.

      ClinVar: 811743

      gnomAD: The variant was not found in gnomAD.

      VariantEvidence: NM_000180.4(GUCY2D):c.2513G>C (p.Arg838Pro) 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.

      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. 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

    2. this gene

      Case#: Mykykyn_2002_Proband_D, gender not specified, age not described, family origin reported as from Turkish

      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.851del (p.Tyr284fs) variant in the homozygous state.

      ClinVar ID: 12146

      gnomAD: The variant is found in gnomAD v2.1.1 at a frequency of 0.00001758 (2 alleles out of 113768 total alleles, with 0 homozygotes) in the European non-Finnish population https://gnomad.broadinstitute.org/variant/11-66290946-TA-T?dataset=gnomad_r2_1

      VariantEvidence: NM_024649.5(BBS1):c.851del (p.Tyr284fs) is a frameshift variant in exon 10 of 17 that is predicted to trigger nonsense mediated decay or to at least truncate the C-terminal 52% of the protein product.

      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. 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

    3. No evidence for a founder allele was found for the families carrying the stop mutation C35X (Fig. 2b).

      Case#: Pusch_2000_Familly_9606_Proband, male, age and race not mentioned

      CasePresentingHPOs: HP:0030640 (Complete 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: N/A

      CaseMethod1: Sanger sequencing of PCR amplified exons from NYX

      CaseMethod2: N/A

      CaseGenotypingMethod: The proband and family members were subjected to Sanger sequencing of NYX to identify the variant.

      Variant: The proband harbors the NM_001378477.3(NYX):c.90C>A (p.Cys30Ter) variant on the X chromosome.

      ClinVar: 11422

      gnomAD: NM_001378477.3(NYX):c.90C>A (p.Cys30Ter) was not found in gnomAD.

      VariantEvidence: This nonsense variant is located in exon 2/3 and is predicted to trigger NMD. It introduces a premature stop codon that would truncate 93% of the protein product.

      CaseAddInfo: This variant appears not only in Family 9606, but also in Family 2438T, yet is not suspected to be a founder alelle.

      CasePMIDs: N/A

    1. 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. 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

    2. 4

      Case#: Xin_Patient_8, sex not mentioned, age 5.5 at onset, U.S. nationality, Indian ethnicity

      CasePresentingHPOs: HP:0004302 (Functional motor deficit), HP:0000512 (Abnormal electroretinogram), HP:0001250 (Seizure), HP:0001268 (Mental deterioration), HP:0011463 (Childhood onset)

      CaseHPOFreeText: Motor difficulty was the phenotype at presentation (age 5.5). Cognitive regression (age 6), and visual findings (abnormal ERG) had later onset.

      CaseNotHPOs: HP:0003205 (Curvilinear intracellular accumulation of autofluorescent lipopigment storage material), HP:0003208 (Fingerprint intracellular accumulation of autofluorescent lipopigment storage material)

      CaseNotHPOFreeText: The electron microscopy findings referred to above (from conjunctiva biopsy) were normal.

      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.428A>G p.Asn143Ser variant.

      ClinVar: 56539 (homozygous)

      gnomAD: The NM_006493.4(CLN5):c.428A>G p.Asn143Ser variant is absent from gnomAD.

      VariantEvidence: NM_006493.4(CLN5):c.428A>G p.Asn143Ser is a missense variant at a highly conserved residue, and is speculated by the authors to function as an exonic splicing enhancer. SpliceAI finds some evidence of a possible donor loss (change score of 0.02) or acceptor gain (change score of 0.09).

      CaseAddInfo: Parents have not been subjected to genotyping, so homozygosity of variants is assumed. This conclusion was supported by failure to detect a deletion. Family history of non-consanguinity or consanguinity was not mentioned, but both parents share the same local area of origin within India.

      CasePMIDs: N/A

    3. insertion

      Case#: Xin_Patient_10, sex not mentioned, age 5 at onset, U.S. nationality, Pakistani ethnicity

      CasePresentingHPOs: HP:0004302 (Functional motor deficit), HP:0000572 (Visual loss), HP:0001250 (Seizure), HP:0001268 (Mental deterioration), HP:0011463 (Childhood onset), HP:0003205 (Curvilinear intracellular accumulation of autofluorescent lipopigment storage material), HP:0003208 (Fingerprint intracellular accumulation of autofluorescent lipopigment storage material)

      CaseHPOFreeText: Motor difficulty was the phenotype at presentation (age 5). Cognitive regression and Seizures had onset at age 5, while Visual loss had onset at age 24.

      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.379dup p.Thr127AsnfsTer11 variant.

      CAID: CA611398060 (homozygous)

      gnomAD: The maximum allele frequency for the NM_006493.4(CLN5):c.379dup p.Thr127AsnfsTer11 variant is 0.00003266 (jn the South Asian population, with no homozygotes).

      VariantEvidence: NM_006493.4(CLN5):c.379dup p.Thr127AsnfsTer11 is a frameshift variant that disrupts ~65% of the protein product and is likely to trigger nonsense mediated decay.

      CaseAddInfo: Parents have not been subjected to genotyping, so homozygosity of variants is assumed. This conclusion was supported by failure to detect a deletion, and by family history of consanguinity.

      CasePMIDs: N/A

    4. pathogenic

      Case#: Xin_Patient_1, sex not mentioned, age 5 at onset, U.S. nationality, ethnic admixture of French / Canadian / Irish / U.K. / Dutch

      CasePresentingHPOs: HP:0004302 (Functional motor deficit), HP:0000572 (Visual loss), HP:0001250 (Seizure), HP:0001268 (Mental deterioration), HP:0011463 (Childhood onset)

      CaseHPOFreeText: Motor difficulty and visual loss were the phenotypes at presentation (age 5). Seizure and cognitive regression had onset at age 7.

      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 harbors the NM_006493.4(CLN5):c.524G>A (p.Trp175Ter) and NM_006493.4(CLN5):c.956_959del (p.Lys319fs) variants.

      ClinVar: 56544 and 56529

      gnomAD: Maximum allele frequency for NM_006493.4(CLN5):c.524G>A (p.Trp175Ter) is 0.00003517 (in the European non-Finnish population, no homozygotes). https://gnomad.broadinstitute.org/variant/13-77570221-G-A Maximum allele frequency for NM_006493.4(CLN5):c.956_959del (p.Lys319fs) is 0.0001148 (in the African / African-American population, no homozygotes). https://gnomad.broadinstitute.org/variant/13-77574979-CACAA-C

      VariantEvidence: NM_006493.4(CLN5):c.524G>A (p.Trp175Ter) is a nonsense variant that results in truncation of approximately 51% of the protein product. The NM_006493.4(CLN5):c.956_959del (p.Lys319fs) variant triggers a frameshift that affects the final 40 amino acids (approximately 11%) of the protein product. While both variants occur in the final exon (exon 4) and neither is predicted to trigger NMD, the C-terminal region disrupted in both cases has been shown to be glycosylated and is important for proper localization of the protein (PMID:19309691).

      CaseAddInfo: Parents do not appear to have been genotyped, so it is not clear whether the two variants are confirmed to be in trans.

      CasePMIDs: N/A

    1. 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

    2. 335 bp deletion in exon 3c−d in two families (X05 and X09)

      Case#: Allen_2003_Familly_X05_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.1122_*11del (p.Ser374ArgfsTer10) variant on the X chromosome.

      CAID: CA2573050969

      gnomAD: NM_022567.2(NYX):c.1122_*11del (p.Ser374ArgfsTer10) was not found in gnomAD.

      VariantEvidence: NM_022567.2(NYX):c.1122_*11del (p.Ser374ArgfsTer10) is a frameshift variant in exon 3/3 that is not predicted to trigger NMD but disrupts the C-terminal 22% 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. This is a recurrent variant reported here in multiple apparently unrelated British families (X05 and X09).

      CaseAddInfo: N/A

      CasePMIDs: N/A

    3. splice site mutation, G→C, was detected in family X03 at position +1 in intron 2.

      Case#: Allen_2003_Familly_X03_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.37+1G>C (p.=) variant on the X chromosome.

      CAID: CA412988630

      gnomAD: NM_022567.2(NYX):c.37+1G>C (p.=) was not found in gnomAD.

      VariantEvidence: This splice site variant disrupts a canonical splice site between the two coding exons (exon 2 and exon 3), and is therefore predicted to disrupt the protein product.

      CaseAddInfo: N/A

      CasePMIDs: N/A

    4. an in-frame 15 bp deletion in exon 3a in two families (X04 and X06)

      Case#: Allen_2003_Familly_X04_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.339_353del (p.Glu114_Ala118del) variant on the X chromosome.

      CAID: CA2573050968

      gnomAD: NM_022567.2 (NYX):c.339_353del (p.Glu114_Ala118del) was not found in gnomAD.

      VariantEvidence: NM_022567.2:c.339_353del is an in-frame deletion variant that removes 5 amino acids from the center of the polypeptide sequence. It is a recurrent variant reported here in multiple apparently unrelated British families (X04 and X06).

      CaseAddInfo: N/A

      CasePMIDs: N/A

    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. 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

    2. Here, we identified two heterozygous variants in PRPF4, including c.-114_-97del in a simplex RP patient and c.C944T (p.Pro315Leu), which co-segregates with disease phenotype in a family with adRP. Both variants were absent in 400 unrelated controls. The c.-114_-97del, predicted to affect two transcription factor binding sites, was shown to down-regulate the promoter activity of PRPF4 by a luciferase assay, and was associated with a significant reduction of PRPF4 expression in the blood cells of the patient. In fibroblasts from an affected individual with the p.Pro315Leu variant, the expression levels of several tri-snRNP components, including PRPF4 itself, were up-regulated, with altered expression pattern of SC35, a spliceosome marker. The same alterations were also observed in cells over expressing hPrp4(Pro315Leu), suggesting that they arose as a compensatory response to a compromised splicing mechanism caused by hPrp4 dysfunction.

      Case#: Chen_2014_Proband_AD01-II:3, male, age 15 years at time of first exam for poor night vision, age 58 years at time of report, family origin reported as Han Chinese

      CasePresentingHPOs: Nyctalopia HP:0000662, Constriction of peripheral visual field HP:0001133, Reduced visual acuity HP:0007663, Cataract HP:0000518, Retinal degeneration HP:0000546, Macular degeneration HP:0000608, Optic disc pallor HP:0000543, Attenuation of retinal blood vessels HP:0007843, Pigmentary retinopathy HP:0000580, Central thinning of the outer nuclear layer of the retina HP:6000367, Decreased light- and dark-adapted electroretinogram amplitude HP:0000654

      CaseHPOFreeText: The proband has been diagnosed with autosomal dominant retinitis pigmentosa, with features including complete loss of outer/inner segments (OS/IS) by OCT. Patient fibroblasts showed increased expression of PRPF3, PRPF6, PRPF8, PRPF31, EFTUD2, SART1, and PRPF4 itself.

      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_001244926.2(PRPF4):c.941C>T (p.Pro314Leu) variant in the heterozygous state.

      ClinVar ID: 143057

      gnomAD: The NM_001244926.2(PRPF4):c.941C>T (p.Pro314Leu) variant is found in gnomAD v4.1.0 at a frequency of 0.000003390 (4 alleles / 1179980 total alleles, with 0 homozygotes) in the European (non-Finnish) population https://gnomad.broadinstitute.org/variant/9-113288183-C-T?dataset=gnomad_r4

      VariantEvidence: NM_001244926.2(PRPF4):c.941C>T (p.Pro314Leu) is a missense variant. When over-expressed in zebrafish, the variant causes severely disrupted photoreceptors in the retina and other deformities such as malformed brains, short trunks, cardiac edema and curved body axis, unlike the wild-type control.

      CaseAddInfo: The proband has two similarly affected siblings (with onset in their 20's) and an unaffected child (approximately age 10 years) who also harbor the variant.

      CasePMIDs: N/A

    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

    2. MOL0732

      Case#: Bandah-Rozenfeld_2010_MOL0732_proband, female, age 63 years at time of diagnosis, ethnic origin reported as Israeli Christian Arab

      CasePresentingHPOs: HP:0008002 (Abnormality of macular pigmentation), HP:0030613 (Abnormal foveal morphology on macular OCT), HP:0030557 (Best corrected visual acuity 0.4 LogMAR), HP:0000603 (Central scotoma), HP:0031729 (Moderate hypermetropia), HP:0000518 (Cataract)

      CaseHPOFreeText: The patient has been diagnosed with mild maculopathy. "Abnormal foveal morphology" refers to elevation of the photoreceptor layer in foveal region by OCT analysis. The "cataract" specifically refers to mild nuclear sclerosis.

      CaseNotHPOs: HP:0000512 (Abnormal electroretinogram), HP:0000551 (Color vision defect)

      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.370T>C (p.Phe124Leu) variant in the homozygous state.

      ClinVar: 3550

      gnomAD: The NM_016247.4(IMPG2):c.370T>C (p.Phe124Leu) variant is found in gnomAD v2.1.1 at a maximum allele frequency of 0.0001318 (17/129010, with 0 homozygotes) in the European (non-Finnish) population. https://gnomad.broadinstitute.org/variant/3-101023121-A-G

      VariantEvidence: NM_016247.4(IMPG2):c.370T>C (p.Phe124Leu) is a missense variant in exon 3 of 19 that does not have evidence of impact on the protein product.

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

      CasePMIDs: A publication by a separate group referred to this case as autosomal recessive vitelliform macular dystrophy, but did not indicate the existence of any additional details about the case (PMID: 25085631).

    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

    2. R838C

      Case#: Kelsell_1998_CORD6_Family_2_Proband, female, age 45 at time of report, nationality listed as British

      CasePresentingHPOs: HP:0007401 (Macular atrophy), HP:0000548 (Cone/cone-rod dystrophy)

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      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 her 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.2512C>T (p.Arg838Cys) variant in the heterozygous state.

      ClinVar: 9355

      gnomAD: The variant is present in gnomAD at a frequency of 0.000007744 (1/129124) in the European non-Finnish population, with no homozygotes. https://gnomad.broadinstitute.org/variant/17-7918018-C-T

      VariantEvidence: NM_000180.4(GUCY2D):c.2512C>T (p.Arg838Cys) is a missense variant located within the coiled-coil domain that mediates GUCY2D 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.Arg838Cys 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. 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

    2. had truncation

      Case#: Family_11850_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.518_519insC (p.Ala174CysfsTer?) variant in the hemizygous state.

      CAID: CA3071606830

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

      VariantEvidence: NM_020061.6(OPN1LW):c.518_519insC (p.Ala174CysfsTer?) 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

    3. 4 families

      Case#: Family_9073_Proband_III-1, 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:c.757C>T (p.Gln253Ter) variant in the hemizygous state.

      CAID: CA415307744

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

      VariantEvidence: NM_020061.6:c.757C>T (p.Gln253Ter) is a nonsense variant in exon 5 of 6 that is predicted to undergo nonsense-mediated decay.

      CaseAddInfo: The proband was seen at a medical center in Guangzhou. A maternal uncle is similarly affected but ungenotyped.

      CasePMIDs: N/A

    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

    2. All families carrying the SVA F are of European ancestry: 4 originated from the western part of France (family A, C, E and F), one from the northern part of France (family B)

      Case#: Delvallée_2021_Proband_B.II-1, male, age not described, family origin reported as from western France, ancestry reported as European

      CasePresentingHPOs: HP:0000556 (Retinal dystrophy), HP:0000639 (Nystagmus), HP:0001162 (Postaxial hand polydactyly), HP:0001156 (Brachydactyly), HP:0001513 (Obesity), HP:0001256 (Intellectual disability, mild), HP:0001270 (Motor delay), HP:0000054 (Micropenis), HP:0000028 (Cryptorchidism)

      CaseHPOFreeText: N/A

      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 includes two similarly affected brothers sharing the same genotype.

      CasePMIDs: N/A

    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. 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. 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

    2. To assess whether mutations in KCNJ13 are a common cause of autosomal recessive retinal dystrophy, we performed bidirectional Sanger sequencing of the entire coding region and intron-exon boundaries of the gene in 333 additional unrelated patients (primer details are listed in Table S2). Among the patients, 132 were affected with recessive LCA or childhood onset retinal dystrophy; this panel was enriched for mutations in novel genes, as the patients' DNA had been screened and excluded for previously reported LCA-causing variants through a microarray chip (LCA Chip, Asper Biotech; 35% mutation detection rate; D.S.M, unpublished data). The remaining 201 individuals were diagnosed with autosomal recessive adult onset rod-cone or cone-rod dystrophy and had unknown molecular diagnosis. A homozygous missense variant (c.722T>C [p.Leu241Pro]) was identified in a patient of white European descent (subject B-3, III-2 in Figure 1A; proband of family B) with a remarkably similar phenotype to that observed in family A. Segregation analysis confirmed heterozygosity for the p.Leu241Pro change in maternal (subject B-1, II-4 in Figure 1A) and paternal (subject B-2, II-5 in Figure 1A) DNA. This sequence change has not been previously reported (dbSNP and 1000 genomes) and was found to be absent from 382 ethnically matched control chromosomes (Human Random Control DNA Panels, Salisbury, UK). Although the patient is not knowingly consanguineous, his parents originate from the same isolated geographic area. It is therefore likely that the homozygous state at this locus is consequent upon the presence of a recent common ancestor.

      Case#: Sergouniotis_2011_Proband_B-3, male, age 33 years, family ethnic origin described as European

      CasePresentingHPOs: Reduced visual acuity HP:0007663, Constriction of peripheral visual field HP:0001133, Infantile onset HP:0003593, Strabismus HP:0000486, Nystagmus HP:0000639, Progressive night blindness HP:0007675, Moderate myopia HP:0031624, Decreased light- and dark-adapted electroretinogram amplitude HP:0000654, Presenile cataracts HP:0007819, Nummular pigmentation of the fundus HP:0030505, Retinal pigment epithelial loss on macular OCT HP:0030611

      CaseHPOFreeText: The proband received a diagnosis of Leber congenital amaurosis. His phenotype is described as similar to the other affected individuals, including "a distinct and unusual retinal appearance and a similar early onset of visual loss, suggesting both impaired retinal development and progressive retinal degeneration, involving both rod and cone pathways". The disease was described as mildly progressive. OCT showed distorted retinal microanatomy even in areas without cell death, possibly indicating disturbance of the early development of the neurosensory retina.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The proband was previously genotyped by screening for previously-reported LCA-causing variants by microarray chip, with no molecular diagnosis.

      CaseMethod1: screening for previously-reported LCA-causing variants by microarray chip

      CaseMethod2: Sanger sequencing of the KCNJ13 exons and intron-exon boundaries

      CaseGenotypingMethod: The proband was previously genotyped by screening for previously-reported LCA-causing variants by microarray chip, with no molecular diagnosis. Sanger sequencing of the KCNJ13 exons and intron-exon boundaries was subsequently performed.

      Variant: The individual is homozygous for the NM_002242.4(KCNJ13):c.722T>C (p.Leu241Pro) variant.

      ClinVar: 30332

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

      VariantEvidence: NM_002242.4(KCNJ13):c.722T>C (p.Leu241Pro) is a missense variant that has no experimental evidence in this study but has separately been shown to severely decrease expression and abolish complex glycosylation of KCNJ13 (PMID: 30257863, Figure 10).

      CaseAddInfo: The proband's family history is not known to include consanguinity but heterozygous parents originate from the same isolated geographic area.

      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

    2. Affected individuals of the nonconsanguineous simplex FII

      Case#: Perrault_2012_Patient_FII1, male, 18 years of age at time of study, ethnicity not specified

      CasePresentingHPOs: HP:0003577 (Congenital onset), HP:0000639 (Nystagmus), HP:0025573 (Mild myopia), HP:0007994 (Peripheral visual field loss), HP:0007663 (Reduced visual acuity), HP:0007814 (Retinal pigment epithelial mottling), HP:0000608 (Macular degeneration), HP:0000550 (Undetectable electroretinogram), HP:0010164 (Cone-shaped epiphyses of the toes), HP:0003774 (Stage 5 chronic kidney disease), HP:0002153 (Hyperkalemia), HP:0000113 (Polycystic kidney dysplasia), HP:0000556 (Retinal dystrophy), HP:0001396 (Cholestasis), HP:0010230 (Cone-shaped epiphyses of the phalanges of the hand)

      CaseHPOFreeText: Photoattraction was listed as a phenotype. Acetylated alpha-tubulin staining in cultured fibroblasts showed an absence of primary cilia in a high number of cells from this patient.

      CaseNotHPOs: HP:0004322 (Short stature), HP:0000773 (Short ribs), HP:0000900 (Thickened ribs), HP:0000929 (Abnormal skull morphology), HP:0040064 (Abnormality of limbs), HP:0001263 (Global developmental delay), HP:0004979 (Metaphyseal sclerosis)

      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.932A>G (p.Tyr311Cys) and NM_014714.4(IFT140):c.857_860del (p.Ile286LysfsTer6) variants in IFT140.

      ClinVar: 31681

      CAID: CA129888

      gnomAD: Neither variant was found in gnomAD.

      VariantEvidence: Exogenous expression of the FLAG-tagged p.Tyr311Cys 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, although milder than another suspected pathogenic missense variant (Figure 3A). The p.Ile286LysfsTer6) variant is a frameshift variant in exon 8 of 31, introducing a premature stop codon predicted to trigger nonsense-mediated decay or at least disrupt the C-terminal 81% of the protein product.

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

      CasePMIDs: N/A

    3. FV

      Case#: Perrault_2012_Patient_FV1, male, 10 years of age at time of study, ethnicity not specified

      CasePresentingHPOs: HP:0011463 (Childhood onset), HP:0000545 (Myopia), HP:0007994 (Peripheral visual field loss), HP:0032037 (Mildly reduced visual acuity), HP:0000510 (Rod-cone dystrophy), HP:0000512 (Abnormal electroretinogram), HP:0004322 (Short stature), HP:0001363 (Craniosynostosis), HP:0030799 (Scaphocephaly), HP:0001999 (Abnormal facial shape), HP:0010230 (Cone-shaped epiphyses of the phalanges of the hand), HP:0000365 (Hearing impairment), HP:0003774 (Stage 5 chronic kidney disease), HP:0000107 (Renal cyst), HP:0004719 (Hyperechogenic kidneys), HP:0005565 (Reduced renal corticomedullary differentiation), HP:0001510 (Growth delay)

      CaseHPOFreeText: This proband was diagnosed with Mainzer-Saldino syndrome.

      CaseNotHPOs: HP:0000639 (Nystagmus)

      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.3916dup (p.Ala1306fs) variants in IFT140.

      ClinVar: 31683, 31684

      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.3916dup (p.Ala1306fs) variant is present in gnomAD at a frequency of 0.0001210 in the African / African-American population (3/24790, with no homozygotes) https://gnomad.broadinstitute.org/variant/16-1570005-G-GC

      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). NM_014714.4(IFT140):c.3916dup (p.Ala1306fs) is a frameshift variant that introduces a premature stop codon in exon 28/31 and is predicted to trigger NMD or at least to truncate ~11% of the protein product.

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

      CasePMIDs: N/A

    4. FIV3 (homozygous for the c.1990G>A [p.Glu664Lys] change)

      Case#: Perrault_2012_Patient_FIV3, male, 17 years of age at time of study, Saudi Arabian national origin

      CasePresentingHPOs: HP:0003593 (Infantile onset), HP:0000639 (Nystagmus), HP:0000729 (Autistic behavior), HP:0001250 (Seizure), HP:0008499 (High hypermetropia), HP:0001123 (Visual field defect), HP:0007663 (Reduced visual acuity), HP:0000550 (Undetectable electroretinogram), HP:0010230 (Cone-shaped epiphyses of the phalanges of the hand), HP:0000556 (Retinal dystrophy)

      CaseHPOFreeText: Acetylated alpha-tubulin staining in cultured fibroblasts showed an absence of primary cilia in a high number of cells from this patient. IFT140 protein localization along the ciliary axoneme was unaffected, however, two components of the anterograde transport IFT-B complex, IFT88 and IFT46, were aberrantly localized. They were evenly distributed along the cilium instead of primarily localized at the base and the tip of the cilium, suggesting an alteration in retrograde ciliary transport.

      CaseNotHPOs: HP:0004322 (Short stature), HP:0000765 (Abnormal thorax morphology), HP:0000929 (Abnormal skull morphology), HP:0040064 (Abnormality of limbs), HP:0001410 (Decreased liver function), HP:0012211 (Abnormal renal physiology), HP:0003272 (Abnormal hip bone 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: Affected individuals harbor the NM_014714.4(IFT140):c.1990G>A (p.Glu664Lys) variant in a homozygous state.

      ClinVar: 31679

      gnomAD: The NM_014714.4(IFT140):c.1990G>A (p.Glu664Lys) variant is present in gnomAD at a frequency of 0.00004031 in the African / African-American population (1/24806, with no homozygotes) https://gnomad.broadinstitute.org/variant/16-1614075-C-T

      VariantEvidence: Exogenous expression of the FLAG-tagged p.Glu664Lys variant in the RPE1 (retinal pigment epithelial) cell line revealed an inability to co-localize with gamma-tubulin, indicating a relatively severe defect in localization to the basal body in most cells, relative to other suspected pathogenic missense variants and the wild-type control (Figure 3A).

      CaseAddInfo: The proband's parents are reportedly consanguineous (first cousins).

      CasePMIDs: N/A

    5. To identify the genetic mutations responsible for MSS, we subjected the genomic DNA of an affected individual born to unrelated parents (FI1; Figure 1 and Table S1) to ciliome resequencing, using a 5.3 Mb customized Agilent SureSelect Target Enrichment library to capture 32,146 exons of 1,666 genes. We first focused our analysis on consensus splice-site changes, nonsynonymous variants, and insertion and/or deletion in coding regions. Considering that MSS-causing mutations are rare, we assumed that the affected individual was likely compound heterozygous for variants absent in the dbSNP132, 1000Genome, and in-house databases. This pointed to one candidate gene only, IFT140 (intraflagellar transport protein 140 homolog (chalydomonas)

      Case#: Perrault_2012_Patient_FI1, male, 17 years of age at time of study, ethnicity not specified

      CasePresentingHPOs: HP:0000774 (Narrow chest), HP:0030289 (Flattened femoral epiphysis), HP:0006429 (Broad femoral neck), HP:0004979 (Metaphyseal sclerosis), HP:0010230 (Cone-shaped epiphyses of the phalanges of the hand), HP:0003593 (Infantile onset), HP:0000639 (Nystagmus), HP:0008499 (High hypermetropia), HP:0030526 (Severe constriction of peripheral visual field), HP:0008043 (Retinal arteriolar constriction), HP:0000550 (Undetectable electroretinogram), HP:0004322 (Short stature), HP:0000773 (Short ribs), HP:0000900 (Thickened ribs), HP:0003774 (Stage 5 chronic kidney disease), HP:0000107 (Renal cyst), HP:0030532 (Visual acuity test abnormality), HP:0000556 (Retinal dystrophy)

      CaseHPOFreeText: N/A

      CaseNotHPOs: HP:0002093 (Respiratory insufficiency), HP:0010454 (Acetabular spurs), HP:0001410 (Decreased liver function), HP:0000929 (Abnormal skull morphology), HP:0040064 (Abnormality of limbs), HP:0001263 (Global developmental delay)

      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.1990G>A (p.Glu664Lys) and NM_014714.4(IFT140):c.2399+1G>T variants in IFT140.

      ClinVar: 31679, 31680

      gnomAD: The NM_014714.4(IFT140):c.1990G>A (p.Glu664Lys) variant is present in gnomAD at a frequency of 0.00004031 in the African / African-American population (1/24806, with no homozygotes) https://gnomad.broadinstitute.org/variant/16-1614075-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.Glu664Lys variant in the RPE1 (retinal pigment epithelial) cell line revealed an inability to co-localize with gamma-tubulin, indicating a relatively severe defect in localization to the basal body in most cells, relative to other suspected pathogenic missense variants and the wild-type control (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. 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. 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

    2. variant

      Case#: Holmberg_Patient_2, male, age 3 at onset and age 12 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 giant flash visual evoked potentials at age 6. Abolished ERG was found at age 7, and ataxia at age 8. Seizures and 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.

      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

    3. known

      Case#: Holmberg_Patient_5, female, age 4 at onset and age 7 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: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)

      CaseHPOFreeText: Age of onset was 4, while visual deterioration was found at age 6. Mental decline was found at age 7. 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.

      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.78G>A (p.Trp26Ter) variant.

      ClinVar: 2565 (homozygous)

      gnomAD: The maximum allele frequency of the NM_006493.4(CLN5):c.78G>A (p.Trp26Ter) variant is 0.00005132 (within the European non-Finnish population, with no homozygous occurrences). https://gnomad.broadinstitute.org/variant/13-77566311-G-A

      VariantEvidence: NM_006493.4(CLN5):c.78G>A (p.Trp26Ter) is a recurring nonsense variant that is predicted to trigger nonsense-mediated decay of CLN5.

      CaseAddInfo: N/A

      CasePMIDs: N/A

    4. novel

      Case#: Holmberg_Patient_7, female, age 4 at onset and age 9 at time of study, Finnish origin with some ancestors traced to Sweden

      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 4, while mental decline, visual deterioration and abolished ERG were found at age 7. Ataxia and Seizures developed at age 8, while Loss of independent walking and Giant flash visual evoked potentials 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.

      CaseNotHPOs: HP:0007082 (Dilated third ventricle)

      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 a compound heterozygote harboring the NM_006493.4(CLN5):c.1028_1029del (p.Thr342_Tyr343insTer) and NM_006493.4(CLN5):c.522dup (p.Trp175LeufsTer30) variants.

      ClinVar: 2564, 56543

      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 The maximum allele frequency of the NM_006493.4(CLN5):c.522dup (p.Trp175LeufsTer30) variant is 0.00007033 (within the European non-Finnish population, with no homozygotes) https://gnomad.broadinstitute.org/variant/13-77570218-A-AC

      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). NM_006493.4(CLN5):c.522dup (p.Trp175LeufsTer30) is also a frameshift variant, is predicted to disrupt ~51% of the protein product, and exhibits defective localization to the ER rather than the lysosome (PMID:20052765).

      CaseAddInfo: N/A

      CasePMIDs: N/A

    5. late infantile neuronal ceroid lipofuscinosis

      Case#: Holmberg_Patient_3, male, age 3 at onset and age 19 at time of death, 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 4, while mental decline, visual deterioration and abolished ERG were found at age 6. Giant flash visual evoked potentials were present at age 8, and ataxia at age 9. Seizures and Loss of independent walking occurred at age 10. 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.

      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. 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. 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. 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. 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

    2. 65 + 5G-->A

      Case#: Gu_1997_Patient_arRP181-II-1, female, 45, German ethnicity

      CasePresentingHPOs: HP:0000662 (Nyctalopia), HP:0000572 (Visual loss), HP:0410280 (Pediatric onset), HP:0000546 (Retinal degeneration), HP:0000618 (Blindness)

      CaseHPOFreeText: Visual loss had onset in childhood. Retinal degeneration was diagnosed at age 10. Legal blindness was found at age 18.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous testing was limited to clinical diagnosis of arRP.

      CaseMethod1: PCR amplification and Sanger sequencing

      CaseMethod2: N/A

      CaseGenotypingMethod: RPE65 was subjected to PCR amplification and Sanger sequencing.

      Variant: The patient is homozygous for the NM_000329.3(RPE65):c.11+5G>A variant.

      ClinVar: 98825 (homozygous)

      gnomAD: The maximum allele frequency of the NM_000329.3(RPE65):c.11+5G>A variant is 0.0001626 (in the European non-Finnish population, with no homozygotes): https://gnomad.broadinstitute.org/variant/1-68915573-C-T

      VariantEvidence: The variant is located within intron 1 of the RPE65 transcript and affects part of the splice donor consensus sequence. SpliceAI calculates a delta score of 0.06 for loss of splice donor site.

      CaseAddInfo: Consanguinity of the parents is not proven but considered possible due to their origin from the same village. One of the patient's three siblings is affected (similarly or more severely), but none have been genotyped.

      CasePMIDs: N/A

    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. 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

    2. LCA was diagnosed in patient 21557

      Case#: Yzer_2006_Patient_21557, male, age 4 months at diagnosis, Dutch or Belgian family origin

      CasePresentingHPOs: HP:0003593 (Infantile onset), HP:0000618 (Blindness), HP:0030553 (Visual acuity no light perception), HP:0000563 (Keratoconus), HP:0007688 (Undetectable light- and dark-adapted electroretinogram), HP:0020049 (Exodeviation), HP:0000518 (Cataract), HP:0000639 (Nystagmus),

      CaseHPOFreeText: The individual is described as having Leber congenital amaurosis. Bilateral cataracts were dense and prevented fundoscopy.

      CaseNotHPOs: HP:0000662 (Nyctalopia), HP:0000613 (Photophobia)

      CaseNotHPOFreeText: N/A

      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 note reported to be consanguineous. Segregation / phasing of two variants was confirmed by parental genotyping.

      CasePMIDs: N/A

    3. patient 21067

      Case#: Yzer_2006_Patient_21067, female, age 6 months at diagnosis, family origin not described

      CasePresentingHPOs: HP:0003593 (Infantile onset), HP:0000486 (Strabismus), HP:0000565 (Esotropia), HP:0008043 (Retinal arteriolar constriction), HP:0000543 (Optic disc pallor), HP:0012426 (Optic disc drusen), HP:0012643 (Foveal hypopigmentation), HP:0007703 (Abnormality of retinal pigmentation), HP:0000639 (Nystagmus), HP:0000613 (Photophobia), HP:0007663 (Reduced visual acuity), HP:0000550 (Undetectable electroretinogram)

      CaseHPOFreeText: The individual is described as having Leber congenital amaurosis.

      CaseNotHPOs: HP:0000662 (Nyctalopia), HP:0000563 (Keratoconus)

      CaseNotHPOFreeText: Fundus was described as largely normal.

      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 each of the 20 exons 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 all 20 exons of the GUCY2D locus.

      Variant: The individual is compound heterozygous for the NM_000180.4(GUCY2D):c.2302C>T (p.Arg768Trp) and NM_000180.4(GUCY2D):c.2837C>T (p.Ala946Val) variants.

      ClinVar: 98563, 98576

      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 The NM_000180.4(GUCY2D):c.2837C>T (p.Ala946Val) variant exhibits a maximum allele frequency of 0.00004013 in gnomAD version 2.1.1 (in the African / African-American population, with no homozygotes). https://gnomad.broadinstitute.org/variant/17-7918713-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. Evidence for the pathogenicity of the NM_000180.4(GUCY2D):c.2837C>T (p.Ala946Val) variant is limited to computational predictions.

      CaseAddInfo: Parents were reported to be consanguineous. Segregation / phasing of two variants was 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

    2. one had only one heterozygous splice site mutation. In this patient, RT-PCR from lymphocytic RNA demonstrated splice error resulting in 63-bp insertion between exons 7 and 8. Furthermore, the patient was found to have only mutated RT-PCR fragment, implying that a seemingly normal allele did not express LRP5 mRNA. We then conducted custom- designed oligonucleotide tiling microarray analyses targeted to a 600-kb genome region harboring LRP5 and discovered a 7.2-kb microdeletion encompassing exons 22 and 23 of LRP5.

      Case#: Narumi_2010_patient_4, male, age 7 years at report, national origin listed as Japanese

      CasePresentingHPOs: HP:0000555 (Leukocoria, bilateral), HP:0000541 (Retinal detachment), HP:0007968 (Remnants of the hyaloid vascular system), HP:0000529 (Progressive visual loss), HP:0000618 (Blindness), HP:0001249 (Intellectual disability), HP:0002757 (Recurrent fractures), HP:0000938 (Osteopenia), HP:0000926 (Platyspondyly), HP:0000774 (Narrow chest), HP:0000883 (Thin ribs), HP:0003100 (Slender long bone), HP:0004322 (Short stature), HP:0004349 (Reduced bone mineral density)

      CaseHPOFreeText: The patient has been diagnosed with osteoporosis-pseudoglioma syndrome. Minor breathing problems were observed at birth.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Genotyping appears to have been limited to the LRP5 locus and the surrounding genomic region.

      CaseMethod1: Oligonucleotide tiling microarray analyses in the 600-kb region around LRP5.

      CaseMethod2: Sanger sequencing of 23 PCR-amplified exons and flanking regions of the LRP5 locus

      CaseGenotypingMethod: Genotyping appears to have been limited to oligonucleotide tiling microarray analyses in the 600-kb region around LRP5, and Sanger sequencing of 23 PCR-amplified exons and flanking regions of the LRP5 locus.

      Variant: The patient harbors the NM_002335.4(LRP5):c.1584+1G>A and NC_000011.8:g.(67967534_67967551)_(67974756_67974774)del variants in the compound heterozygous state.

      ClinVar: 40291, 40292

      gnomAD: The NM_002335.4(LRP5):c.1584+1G>A and NC_000011.8:g.(67967534_67967551)_(67974756_67974774)del variants were not found in gnomAD v2.1.1.

      VariantEvidence: NM_002335.4(LRP5):c.1584+1G>A is a canonical splice site variant that triggers the inclusion of 63 aberrant base pairs between exons 7 and 8 (Figure 3A). NC_000011.8:g.(67967534_67967551)_(67974756_67974774)del is a 7.2-kb microdeletion that removes the final two exons of LRP5, disrupting the C-terminal 7% of the protein product.

      CaseAddInfo: The patient has 2 apparently unaffected parents, one of whom carries the NM_002335.4(LRP5):c.1584+1G>A variant (mother) and one of whom carries the NC_000011.8:g.(67967534_67967551)_(67974756_67974774)del variant (father). Both parents and a carrier sister had significantly decreased bone mineral density, and the father had multiple reported long bone fractures.

      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

    2. biallelic

      Case#: Weisschuh_2018_Patient_3, sex unreported, age 17 years at time of report, likely from Europe or of European descent

      CasePresentingHPOs: HP:0030465 (Undetectable light-adapted electroretinogram), HP:0000613 (Photophobia), HP:0000639 (Nystagmus)

      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.1579C>T (p.Arg527Ter) variant in the homozygous state.

      ClinVar ID: 487692

      gnomAD: The NM_006204.4(PDE6C):c.1579C>T (p.Arg527Ter) variant is found in gnomAD v2.1.1 at a frequency of 0.0002603 (9/34574) in the Latino / Admixed-American population, with 0 homozygotes https://gnomad.broadinstitute.org/variant/10-95399923-C-T

      VariantEvidence: NM_006204.4(PDE6C):c.1579C>T (p.Arg527Ter) is a nonsense variant in exon 12 of 22 that is predicted to trigger nonsense mediated decay or to at least truncate the C-terminal 39% of the protein product.

      CaseAddInfo: N/A

      CasePMIDs: N/A

    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. 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. two

      Case#: Meindl_1996_Family_RP07_Proband, male, age not specified, family origin either German or British

      CasePresentingHPOs: HP:0000510 (Rod-cone dystrophy)

      CaseHPOFreeText: The proband has been diagnosed with retinitis pigmentosa. Disease onset was reported as early.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The family members previously underwent linkage analysis to map the underlying genetic cause to the region on chromosome Xp21.1 between the CYBB and OTC genes.

      CaseMethod1: Hybridization analysis of amplified cDNA fragments from the RPGR locus to look for deletions, and SSCP analysis to look for point mutations

      CaseMethod2: Sanger sequencing of the RPGR locus

      CaseGenotypingMethod: The family members previously underwent linkage analysis to map the underlying genetic cause to the region on chromosome Xp21.1 between the CYBB and OTC genes. Amplified cDNA fragments from the RPGR locus were then screened by hybridization analysis to look for deletions and SSCP analysis to look for point mutations. The presence of the variant was confirmed by Sanger sequencing of the RPGR locus.

      Variant: The affected family members harbor the NM_001034853.2(RPGR):c.154G>T (p.Gly52Ter) variant in the hemizygous state.

      ClinVar: 98747

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

      VariantEvidence: NM_001034853.2(RPGR):c.154G>T (p.Gly52Ter) is a nonsense variant predicted to trigger nonsense-mediated decay or to at least disrupt the C-terminal 94% of the protein product.

      CaseAddInfo: The proband is a member of Family RP07.

      CasePMIDs: N/A

    2. nonsense

      Case#: Meindl_1996_Family_F50_Proband, male, age not specified, family origin either German or British

      CasePresentingHPOs: HP:0000510 (Rod-cone dystrophy)

      CaseHPOFreeText: The proband has been diagnosed with retinitis pigmentosa. Disease onset was reported as early.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The family members previously underwent linkage analysis to map the underlying genetic cause to the region on chromosome Xp21.1 between the CYBB and OTC genes.

      CaseMethod1: Hybridization analysis of amplified cDNA fragments from the RPGR locus to look for deletions, and SSCP analysis to look for point mutations

      CaseMethod2: Sanger sequencing of the RPGR locus

      CaseGenotypingMethod: The family members previously underwent linkage analysis to map the underlying genetic cause to the region on chromosome Xp21.1 between the CYBB and OTC genes. Amplified cDNA fragments from the RPGR locus were then screened by hybridization analysis to look for deletions and SSCP analysis to look for point mutations. The presence of the variant was confirmed by Sanger sequencing of the RPGR locus.

      Variant: The affected family members harbor the NM_001034853.2(RPGR):c.581G>A (p.Trp194Ter) variant in the hemizygous state.

      ClinVar: 98790

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

      VariantEvidence: NM_001034853.2(RPGR):c.581G>A (p.Trp194Ter) is a nonsense variant predicted to trigger nonsense-mediated decay or to at least disrupt the C-terminal 76% of the protein product.

      CaseAddInfo: The proband is a member of Family F50.

      CasePMIDs: N/A

    1. retrospective study

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

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

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

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

      CaseNotHPOFreeText: N/A

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

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

      CaseMethod2: Sanger sequencing-based confirmation

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

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

      CAID: CA364775681

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

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

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

      CasePMIDs: N/A

    2. patients

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

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

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

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

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

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

      CaseMethod2: Sanger sequencing-based confirmation

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

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

      ClinVar ID: 1056230

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

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

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

      CasePMIDs: N/A

    3. RP

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

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

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

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

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

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

      CaseMethod2: Sanger sequencing-based confirmation

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

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

      CAID: CA364770054

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

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

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

      CasePMIDs: N/A

    1. In MOL0277, a homozygous intronic change (c.411-8A→G) was the only potentially pathogenic change identified. Sequence of cDNA derived from patients' peripheral blood lymphocyte mRNA demonstrated that this mutation activated a cryptic splice acceptor site giving rise only to an aberrant transcript (Figure 2B). The mutant transcript has seven additional base pairs of sequence added to the beginning of exon 6 and is predicted to introduce a frameshift resulting in premature termination (R137SfsX16).

      Case#: Parry_2009_Family_MOL0277_patient_IV:2, male, age not specified, family origin reported to be Arab Muslim

      CasePresentingHPOs: HP:0410280 (Pediatric onset), HP:0007663 (Reduced visual acuity), HP:0007401 (Macular atrophy), HP:0000580 (Pigmentary retinopathy), HP:0007769 (Peripheral retinal degeneration), HP:0008323 (Abnormal light- and dark-adapted electroretinogram)

      CaseHPOFreeText: The proband was diagnosed with cone-rod dystrophy, with family showing autosomal recessive mode of inheritance. Most affected members of the proband's family had white patches around the optic disc and in the posterior pole.

      CaseNotHPOs: HP:0000639 (Nystagmus), HP:0000613 (Photophobia)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The proband and his family have been initially genotyped by autozygosity mapping with both 10k and 250k Affymetrix SNP arrays and microsatellite markers.

      CaseMethod1: Autozygosity mapping

      CaseMethod2: Sanger sequencing

      CaseGenotypingMethod: The proband and his family have been initially genotyped by autozygosity mapping with both 10k and 250k Affymetrix SNP arrays and microsatellite markers. Sanger sequencing of the ADAM9 locus then identified the variants.

      Variant: The proband harbors the NM_003816.3(ADAM9):c.411-8A>G variant in the homozygous state.

      ClinVar: 6879

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

      VariantEvidence: NM_003816.3(ADAM9):c.411-8A>G is a variant in intron 5 that has been shown to trigger aberrant splicing and abolish normal splicing by activating use of a cryptic splice acceptor site (Figure 2B). The predicted result is to add 7 bp to the 5' end of exon 6 and introduce a frameshift causing premature termination. Since this affects exon 6 of 21, the predicted result is nonsense-mediated decay or truncation of the C-terminal 83% of the protein product (p.Arg137SerfsX16).

      CaseAddInfo: The proband's family is known to be consanguineous, with the parents being first cousins (pedigree shown in Figure 2).

      CasePMIDs: N/A

    2. Direct sequencing of ADAM9 in MEP49 revealed a homozygous point mutation in exon 9, creating a premature stop codon (c.766C→T; p.R256X) (Figure 2A).

      Case#: Parry_2009_Family_MEP49_patient_IV:5, male, age not specified, family origin reported to be Pakistani

      CasePresentingHPOs: HP:0410280 (Pediatric onset), HP:0007663 (Reduced visual acuity), HP:0007401 (Macular atrophy), HP:0000580 (Pigmentary retinopathy), HP:0007769 (Peripheral retinal degeneration), HP:0008323 (Abnormal light- and dark-adapted electroretinogram)

      CaseHPOFreeText: The proband was diagnosed with cone-rod dystrophy, with family showing autosomal recessive mode of inheritance. Most affected members of the proband's family had white patches around the optic disc and in the posterior pole.

      CaseNotHPOs: HP:0000639 (Nystagmus), HP:0000613 (Photophobia)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The proband and his family have been initially genotyped by autozygosity mapping with both 10k and 250k Affymetrix SNP arrays and microsatellite markers.

      CaseMethod1: Autozygosity mapping

      CaseMethod2: Sanger sequencing

      CaseGenotypingMethod: The proband and his family have been initially genotyped by autozygosity mapping with both 10k and 250k Affymetrix SNP arrays and microsatellite markers. Sanger sequencing of the ADAM9 locus then identified the variants.

      Variant: The proband harbors the NM_003816.3(ADAM9):c.766C>T (p.Arg256Ter) variant in the homozygous state.

      ClinVar: 6877

      gnomAD: This variant is found in gnomAD v2.1.1 at a frequency of 0.00003267 (1/30608) in the South Asian population, with no homozygotes. https://gnomad.broadinstitute.org/variant/8-38880696-C-T

      VariantEvidence: NM_003816.3(ADAM9):c.766C>T (p.Arg256Ter) is a nonsense variant in exon 9 of 21, and is therefore predicted to result in nonsense-mediated decay.

      CaseAddInfo: The proband's family is known to be consanguineous, with the parents being first cousins (pedigree shown in Figure 2).

      CasePMIDs: N/A

    1. novel mutation

      Case#: Corton_2010_Family_RP-72_patient_IV:2, male, age 35 years at time of study, age 6 at onset, Spanish family origin from Galicia

      CasePresentingHPOs: HP:0000662 (Nyctalopia), HP:0000540 (Hypermetropia), HP:0007663 (Reduced visual acuity), HP:0030526 (Severe constriction of peripheral visual field), HP:0000550 (Undetectable electroretinogram), HP:0007737 (Bone spicule pigmentation of the retina), HP:0007401 (Macular atrophy), HP:0007843 (Attenuation of retinal blood vessels), HP:0000543 (Optic disc pallor)

      CaseHPOFreeText: The proband and his affected family members have been diagnosed with autosomal recessive retinitis pigmentosa.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Haplotype analysis was initially performed in the patient and his affected family members.

      CaseMethod1: Haplotype analysis

      CaseMethod2: Sanger sequencing of PDE6A, PDE6B, and RHO

      CaseGenotypingMethod: Haplotype analysis was initially performed in the patient and his affected family members, showing shared regions of homozygosity in the PDE6A, PDE6B, and RHO genes. Sanger sequencing was then performed on PCR products of exons and flanking regions from these three loci.

      Variant: The proband harbors the NM_000440.3(PDE6A):c.2053G>A (p.Val685Met) variant in the homozygous state.

      ClinVar: 29874

      gnomAD: In gnomAD v2.1.1, NM_000440.3(PDE6A):c.2053G>A (p.Val685Met) has a frequency of 0.00008531 (11/128938) in the European non-Finnish population, with 0 homozygotes https://gnomad.broadinstitute.org/variant/5-149263074-C-T

      VariantEvidence: A mutation equivalent to this variant in the homozygous nmf28/nmf28 mouse model caused grainy abnormalities in fundus pigmentation associated with loss of most photoreceptor cells shortly after birth, as well as loss of cGMP-PDE6 activity resulting in increased intracellular cGMP levels (PMID: 18849587).

      CaseAddInfo: The proband is from a family with multiple consanguineous unions and three affected paternal aunts.

      CasePMIDs: N/A

    1. Sequence of a patient carrying the CLN5 Fin major mutation, (AT)2467 deletion.

      Case#: Savukoski_Fin_Major_Patient_1, no demographic details, Finnish origin

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous testing relied on linkage analysis using PCR-amplifiable polymorphisms, including microsatellite markers. The marker D13S160 was found to co-segregate with disease with a LOD score of 4.78 across 14 Finnish pedigrees, mapping the disease locus to chromosome 13q21.1-q32 (PMID:7942847). A follow-up study used two additional microsatellite markers to map the locus to a 200-kb region (PMID:8661106), which was then analyzed in the present study and found to contain a single coding gene.

      CaseMethod1: Linkage analysis using PCR-amplifiable polymorphisms, including microsatellite markers, followed by more detailed linkage analysis using two additional microsatellite markers to map the locus to a smaller 200-kb region (PMID:8661106).

      CaseMethod2: N/A

      CaseGenotypingMethod: PCR products from the four exons of CLN5 were generated from the affected individual and a control individual and subjected to Sanger sequencing. Genome-wide analysis methods were not used.

      Variant: Patient is homozygous for NM_006493.4(CLN5):c.1028_1029del (p.Thr342_Tyr343insTer), although this variant is referred to in the article as (AT)2467del.

      ClinVar: 2564

      gnomAD: The variant is reported to have a maximum allele frequency of 0.0008137 (in the European Finnish population, with no homozygous individuals). https://gnomad.broadinstitute.org/variant/13-77575052-CAT-C

      VariantEvidence: This frameshift variant is expected to truncate 16 amino acids from the C-terminus of CLN5 (between 4-5% of the total polypeptide), without triggering NMD. However, it abolishes an N-glycosylation site (PMID:24058541). This may explain why it fails to localize to large endosomes but rather is retained within the ER, possibly indicating improper folding (PMID:24058541). It also exhibits reduced stability relative to other variants (PMID:24058541).

      CaseAddInfo: N/A

      CasePMIDs: PMID:7942847, PMID:8661106

    2. Sequence of a Dutch patient with the CLN5 European mutation, a G2127→A transversion.

      Case#: Savukoski_European_Patient_1, no demographic details, Dutch origin

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      CaseMethod1: N/A

      CaseMethod2: N/A

      CaseGenotypingMethod: PCR products from the four exons of CLN5 were generated from the affected individual and a control individual and subjected to Sanger sequencing. Genome-wide analysis methods were not used.

      Variant: Patient is homozygous for NM_006493.4(CLN5):c.688G>A (p.Asp230Asn), although this variant is referred to in the article as c.G2127A or p.Asp279Asn.

      ClinVar: 2566

      gnomAD: The variant is reported to have a maximum allele frequency of 0.00005437 (in the East Asian population, with no homozygous individuals). https://gnomad.broadinstitute.org/variant/13-77574715-G-A

      VariantEvidence: This missense variant in the fourth / final exon is predicted to introduce an additional N-glycosylation site within the C-terminal region of CLN5. Slower electrophoretic migration of the exogenously expressed protein indicates that the abnormal N-glycosylation site is functional (PMID:20052765). The variant also disturbs lysosomal trafficking (PMID:20052765).

      CaseAddInfo: N/A

      CasePMIDs: N/A

    1. 488

      Case#: Bravo-Gil_2016_Proband_488, sex not specified, onset at birth, family origin reported as Spanish

      CasePresentingHPOs: HP:0000618 (Blindness), HP:0001133 (Constriction of peripheral visual field), and HP:0000662 (Nyctalopia), HP:0003577 (Congenital onset), HP:0000639 (Nystagmus), HP:0010442 (Polydactyly). HP:0001249 (Intellectual disability), HP:0001513 (Obesity)

      CaseHPOFreeText: The proband is part of an inherited retinal disease cohort and received an initial diagnosis of Bardet-Biedl syndrome. Reduced visual acuity was the first visual symptom. The patient is now described as having total blindness.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The proband was genotyped by a capture-based next-generation sequencing panel that included 64 known retinal genes.

      CaseMethod1: next-generation sequencing panel

      CaseMethod2: Sanger sequencing of BBS1 to validate the presence of the variants

      CaseGenotypingMethod: The proband was genotyped by a capture-based next-generation sequencing panel that included 64 known retinal genes, followed by Sanger sequencing of BBS1 to validate the presence of the variants.

      Variant: The proband harbors the NM_024649.5(BBS1):c.1169T>G (p.Met390Arg) and NM_024649.5(BBS1):c.118del (p.Cys40fs) variants in the compound heterozygous state.

      ClinVar ID: 12143, 802688

      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.118del (p.Cys40fs) variant is found in gnomAD v2.1.1 at a frequency of 0.00005782 (2 alleles / 34592 total alleles, with 0 homozygotes) in the Admixed American population https://gnomad.broadinstitute.org/variant/11-66278553-CT-C?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. NM_024649.5(BBS1):c.118del (p.Cys40fs) is a frameshift variant in exon 2 of 17 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 has not been described as consanguineous.

      CasePMIDs: N/A

    2. 95

      Case#: Bravo-Gil_2016_Proband_95, sex not specified, age 7 years at onset, family origin reported as Spanish

      CasePresentingHPOs: HP:0007663 (Reduced visual acuity), HP:0001133 (Constriction of peripheral visual field), and HP:0000662 (Nyctalopia), HP:0000550 (Undetectable electroretinogram), HP:0410280 (Pediatric onset)

      CaseHPOFreeText: The proband is part of an inherited retinal disease cohort and received an initial diagnosis of simplex retinitis pigmentosa. Night blindness was the first visual symptom.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The proband was genotyped by a capture-based next-generation sequencing panel that included 64 known retinal genes.

      CaseMethod1: next-generation sequencing panel

      CaseMethod2: Sanger sequencing of BBS1 to validate the presence of the variants

      CaseGenotypingMethod: The proband was genotyped by a capture-based next-generation sequencing panel that included 64 known retinal genes, followed by Sanger sequencing of BBS1 to validate the presence of the variants.

      Variant: The proband harbors the NM_024649.5(BBS1):c.1169T>G (p.Met390Arg) and NM_024649.5(BBS1):c.1474-2A>G variants in the compound heterozygous state.

      ClinVar ID: 12143

      CAID: CA381424925

      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.1474-2A>G variant 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.1474-2A>G is a canonical splice site variant in intron 14 that is predicted but not confirmed to disrupt BBS1 splicing.

      CaseAddInfo: The proband's family has not been described as consanguineous.

      CasePMIDs: N/A

    1. BBS7

      Case#: Solmaz_2015_Proband_9, male, age 19 years at time of report, part of cohort from Turkey

      CasePresentingHPOs: HP:0031418 (Increased body mass index), HP:0000510 (Rod-cone dystrophy), HP:0000750 (Delayed speech and language development), HP:0000218 (High palate), HP:0000678 IDental crowding), HP:0010442 (Polydactyly), HP:0001159 (Syndactyly), HP:0001156 (Brachydactyly), HP:0000026 (Male hypogonadism), HP:0001256 (Intellectual disability, mild)

      CaseHPOFreeText: The patient has been diagnosed with Bardet-Biedl syndrome.

      CaseNotHPOs: HP:0000365 (Hearing impairment), HP:0000077 (Abnormality of the kidney)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping consisted of an NGS-based panel focusing on the BBS1, BBS2, ARL6, BBS4, BBS5, MKKS, BBS7, TTC8, BBS9, BBS10, TRIM32, BBS12, MKS1, CEP290, WDPCP, SDCCAG8, NPHP1 loci.

      CaseMethod1: NGS-based panel focusing on the BBS1, BBS2, ARL6, BBS4, BBS5, MKKS, BBS7, TTC8, BBS9, BBS10, TRIM32, BBS12, MKS1, CEP290, WDPCP, SDCCAG8, NPHP1 loci.

      CaseMethod2: Sanger sequencing of the BBS7 locus

      CaseGenotypingMethod: Genotyping consisted of an NGS-based panel focusing on the BBS1, BBS2, ARL6, BBS4, BBS5, MKKS, BBS7, TTC8, BBS9, BBS10, TRIM32, BBS12, MKS1, CEP290, WDPCP, SDCCAG8, NPHP1 loci, followed by Sanger sequencing of the BBS7 locus.

      Variant: The patient harbors the NM_018190.4:c.712_715del (p.Arg238GlufsTer59) variant in the homozygous state.

      CAID: CA3064432

      gnomAD: The NM_018190.4:c.712_715del (p.Arg238GlufsTer59) variant is found in gnomAD v2.1.1 at a maximum allele frequency of 0.0001146 (13/113390) in the European non-Finnish population, with 0 homozygotes https://gnomad.broadinstitute.org/variant/4-122775861-CCTCT-C

      VariantEvidence: NM_018190.4:c.712_715del (p.Arg238GlufsTer59) is an out-of-frame deletion variant in exon 7 of 18 and is predicted to trigger nonsense-mediated decay or to at least truncate the C-terminal 65% of the protein product.

      CaseAddInfo: Consanguinity of this specific patient's family is unknown, but the cohort was reported to have a high rate of consanguineous probands.

      CasePMIDs: N/A

    1. V.1

      Case: Gliem_2000_Family_2_patient_V.1, male, country of origin Germany, onset at 51 years of age

      DiseaseAssertion: Sorsby fundus dystrophy

      FamilyInfo: The variant was inherited by the proband rather than acquired de novo.

      CasePresentingHPOs: HP:0007663 (Reduced visual acuity), HP:0011510 (Drusen), HP:0000533 (Chorioretinal atrophy), HP:0012508, (Metamorphopsia), HP:0000662 (Nyctalopia)

      CaseHPOFreeText: Presentation at age 51 with visual loss. Evaluation at age 71 found widespread central and midperipheral chorioretinal atrophy, thinning of the choroid in areas of atrophy, central focal subretinal fibrosis at the posterior pole, metamorphopsia (with onset in the sixth decade of life), and nyctalopia that was only developed late in disease progression.

      CaseNOTHPOs: N/A

      CaseNOTHPOFreeText: N/A

      CasePreviousTesting: Phenotypic characterization only

      GenotypingMethod: Sanger sequencing of PCR products from all 5 exons and flanking splice junctions of the TIMP3 gene.

      PreviouslyPublished: Some of the family members were previously identified by genotyping as having Sorsby fundus dystrophy (PMID:25390527), and are more extensively phenotypically described in this study.

      SupplementalData: N/A

      Variant: Patients harbor the NM_000362.5(TIMP3):c.545A>G (p.Tyr182Cys) missense variant.

      CAID: CA411540365

      gnomAD: Variant is absent from gnomAD.

      VariantEvidence: This missense variant within exon 5 of TIMP3 results in an unpaired Cys residue.

    2. II.1

      Case: Gliem_2000_Family_1_patient_II.1, female, country of origin Germany, onset at 47 years of age

      DiseaseAssertion: Sorsby's fundus dystrophy

      FamilyInfo: The variant was inherited by the proband rather than acquired de novo.

      CasePresentingHPOs: HP:0000662 (Nyctalopia), HP:0007663 (Reduced visual acuity), HP:0011510 (Drusen), HP:0000533 (Chorioretinal atrophy)

      CaseHPOFreeText: Presentation at age 47 with nyctalopia. Evaluation at age 61 showed drusen deposits in macular area, near optic disk and along vascular arcades, central and midperipheral atrophy, and reduced choroidal thickness.

      CaseNOTHPOs: HP:0011506 (Choroidal neovascularization)

      CaseNOTHPOFreeText: N/A

      CasePreviousTesting: Phenotypic characterization only

      GenotypingMethod: Sanger sequencing of PCR products from all 5 exons and flanking splice junctions of the TIMP3 gene.

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: Proband harbors the NM_000362.5(TIMP3):c.530A>G (p.Tyr177Cys) missense variant.

      CAID: CA411540328

      gnomAD: Variant is absent from gnomAD.

      VariantEvidence: This missense variant within exon 5 of TIMP3 results in an unpaired Cys residue.

    1. F5-P9,10,11PRSS56: c.[1066dupC];[1066dupC],p.[Gln356ProfsX152];[Gln356ProfsX152

      Case#: Gal_2011_Family_5_Proband_P9, female, age 21 years at time of report, family national origin described as Saudi

      CasePresentingHPOs: Hypermetropia HP:0000540, Microphthalmia HP:0000568

      CaseHPOFreeText: The proband received a diagnosis of posterior microphthalmos, with one feature being a moderate papillomacular fold.

      CaseNotHPOs: Ocular hypertension HP:0007906

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The proband's family may have been previously subjected to linkage mapping, and was also previously genotyped by Sanger sequencing of the MFRP locus.

      CaseMethod1: Sanger sequencing of MFRP

      CaseMethod2: Sanger sequencing of PRSS56

      CaseGenotypingMethod: The proband's family may have been previously subjected to linkage mapping, and was also previously genotyped by Sanger sequencing of the MFRP locus, followed by Sanger sequencing of PRSS56.

      Variant: The individual harbors the NM_001195129.2(PRSS56):c.1066dup (p.Gln356fs) variant in the homozygous state.

      ClinVar: 31077

      gnomAD: This variant is found in gnomAD v4.1.0 at a frequency of 0.0008496 in the Middle Eastern population https://gnomad.broadinstitute.org/variant/2-232523817-A-AC?dataset=gnomad_r4

      VariantEvidence: NM_001195129.2(PRSS56):c.1066dup (p.Gln356fs) is a frameshift variant in exon 9 of 13 and is predicted to trigger nonsense-mediated decay.

      CaseAddInfo: The proband is from a cohort where more than half of the families had known consanguinity.

      CasePMIDs: N/A

    1. The JATD1 patient was notable for having had severe kidney involvement requiring kidney transplant during childhood, as well as retinal disease, as detailed in Table 1. In addition, typical skeletal features of JATD were present in this patient (Fig. 1A, F, and L). We proceeded to screen additional patients using a diagnostic NGS panel developed for ciliopathies encompassing all exons and adjacent intronic boundaries of 131 known ciliopathy genes. This totaled 2,412 coding exons of genes selected from cilia proteome and ciliary trafficking studies (Frank et al., 2012).

      Case#: Schmidts_2013_Patient_JATD1, male, 12 years of age at time of study, of Serbian ethnicity

      CasePresentingHPOs: HP:0003593 (Infantile onset), HP:0002093 (Respiratory insufficiency), HP:0000556 (Retinal dystrophy), HP:0009370 (Type A brachydactyly), HP:0004322 (Short stature), HP:0005257 (Thoracic hypoplasia), HP:0010579 (Cone-shaped epiphysis), HP:0000369 (Low-set ears), HP:0003774 (Stage 5 chronic kidney disease), HP:0007703 (Abnormality of retinal pigmentation), HP:0000803 (Renal cortical cysts), HP:0033130 (Abnormal renal echogenicity), HP:0000822 (Hypertension), HP:0000773 (Short ribs), HP:0000900 (Thickened ribs), HP:0000774 (Narrow chest)

      CaseHPOFreeText: This proband was diagnosed with Jeune's asphyxiating thoracic dystrophy (JATD).

      CaseNotHPOs: HP:0010442 (Polydactyly), HP:0001737 (Pancreatic cysts), HP:0001392 (Abnormality of the liver), HP:0001263 (Global developmental delay)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous testing appears to have been limited to a clinical diagnosis of Jeune's asphyxiating thoracic dystrophy.

      CaseMethod1: Whole exome sequencing, focusing on variants consistent with autosomal recessive inheritance and homologous to genes present in the ciliary proteome.

      CaseMethod2: Sanger sequencing of IFT140 in the patient and available family members

      CaseGenotypingMethod: The patient and family members were genotyped by whole exome sequencing and confirmed by Sanger sequencing of IFT140.

      Variant: The patient is a compound heterozygote harboring the paternal NM_014714.4(IFT140):c.874G>A (p.Val292Met) and maternal NM_014714.4(IFT140):c.1380del (p.Asn460fs) variants in IFT140.

      ClinVar ID: 97053, 97055

      gnomAD: The NM_014714.4(IFT140):c.874G>A (p.Val292Met) variant is present in gnomAD at a frequency of 0.000008852 in the European non-Finnish population (1/112966, with no homozygotes). https://gnomad.broadinstitute.org/variant/16-1637962-C-T The NM_014714.4(IFT140):c.1380del (p.Asn460fs) variant is present in gnomAD at a frequency of 0.000008804 in the European non-Finnish population (1/113590, with no homozygotes). https://gnomad.broadinstitute.org/variant/16-1633366-CG-C

      VariantEvidence: NM_014714.4(IFT140):c.874G>A (p.Val292Met) is a missense variant that does not have functional evidence of gene impact. NM_014714.4(IFT140):c.1380del (p.Asn460fs) is a frameshift variant that introduces a premature stop codon in exon 12/31 and is predicted to trigger NMD or at least to truncate ~69% of the protein product.

      CaseAddInfo: The proband's parents are each heterozygous for one variant.

      CasePMIDs: N/A

    1. i

      Case#: Haider_2000_Proband_6, sex, age, and origin not reported

      CasePresentingHPOs: N/A

      CaseHPOFreeText: The proband is part of a cohort in which all patients had a diagnosis of enhanced S-cone syndrome, based on electroretinogram and/or psychophysics, as well as optical coherence tomography. Other phenotypes within the cohort members (but not tracked individually) included increased sensitivity to blue light; visual loss, night blindness occurring from early in life, varying degrees of L-cone and M-cone vision, and retinal degeneration.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping was limited to Sanger sequencing of NR2E3, followed by SSCP to screen other family members for the variant.

      CaseMethod1: Sanger sequencing of NR2E3

      CaseMethod2: SSCP analysis of PCR products from NR2E3

      CaseGenotypingMethod: Genotyping was performed by Sanger sequencing of NR2E3, followed by SSCP to screen other family members for the variant.

      Variant: The individual harbors the NM_014249.4(NR2E3):c.310C>T (p.Arg104Trp) variant in the homozygous state.

      ClinVarID: 846973

      gnomAD: The variant is found in gnomAD version 4.1.0 at a frequency of 0.00002739 (2 alleles / 73,032 total alleles) in the African / African-American population, with no homozygous occurrences. https://gnomad.broadinstitute.org/variant/chr15-71811830-C-T?dataset=gnomad_r4

      VariantEvidence: NM_014249.4(NR2E3):c.310C>T (p.Arg104Trp) is a missense variant within the zinc finger / DNA-binding domain of NR2E3,.

      CaseAddInfo: It is not clear whether or not the proband comes from a consanguineous family.

      CasePMIDs: N/A

    2. m

      Case#: Haider_2000_Proband_1, male, age and origin not reported

      CasePresentingHPOs: N/A

      CaseHPOFreeText: The proband is part of a cohort in which all patients had a diagnosis of enhanced S-cone syndrome, based on electroretinogram and/or psychophysics, as well as optical coherence tomography. Other phenotypes within the cohort members (but not tracked individually) included increased sensitivity to blue light; visual loss, night blindness occurring from early in life, varying degrees of L-cone and M-cone vision, and retinal degeneration.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping was limited to Sanger sequencing of NR2E3, followed by SSCP to screen other family members for the variant.

      CaseMethod1: Sanger sequencing of NR2E3

      CaseMethod2: SSCP analysis of PCR products from NR2E3

      CaseGenotypingMethod: Genotyping was performed by Sanger sequencing of NR2E3, followed by SSCP to screen other family members for the variant.

      Variant: The individual harbors the NM_014249.4(NR2E3):c.119-2A>C variant in the homozygous state.

      ClinVarID: 191059

      gnomAD: The variant is found in gnomAD version 4.1.0 at a frequency of 0.001359 in the Ashkenazi Jewish population and 0.0007992 in the European (non-Finnish) population (919 / 1,149,942), with no homozygotes observed. https://gnomad.broadinstitute.org/variant/chr15-71811481-A-C?dataset=gnomad_r4

      VariantEvidence: NM_014249.4(NR2E3):c.119-2A>C is a canonical splice acceptor site variant adjacent to exon 2 of 6, which is an out-of-frame exon that could potentially trigger nonsense-mediated decay if skipped.

      CaseAddInfo: The proband is the offspring of 3rd cousins and has an affected sibling and an affected second cousin once removed harboring the variant in the same homozygous genotype (Figure 3c).

      CasePMIDs: N/A

    3. t

      Case#: Haider_2000_Proband_3, sex, age, and origin not reported

      CasePresentingHPOs: N/A

      CaseHPOFreeText: The proband is part of a cohort in which all patients had a diagnosis of enhanced S-cone syndrome, based on electroretinogram and/or psychophysics, as well as optical coherence tomography. Other phenotypes within the cohort members (but not tracked individually) included increased sensitivity to blue light; visual loss, night blindness occurring from early in life, varying degrees of L-cone and M-cone vision, and retinal degeneration.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping was limited to Sanger sequencing of NR2E3, followed by SSCP to screen other family members for the variant.

      CaseMethod1: Sanger sequencing of NR2E3

      CaseMethod2: SSCP analysis of PCR products from NR2E3

      CaseGenotypingMethod: Genotyping was performed by Sanger sequencing of NR2E3, followed by SSCP to screen other family members for the variant.

      Variant: The individual harbors the NM_014249.4(NR2E3):c.226C>T (p.Arg76Trp) variant in the homozygous state.

      ClinVarID: 5529

      gnomAD: The variant is not found in gnomAD version 4.1.0 at a frequency of 0.0001124 in the South Asian population (10 alleles / 88,960 total alleles, with no homozygotes) https://gnomad.broadinstitute.org/variant/chr15-71811590-C-T?dataset=gnomad_r4

      VariantEvidence: NM_014249.4(NR2E3):c.226C>T (p.Arg76Trp) is a missense variant within the zinc finger / DNA-binding domain of NR2E3, and occurs at the same amino acid position as another missense substitution reported in the same article.

      CaseAddInfo: It is not clear whether the proband came from a consanguineous family.

      CasePMIDs: N/A

    4. u

      Case#: Haider_2000_Proband_2, sex, age, and origin not reported

      CasePresentingHPOs: N/A

      CaseHPOFreeText: The proband is part of a cohort in which all patients had a diagnosis of enhanced S-cone syndrome, based on electroretinogram and/or psychophysics, as well as optical coherence tomography. Other phenotypes within the cohort members (but not tracked individually) included increased sensitivity to blue light; visual loss, night blindness occurring from early in life, varying degrees of L-cone and M-cone vision, and retinal degeneration.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping was limited to Sanger sequencing of NR2E3, followed by SSCP to screen other family members for the variant.

      CaseMethod1: Sanger sequencing of NR2E3

      CaseMethod2: SSCP analysis of PCR products from NR2E3

      CaseGenotypingMethod: Genotyping was performed by Sanger sequencing of NR2E3, followed by SSCP to screen other family members for the variant.

      Variant: The individual harbors the NM_014249.4(NR2E3):c.200_208del (p.Cys67_Gly69del) variant in the homozygous state.

      ClinVarID: 5531

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

      VariantEvidence: NM_014249.4(NR2E3):c.200_208del (p.Cys67_Gly69del) is a short in-frame deletion variant within the zinc finger / DNA-binding domain of NR2E3.

      CaseAddInfo: It is not clear whether the proband came from a consanguineous family.

      CasePMIDs: N/A

    5. a

      Case#: Haider_2000_Proband_4, sex, age, and origin not reported

      CasePresentingHPOs: N/A

      CaseHPOFreeText: The proband is part of a cohort in which all patients had a diagnosis of enhanced S-cone syndrome, based on electroretinogram and/or psychophysics, as well as optical coherence tomography. Other phenotypes within the cohort members (but not tracked individually) included increased sensitivity to blue light; visual loss, night blindness occurring from early in life, varying degrees of L-cone and M-cone vision, and retinal degeneration.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping was limited to Sanger sequencing of NR2E3, followed by SSCP to screen other family members for the variant.

      CaseMethod1: Sanger sequencing of NR2E3

      CaseMethod2: SSCP analysis of PCR products from NR2E3

      CaseGenotypingMethod: Genotyping was performed by Sanger sequencing of NR2E3, followed by SSCP to screen other family members for the variant.

      Variant: The individual harbors the NM_014249.4(NR2E3):c.227G>A (p.Arg76Gln) variant in the homozygous state.

      ClinVarID: 5530

      gnomAD: The variant is found in gnomAD version 4.1.0 at a frequency of 0.0004046 in the South Asian population (36 alleles / 88,984 total alleles, with 1 homozygote) https://gnomad.broadinstitute.org/variant/chr15-71811591-G-A?dataset=gnomad_r4

      VariantEvidence: NM_014249.4(NR2E3):c.227G>A (p.Arg76Gln) is a missense variant within the zinc finger / DNA-binding domain of NR2E3, and occurs at the same amino acid position as another missense substitution reported in the same article.

      CaseAddInfo: It is not clear whether the proband came from a consanguineous family.

      CasePMIDs: N/A

    1. non-syndromic

      Case#: Jespersgaard_2019_Patient_163, gender and age not specified, origin likely to be Danish based on cohort

      CasePresentingHPOs: N/A

      CaseHPOFreeText: The proband has been diagnosed with retinitis pigmentosa, as part of a larger group of generalized non-syndromic retinal dystrophies. Detailed phenotypes are not described.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Next-generation sequencing was performed focusing on a targeted panel of 125 genes known to be linked to inherited retinal disease.

      CaseMethod1: NGS panel

      CaseMethod2: N/A

      CaseGenotypingMethod: Next-generation sequencing was performed focusing on a targeted panel of 125 genes known to be linked to inherited retinal disease. It is not clear whether Sanger sequencing was used to validate the genotyping of this particular case.

      Variant: The proband harbors the NM_000440.3(PDE6A):c.612del (p.Lys205fs) variant in the homozygous state.

      ClinVar: 636056

      gnomAD: The NM_000440.3(PDE6A):c.612del (p.Lys205fs) variant is not found in gnomAD v2.1.1.

      VariantEvidence: NM_000440.3(PDE6A):c.612del (p.Lys205fs) is a frameshift variant in exon 2 that is predicted to result in nonsense-mediated decay or at least to truncate the C-terminal ~76% of the protein product.

      CaseAddInfo: N/A

      CasePMIDs: N/A

    2. IRD can be inherited as autosomal recessive (AR)

      Case#: Jespersgaard_2019_Patient_165, gender and age not specified, origin likely to be Danish based on cohort

      CasePresentingHPOs: N/A

      CaseHPOFreeText: The proband has been diagnosed with retinitis pigmentosa, as part of a larger group of generalized non-syndromic retinal dystrophies. Detailed phenotypes are not described.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Next-generation sequencing was performed focusing on a targeted panel of 125 genes known to be linked to inherited retinal disease.

      CaseMethod1: NGS panel

      CaseMethod2: N/A

      CaseGenotypingMethod: Next-generation sequencing was performed focusing on a targeted panel of 125 genes known to be linked to inherited retinal disease. It is not clear whether Sanger sequencing was used to validate the genotyping of this particular case.

      Variant: The proband harbors the NM_000440.3(PDE6A):c.1620+1G>A variant in the homozygous state.

      ClinVar: 636054

      gnomAD: The NM_000440.3(PDE6A):c.1620+1G>A variant is found in gnomAD v2.1.1 at a frequency of 0.00003267 (1/30608) in the South Asian population https://gnomad.broadinstitute.org/variant/5-149275918-C-T

      VariantEvidence: The NM_000440.3(PDE6A):c.1620+1G>A variant disrupts a canonical splice site in intron 12, but does not have experimental confirmation of exon skipping or frameshift.

      CaseAddInfo: N/A

      CasePMIDs: N/A

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

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

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

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

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

      CaseNotHPOFreeText: N/A

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

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

      CaseMethod2: N/A

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

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

      ClinVar: 1240018

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

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

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

      CasePMIDs: N/A

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

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

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

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

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

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

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

      CaseMethod2: N/A

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

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

      ClinVar: 162134

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

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

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

      CasePMIDs: N/A

    1. 7775

      Case#: Morimura_1998_Family_7775_Patient_II-1, female, age and family origin not specified

      CasePresentingHPOs: HP:0000546 (Retinal degeneration)

      CaseHPOFreeText: While specific phenotypes are not provided, the initial diagnosis of Leber congenital amaurosis indicates that the proband was either born blind or lost vision within a period of months after birth.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

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

      CaseMethod1: Screening of PCR-amplified RPE65 exons using SSCA

      CaseMethod2: Sanger sequencing of all 14 exons of RPE65

      CaseGenotypingMethod: PCR-amplified exons identified by SSCA as candidates to harbor variants were subjected to Sanger sequencing.

      Variant: The proband is a homozygote within the RPE65 locus, harboring the NM_000329.3(RPE65):c.271C>T (p.Arg91Trp) variant.

      ClinVar: 13115 (homozygous)

      gnomAD: The NM_000329.3(RPE65):c.271C>T (p.Arg91Trp) variant has a maximum allele frequency of 0.0002406 (within the African / African-American population, with no homozygotes): https://gnomad.broadinstitute.org/variant/1-68910541-G-A

      VariantEvidence: The NM_000329.3(RPE65):c.271C>T (p.Arg91Trp) variant was also detected in this publication in a heterozygous state within two apparently unrelated probands with Retinitis pigmentosa (Figure 2A) and Leber congenital amaurosis (Figure 2B), respectively. A separate publication (PMID: 16754667) expressed this missense variant in non-patient cells and showed that it abolished the isomerohydrolase activity of the protein product, reduced its stability, and shifted the subcellular localization from predominantly membrane-associated to predominantly cytosolic.

      CaseAddInfo: Genotyping of the proband's mother revealed NM_000329.3(RPE65):c.271C>T (p.Arg91Trp) in a heterozygous state. The father was not genotyped. Potential consanguinity between the parents was not reported.

      CasePMIDs: N/A

    2. Gly40Ser (GGC to AGC)

      Case#: Morimura_1998_Family_9148_Patient_II-1, male, age and family origin not specified

      CasePresentingHPOs: HP:0000546 (Retinal degeneration)

      CaseHPOFreeText: While specific phenotypes are not provided, the initial diagnosis of Leber congenital amaurosis indicates that the proband was either born blind or lost vision within a period of months after birth.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

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

      CaseMethod1: Screening of PCR-amplified RPE65 exons using SSCA

      CaseMethod2: Sanger sequencing of all 14 exons of RPE65

      CaseGenotypingMethod: PCR-amplified exons identified by SSCA as candidates to harbor variants were subjected to Sanger sequencing.

      Variant: The proband is a compound heterozygote within the RPE65 locus, harboring the NM_000329.3(RPE65):c.118G>A (p.Gly40Ser) and NM_000329.3(RPE65):c.544C>T (p.His182Tyr) variants.

      ClinVar: 98830, 98875

      gnomAD: The NM_000329.3(RPE65):c.2T>C (p.Met1Thr) variant has a maximum allele frequency of 0.00009643 (within the Ashkenazi Jewish population, with no homozygotes): https://gnomad.broadinstitute.org/variant/1-68912520-C-T The NM_000329.3(RPE65):c.544C>T (p.His182Tyr) variant has a maximum allele frequency of 0.00009925 (within the Ashkenazi Jewish population, with no homozygotes): https://gnomad.broadinstitute.org/variant/1-68906635-G-A

      VariantEvidence: The paternal NM_000329.3(RPE65):c.118G>A (p.Gly40Ser) and maternal NM_000329.3(RPE65):c.544C>T (p.His182Tyr) variants are missense variants that do not have evidence of gene impact.

      CaseAddInfo: Genotyping of family members revealed the two variants to be in trans. The brother of the proband shares the same genotype and diagnosis of Leber congenital amaurosis.

      CasePMIDs: N/A

    3. Glu102Lys (GAA to AAA)

      Case#: Morimura_1998_Family_3867_Patient_II-1, female, age and family origin not specified

      CasePresentingHPOs: HP:0000546 (Retinal degeneration)

      CaseHPOFreeText: While specific phenotypes are not provided, the initial diagnosis of Leber congenital amaurosis indicates that the proband was either born blind or lost vision within a period of months after birth.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

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

      CaseMethod1: Screening of PCR-amplified RPE65 exons using SSCA

      CaseMethod2: Sanger sequencing of all 14 exons of RPE65

      CaseGenotypingMethod: PCR-amplified exons identified by SSCA as candidates to harbor variants were subjected to Sanger sequencing.

      Variant: The proband is a compound heterozygote within the RPE65 locus, harboring the NM_000329.3(RPE65):c.271C>T (p.Arg91Trp) and NM_000329.3(RPE65):c.304G>A (p.Glu102Lys) variants.

      ClinVar: 13115, 98862

      gnomAD: The NM_000329.3(RPE65):c.271C>T (p.Arg91Trp) variant has a maximum allele frequency of 0.0002406 (within the African / African-American population, with no homozygotes): https://gnomad.broadinstitute.org/variant/1-68910541-G-A The NM_000329.3(RPE65):c.304G>A (p.Glu102Lys) variant is not found within gnomAD.

      VariantEvidence: NM_000329.3(RPE65):c.304G>A (p.Glu102Lys) is a missense variant that does not have evidence of gene impact. The NM_000329.3(RPE65):c.271C>T (p.Arg91Trp) variant was also detected in this publication in a heterozygous state within two apparently unrelated probands with Retinitis pigmentosa (Figure 2A) and Leber congenital amaurosis (Figure 2B), respectively. A separate publication (PMID: 16754667) expressed this missense variant in non-patient cells and showed that it abolished the isomerohydrolase activity of the protein product, reduced its stability, and shifted the subcellular localization from predominantly membrane-associated to predominantly cytosolic.

      CaseAddInfo: Genotyping of the proband's parents revealed NM_000329.3(RPE65):c.271C>T (p.Arg91Trp) as the paternal variant and NM_000329.3(RPE65):c.304G>A (p.Glu102Lys) as a de novo variant.

      CasePMIDs: N/A

    1. The two affected individuals in Family B had initial symptoms of decreased night vision with onset of disease in the first few years of life (Table 2). The fundus showed features of an atypical retinal dystrophy with white flecks in the periphery and gliotic scars in the posterior pole (Figure 2C). ERGs were of the rod-cone type. The condition of the ERG and clinical features were highly suggestive of an enhanced S-cone syndrome (ESCS) phenotype [11]. However, ESCS could not be confirmed as the patient did not undergo optical coherence tomography for macula schisis. In addition, the gliotic scars observed were unusual.

      Case#: Kannabiran _2012_Proband_B-2, male, age 10 years at time of report, national origin from India

      CasePresentingHPOs: Nyctalopia HP:0000662, Childhood onset HP:0011463, Retinal flecks HP:0012045, Decreased light- and dark-adapted electroretinogram amplitude (rod-cone pattern) HP:0000654, Retinal pigment epithelial atrophy HP:0007722

      CaseHPOFreeText: The proband has a diagnosis of autosomal recessive retinitis pigmentosa, with phenotypes highly suggestive of enhanced S-cone syndrome. The proband had gliotic scars in the posterior pole. No OCT was performed, so it is unknown whether macula schisis was present.

      CaseNotHPOs: Abnormal optic disc morphology HP:0012795, Abnormal retinal artery morphology HP:0000630, Bone spicule pigmentation of the retina HP:0007737

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping consisted of homozygosity mapping, which established linkage to a 41Mb region of chromosome 15, identifying NR2E3 and RLBP1 as the likely candidate loci.

      CaseMethod1: Homozygosity mapping within the family of the proband

      CaseMethod2: Sanger sequencing of NR2E3 and RLBP1

      CaseGenotypingMethod: Genotyping was performed by homozygosity mapping within the family of the proband, followed by Sanger sequencing of NR2E3 and RLBP1.

      Variant: The individual harbors the NM_014249.4(NR2E3):c.143_144delinsAGTGTGCCTCCAGTGCCTCGCTCCA (p.Arg48fs) variant in the homozygous state.

      ClinVarID: 183143

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

      VariantEvidence: NM_014249.4(NR2E3):c.143_144delinsAGTGTGCCTCCAGTGCCTCGCTCCA (p.Arg48fs) is a frameshift variant in exon 2 of 8 that is predicted to introduce a premature stop codon and trigger nonsense-mediated decay.

      CaseAddInfo: The proband has two unaffected heterozygous parents and an affected sister who shares the same homozygous genotype.

      CasePMIDs: N/A

    1. c.481–12T>A and c.1483–2A>G in family CHRO 9

      Case#: Chang_2009_Family_CHRO9_Proband_II:3, female, age 26 years at time of report, family origin not described

      CasePresentingHPOs: HP:0000613 (Photophobia), HP:0003593 (Infantile onset), HP:0001141 (Severely reduced visual acuity), HP:0011003 (High myopia), HP:0000551 (Color vision defect, described as complete lack of color discrimination), HP:0000603 (Central scotoma), HP:0030465 (Undetectable light-adapted electroretinogram), HP:0030479 (Abnormal amplitude of light-adapted flicker electroretinogram, described as extinguished), HP:0007401 (Macular atrophy)

      CaseHPOFreeText: The proband and an affected family member were previously diagnosed with achromatopsia.

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

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Affected and unaffected family members were initially subjected to genotyping of the CNGA3, GNGB3, and GNAT2 loci, confirming absence of causal variants in these known achromatopsia-related genes.

      CaseMethod1: Sanger sequencing of CNGA3, GNGB3, and GNAT2

      CaseMethod2: Sanger sequencing of the 22 exons and flanking regions of PDE6C

      CaseGenotypingMethod: CNGA3, GNGB3, and GNAT2 were previously screened / known not to harbor causal variants for achromatopsia. The family members were then subjected to Sanger sequencing of the 22 exons and flanking regions of PDE6C.

      Variant: The proband harbors the NM_006204.4(PDE6C):c.481-12T>A and NM_006204.4(PDE6C):c.1483-2A>G variants in the compound heterozygous state.

      ClinVar ID: 8770, 8771

      gnomAD: The NM_006204.4(PDE6C):c.481-12T>A variant was not found in gnomAD v2.1.1. The NM_006204.4(PDE6C):c.1483-2A>G variant was not found in gnomAD v2.1.1.

      VariantEvidence: NM_006204.4(PDE6C):c.481-12T>A is an intronic variant that has been subjected to a mini-gene assay in COS7 cells and triggers a fully penetrant splicing defect (use of a cryptic splice site 10 nucleotides upstream, resulting in a frameshift encoding p.Asn161fsX169, Figure S5A). NM_006204.4(PDE6C):c.1483-2A>G is a canonical splice site variant that has been subjected to a mini-gene assay in COS7 cells and triggers a fully penetrant splicing defect (exon 12 skipping, resulting in an in-frame deletion encoding p.495_543del49, Figure S5B).

      CaseAddInfo: The patient has an affected sister who shares the same compound heterozygous genotype, while the parents and one other sibling are each unaffected carriers.

      CasePMIDs: N/A

    1. TCD-G proband

      Case#: Bowne_2011_Family_TCD-G_Patient_53, male, unspecified age, family origin in Ireland

      CasePresentingHPOs: N/A

      CaseHPOFreeText: The patient was initially diagnosed with retinitis pigmentosa prior to genotyping. Detailed phenotypes are not specified for individual patients.

      CaseNotHPOs: HP:0003593 (Infantile onset), HP:0011463 (Childhood onset)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Candidate gene sequencing for variants in other known retinitis pigmentosa genes. SNP-based linkage analysis mapped the phenotype of autosomal dominant retinitis pigmentosa to an 8.8-Mb genomic region located at chr1 p31. It is not clear whether the patient was one of 3 affected individuals subjected to whole exome sequencing.

      CaseMethod1: SNP-based linkage analysis and whole exome sequencing

      CaseMethod2: Candidate gene sequencing

      CaseGenotypingMethod: Sanger sequencing of 11 candidate genes among the 50 known genes from the mapped region, including RPE65 and PDE4B.

      Variant: The patient harbors the NM_000329.3(RPE65):c.1430A>G (p.Asp477Gly) variant in one allele of RPE65.

      ClinVar: 750796

      gnomAD: The NM_000329.3(RPE65):c.1430A>G (p.Asp477Gly) variant was not found in gnomAD.

      VariantEvidence: Exogenous expression of the variant reveals protein expression levels, cellular localization and retinoid isomerase activity comparable to the wild-type (PMID: 29659842). However, knock-in mouse models exhibit retinyl ester accumulation (PMID: 29659842), abnormally slow regeneration of 11-cis-retinal after light exposure, and ERG results indicative of delayed dark adaptation (PMID: 28041994). Mice with CRISPR-mediated knock-in of the variant also exhibit a splicing defect in RPE65 due to the introduction of a cryptic splice site, which likely triggers a frameshift, exclusion of exons 13 and 14 from the transcript, and premature truncation of the protein product (PMID: 30628748).

      CaseAddInfo: N/A

      CasePMIDs: PMID: 20861475, PMID: 16799052, PMID: 17982421, PMID: 17924349, PMID: 19520207, PMID: 17003455

    1. preserved functional vision until later life with essentially uninvolved peripheral retina

      Case: Tabata_1998_Family_Ue_patient_1, female, 73 years of age at onset of visual symptoms, country of origin Japan

      DiseaseAssertion: Sorsby's fundus dystrophy

      FamilyInfo: The proband has two affected siblings. All three were subjected to genotyping.

      CasePresentingHPOs: HP:0007663 (Reduced visual acuity), HP:0025094 (Disciform macular scar), HP:0000603 (Central scotoma), HP:0030496 (Macular exudate), HP:0030506 (Yellow/white lesions of the retina), HP:0025243 (Subretinal hemorrhage), HP:0000580 (Pigmentary retinopathy), HP:0030491(Choriocapillaris atrophy)

      CaseHPOFreeText: Onset of decreased central vision was seen in the 8th decade of life (both eyes between the ages of 73 and 77).

      CaseNOTHPOs: HP:0007994 (Peripheral visual field loss), HP:0000512 (Abnormal electroretinogram), HP:0000662 (Nyctalopia)

      CaseNOTHPOFreeText: Although central vision was decreased, peripheral fundi remained uninvolved. Patient had no difficulties with daily activities.

      CasePreviousTesting: PCR-based heteroduplex analysis using gel electophoresis

      CaseGenotypingMethod: Sanger sequencing

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: NM_000362.5:c.439-2dup (TIMP3) is predicted to disrupt a splice acceptor site at the junction of intron 4 and exon 5.

      CAID: CA1139771334

      gnomAD: Variant is absent from gnomAD.

      VariantEvidence: Variant introduces an extra base within a splice acceptor site within intron 4, two bases upstream of exon 5.

    2. developed macular dystrophies at an approximately 30-year later age of onset

      Case: Tabata_1998_Family_Ch_patient_1, male, 52 years of age at onset of visual symptoms, country of origin Japan

      DiseaseAssertion: Sorsby's fundus dystrophy

      FamilyInfo: The proband passed on the variant to his son and likely inherited it from his affected mother (who was not genotyped).

      CasePresentingHPOs: HP:0007663 (Reduced visual acuity), HP:0025094 (Disciform macular scar), HP:0000529 (Progressive visual loss), HP:0000603 (Central scotoma)

      CaseHPOFreeText: Onset of decreased central vision was seen in the 6th decade of life (both eyes between the ages of 52 and 57).

      CaseNOTHPOs: HP:0007994 (Peripheral visual field loss), HP:0000512 (Abnormal electroretinogram)

      CaseNOTHPOFreeText: Although central vision was progressively lost, peripheral fundi have remained uninvolved and the individual has continued to walk unguided into the 8th decade of his life.

      CasePreviousTesting: PCR-based heteroduplex analysis using gel electophoresis

      CaseGenotypingMethod: Sanger sequencing

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: NM_000362.5:c.439-2dup (TIMP3) is predicted to disrupt a splice acceptor site at the junction of intron 4 and exon 5.

      CAID: CA1139771334

      gnomAD: Variant is absent from gnomAD.

      VariantEvidence: Variant introduces an extra base within a splice acceptor site within intron 4, two bases upstream of exon 5.

    1. The 55-year-old proband (III-6 in Fig. 1a) was a woman who presented with gait instability, dysarthria, and a mild cognitive deficit. Her past medical history had been unremarkable until she first sought neurological expert consultation after age 50 years because of unsteady gait.

      Case#: Mancini_2015_Patient_III-6, female, age 52 at onset of visual symptoms, North-West Italian origin

      CasePresentingHPOs: HP:0003596 (Middle age onset), HP:0002355 (Difficulty walking), HP:0001260 (Dysarthria), HP:0001268 (Mental deterioration), HP:0000572 (Visual loss), HP:0001272 (Cerebellar atrophy), HP:0006855 (Cerebellar vermis atrophy), HP:0008278 (Cerebellar cortical atrophy), HP:0001251 (Ataxia), HP:0002317 (Unsteady gait), HP:0000639 (Nystagmus), HP:0001310 (Dysmetria), HP:0007350 (Hyperreflexia in upper limbs), HP:0002395 (Lower limb hyperreflexia), HP:0000736 (Short attention span), HP:0002075 (Dysdiadochokinesis), HP:0001123 (Visual field defect), HP:0030528 (Paracentral scotoma), HP:0000543 (Optic disc pallor), HP:0002346 (Head tremor)

      CaseHPOFreeText: Presentation was at age 52, with visual loss (attributed to glaucoma) as the first phenotype manifested. Pale and excavated optic disc (bilateral) was consistent with severe glaucoma or previous lesion of optic nerve. Neurological symptoms were recognized at age 55 (gait instability, dysarthria, and mild cognitive deficit). Onset of slight attention deficit, nystagmus with vertical component, dysarthric slurred speech, mild head tremor, truncal ataxia, mild dysmetria and dysdiadochokinesia, ataxic gait / posture, brisk deep reflexes in all four limbs, marked cerebellar atrophy (particularly in the vermis), severe bilateral cortical atrophy (especially parietal and temporal), limited visual field (bilateral, with paracentral scotoma in the left eye only), and pale and excavated optic discs (bilateral) were found at age 58. Dysarthria worsened at age 61, when patient also exhibited an inability to walk unassisted, severe intentional tremor in the limbs, and severe cognitive impairment.

      CaseNotHPOs: HP:0410280 (Pediatric onset), HP:0003474 (Somatic sensory dysfunction), HP:0002353 (EEG abnormality), HP:0040129 (Abnormal nerve conduction velocity),

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous testing was limited to molecular tests ruling out Friedreich Ataxia and Spinocerebellar Ataxia types 1 and 2.

      CaseMethod1: N/A

      CaseMethod2: N/A

      CaseGenotypingMethod: Whole exome sequencing of the proband and the affected sibling. Homozygosity was assumed due to the consanguinity of the family, contributing to the decision to focus on the variant in CLN5. This variant was confirmed by Sanger sequencing of PCR products from exon 4 of the CLN5 gene in both affected family members and an additional unaffected sibling. Parents were not subjected to genotyping.

      Variant: The proband is homozygous for the NM_006493.4(CLN5):c.788G>A (p.Ser263Asn) variant.

      ClinVar: 183049 (homozygous)

      gnomAD: The maximum allele frequency for the NM_006493.4(CLN5):c.788G>A (p.Ser263Asn) variant is 0.000008805 (in the European non-Finnish population, with no homozygotes). https://gnomad.broadinstitute.org/variant/13-77574815-G-A

      VariantEvidence: The variant encodes a missense substitution that results in aberrant retention in the ER compartment rather than proper localization to lysosomal vesicles (Figs. 1E-1J).

      CaseAddInfo: Family is consanguineous (parents were first cousins).

      CasePMIDs: N/A

    1. nonsense

      Case#: Gong_2001_Proband_2, no reported gender, age or national origin

      CasePresentingHPOs: HP:0004349 (Reduced bone mineral density)

      CaseHPOFreeText: The proband has been diagnosed with osteoporosis-pseudoglioma syndrome segregating with an autosomal recessive mode of inheritance. This implies a combination of ophthalmologic and radiographic features, but these have not been described in detail.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Genome-wide linkage mapping with 160 SSRP markers was performed on three different consanguineous kindreds (from Finland, South Africa, and Italy) (fig. 1), but it is not clear whether this proband was a member of one of these kindreds.

      CaseMethod1: Linkage analysis with additional markers around a strong candidate marker

      CaseMethod2: Sanger sequencing of PCR-amplified exons and flanking regions of the LRP5 locus

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

      Variant: The patient harbors the NM_002335.4(LRP5):c.1282C>T (p.Arg428Ter) variant in the homozygous state.

      ClinVar: 6269

      gnomAD: The NM_002335.4(LRP5):c.1282C>T (p.Arg428Ter) variant was not found in gnomAD v2.1.1.

      VariantEvidence: NM_002335.4(LRP5):c.1282C>T (p.Arg428Ter) is a nonsense variant in exon 6 out of 23 that is predicted to trigger nonsense-mediated decay or at least to truncate the C-terminal ~74% of the protein product.

      CaseAddInfo: The family is reportedly consanguineous.

      CasePMIDs: PMID: 8659519

    2. disease-causing

      Case#: Gong_2001_Proband_4, no reported gender, age or national origin

      CasePresentingHPOs: HP:0004349 (Reduced bone mineral density)

      CaseHPOFreeText: The proband has been diagnosed with osteoporosis-pseudoglioma syndrome segregating with an autosomal recessive mode of inheritance. This implies a combination of ophthalmologic and radiographic features, but these have not been described in detail.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Genome-wide linkage mapping with 160 SSRP markers was performed on three different consanguineous kindreds (from Finland, South Africa, and Italy) (fig. 1), but it is not clear whether this proband was a member of one of these kindreds.

      CaseMethod1: Linkage analysis with additional markers around a strong candidate marker

      CaseMethod2: Sanger sequencing of PCR-amplified exons and flanking regions of the LRP5 locus

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

      Variant: The patient harbors the NM_002335.4(LRP5):c.2151dup (p.Asp718Ter) variant in the homozygous state.

      ClinVar: 6271

      gnomAD: The NM_002335.4(LRP5):c.2151dup (p.Asp718Ter) variant was not found in gnomAD v2.1.1.

      VariantEvidence: NM_002335.4(LRP5):c.2151dup (p.Asp718Ter) is a nonsense variant in exon 10 out of 23 that is predicted to trigger nonsense-mediated decay or at least to truncate the C-terminal ~56% of the protein product.

      CaseAddInfo: The family is reportedly consanguineous.

      CasePMIDs: PMID: 8659519

    3. Q853X

      Case#: Gong_2001_Proband_5, no reported gender, age or national origin

      CasePresentingHPOs: HP:0004349 (Reduced bone mineral density)

      CaseHPOFreeText: The proband has been diagnosed with osteoporosis-pseudoglioma syndrome segregating with an autosomal recessive mode of inheritance. This implies a combination of ophthalmologic and radiographic features, but these have not been described in detail.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Genome-wide linkage mapping with 160 SSRP markers was performed on three different consanguineous kindreds (from Finland, South Africa, and Italy) (fig. 1), but it is not clear whether this proband was a member of one of these kindreds.

      CaseMethod1: Linkage analysis with additional markers around a strong candidate marker

      CaseMethod2: Sanger sequencing of PCR-amplified exons and flanking regions of the LRP5 locus

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

      Variant: The patient harbors the NM_002335.4(LRP5):c.2557C>T (p.Gln853Ter) variant in the homozygous state.

      ClinVar: 6272

      gnomAD: The NM_002335.4(LRP5):c.2557C>T (p.Gln853Ter) variant was not found in gnomAD v2.1.1.

      VariantEvidence: NM_002335.4(LRP5):c.2557C>T (p.Gln853Ter) is a nonsense variant in exon 12 out of 23 that is predicted to trigger nonsense-mediated decay or at least to truncate the C-terminal ~47% of the protein product. It appears to be stable at the protein level but is not secreted in the exogenous expression system, consistent with loss-of-function rather than dominant negative effect.

      CaseAddInfo: The family is reportedly consanguineous.

      CasePMIDs: PMID: 8659519

    1. Homozygosity mapping was performed in a consanguineous family with four affected members originally referred as cases of LCA. Detailed electroretinographic recordings were obtained. Results: A novel homozygous single base-pair insertion was identified in all four siblings. The patients had an LCA-like phenotype, including either flat or greatly diminished electroretinographic activity. Conclusions: This report significantly expands on the phenotype associated with calcium binding protein 4 mutations, which has so far been limited to congenital stationary night blindness, and further demonstrates how molecular data often blur the boundaries between what are believed to be clinically distinct retinal disorders.

      Case#: Aldahmesh_2010_Family_Proband_II-1, male, onset in early childhood, age 12 years at time of report, family ancestry reported as Dutch

      CasePresentingHPOs: HP:0011463 (Childhood onset), HP:0000639 (Nystagmus), HP:0007663 (Reduced visual acuity), HP:0000613 (Photophobia), HP:0000551 (Color vision defect)

      CaseHPOFreeText: The proband and his sibling have a diagnosis of cone-rod dysfunction, including color vision described as severely abnormal and electroretinogram responses that showed absent cone a-wave but normal-to-subnormal rod function.

      CaseNotHPOs: HP:0000662 (Nyctalopia)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping was limited to homozygosity mapping of the sibling and his affected sister that identified a shared region of homozygosity on chromosome 13.

      CaseMethod1: Homozygosity mapping

      CaseMethod2: Sanger sequencing of CABP4

      CaseGenotypingMethod: Genotyping began with homozygosity mapping of the sibling and his affected sister that identified a shared region of homozygosity on chromosome 13, followed by Sanger sequencing of PCR products from the CABP4 gene.

      Variant: The individual harbors the NM_145200.5(CABP4):c.646C>T (p.Arg216Ter) variant in the homozygous state.

      ClinVar ID: 190959

      gnomAD: The variant is found in gnomAD version 4.1.1 at a frequency of 0.0001418 in the European (non-Finnish) population, with 0 homozygotes https://gnomad.broadinstitute.org/variant/chr11-67457677-C-T?dataset=gnomad_r4

      VariantEvidence: NM_145200.5(CABP4):c.646C>T (p.Arg216Ter) is a nonsense variant within exon 4 of 6 that is predicted to trigger nonsense-mediated decay.

      CaseAddInfo: The proband's family includes a similarly affected sister harboring the variant in the homozygous state, and unaffected parents who each carry the variant in the heterozygous state. Consanguinity has not been commented upon.

      CasePMIDs: N/A

    1. The point mutation present in patients from two large pedigrees of Hispanic origin (from Costa Rica) changes a tryptophan codon to the stop codon TAG (W350X; Fig. 5a). This is predicted to eliminate the portion of nyctalopin required for establishing the GPI anchor, and potentially results in the protein being soluble rather than membrane-tethered.

      Case#: Bech-Hansen_2000_Patient_610-1, male, age and race not mentioned, national origin in Costa Rica

      CasePresentingHPOs: HP:0030640 (Complete congenital stationary night blindness)

      CaseHPOFreeText: Patients in this study have a diagnosis of complete congenital stationary night blindness. Although this implies nyctalopia and photopic vision loss, specific phenotypic details are absent.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Linkage analysis was performed using 17 X-chromosomal restriction fragment length polymorphism markers.

      CaseMethod1: FokI restriction enzyme digestion of the relevant PCR product to monitor segregation in the proband and family members

      CaseMethod2: Sanger sequencing of PCR amplified exons from NYX

      CaseGenotypingMethod: Linkage analysis was initially performed using 17 X-chromosomal restriction endonuclease-based markers. The proband and family members were then subjected to restriction enzyme analysis of PCR products and Sanger sequencing to identify the variant.

      Variant: The proband harbors the NM_001378477.3(NYX):c.1034G>A (p.Trp345Ter) variant on the X chromosome.

      ClinVar: 11421

      gnomAD: NM_001378477.3(NYX):c.1034G>A (p.Trp345Ter) has a maximum allele frequency of 0.00007388 (2/27070, with no males or homozygous females) in the Latino / Admixed American population. https://gnomad.broadinstitute.org/variant/X-41333755-G-A

      VariantEvidence: This nonsense variant is located in the final exon and is not predicted to trigger NMD, but introduces a premature stop codon that truncates 28% of the protein product. The disrupted region is part of the predicted GPI anchor responsible for tethering the protein to the membrane.

      CaseAddInfo: N/A

      CasePMIDs: N/A

    2. As illustrated for family R5, affected males have a 238-bp fragment, unaffected males have a 262-bp fragment and carrier females have both fragments. Affected individuals from 5 other families also have the shorter 238-bp fragment.

      Case#: Bech-Hansen_2000_Family_R5_proband, male, age and race not mentioned, national origin in the United States

      CasePresentingHPOs: HP:0030640 (Complete congenital stationary night blindness), HP:0030469 (Abnormal dark-adapted electroretinogram)

      CaseHPOFreeText: At least one of two ERG abnormalities were observed in each affected family member; absence of rod psychophysical dark adaptation and/or absence of rod ERG with low-intensity blue flash.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Linkage analysis was originally performed in PMID: 2574143 using 17 X-chromosomal restriction fragment length polymorphism markers.

      CaseMethod1: Agarose gel electrophoresis of the relevant PCR product to monitor segregation in the proband and family members

      CaseMethod2: Sanger sequencing of PCR amplified exons from NYX

      CaseGenotypingMethod: Linkage analysis was initially performed in PMID: 2574143 using 17 X-chromosomal restriction endonuclease-based markers. The proband and family members were then subjected to gel electrophoresis analysis of PCR products and Sanger sequencing to identify the variant.

      Variant: The proband harbors the NM_001378477.3(NYX):c.70_93del (p.Arg24_Ala31del) variant on the X chromosome.

      ClinVar: 99841

      gnomAD: NM_001378477.3(NYX):c.70_93del (p.Arg24_Ala31del) has a maximum allele frequency of 0.0001018 (1/9823, with no males or homozygous females) in the European non-Finnish population https://gnomad.broadinstitute.org/variant/X-41332781-GGCCTGCGCCCGCGCTTGTCCCGCC-G

      VariantEvidence: This in-frame deletion variant does not have experimental evidence of impact on the protein product, but is a recurrent variant observed in multiple apparently unrelated families (PMID: 2574143 and Figure 5 from this paper).

      CaseAddInfo: Family phenotypes were described in PMID: 2574143.

      CasePMIDs: PMID: 2574143

    1. All affected individuals displayed an early cone dysfunction characterized by decreased vision acuity, with severe color dyschromatopsia and photophobia, during the 1st decade of life. At this stage, ophthalmoscopical examinations were not specific. By contrast, electrophysiological testing revealed marked loss of photopic function, with scotopic function relatively well preserved, and the visual field showed a consistent central scotoma. During the 2d and 3d decades, visual acuity decreased dramatically, and the color-vision defect was confined to achromatopsia, hampering normal schooling and professional insertion. After 40 years, peripheral visual field loss and progressive night blindness were observed, and the ERG became unrecordable (individual I-1; fig. 1).

      Case#: Perrault_1998_Patient_I-1, male, age and ethnicity not described

      CasePresentingHPOs: HP:0410280 (Pediatric onset), HP:0007663 (Reduced visual acuity), HP:0007641 (Dyschromatopsia), HP:0000613 (Photophobia), HP:0000603 (Central scotoma), HP:0011516 (Achromatopsia), HP:0007994 (Peripheral visual field loss), HP:0007675 (Progressive night blindness), HP:0000550 (Undetectable electroretinogram)

      CaseHPOFreeText: Onset was during the 1st decade of life. Diagnosis was autosomal dominant cone-rod dystrophy.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous testing established linkage to the D17S1796 and D17S1881 microsatellite markers.

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

      CaseMethod2: N/A

      CaseGenotypingMethod: The proband and his family members were subjected to linkage analysis using the D17S1796 and D17S1881 microsatellite markers, as well as sequencing of PCR products from each of the 18 exons of the GUCY2D locus.

      Variant: The proband harbors the NM_000180.3(GUCY2D):c.[2511G>C;2512C>T;2516C>T] variant in the heterozygous state.

      ClinVar: 453244

      gnomAD: The variant was not found in gnomAD.

      VariantEvidence: NM_000180.3(GUCY2D):c.[2511G>C;2512C>T;2516C>T] is a missense variant that causes three adjacent substitutions at the protein level (p.Glu837Asp;Arg838Cys;Thr839Met), 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: 9618177, PMID: 12552567, PMID: 26298565). The p.Arg838Cys 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 patient is a member of a three-generation family with affected children and grandchildren.

      CasePMIDs: N/A

    1. A frameshift homozygous germline mutation in BBS7 was detected by WES and identified by Sanger sequencing in affected individuals. This mutation was predicted to result in premature termination of exon5 (c.389_390delAC, p.Asn130ThrfsX3; RefSeq NM_176824.2) and lead to a 133 amino acid truncated protein. The inheritance patterns in the families are consistent with autosomal recessive inheritance, and no such homozygous mutation was found in the other 981 controls.

      Case#: Shen_2019_Patient_III-10, female, age 39 years at time of report, national origin reported as Chinese, ethnicity reported as Miao

      CasePresentingHPOs: HP:0001513 (Obesity), HP:0000822 (Hypertension), HP:0000107 (Renal cyst), HP:0010442 (Polydactyly), HP:0000750 (Delayed speech and language development), HP:0000678 (Dental crowding), HP:0011342 (Mild global developmental delay), HP:0001156 (Brachydactyly), HP:0000470 (Short neck), HP:0005280 (Depressed nasal bridge), HP:0000140 (Abnormality of the menstrual cycle)

      CaseHPOFreeText: The patient has been diagnosed with Bardet-Biedl syndrome.

      CaseNotHPOs: HP:0000134 (Female hypogonadism), HP:0002194 (Delayed gross motor development), HP:0000708 (Atypical behavior), HP:0000819 (Diabetes mellitus), HP:0000365 (Hearing impairment), HP:0000518 (Cataract), HP:0000639 (Nystagmus)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping consisted of exome sequencing.

      CaseMethod1: exome sequencing

      CaseMethod2: Sanger sequencing of the BBS7 locus

      CaseGenotypingMethod: Genotyping consisted of exome sequencing, followed by Sanger sequencing of the BBS7 locus.

      Variant: The patient harbors the NM_176824.3(BBS7):c.389_390del (p.Asn130fs) variant in the homozygous state.

      ClinVar ID: 216138

      gnomAD: The NM_176824.3(BBS7):c.389_390del (p.Asn130fs) variant was not found in gnomAD v2.1.1.

      VariantEvidence: NM_176824.3(BBS7):c.389_390del (p.Asn130fs) is an out-of-frame deletion variant in exon 5 of 18 that is predicted to trigger nonsense-mediated decay or at least truncation of the C-terminal 82% of the protein product.

      CaseAddInfo: Consanguinity in the proband's family is suspected but has not been confirmed. She has two similarly affected cousins who share the same homozygous genotype. The carrier status of her unaffected parents and an unaffected sibling have been confirmed by genotyping.

      CasePMIDs: N/A

    1. Here, we report the identification of the p.R192H variant of the tri-snRNP factor PRPF4 in a patient with RP. The mutation affects a highly conserved arginine residue that is crucial for PRPF4 function. Introduction of a corresponding mutation into the zebrafish homolog of PRPF4 resulted in a complete loss of function in vivo. A series of biochemical experiments suggested that p.R192H disrupts the binding interface between PRPF4 and its interactor PRPF3. This interferes with the ability of PRPF4 to integrate into the tri-snRNP, as shown in a human cell line and in zebrafish embryos. These data suggest that the p.R192H variant of PRPF4 represents a functional null allele. The resulting haploinsufficiency of PRPF4 compromises the function of the tri-snRNP, reinforcing the notion that this spliceosomal particle is of crucial importance in the physiology of the retina.

      Case#: Linder_2014_Proband_RP-106, female, age 20 years at time of onset / first visual complaints, age 73 year at time of report, family origin not reported

      CasePresentingHPOs: Nyctalopia HP:0000662, Constriction of peripheral visual field HP:0001133, Cataract HP:0000518, Attenuation of retinal blood vessels HP:0007843, Bone spicule pigmentation of the retina HP:0007737, Undetectable dark-adapted electroretinogram HP:0030474, Decreased light- and dark-adapted electroretinogram amplitude HP:0000654

      CaseHPOFreeText: The proband has been diagnosed with sporadic retinitis pigmentosa. Phenotypes included pale papillae in fundus.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous testing in the proband was not clearly described, but she was part of a cohort of patients with no previously-identified retinitis pigmentosa-associated variants.

      CaseMethod1: SSCP analysis of 14 PCR-amplified PRPF4 exons

      CaseMethod2: Sanger sequencing of PRPF4

      CaseGenotypingMethod: Previous testing in the proband was not clearly described, but she was part of a cohort of patients with no previously-identified retinitis pigmentosa-associated variants. SSCP was performed on each of 14 PCR-amplified exons of PRPF4, followed by Sanger sequencing analysis.

      Variant: The proband harbors the NM_001244926.2(PRPF4):c.572G>A (p.Arg191His) variant in the heterozygous state.

      ClinVar ID: 967144

      gnomAD: The NM_001244926.2(PRPF4):c.572G>A (p.Arg191His) variant is found in gnomAD v4.1.0 at a frequency of 0.00004999 (3 / 60014, with 0 homozygotes) in the Admixed American population https://gnomad.broadinstitute.org/variant/9-113283400-G-A?dataset=gnomad_r4

      VariantEvidence: NM_001244926.2(PRPF4):c.572G>A (p.Arg191His) is a missense variant. When overexpressed in zebrafish, the variant fails to rescue the lethality of Prpf4 silencing, unlike overexpression of the wild-type gene (Figure 2). Co-immunoprecipitation experiments show that the variant localizes normally but disrupts interaction with PRPF3 (Figure 3) and blocks PRPF4 integration into snRNP complexes (Figure 4).

      CaseAddInfo: The proband has two daughters at ages 52 and 54 years who harbor the variant but showed no retinal abnormalities in ophthalmological examinations.

      CasePMIDs: N/A

    1. c.276G>A (p.W92X)

      Case#: Zou_2017_Patient_F2-II:1, male, age 3 at time of report, family national origin reported to be from China

      CasePresentingHPOs: HP:0000639 (Nystagmus), HP:0000613 (Photophobia), HP:0007663 (Reduced visual acuity), HP:0007750 (Hypoplasia of the fovea), HP:0007894 (Hypopigmentation of the fundus)

      CaseHPOFreeText: The proband has been diagnosed with ocular albinism 1. Foveal hypoplasia was described as severe. Best-corrected visual acuity was limited to light perception.

      CaseNotHPOs: HP:0007730 (Iris hypopigmentation)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: N/A

      CaseMethod1: Sanger sequencing

      CaseMethod2: N/A

      CaseGenotypingMethod: Patients were genotyped by Sanger sequencing of PCR products from the 9 exons of the GPR143 gene.

      Variant: The proband harbors the NM_000273.3(GPR143):c.276G>A (p.Trp92Ter) variant in the hemizygous state.

      CAID: CA411999243

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

      VariantEvidence: NM_000273.3(GPR143):c.276G>A (p.Trp92Ter) is a nonsense variant in exon 2 of 9, and is predicted to trigger nonsense-mediated decay or to at least truncate the C-terminal 77% of the protein product.

      CaseAddInfo: N/A

      CasePMIDs: N/A

    1. Arg768Trp

      Case#: Stunkel_2018_Patient_5, female, age 45 at diagnosis with congenital night blindness, at least as early as age 4 at time of onset, 52 years old at time of report, ethnic origin not mentioned

      CasePresentingHPOs: HP:0011463 (Childhood onset), HP:0000662 (Nyctalopia), HP:0000552 (Tritanomaly), HP:0000539 (Abnormality of refraction), HP:0001133 (Constriction of peripheral visual field), HP:0007737 (Bone spicule pigmentation of the retina), HP:0008043 (Retinal arteriolar constriction), HP:0030469 (Abnormal dark-adapted electroretinogram), HP:0008275 (Abnormal light-adapted electroretinogram),

      CaseHPOFreeText: Refractive error was minimal. Progression of nyctalopia was noticed at 44 years of age. Rod-based ERG was not detectable at age 52.

      CaseNotHPOs: HP:0030586 (Abnormal Ishihara plate test), HP:0000539 (Abnormality of refraction), HP:0000639 (Nystagmus), HP:0000486 (Strabismus), HP:0007663 (Reduced visual acuity), HP:0030473 (Abnormal light-adapted flicker electroretinogram), HP:0030617 (Abnormal OCT-measured foveal thickness)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Patient 5 was tested for known LCA-causing variants using an allele-specific method.

      CaseMethod1: It is not clear whether Sanger sequencing was used to confirm the initial genotyping method.

      CaseMethod2: N/A

      CaseGenotypingMethod: Patient 5 was tested for known LCA-causing variants using an allele-specific method, leading to the detection of 2 variants in GUCY2D.

      Variant: The individual is compound heterozygous for the NM_000180.4(GUCY2D):c.2302C>T (p.Arg768Trp) and NM_000180.4(GUCY2D):c.2281C>T (p.p.Arg761Trp) variants.

      ClinVar: 98563, 854601

      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 The NM_000180.4(GUCY2D):c.2281C>T (p.p.Arg761Trp) variant has a maximum allele frequency of 0.00004007 in gnomAD version 2.1.1 (in the African / African-American population, with no homozygotes). https://gnomad.broadinstitute.org/variant/17-7917215-C-T

      VariantEvidence: Evidence supporting the pathogenicity of the NM_000180.4(GUCY2D):c.2281C>T (p.p.Arg761Trp) variant is limited to computational prediction. 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: The possibility of consanguinity and variant phase have not been reported in detail.

      CasePMIDs: N/A

    1. Genome-wide homozygosity mapping, with a 250K SNP-array followed by a search for candidate genes, was performed. The patients underwent ophthalmic examination, including elaborate electroretinography. Results: In a Dutch sib pair, a shared 9-Mb homozygous region was found on 11q13.1-q13.5 that encompasses the CABP4 gene, previously implicated in autosomal recessive incomplete congenital stationary night blindness (CSNB2) in two small families. A novel homozygous p.Arg216X mutation in CABP4 was detected in the sib pair. Quantitative RT-PCR on RNA isolated from patient lymphoblast cells showed no nonsense-mediated degradation of mutant CABP4 mRNA. Clinically, patients presented with reduced visual acuity, photophobia, and abnormal color vision, but they did not experience night blindness. Electroretinograms showed electronegative mixed rod-cone responses and severely reduced cone responses, as in CSNB2. Isolated rod responses, however, were (sub)normal.

      Case#: Littink_2009_Family_Proband_II-1, male, onset in early childhood, age 12 years at time of report, family ancestry reported as Dutch

      CasePresentingHPOs: HP:0011463 (Childhood onset), HP:0000639 (Nystagmus), HP:0007663 (Reduced visual acuity), HP:0000613 (Photophobia), HP:0000551 (Color vision defect)

      CaseHPOFreeText: The proband and his sibling have a diagnosis of cone-rod dysfunction, including color vision described as severely abnormal and electroretinogram responses that showed absent cone a-wave but normal-to-subnormal rod function.

      CaseNotHPOs: HP:0000662 (Nyctalopia)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping was limited to homozygosity mapping of the sibling and his affected sister that identified a shared region of homozygosity on chromosome 13.

      CaseMethod1: Homozygosity mapping

      CaseMethod2: Sanger sequencing of CABP4

      CaseGenotypingMethod: Genotyping began with homozygosity mapping of the sibling and his affected sister that identified a shared region of homozygosity on chromosome 13, followed by Sanger sequencing of PCR products from the CABP4 gene.

      Variant: The individual harbors the NM_145200.5(CABP4):c.646C>T (p.Arg216Ter) variant in the homozygous state.

      ClinVar ID: 190959

      gnomAD: The variant is found in gnomAD version 4.1.1 at a frequency of 0.0001418 in the European (non-Finnish) population, with 0 homozygotes https://gnomad.broadinstitute.org/variant/chr11-67457677-C-T?dataset=gnomad_r4

      VariantEvidence: NM_145200.5(CABP4):c.646C>T (p.Arg216Ter) is a nonsense variant within exon 4 of 6 that is predicted to trigger nonsense-mediated decay.

      CaseAddInfo: The proband's family includes a similarly affected sister harboring the variant in the homozygous state, and unaffected parents who each carry the variant in the heterozygous state. Consanguinity has not been commented upon.

      CasePMIDs: N/A

    1. IMPG2

      Case#: van_Huet_2014_Patient_A-II:1, female, age 8 years at the time of onset, age 59 at the time of report, national origin reported as Dutch

      CasePresentingHPOs: HP:0410280 (Pediatric onset), HP:0007663 (Reduced visual acuity), HP:0000545 (Myopia), HP:0000550 (Undetectable electroretinogram), HP:0007787 (Posterior subcapsular cataract), HP:0011504 (Bull's eye maculopathy), HP:0500087 (Peripapillary atrophy), HP:0000543 (Optic disc pallor), HP:0007843 (Attenuation of retinal blood vessels), HP:0007722 (Retinal pigment epithelial atrophy), HP:0007737 (Bone spicule pigmentation of the retina)

      CaseHPOFreeText: The patient and her family members have been diagnosed with retinitis pigmentosa, with macular abnormalities present in all cases.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping outside of the IMPG2 locus has not been described for this family.

      CaseMethod1: Sanger sequencing of the 19 exons of the IMPG2 gene

      CaseMethod2: N/A

      CaseGenotypingMethod: Genotyping may have been limited to Sanger sequencing of the 19 exons of the IMPG2 gene, as previous genotyping of other loci has not been described for this family.

      Variant: The affected family members harbor the NM_016247.4(IMPG2):c.887+430_908+274del variant in the homozygous state.

      ClinVar: 3547

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

      VariantEvidence: The NM_016247.4(IMPG2):c.887+430_908+274del variant is a deletion of exon 9 that is predicted to lead to in-frame removal of a region encoding 7 amino acids. When expressed exogenously in COS-1 cells, this results in retention of the protein product in the endoplasmic reticulum and failure to properly localize to the plasma membrane (PMID: 20673862, Figure 4).

      CaseAddInfo: Despite the homozygous state of the variant, the family is reportedly not consanguineous. The proband has two affected siblings who share the same genotype, and each parent is a heterozygous carrier.

      CasePMIDs: PMID: 20673862

    2. nherited retinal disease

      Case#: van_Huet_2014_Patient_F-II:2, female, age 10 years at time of onset, age 32 at the time of report, national origin reported as from Pakistan

      CasePresentingHPOs: HP:0410280 (Pediatric onset), HP:0000662 (Nyctalopia), HP:0000545 (Myopia), HP:0007663 (Reduced visual acuity), HP:0011504 (Bull's eye maculopathy), HP:0100014 (Epiretinal membrane), HP:0000543 (Optic disc pallor), HP:0007843 (Attenuation of retinal blood vessels), HP:0000546 (Retinal degeneration), HP:0007737 (Bone spicule pigmentation of the retina)

      CaseHPOFreeText: The patient and her family members have been diagnosed with retinitis pigmentosa, with macular abnormalities present in all cases.

      CaseNotHPOs: HP:0000517 (Abnormal lens morphology, such as cataract)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping outside of the IMPG2 locus has not been described for this family.

      CaseMethod1: Sanger sequencing of the 19 exons of the IMPG2 gene

      CaseMethod2: N/A

      CaseGenotypingMethod: Genotyping may have been limited to Sanger sequencing of the 19 exons of the IMPG2 gene, as previous genotyping of other loci has not been described for this family.

      Variant: The affected family members harbor the NM_016247.4(IMPG2):c.1680T>A (p.Tyr560Ter) variant in the homozygous state.

      ClinVar: 437938

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

      VariantEvidence: The NM_016247.4(IMPG2):c.1680T>A (p.Tyr560Ter) variant is a nonsense variant in exon 13 of 19 that is predicted to lead to nonsense mediated decay or at least to C-terminal truncation of 55% of the protein product.

      CaseAddInfo: The family is reportedly consanguineous, with the parents being first cousins. The proband has an affected brother and an affected mother who have the same genotype, as well as a heterozygous carrier father.

      CasePMIDs: PMID: 20673862

    1. patients with FEVR who harbor LRP5 mutations

      Case#: Qin_2005_Patient_7, gender not reported, age 1 year at report, national origin reported as Japanese

      CasePresentingHPOs: HP:0004349 (Reduced bone mineral density), HP:0008052 (Retinal fold), HP:0000541 (Retinal detachment)

      CaseHPOFreeText: The patient has been diagnosed with FEVR. Retinal folds and later complete retinal detachment were present in both eyes.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Genotyping appears to have been limited to the LRP5 and FZD4 loci.

      CaseMethod1: Sanger sequencing of PCR-amplified exons and flanking regions of the LRP5 and FZD4 loci

      CaseMethod2: N/A

      CaseGenotypingMethod: Genotyping appears to have been limited to Sanger sequencing of PCR-amplified exons and flanking regions of the LRP5 and FZD4 loci.

      Variant: The patient harbors the NM_002335.4(LRP5):c.1604C>T (p.Thr535Met) and NM_002335.4(LRP5):c.1850T>G (p.Phe617Cys) variants in the compound heterozygous state.

      ClinVar: 2137179

      CAID: CA224268235

      gnomAD: The NM_002335.4(LRP5):c.1850T>G (p.Phe617Cys) variant was not found in gnomAD v2.1.1. The NM_002335.4(LRP5):c.1604C>T (p.Thr535Met) variant was found in gnomAD v2.1.1 at a frequency of 0.00001759 (2/113686) in the European non-Finnish population https://gnomad.broadinstitute.org/variant/11-68170970-C-T?dataset=gnomad_r2_1

      VariantEvidence: NM_002335.4(LRP5):c.1604C>T (p.Thr535Met) and NM_002335.4(LRP5):c.1850T>G (p.Phe617Cys) are missense variants in exons 8 and 9, respectively, out of 23. Neither has evidence of an impact on the gene product.

      CaseAddInfo: The proband's parents are carriers for p.Phe617Cys (maternal) and p.Thr535Met (paternal). The father was apparently unaffected in terms of retinal change and reduced bone mass. The mother was subclinically affected unilaterally with localized retinal avascularization with tortuosity of the retinal vessels and reduced bone density.

      CasePMIDs: N/A

    2. patients carried compound heterozygous mutations in LRP5

      Case#: Qin_2005_patient_8, female, age 14 years at report, national origin reported as Japanese

      CasePresentingHPOs: HP:0001103 (Abnormal macular morphology), HP:0004349 (Reduced bone mineral density), HP:0003621 (Juvenile onset)

      CaseHPOFreeText: The patient has been diagnosed with simplex FEVR, with bilateral dragged macula.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Genotyping appears to have been limited to the LRP5 and FZD4 loci.

      CaseMethod1: Sanger sequencing of PCR-amplified exons and flanking regions of the LRP5 and FZD4 loci

      CaseMethod2: N/A

      CaseGenotypingMethod: Genotyping appears to have been limited to Sanger sequencing of PCR-amplified exons and flanking regions of the LRP5 and FZD4 loci.

      Variant: The patient harbors the NM_002335.4(LRP5):c.804_813del (p.Gly269fs) and NM_002335.4(LRP5):c.1828G>A (p.Gly610Arg) variants in the compound heterozygous state.

      ClinVar: 6295, 6294

      gnomAD: The NM_002335.4(LRP5):c.804_813del (p.Gly269fs) variant was not found in gnomAD v2.1.1. The NM_002335.4(LRP5):c.1828G>A (p.Gly610Arg) variant was found in gnomAD v2.1.1 at a frequency of 0.00002644 (3/113484) in the European non-Finnish population https://gnomad.broadinstitute.org/variant/11-68174018-G-A

      VariantEvidence: NM_002335.4(LRP5):c.1828G>A (p.Gly610Arg) is a missense variant in exon 9 that does not have experimental evidence of an impact on the protein product. NM_002335.4(LRP5):c.804_813del (p.Gly269fs) is a frameshift variant in exon 4 of 23 that is predicted to trigger nonsense-mediated decay or to at least disrupt the C-terminal 83% of the protein product.

      CaseAddInfo: The patient has no family history of FEVR in her parents and brother, although bone mineral density was reduced in both parents. The mother is a carrier for p.Gly610Arg, while the father and brother are heterozygous for p.G268fsX272.

      CasePMIDs: N/A

    1. nt 460 del C

      Case#: Perrault_2000_Family_3_Proband, Female, age unknown, family origin in Tunisia with Jewish Sefardi ancestry

      CasePresentingHPOs: N/A

      CaseHPOFreeText: The individual is described as having Leber congenital amaurosis.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Linkage mapping of the disease locus to chromosome 17p13.1 (PMID: 7581387, PMID: 8641699)

      CaseMethod1: Sanger sequencing of PCR products from each of the 20 exons

      CaseMethod2: Single strand conformational polymorphism analysis

      CaseGenotypingMethod: The individual was included in multi-family homozygosity mapping, establishing linkage to chromosome 17p13.1 and particularly between the D17S1353 and D17S1854 markers (PMID: 7581387, PMID: 8641699). Subsequent genotyping was performed by SSCP and by Sanger sequencing of PCR products from all 20 exons of the GUCY2D locus.

      Variant: The individual is homozygous for the NM_000180.4:c.389del (p.Pro130LeufsTer36) variant.

      ClinVar: 98602

      gnomAD: The variant exhibits a maximum allele frequency of 0.00008370 in gnomAD version 2.1.1 (in the Latino / Admixed American population, with no homozygotes). https://gnomad.broadinstitute.org/variant/17-7906751-AC-A

      VariantEvidence: The NM_000180.4:c.389del (p.Pro130LeufsTer36) variant is predicted to trigger nonsense mediated decay or to disrupt ~88% of the protein product by frameshift.

      CaseAddInfo: The family is reportedly consanguineous.

      CasePMIDs: PMID: 7581387, PMID: 8641699

    1. We identified a novel heterozygous Gly166Cys mutation in TIMP3 in all affected individuals

      Case: Felbor_1997_Family_1_patient_III-4, gender not specified, country of origin Finland, onset not specified

      DiseaseAssertion: Sorsby's fundus dystrophy

      FamilyInfo: The variant was inherited by the proband rather than acquired de novo.

      CasePresentingHPOs: N/A

      CaseHPOFreeText: While phenotypes were not described for the specific proband, the affected family members exhibit early onset of visual loss between the second and fourth decade of life, with the first sign in young family members being uneven or absent pigmentation in the extreme fundus periphery. Affected individuals experience progressive vision loss, iris atrophy, and glaucoma in some cases.

      CaseNOTHPOs: N/A

      CaseNOTHPOFreeText: N/A

      CasePreviousTesting: Single-stranded conformational analysis (SSCA) of the coding and promoter regions of TIMP3, detecting a disease-specific mobility shift in exon 5. Sanger sequencing of PCR products from exon 5 of the TIMP3 gene in comparison to a control individual.

      GenotypingMethod: Enzymatic digestion of TIMP3 exon 5 PCR products with the HaeIII restriction endonuclease.

      PreviouslyPublished: This highly consanguineous family was previously published in PMID:7148944 and PMID:2387082. It was proposed to show an autosomal recessive pattern of inheritance (not previously observed for Sorsby fundus dystrophy). The family has been genotyped for the first time in this study, revealing segregation of disease phenotypes with a heterozygous variant in TIMP3, with autosomal dominant inheritance.

      SupplementalData: N/A

      Variant: Proband harbors the NM_000362.5(TIMP3):c.565G>T (p.Gly189Cys) missense variant.

      ClinVar: 12679

      gnomAD: Variant is absent from gnomAD.

      VariantEvidence: This missense variant within exon 5 of TIMP3 results in an unpaired Cys residue.

    1. Two male siblings had confirmed BED with myopia and protanopia. The younger brother had high myopia, subnormal BCVA, and ocular fundi that showed tilted discs, crescent shaped peripapillary atrophy, and visible choroidal vessels. OCT confirmed retinal and choroidal atrophy. The older brother was lightly myopic with normal/subnormal BCVA and subtle findings in the fundi. Both brothers had abnormal ERG recordings with a decreased cone response. They also had a structurally intact OPN1LW/OPN1MW gene cluster. The OPN1LW gene was shown to carry a deleterious variant combination in exon 3 known to result in mis-splicing of opsin mRNA and acknowledged as LIAVA amino acid delineation (Leu153-Ile171-Ala174-Val178-Ala180), while the OPN1MW gene exon 3 showed a non-pathogenic variant combination (MVVVA).

      Case#: Holmquist_2021_Proband, onset before age 6 years, male, family national origin from Sweden

      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 PCR / RFLP-based analysis of OPN1LW and OPN1MW locus structure, real-time PCR-based analysis of OPN1LW and OPN1MW copy number, and Sanger sequencing of long-range PCR products from exon 3 of OPN1LW and OPN1MW.

      CaseMethod1: RFLP- and RT-PCR-based analyses of OPN1LW and OPN1MW structure and copy number

      CaseMethod2: long-range PCR and Sanger sequencing of OPN1LW and OPN1MW

      CaseGenotypingMethod: Genotyping of the proband was performed by RFLP- and RT-PCR-based analyses of OPN1LW and OPN1MW structure and copy number, followed by long-range PCR and Sanger sequencing of OPN1LW and OPN1MW.

      Variant: The individual harbors the NM_020061.6(OPN1LW):c.511_513delinsATT (p.Val171Ile) and NM_020061.6(OPN1LW):c.532A>G (p.Ile178Val) variants in the hemizygous state.

      ClinVarID / CAID: CA2695237719 / 403267

      gnomAD: The NM_020061.6(OPN1LW):c.511_513delinsATT (p.Val171Ile) variant was not found in gnomAD v4.1.0. The NM_020061.6(OPN1LW):c.532A>G (p.Ile178Val) variant is found in gnomAD v4.1.0 at a frequency of 0.04886 in the African / African American population, with 862 total homozygotes.

      VariantEvidence: NM_020061.6(OPN1LW):c.511_513delinsATT (p.Val171Ile) and NM_020061.6(OPN1LW):c.532A>G (p.Ile178Val) are missense variants in exon 3 that make up the "LIAVA" genotype that has been previously reported in the context of this disease (PMID: 22732407) but individually are not known to be disease-causing.

      CaseAddInfo: The proband has a similarly affected brother who shares the same genotype, and an unaffected brother who does not harbor the variants.

      CasePMIDs: PMID: 27339364

    1. Six affected members spanning two generations of a single family were examined. Five were studied in detail electrophysiologically and psychophysically. Methods: Psychophysical testing included color vision testing, photopic and scotopic static threshold perimetry, and dark adaptometry. Electrophysiological testing included flash and pattern electroretinography, as well as electrooculography. Results: Clinical findings ranged from subtle pigmentary changes at the level of the retinal pigment epithelium to more widespread pigmentary changes associated with choroidal neovascularization. Those with severe fundus changes exhibited greater abnormalities in psychophysical and electrophysiological testing than those with minimal fundus changes.

      Case#: Kim_1995_Proband_III-14, female, age 59 years at time of report, family national origin reported as English

      CasePresentingHPOs: Subretinal deposits HP:0031528, Pigmentary retinopathy HP:0000580, Disciform macular scar HP:0025094, Dark choroid HP:0025148, Decreased light- and dark-adapted electroretinogram amplitude HP:0000654, Anomalous trichromacy HP:0011519, Reduced visual acuity HP:0007663, Decreased Arden ratio of electrooculogram HP:0008179

      CaseHPOFreeText: The proband has been diagnosed with pattern dystrophy of the retina/macula. All affected family members including the proband exhibited perifoveal yellow pigment deposits at the level of the RPE.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous testing in this family is not described but genotyping appears to have been limited to the PRPH2 locus and did not include other candidate genes.

      CaseMethod1: single-strand conformational polymorphism (SSCP) analysis of PCR products from the 3 exons of PRPH2 (described in PMID: 8004111)

      CaseMethod2: Sanger sequencing of PRPH2 (described in PMID: 8004111)

      CaseGenotypingMethod: Previous testing in this family is not described but genotyping appears to have been limited to the PRPH2 locus and did not include other candidate genes. Genotyping methods are previously described in PMID: 8004111 and included SSCP analysis of PCR products from the 3 exons of PRPH2 and Sanger sequencing of PRPH2

      Variant: The proband harbors the NM_000322.5(PRPH2):c.418_421dup (p.Tyr141fs) variant in the heterozygous state.

      ClinVar ID: 13174

      gnomAD: The NM_000322.5(PRPH2):c.418_421dup (p.Tyr141fs) variant was not found in gnomAD v4.0.0.

      VariantEvidence: NM_000322.5(PRPH2):c.418_421dup (p.Tyr141fs) is a frameshift variant in exon 1 of 3 that is predicted to trigger nonsense-mediated decay or at least to truncate the C-terminal 60% of the protein product.

      CaseAddInfo: The proband has five affected extended family members who similarly carry the variant, as well as 7 unaffected family members who are negative for the variant.

      CasePMIDs: PMID: 8004111

    1. Visual acuity in affected individuals 21 and 30 was limited, progressing to only counting fingers in affected individual 21 (Table 1). The fundus examination of affected individual 21 shows severe bone spicule-like pigmentation in the mid-periphery and periphery of the retina along with milder macular involvement, arteriolar attenuation, and disc pallor (Figure 2A). The fundus examination of affected individual 30 shows only milder macular involvement, arteriolar attenuation, and disc pallor, and no bone spicule-like pigmentation was observed in the mid-periphery and periphery of the retina (Figure 2B). The affected individuals had reduced ERG responses with delayed implicit time (Figure 3A–D). Photophobia or nystagmus was not observed in any affected or unaffected family member.

      Case#: Khan_2015_Family_PKRP133_Patient_21, male, age not specified, family of Pakistani origin from the Punjab province

      CasePresentingHPOs: HP:0000662 (Nyctalopia), HP:0007663 (Reduced visual acuity), HP:0007737 (Bone spicule pigmentation of the retina), HP:0007843 (Attenuation of retinal blood vessels), HP:0000543 (Optic disc pallor), HP:0000608 (Macular degeneration), HP:0007688 (Undetectable light- and dark-adapted electroretinogram)

      CaseHPOFreeText: The proband and his family members have been diagnosed with retinitis pigmentosa, with family history consistent with retinal dystrophy with early / congenital onset. Loss of visual acuity progressed to only counting fingers.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Genome-wide linkage analysis was performed with several hundred markers, in combination with haplotype analysis of the patient and family members to map the causal variant to chromsome 5q33-35.

      CaseMethod1: Whole-genome linkage analysis and haplotype analysis

      CaseMethod2: Whole-exome sequencing of one family member followed by Sanger sequencing of others, including the patient.

      CaseGenotypingMethod: Genome-wide linkage analysis was performed with several hundred markers, in combination with haplotype analysis of the patient and family members to map the causal variant to chromsome 5q33-35. This was followed by whole-exome sequencing of one family member and Sanger sequencing of the PDE6A locus in the patient.

      Variant: The proband harbors the NM_000440.3:c.2028-1G>A variant in the homozygous state.

      CAID: CA361692783

      gnomAD: The NM_000440.3:c.2028-1G>A variant is not found in gnomAD v2.1.1.

      VariantEvidence: The NM_000440.3:c.2028-1G>A variant disrupts a canonical splice site in intron 17, but does not have experimental confirmation of exon 17 skipping or frameshift.

      CaseAddInfo: The proband is part of a large family known to have other affected family members and to include consanguineous unions.

      CasePMIDs: N/A

    1. 3

      Case# Pat3, F, Chinese, 12day onset

      CasePresentingHPOs HP:0008344, HP:0002013, HP:0011968, HP:0001250, HP:0001263

      CaseNotHPOs HP:0001276, HP:0001279,

      CasePreviousTesting tested for serum BCAAs

      CaseMethod1 PCR

      CaseMethod2 Direct

      CaseGenotypingMethod exons and flanking intronic regions of the BCKDHA, BCKDHB and DBT genes were amplified using PCR and sequenced

      Variant NM_000709.3:c.178G>T, NM_000709.3:c.1214_1219dup

      CAID CA406004676(c.178), CA658820662(c.1214)

      CaseAddInfo mutations confirmed in parents by Sanger sequencing, Her elder brother was healthy. She exhibited feeding difficulties and vomiting at 12 days of age. Severe psychomotor retardation was found at the age of 3 months. Cerebral MRI showed bilateral damage to the globus pallidus, basal ganglia, capsula interna and capsula externa. After treatment, clinical improvement was observed. Currently, she is 4 years old and has moderate psychomotor retardation.

    2. 1

      Case# Pat1, M, Chinese, 3day onset

      CasePresentingHPOs HP:0008344, HP:0008872, HP:0001250, HP:0001276, HP:0001279, HP:0001263

      CaseNotHPOs HP:0002013

      CaseMethod1 PCR

      CaseMethod2 Direct

      CaseGenotypingMethod exons and flanking intronic regions of the BCKDHA, BCKDHB and DBT genes were amplified using PCR and sequenced

      Variant NM_000709.3:c.853+1delG ?

    1. The splice-site deletion of exon 3, found in one Indian patient, probably results in the skipping of exon 3, leading to a frame shift p.(Gly114Alafs*53)

      Case# P2, 5mon onset, Indian

      CasePresentingHPOs HP:0002151, HP:0001946, HP:0001942, HP:0001987

      CasePreviousTesting Of the negative samples, we include here only those negative for NAGS and CPS1 genes. NAGS testing was done by single-exon amplification and DNA sequencing.24 CPS1 testing was done by RNA sequencing, in most cases using stimulated lymphocytes

      CaseGenotypingMethod sequence analysis of coding exons, including flanking intronic regions of CA5A and CA5B, was performed.

      Variant NM_001739.1:c.458_459+22del (p.Gly114Alafs*53)

      CAID CA658820625

      CaseAddInfo consanguineous

    1. Case 4

      Case# Case 4, F, Chinese, 5day onset

      CasePresentingHPOs HP:0008344, HP:0011968, HP:0001954, HP:0002373

      CasePreviousTesting Tested blood aa levels with liquid chromatography-mass spectrum spectrometry, several branched chain amino acids were overly abundant. Whole exome targeted capture sequencing was applied for the mutation screening of the suspicious patients. A total of 712 genes associated with inherited metabolic diseases were selected and their coding regions were captured.

      CaseMethod1 Whole Exome

      CaseMethod2 Sanger

      CaseGenotypingMethod validated whole exome findings with sanger and qPCR.

      Variant NM_000056.4(BCKDHB):c.93_103dupGGCGCGGGGCT (p.Phe35Trpfs), NM_000056.3:c.550del

      ClinVar 189101 (dup)

      CAID CA658820648 (del)

      gnomAD low quality site (dup)

    2. Case 3

      Case# Case 3, M, Chinese, 3day onset

      CasePresentingHPOs HP:0008344, HP:0001954, HP:0005972, HP:0011968, HP:0008947

      CasePreviousTesting Tested blood aa levels with liquid chromatography-mass spectrum spectrometry, several branched chain amino acids were overly abundant. Whole exome targeted capture sequencing was applied for the mutation screening of the suspicious patients. A total of 712 genes associated with inherited metabolic diseases were selected and their coding regions were captured.

      CaseMethod1 Whole Exome

      CaseMethod2 Sanger

      CaseGenotypingMethod validated whole exome findings with sanger and qPCR.

      Variant NM_000056.3:c.659del(p.D229fs)

      CAID CA658820635

      CaseAddInfo Mother was not tested but WES was used in the patient and father

    3. Case 1

      Case# Case 1, F, Chinese, 4day old Age of Onset

      CasePresentingHPOs HP:0011968, HP:0001276, HP:0002373, HP:0001954, HP:0008344

      CasePreviousTesting Tested blood aa levels with liquid chromatography-mass spectrum spectrometry, several branched chain amino acids were overly abundant. Whole exome targeted capture sequencing was applied for the mutation screening of the suspicious patients. A total of 712 genes associated with inherited metabolic diseases were selected and their coding regions were captured.

      CaseMethod1 Whole Exome

      CaseMethod2 Sanger

      CaseGenotypingMethod validated whole exome findings with sanger and qPCR.

      Variant NM_000056.4(BCKDHB):c.508C>T (p.Arg170Cys), NM_000056.3:c.659del

      ClinVar 96590 (missense)

      CAID CA658820635 (c.659del)

      gnomAD 0.00001791 (European(Non-Finnish)), 0.000008123 (Overall)

      CasePMIDs missense mentioned in 25381949

    1. III4/F

      Case# FIII.4, F, 19 day old diagnosis, Cyprus (Greek Cypriot)

      CasePresentingHPOs HP:0010910, HP:0010911, HP:0010913, HP:0001254, HP:0011968, HP:0001290, HP:0001276, HP:0002789, HP:0002353,

      HPOcont: Hypervalinemia, Hyperleucinemia, Hyperisoleucinemia, Lethargy, Poor feeding, Hypotonia, Hypertonia, Tachypnea, Abnormal EEG

      HPOfreetext: Reduced alloisoleucine and grunting

      CasePreviousTesting Tested blood BCAA (AIleu: 0, Ileu: 220 (NR: 26–100), Leu: 3270 (NR: 65–220), Val: 459 (NR: 90–300), urine organic acids (Increased:lactate, 2-keto-glutarate, 2-keto-isocaproic, 2-OH-isovaleric, 2-keto-isovaleric, 2-keto-3-methylvaleric, 4-OH-phenylacetate, 4-OH-phenylpyruvate and BCKD activity (0.03(NR: 0.4–3.4) (Fibroblasts))

      CaseMethod1 PCR

      CaseMethod2 Direct Sequencing

      CaseGenotypingMethod Direct sequencing repeated on proband and father for deletion varaint

      Variant (1) NM_000709.3(BCKDHA):c.632C>T (p.Thr211Met) (2) NM_000709.3:c.718delG

      ClinVar (1) 93365

      CAID (2) register link if I put that in correctly

      gnomAD (1) 0.0001163(East Asian), 0.00002043 (Overall)

      CaseAddInfo nonconsanguineous

    1. Lo

      Case# Lo, M, 10mo diagnosis---originally 1985

      CasePresentingHPOs HP:0011968, HP:0001531, HP:0000737, HP:0007281, HP:0002013, HP:0001259, HP:0005979, HP:0001943

      CaseMethod1 PCR

      CaseMethod2 Sanger

      CaseGenotypingMethod

      Variant NM_000709.3:c.1265A>G(p.Lys422Arg), NM_000709.3:c.137dup(p.Ser47IlefsTer4)

      CAID CA406015486(miss), CA658820686(dup)

      VariantEvidence 3978850: in patient fibroblasts-rate of decarboxylation of alpha-ketoacids: alpha ketoisovalerate[0<0.31], Pyruvate[0.40>.34], alpha-ketoglutarate[0.14>0.10] (Table 1), BCKDH activity[0.0003<0.107] (Table 2), E1 subunit activity[0.6<5.9] (Table 3)--[ProbandvsNormal]

      CaseAddInfo 3978850( a positive dinitrophenylhydrazine test and elevated urinary a-ketoisocaproate, a-methyl-P-OH-valerate and a-OH-isoval- erate,

      CasePMIDs 3978850, 2914958

    1. For the non-Newfoundland patient with the p.S358L mutation, the parents were also sequenced and paternity confirmed.

      Case# NonNew, male, 40yr

      CasePresentingHPOs HP:0002119, HP:0002375 , HP:0031317

      CaseNotHPOs Annotate with the HPOs that were noted not to manifest within the proband of interest.

      CasePreviousTesting patients referred to our high-risk hereditary heart disorders clinic for assessment of possible ARVC, as well as DNA-bearing blood or tissue samples sent for clinical ARVC gene-testing from other physicians, clinics or institutions to our CLIA-approved molecular genetics laboratory at the Hospital for Sick Children (listed on www.genetests.org).

      CaseMethod1 PCR

      CaseMethod2 as mentioned

      CaseGenotypingMethod direct sequence analysis of all exons and flanking intron sequences of DSP (MIM 125647), PKP2 (MIM 602861), DSC2 (MIM 125645), DSG2 (MIM 125671) and TMEM43.

      Variant NM_024334.2(TMEM43):c.1073C>T (p.Ser358Leu)

      ClinVar 734

      VariantEvidence ?????Surely the presenting relevant phenotypes is not enough, neither are the in silico programs they are running forpathogenicity prediction. There seems to be nothing else provided????

      CaseAddInfo De Novo, Maternity/Paternity confirmed

    2. c.934C>T (p.R312W)

      Case# Baskin RW, Female, 31

      CasePresentingHPOs HP:0004756, HP:0011841, HP:0002013

      CasePreviousTesting patients referred to our high-risk hereditary heart disorders clinic for assessment of possible ARVC, as well as DNA-bearing blood or tissue samples sent for clinical ARVC gene-testing from other physicians, clinics or institutions to our CLIA-approved molecular genetics laboratory at the Hospital for Sick Children (listed on www.genetests.org).

      CaseMethod1 PCR

      CaseGenotypingMethod direct sequence analysis of all exons and flanking intron sequences of DSP (MIM 125647), PKP2 (MIM 602861), DSC2 (MIM 125645), DSG2 (MIM 125671) and TMEM43.

      Variant NM_024334.2(TMEM43):c.934C>T (p.Arg312Trp)

      ClinVar 36873

      gnomAD 0.03553 link

    3. c.829A>T (p.T277S)

      Case# Baskin TS, Male, 16

      CasePresentingHPOs HP:0006956, HP:0100749, HP:0001962, HP:0004756

      CasePreviousTesting patients referred to our high-risk hereditary heart disorders clinic for assessment of possible ARVC, as well as DNA-bearing blood or tissue samples sent for clinical ARVC gene-testing from other physicians, clinics or institutions to our CLIA-approved molecular genetics laboratory at the Hospital for Sick Children (listed on www.genetests.org).

      CaseMethod1 PCR

      CaseGenotypingMethod direct sequence analysis of all exons and flanking intron sequences of DSP (MIM 125647), PKP2 (MIM 602861), DSC2 (MIM 125645), DSG2 (MIM 125671) and TMEM43.

      Variant NM_024334.2(TMEM43):c.829A>T (p.Thr277Ser)

      ClinVar 165456

      gnomAD 0.006432 link

    1. proband with p.K3394N

      Case# B16, female, 30

      CasePresentingHPOs HP:0003124 Hypercholesterolemia

      CasePreviousTesting The APOB domains, including amino acids 2955–3092 and amino acids 3303–3492, were analysed in the 600 molecularly undefined ADH cases by direct Sanger sequencing

      CaseMethod1 as mentioned

      CaseMethod2 as mentioned

      CaseGenotypingMethod Exome sequencing

      Variant NM_000384.2(APOB):c.10182G>T (p.Lys3394Asn)

      ClinVar 438310

      gnomAD n/a

      VariantEvidence Deficient LDL uptake (fig. 2).

    1. F2:II.2

      Case# F2:II.2, F, 5mo onset, Turkey

      CasePresentingHPOs HP:0001263, HP:0006846, HP:0003201, HP:0011675, HP:0002925, HP:0100543, HP:0001250, HP:0002061, HP:0012444, HP:0001943, HP:0002151, HP:0002919, HP:0045045, HP:0040145, HP:0001270, HP:0001259, HP:0003236, HP:0000648

      HPOcont: Global developmental delay, Acute encephalopathy, Rhabdomyolysis, Arrhythmia, Elevated TSH, Cognitive impairment, Seizures, Lower limb spasticity, Brain atrophy, Hypoglycemia, Elevated lactate, Ketonuria, Elevated acylcarnitine, Dicarboxylic acidemia, Motor delay, Coma, Elevated CK, Optic atrophy

      HPOFreeText: "starting from the age of five months, psychomotor development appeared delayed. At the age of one year, spasticity predominantly involving the legs was noted. Nevertheless, the child was relatively active and was able to sit and crawl. However, after an episode of infection, she lost already acquired skills. Laboratory investigations during this episode showed transiently elevated CK activity (up to 2,970 U/l; NR < 269 U/l). At the age of 15 months, the girl suffered from a febrile upper airway infection during which she suddenly became comatose."

      CasePreviousTesting "Sequence analysis of the mitochondrial DNA and CPT2 did not show clinically relevant variants. Laboratory investigations revealed hypoglycemia (31 mg/dl; NR >50 mg/dl) and severe lactic acidosis (lactate up to 16.6 mmol/L; NR < 2.1 mmol/L). Biochemical analysis of fresh muscle tissue showed moderately reduced ATP production rate and a mildly reduced activity of mitochondrial complex I. Brain MRI demonstrated mild global brain atrophy without focal abnormalities. Eye examination showed bilateral optic atrophy. Acylcarnitine profiling showed normal free carnitine concentrations in dried blood while C14:1 acylcarnitine was mildly elevated (0.31 μmol/L; NR 0-0.25 μmol/L). Analysis of organic acids in urine revealed increased concentrations of dicarboxylic acids and ketone bodies as well as massive excretion of lactate." Then at 12 years, elevated TSH concentration (7.17 μIU/ml; NR 0.28-4.31 μIU/ml).

      CaseMethod1 WES

      CaseMethod2 Sanger

      CaseGenotypingMethod WES, confirmed with Sanger in patient and parents

      Variant NM_001283106.2(TANGO2):c.418C>T (p.Arg140Ter)

      ClinVar 224774

      CAID CA358667

      gnomAD 1.501e-05(European (Non-Finnish)), 8.254e-06(Total)

      VariantEvidence (Figure 3) In assessment of Palmitate-Dependent Mitochondrial Respiration, oxygen consumpition rates were decreased in patient fibroblasts by ~20% compared to control.

      CaseAddInfo "measurement of pyruvate-dependent oxygen consumption rates in fibroblast cell lines from individuals F1:II.2 and F2:II.2 was unremarkable." consanguineous parents, healthy older sibling

      CasePMIDs n/a

    2. F1:II.2

      Case# F1:II.2, F, 2yo onset, European

      CasePresentingHPOs HP:0001263, HP:0006846, HP:0003201, HP:0011675, HP:0002925, HP:0001250, HP:0012444, HP:0001943, HP:0002151, HP:0045045, HP:0040145, HP:0001259, HP:0002133, HP:0002913, HP:0003128, HP:0002061, HP:0001664, HP:0008936, HP:0001344, HP:0000252, HP:0003236, HP:0001946, HP:0100543

      HPOcont: Global developmental delay, Acute encephalopathy, Rhabdomyolysis, Arrhythmia, Elevated TSH, Seizures, Brain atrophy, Hypoglycemia, Elevated lactate, Elevated acylcarnitine, Dicarboxylic acidemia, Coma, Status epilepticus, Myoglobinuria, Lactic acidosis, Lower limb spasticity, Torsade de pointes, Trunk hypotonia, Absent Speech, Microcephaly, Elevated CK, Ketosis, Cognitive Impariment

      HPOFreeText: "At the age of 2 7/12 years, she suffered from an infection and suddenly became comatose with status epilepticus. Her renal function was transiently impaired due to massive rhabdomyolysis with myoglobinuria. The girl’s condition subsequently improved but she was unable to sit due to truncal hypotonia. She developed progressive spasticity in the legs, and communicated only non-verbally. Two months later a second episode occurred, which was again triggered by an infection and presented with similar clinical and laboratory findings. A third metabolic decompensation with lactic acidosis, hypoglycemia and rhabdomyolysis occurred six weeks later. This time, additional cardiac involvement with long QT syndrome and torsade de pointes tachyarrhythmia required intensive care treatment and implantation of a cardioverter-defibrillator (ICD) device. Seizures occurred which were responsive to antiepileptic medication. The girl remained with severely impaired psychomotor capabilities, marked truncal muscular hypotonia, moderate spasticity in the lower limbs, dystonic movements in the upper limbs, absent speech, and impaired social interaction. Secondary microcephaly became evident (head circumference < P3)."

      CasePreviousTesting "marked hypoglycemia (18 mg/dl; normal range (NR) > 50 mg/dl). Initial laboratory testing documented massively elevated plasma creatine kinase (CK) activity (maximum 300,000 U/l, NR < 227 U/l) as well as elevated plasma lactate concentrations up to 3.8 mmol/l (NR < 1.6 mmol/l). Urine organic acid analyses during crises showed a massive excretion of ketone bodies (around 2,000 mmol/mol creatinine), lactate (2,000 mmol/mol creatinine; NR < 285 mmol/mol creatinine), and dicarboxylic acids (values given in mmol/mol creatine: adipic (1,513; NR < 34), glutaric (24; NR = not detectable), sebacic (712; NR < 1.4), suberic (494; NR < 10), decenedioic (581; NR = not detectable), and of note malonic (145; NR = not detectable) acid). Acylcarnitine profiling in dried blot spots collected during the crisis showed free carnitine concentrations within normal ranges while several acylcarnitines were elevated 2-5-fold above the respective normal range (i.e. C5DC, C6DC, C10:1, C12, C12:1, C14:1, C14:2). In addition, an elevated TSH concentration (16.6 mU/l; NR 0.5-4.5 mU/l) was detected and treatment with L-thyroxine was initiated. Targeted sequencing of CPT2, ETFA, ETFB, ETFDH, and GCDH did not reveal clinically relevant variants."

      CaseMethod1 WES

      CaseMethod2 Sanger

      CaseGenotypingMethod WES, confirmed with Sanger in patient and parents

      Variant (1) NM_001283106.2(TANGO2):c.4delT (p.Cys2Alafs) (2) NM_152906.5:c.(56+1_57-1)(*1?)del

      ClinVar (1) 224773

      CAID (1) CA358861

      gnomAD n/a

      CaseAddInfo "measurement of pyruvate-dependent oxygen consumption rates in fibroblast cell lines from individuals F1:II.2 and F2:II.2 was unremarkable." Healthy twin brother.

      CasePMIDs n/a

    1. Individual F5-II1

      Case# F5-II1, female, 7mo death, Portuguese

      CasePresentingHPOs HP:0006579, HP:0001433, HP:0001508, HP:0001582, HP:0001290, HP:0001943, HP:0001987, HP:0002611, HP:0001399, HP:0001903, HP:0012115, HP:0001298, HP:0012358, HP:0012347, HP:0003155, HP:0003141, HP:0001394 (Neonatal jaundice, Hepatosplenomegaly, Failure to thrive, Redundant skin, Hypotonia, Hypoglycemia, Hyperammonemia, Cholestatic liver disease, Liver failure, anemia, Hepatitis, Encephalopathy, O-glycosylation, N-glycosylation, Elevated alkaline phosphatase, High cholesterol, Increased LDL cholesterol, Cirrhosis)

      HPOsFreeText persisting jaundice, hepatosplenomegaly, FTT, redundant skin, poor muscle volume, generalized hypotonia(5mo) abnormal coagulation factors, perinuclear iron deposition, severe cholestatic hepatitis, multi-organ failure, elevated aminotransferases, on bone marrow biopsy: dyserythropoiesis, lipidic histiocytes and erythrophagocytosis

      CaseNotHPOs n/a

      CasePreviousTesting type 2 CDG, metabolic work up: AST 207–972 U/l[normal range, 0–50 U/l], ALT 48–153 U/l[normal range, 0–50 U/l], ALP 850–1,031 U/l[normal range, < 360 U/l], cholesterol 431 mg/dl[normal range, 120–200 mg/dl], LDL cholesterol 314 mg/dl[normal range, 50–130 mg/dl], low FVII and high FVIII, INR 0.79–3.0, HB 7 g/dl

      CaseMethod1 WES

      CaseMethod2 n/a

      CaseGenotypingMethod WES on proband, Sanger on parents. Variants with frequency of >0.2%, synonymous variants, deep intronic variants, and variants in UTRs were excluded.

      Variant (1) NM_032357.3(CCDC115):c.92T>C (p.Leu31Ser), (2)NM_032357.3(CCDC115):c.(?-258) (∗1245_?) del(p.0?), compound heterozygous

      ClinVar (1) 218967(2) n/a

      gnomAD (1) 0.00002384(European (Non-Finnish)), 0.00001086(Total)-3 heterozygotes

      VariantEvidence n/a

      CaseAddInfo n/a

      CasePMIDs 29759592

    2. Individual F3-II2

      Case# F3-II2, female, 1yo onset, French

      CasePresentingHPOs HP:0006579, HP:0003155, HP:0001290, HP:0001397, HP:0001395, HP:0001263, HP:0001250, HP:0000718, HP:0000713, HP:0000709, HP:0012347, HP:0003124, HP:0003141, HP:0010837 (Neonatal Jaundice, Elevated alkaline phosphatase, Hypotonia, Steatosis, Hepatic fibrosis, Psychomotor delay, Seizures, Aggressive behavior, Agitation, Psychosis, Abnormal protein N-linked glycosylation, High cholesterol, Increased LDL cholesterol, Low ceruloplasmin)

      HPOsFreeText Persistent moderate hypotonia, elevated AT, necrotic lesions on liver biopsy, steatosis and fibrosis(1yo), developed various behavioral issues by age 25

      CaseNotHPOs n/a

      CasePreviousTesting Metabolic work up: AST 1,780 U/l[normal range, 0–50 U/l], ALT 390 U/l[normal range, 0–50 U/l], and ALP 950 U/l [normal range, < 360 U/l], with increased bone fraction, ceruloplasmin 10 mg/dl[normal range, 15–60 mg/dl], type 2 CDG, abnormal N-glycosylation

      CaseMethod1 Sanger

      CaseMethod2 n/a

      CaseGenotypingMethod Sanger on proband targeting CCDC115.

      Variant NM_032357.3(CCDC115):c.92T>C (p.Leu31Ser), homozygous

      ClinVar 218967

      gnomAD 0.00002384(European (Non-Finnish)), 0.00001086(Total)-3 heterozygotes

      VariantEvidence n/a

      CaseAddInfo unaffected brother

      CasePMIDs 29759592

    3. Individual F2-II1

      Case# F2-II1, male, Italian, 2yo diagnosis

      CasePresentingHPOs HP:0006579, HP:0001433, HP:0010837, HP:0003124, HP:0003155, HP:0001263, HP:0001999, HP:0025321, HP:0012358, HP:0012347, HP:0003141 (Neonatal jaundice, Hepatosplenomegaly, Decreased ceruloplasmin, High cholesterol, Elevated alkaline phosphatase, Psychomotor delay, Dysmorphic facies, Liver copper accumulation, Abnormal protein O-linked glycosylation, Abnormal protein N-linked glycosylation, Increased LDL cholesterol)

      HPOsFreeText Elevated AT, ALT, cholesterol, jaundice, hepatosplenomegaly, low blood ceruloplasmin(neonate), Mild psychomotor disability, mild dysmorphic facies (2yo)

      CaseNotHPOs n/a

      CasePreviousTesting Failed to detect ATP7B on suspected Wilson disease. Metabolic work up: AST 422 U/l[normal range, 0–50 U/l], ALT 588 U/l[normal range, 0–50 U/l], ALP 976 U/l[normal range, < 360 U/l], type 2 CDG (2yo). Hepatic copper 125 μg/g dry weightnormal range, <40 μg/g, Altered ApoC3 pattern, type 2 CDG pattern

      CaseMethod1 WES

      CaseMethod2 Sanger

      CaseGenotypingMethod WES confirmed with Sanger homozygosity in proband and heterozygosity in parents. Variants with frequency of >0.2%, synonymous variants, deep intronic variants, and variants in UTRs were excluded.

      Variant NM_032357.3(CCDC115):c.92T>C (p.Leu31Ser), homozygous

      ClinVar 218967

      gnomAD 0.00002384(European (Non-Finnish)), 0.00001086(Total)-3 heterozygotes

      VariantEvidence n/a

      CaseAddInfo n/a

      CasePMIDs 26833332, 29759592

    1. Subject 5

      Case# Subject 5, F, 7yo onset, Hispanic

      CasePresentingHPOs HP:0001270, HP:0000750, HP:0005184, HP:0001250, HP:0008942, HP:0003236, HP:0001664, HP:0004756, HP:0011675, HP:0001943, HP:0002151, HP:0003201, HP:0001249, HP:0002913, HP:0003324, HP:0001695, HP:0006956

      HPOcont: Motor Delay, Speech Delay, Prolonged QTc interval, Seizures, Elevated CPK, Torsade de pointes, Ventricular tachycardia, Arrhythmia, Hypoglycemia, Elevated Lactate, Acute rhabdomyolysis, Intellectual Disability, Myoglobinuria, Generalized Muscle Weakness, Cardiac Arrest, Enlarged lateral ventricles

      HPOFreeText: speech and motor delay, prolonged QTc interval, seizures, prior to her acute presentation. (7 years) acute rhabdomyolysis, high CPK and myoglobinuria. (13 years) muscle weakness, cardiac arrest, torsade de pointes from prolonged QTc interval, ventricular tachycardia with recurrent pulseless arrest and arrhythmia, able to ambulate.

      CaseNotHPOs n/a

      CasePreviousTesting highest CPK (60,000 U/L), 953 U/L for AST, 540 U/L for ALT, and CPK-MB of 291 U/L.

      CaseMethod1 WES

      CaseMethod2 Sanger

      CaseGenotypingMethod WES and cSNP results confirmed with Sanger

      Variant (1) NM_152906.6:c.460G>A (p.Gly154Arg)

      ClinVar (1) 208823

      CAID (1) CA358646

      gnomAD (1) 0.001549(Other), 0.0001208(Overall)

      VariantEvidence (Figure 3) using "EBV-transformed B-lymphoblastoid cell lines (BLCLs) from another individual, subject 4 with homozygous c.460G>A (p.Gly154Arg) mutation, and evaluated the Golgi by intracellular staining with WGA, as well as cis Golgi marker, anti-GM130 antibody." WGA stain resolved lower area of golgi bodies in p.Gly154Arg cells than WT. Measured immunoglobulin heavy chain binding protein levels in WT and and patient fibroblasts, BiP levels in patient cells lower than WT after ER induced stress by Brefeldin A.

      CaseAddInfo nonconsanguineous, parents confirmed heterozygotes

      CasePMIDs n/a

    1. The index individual in family 1 (F1_IV:5)

      Case# F1_IV:5, M, 6.5yo report, Saudi Arabia

      CasePresentingHPOs HP:0001263, HP:0008947, HP:0001257, HP:0000486, HP:0000639, HP:0004326, HP:0000252

      HPOcont: Global developmental delay, Infantile muscular hypotonia, Spasticity, Strabismus, Nystagmus, Cachexia, Microcephaly

      Free text: "At 4.5 years of age, he was cachectic with a weight of 8.1 kg (−5.2 SD), short with a length of 89 cm (−3.7 SD), and microcephalic with a head circumference of 46 cm (−3.2 SD). He was inattentive and had no visual tracking ability as well as bilateral strabismus and nystagmus. He had severe axial hypotonia and appendicular hypertonia with spasticity."

      CaseNotHPOs HP:0001250

      NotHPOcont: Seizures

      CasePreviousTesting "Plasma lactate, ammonia, uric acid, lipid profile, tandem mass spectrometry (MS), urine organic acids, plasma amino acids, and congenital disorder of glycosylation screenings did not reveal any abnormality. Chromosomal analysis and microarray were unremarkable. Glycosaminoglycans and oligosaccharides in the urine were normal. Lysosomal enzyme analysis was unremarkable. HEXB and SMN1 mutation analysis did not reveal pathogenic mutations. Brain MRI showed mild diffuse brain atrophy, and MRS (magnetic resonance spectroscopy) showed a mild reduction of the N-acetylaspartate peak but a normal lactate peak. Skeletal survey showed diffuse osteopenia."

      CaseMethod1 Exome sequencing

      CaseMethod2 Sanger

      CaseGenotypingMethod autozygome filtering after exome sequencing, confirmed with sanger

      Variant NM_032504.1(UNC80):c.3793C>T (p.Arg1265Ter)

      ClinVar 219188

      gnomAD 0.00004175(Latino), 0.000006613(Overall)

      CaseAddInfo His first-cousin parents had two sons who died at 4 and 6 years of age with a reportedly identical phenotype of profound static encephalopathy and no seizures. The index individual has two living brothers and two sisters who are all healthy

    1. A 37-year-old woman

      Case# Fam1Pat1, F, 21yo onset, Turkish

      CasePresentingHPOs HP:0002061, HP:0002066, HP:0002070, HP:0001260, HP:0001310, HP:0000563, HP:0006986,

      CasePreviousTesting Neurologic examination revealed dysarthria, spasticity in lower >> upper extremities, mild weakness in proximal leg muscles, Achilles tendon contracture, mild dysmetria, dysdiadochokinesia, and a spastic-ataxic gait. Cranial MRI and nerve conduction studies were unremarkable.

      CaseMethod1 Whole Exome

      Variant NM_001198868.1:c.994G>A

      CAID CA381247865

      gnomAD 0.00005842(East Asian), 0.000008204(Overall)

      VariantEvidence none

    1. The index patient in this family is a 13-year-old female

      Case# ObeidIndex, F, 13yo report, Palestinian-Emirati

      CasePresentingHPOs HP:0006829, HP:0010864, HP:0001263, HP:0000252, HP:0001344, HP:0001250, HP:0002650, HP:0000574, HP:0000414, HP:0000179, HP:0000307, HP:0000218, HP:0040079, HP:0030787, HP:0002136, HP:0001344

      HPOcont: Severe muscular hypotonia, Severe intellectual disability, Global developmental delay, Microcephaly, Absent speech, Seizures, Scoliosis, Thick eyebrow, Bulbous nose, Thick lower lip vermilion, Pointed chin, High palate, Irregular dentition, Cerumen abnormality, Broad-based gait, Absent speech

      Free Text: "birth weight of 2.6 Kg (< 10th centile), head circumference of 33 cm (< 3rd centile). At the age of 8 months, her developmental delay was noticed as she was unable to sit unsupported. Formally evaluated at one year of age, at which point EEG was suggestive of symptomatic localization-related epilepsy. EEG revealed ill-defined low spikes over the left temporooccipital area, suggesting symptomatic partial epilepsy. At age 11 developed subtle facial dysmorphic features, including bushy eyebrows, bulbous nose, anteverted nostrils, thick lower lip, pointed chin, high arched palate, irregular teeth, and waxy ears. As an eleven years and three months old girl, she is able to sit independently, without support. However, she has difficulty in standing from squat position. She can ambulate independently with a wide based gait with hands on flexion position, but is not able to run, jump, or pedal tricycle. She can climb stairs, but with support. She demonstrated a pincer grasp. She can do purposeful movements; as in the ability to reach, hold and transfer objects, and she can bring food to mouth. She can also dress herself with help, but does not zip or button. She does not have any meaningful speech, but babbles socially."

      CaseNotHPOs HP:0002540, HP:0002019, HP:0011968, HP:0002014

      NotHPOcont: Inability to walk, Constipation, Feeding difficulties, Diarrhea

      CasePreviousTesting Brain MRI, thyroid function tests, metabolic screening, and eye examination were normal; as were the following genetic investigations: chromosomal microarray, karyotyping, FISH for 15q11–13 deletion, subtelomeric FISH, methylation analysis for Angelmann, and molecular analysis for UBE3A gene. "A 186 such variants were looked at individually in order to uncover any connections with the patient’s phenotype in the context of various modes of inheritance in the analyzed trio. For example, heterozygous mutations in NDRG4, RELN, TYRP1, REEP6, FABP2 and others were found and given low priority when looked at in the light of the patient’s phenotype. None of the other variants from that list appeared to have enough functional links to the patient’s condition to merit discussing it along with the UNC80 variant."

      CaseMethod1 WES

      CaseMethod2 Sanger

      CaseGenotypingMethod WES results confirmed with Sanger sequencing in trio

      Variant NM_032504.1:c.8525G>A (p.Arg2842Gln)

      CAID CA350413877

      gnomAD 0.00006667(European (Non-Finnish), 0.00003230(Overall)

      CaseAddInfo parental consanguinity, confirmed in trans

    1. Patient II-3 of the family presented in figure 2belonged to a large MHS family in which an R1086H mutation responsible for the MHS trait was identified in the CACNA1S  gene.

      Case# Monnier 2:3, male, French

      CasePresentingHPOs HP:0002047

      CasePreviousTesting N/A

      CaseMethod1 sequenced all cDNA

      CaseGenotypingMethod single strand conformation analysis and sequencing

      Variant NM_000069.2(CACNA1S):c.3257G>A (p.Arg1086His)

      ClinVar 17626

      gnomAD 0.00002978 link<br /> gnomAD did not include the G>A mutation, only C>T but it was the same amino acid change

      VariantEvidence N/A, all of these case studies claim ICVT verifies the phenotype but that doesn't seem like enough to pass for variant evidence since it is tested in patient muscle tissue.

      CaseAddInfo Family not counted, too few segregations for the R1086H variant.

    1. Case#: Cluruk_1993_IN-16, male, 13 y.o., Indian ancestry reported (Mandla and Jabalpur districts of Madhya Pradesh)

      CasePresentingHPOs: decreased RBCs (3.34), decreased Hb (9.2), elevated HbS (68.2), elevated HbF (21.9), MCH 27.5%, HB A2 4.5%, HB A 5.4%

      CaseHPOFreeText: S - B+ - thal (aax/aax) x = variant

      CaseNotHPOs:

      CaseNotHPOFreeText:

      CasePreviousTesting:

      CaseMethod1: Sanger

      CaseMethod2: hybridization probing

      CaseGenotypingMethod: Sanger + probing

      Variant: NM_000558.5(HBA1):c.96-1G>A

      ClinVarID: 801169

      CAID: CA7770244

      gnomAD: allele frequency of 0.0009851 (21/21318 alleles) in the South Asian population (PopMax 0.0006591)

      VariantEvidence: Also seen in compound het with 4 patients with a4.2 deletion and 7 patients with 3.7 deletion in this paper. Heterozygotes (aa/aax) had similar levels of Hb S

      CaseAddInfo:

      CasePMIDs:

    1. c.788G>C mutation

      Case# III-1, Female, Caucasian

      CasePresentingHPOs HP:0001643

      CaseMethod1 WES

      CaseMethod2 PCR

      Variant NM_001136239.3(PRDM6):c.788G>C (p.Cys263Ser)

      ClinVar 243050

      VariantEvidence Functional in vitro characterization of PRDM6 p.Cys263Ser in HEK293 cells and human aortic VSMCs showed that the variant protein significantly loses its capability for nuclear localization (Fig 3). DNA overexpression in adenovirus virus infected WT and mutant variants showed MYH11 is also not suppressed by mutant where it is suppressed in WT (Figure 4). Immunoblots of histones in WT human aortic smooth muscle transfected with the variant showed reduced histone modification and and suppression of contractile proteins. (Fig. 5)

    1. 10-year-old male

      Case# Postma 3:1, male, 10yo, white

      CasePresentingHPOs HP:0004758, HP:0000980, HP:0005184, HP:0000961, HP:0002789

      CasePreviousTesting no

      CaseMethod1 PCR

      CaseGenotypingMethod amplified/screen of CASQ2, SCN5A, HRC, PLN, RYR2, KCNQ1, KCNH2, and KCNK1 genes

      Variant NM_001232.3:c.532+1G>A

      CAID CA341763774 link

      VariantEvidence not in this article

    1. SAL-399-073

      Case# SAL-399-073, Female, 46yo, French, Hispanic

      CasePresentingHPOs HP:0002385, HP:0011448, HP:0001260, HP:0002066, HP:0002015, HP:0002650, HP:0001272

      CaseMethod1 Exome

      CaseMethod2 Sanger

      Variant NM_005186.3:c.463C>T(p.Q155X), NM_005186.3:c.1142C>T(p.R512C)

      CAID CA381242841, CA381248914

      gnomAD 0.00003567

      VariantEvidence nonsense, missense in trans with null variant

      CaseAddInfo in article supplement

    1. Subject 2

      Case# Subject 2, F, 5mo died, Kurdish

      CasePresentingHPOs HP:0001319, HP:0008872, HP:0002033, HP:0003128, HP:0002490, HP:0001531, HP:0040288, HP:0001712, HP:0001410, HP:0002098, HP:0002910, HP:0002126, HP:0000365, HP:0002151 (Neonatal hypotonia, Feeding difficulties in infancy, Poor suck, Hyperlactatemia, Increased CSF lactate level, Failure to thrive in infancy, Nasogastric tube feeding, Left ventricular hypertrophy, Decreased liver function, Respiratory distress, Elevated transaminases, Polymicrogyria, Deafness, Elevated serum lactate)

      HPOFreeText: After caesarean delivery, neonatal hypotonia, poor feeding, and sucking. (3 months) failure to thrive, nasogastric feeding, left ventricular hypertrophy and impaired liver function. Brain MRI: bifrontal polymicrogyria and acoustic oto-emissions suggested deafness (4 months). Died of respiratory distress at 5 months.

      CaseNotHPOs n/a

      CasePreviousTesting Serum lactate (7.4 mmol/L; normal range 0.90–1.70 mmol/L), lactate to pyruvate ratio (170; normal range 30–50), CSF lactate (3.1 mmol/L; control < 2.2 mmol/L), liver function (AST: 84 UI/L, normal range 15–60; ALT: 52 UI/L, normal range 7–40; gGT: 262 UI/L, normal range 6–25 UI/L). Screened panel of known mitochondrial disease genes. Analysis of mtDNA and mtDNA copy number from patient muscle DNA were normal, thus excluding mtDNA rearrangements and point mutations.

      CaseMethod1 WES

      CaseMethod2 Sanger

      CaseGenotypingMethod WES confirmed with Sanger in patient and parents to confirm in trans

      Variant NM_017819.3(TRMT10C):c.542G>T (p.Arg181Leu) -homozygous

      ClinVar 224316

      gnomAD 0.0003508(Latino), 0.0001121(Total) -no homozygotes on record

      VariantEvidence n/a

      CaseAddInfo non-consanguineous, healthy older brother, c.542G>T variant in ExAC (10/120,324 alleles) and ESP6500 (1/11,824 alleles)

      CaseAddPMIDs n/a

    2. Subject 1

      Case# Subject 1, M, 5mo died, British

      CasePresentingHPOs HP:0001319, HP:0003324, HP:0008872, HP:0001531, HP:0002020, HP:0000407, HP:0002910, HP:0002151, HP:0002490, HP:0003198, HP:0003200, HP:0003688, HP:0002098, HP:0003348 (Neonatal hypotonia, Generalized muscle weakness, Feeding difficulties in infancy, Failure to thrive in infancy, Gastroesophageal reflux, Sensorineural hearing impairment, Elevated transaminases, Increased serum lactate, Increased CSF lactate level, Myopathy, Ragged red muscle fibers, Cytochrome C oxidase-negative muscle fibers, Respiratory distress, Elevated blood alanine)

      HPOFreeText: Hypotonic and weak soon after birth, had difficulty feeding, slow weight gain and gastro-esophageal reflux, confirmed sensorineural deafness after neonatal screen. Lateral skull X-ray showed fused sutures, supporting possible craniosynostosis. Died of 5.5 months of respiratory distress after rhinovirus bronchiolitis.

      CaseNotHPOs HP:0045045 (Elevated acylcarnitine)

      CasePreviousTesting Alanine transaminase (439 U/L; normal range 4–45 U/L), blood lactate (5 to 10 mmol/L; normal range 0.7–2.1 mmol/L). Screened panel of known mitochondrial disease genes. Analysis of mtDNA and mtDNA copy number were normal in patient muscle cells, thus excluding mtDNA rearrangements and point mutations.

      CaseMethod1 WES

      CaseMethod2 Sanger

      CaseGenotypingMethod WES confirmed with Sanger in patient and parents to confirm in trans

      Variant (1) NM_017819.3(TRMT10C):c.542G>T (p.Arg181Leu), (2) NM_017819.3(TRMT10C):c.814A>G (p.Thr272Ala)

      ClinVar (1) 224316, (2) 224317

      gnomAD (1) 0.0003508(Latino), 0.0001121(Total) - no homozygotes listed (2) n/a

      VariantEvidence n/a

      CaseAddInfo non-consanguineous, healthy older sister, c.542G>T variant in ExAC (10/120,324 alleles) and ESP6500 (1/11,824 alleles), c.814A>G was not in ExAC, ESP6500 or COSMIC

      CaseAddPMIDs n/a

    1. On gene analysis thereafter, two missense mutations were verified in exons 3 and 11 of transmembrane protein 43 (TMEM43) in this patient and her mother (Fig. 3). The mutations were c. 265 g > a, p.V89M and c.896 g > c, p.R299T.

      Case# HondaF, female, newborn

      CasePresentingHPOs HP:0001640, HP:0006682, HP:0011713, HP:0100572

      CaseGenotypingMethod "gene analysis"

      Variant NC_000003.10:g.14147425G>A

      CAID CA052413

      gnomAD 0.001044 link

      CaseAddInfo 2 mutations in cis from mom, phenotypes described at birth (usually adult onset)

    1. The proband had first presented aged 14 years

      Case# II-4, Female, 14, Ireland

      CasePresentingHPOs HP:0002506, HP:0002497, HP:0002061, HP:0011448, HP:0001347

      CasePreviousTesting Initial genetic testing (with patient consent) included a screening panel for HSP, as well as SCA 1, 2, 3 and 6, all of which were negative.

      CaseMethod1 WES

      Variant NM_005186.3:c.1534C>T(p.Arg512Cys)

      CAID CA6093457

      gnomAD 0.000008977

    1. patient with congenital-onset pure spastic paraplegia caused by novel pathogenic variants in CAPN1

      Case# Travaglini 1, Male, 16 report, Italian

      CasePresentingHPOs HP:0006895, HP:0040083, HP:0001347, HP:0003487

      CasePreviousTesting Sanger of SPG4 and 89 other known/candid genes by Nextera Custom Enrichment panel

      CaseMethod1 Sanger Sequencing

      CaseGenotypingMethod CAPN1 variants found in same panel screen

      Variant NM_005186.3:c.221G>A (p.G74D), NM_005186.3:c.911C>T(p.T304M), NM_005186.3:c.1418G>T (p.R473L)

      CAID CA6092976, CA6093221, CA6093432

      gnomAD 0.0006904 , 0.0003415, 0.00003952

      CaseAddInfo nonconsanguineous family

    1. Genetic testing in the probands from two independent Slovenian families identified a novel variant c.3457T>A (Ter1153Lysext*38) in the RPGRORF15. The variant is predicted to disrupt the terminal codon of the RPGRORF15, resulting in a C-terminal extension of the protein by 38 aminoacids ending with a new stop codon. The variant has not been reported in the biomedical literature and is not present in the GnomAD population database (gnomad.broadinstitute.org, accessed on 06.01.2021). Single-nucleotide polymorphism analysis comparing X-chromosomes of the probands is shown in Figure 2C. On the X-chromosome we identified a large block of hemizygous SNPs shared by both probands with an estimated size of 29 megabases, which suggests that observation of an identical variant in two independent families may be due to a founder effect.

      Case#: Hadalin_2021_Family_1_Patient_III-1, male, 31 years old at first examination, family origin in Slovenia

      CasePresentingHPOs: HP:0011463 (Childhood onset), HP:0000545 (Myopia), HP:0008020 (Cone dystrophy), HP:0007663 (Reduced visual acuity), HP:0012230 (Rhegmatogenous retinal detachment), HP:0000603 (Central scotoma), HP:0007814 (Retinal pigment epithelial mottling), HP:0008043 (Retinal arteriolar constriction), HP:0000543 (Optic disc pallor), HP:0030602 (Abnormal fundus autofluorescence imaging), HP:0200070 (Peripheral retinal atrophy), HP:0030465 (Undetectable light-adapted electroretinogram), HP:0000613 (Photophobia), HP:0011504 (Bull's eye maculopathy), HP:0007737 (Bone spicule pigmentation of the retina),

      CaseHPOFreeText: The patient received a diagnosis of cone dystrophy. Myopia was present from childhood, while visual loss occurred in the early 30's.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: Dark-adapted ERG was normal at the time of the study.

      CasePreviousTesting: The patient and an apparently unrelated proband from another family were subjected to whole-exome sequencing.

      CaseMethod1: Whole-exome sequencing

      CaseMethod2: Haplotype analysis using SNPs on the X chromosome

      CaseGenotypingMethod: The patient and a proband from another family not known to be related were subjected to whole-exome sequencing, followed by haplotype analysis using SNPs on the X chromosome.

      Variant: The patient harbors the NM_001034853.2(RPGR):c.3457T>A (p.Ter1153Lys) variant in the hemizygous state.

      ClinVar: 931960

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

      VariantEvidence: NM_001034853.2(RPGR):c.3457T>A (p.Ter1153Lys) is a stop-loss variant that triggers an extension of the C-terminus of RPGR by 38 amino acids. It is not predicted to undergo nonsense-mediated decay, and its inheritance pattern with largely unaffected female carriers is consistent with loss-of-function.

      CaseAddInfo: The proband is a member of Family 1, with the mother being a female carrier with mild myopia, and an apparently affected maternal grandfather. Two other patients not known to be close relatives but harboring the same founder variant within a 29-megabase shared region received the same diagnosis of cone dystrophy.

      CasePMIDs: N/A

    1. Herein, we report the identification of a novel nonsense mutation in the second exon of the KCNJ13 gene that leads to a premature stop codon in association with LCA16. We have determined that the mutation results in a severe truncation of the Kir7.1 C-terminus, alters protein localization, and disrupts potassium currents. Coexpression of the mutant and wild-type channel has no negative influence on the wild-type channel function, consistent with the normal clinical phenotype of carrier individuals.

      Case#: Pattnaik_2015_Proband, male, age 10 years, family national origin described as Jordanian

      CasePresentingHPOs: Nyctalopia HP:0000662, Childhood onset HP:0011463, Severely reduced visual acuity HP:0001141, Granular macular appearance HP:0007793, Retinal arteriolar constriction HP:0008043, Retinal degeneration HP:0000546, Abnormal choroid morphology (hypertrophy) HP:0000610

      CaseHPOFreeText: The proband has been diagnosed at different times with Stargardt disease, retinitis pigmentosa, cone-rod dystrophy, and Leber congenital amaurosis, first presenting with night vision difficulties at age 2 years. Small focal sub-RPE deposits were observed.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The proband was initially genotyped by PCR-based screening for known LCA-associated variants and next-generation sequencing focused on a 19-gene LCA panel.

      CaseMethod1: PCR-based screening for known LCA-associated variants as well as next-generation sequencing of a 19-gene LCA panel

      CaseMethod2: Sanger sequencing of gaps and low-coverage regions as well as for confirmation of the variants detected by other methods.

      CaseGenotypingMethod: The proband was initially genotyped by PCR-based screening for known LCA-associated variants and next-generation sequencing focused on a 19-gene LCA panel. Sanger sequencing of gaps and low-coverage regions as well as for confirmation of the variants detected by other methods.

      Variant: The individual is homozygous for the NM_002242.4(KCNJ13):c.158G>A (p.Trp53Ter) variant.

      ClinVar: 224857

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

      VariantEvidence: Heterologous expression of the NM_002242.4(KCNJ13):c.158G>A (p.Trp53Ter) variant in CHO-K1 cells revealed that the variant channel retained very little ability to enable the flow of current, with the measurement of -68.8pA more comparable to the negative control (-42.4pA) than to the wild-type control (-588.7pA).

      CaseAddInfo: The family history does not reportedly indicate consanguinity.

      CasePMIDs: N/A

    1. An 18-year old highly myopic woman presented with bilateral retinoschisis associated with a unilateral macular hole in the right eye and vitreomacular traction in the left eye. Methods: Genetic studies disclosed a heterozygous pathogenic variant in the KCNJ13 gene was identified (c.484C>T (p.Arg162Trp)), consistent with a diagnosis of snowflake vitreoretinal degeneration (SVD). Results: While there were no corneal guttata, juvenile cataracts, or perivascular sheathing in this case, salient features of SVD included a fibrillar vitreous structure, crystalline retinopathy, and flattened optic nerves. The patient developed a FTMH in the left eye at 17 months follow up, followed by a rhegmatogenous retinal detachment (RRD) requiring 2 surgical repairs.

      Case#: Ashkenazy_2023_Proband, female, age 18 at time of report, family origin unknown due to adoption but reported in the United States

      CasePresentingHPOs: Snowflake vitreoretinal degeneration HP:0011533, High myopia HP:0011003, Retinoschisis HP:0030502, Rhegmatogenous retinal detachment HP:0012230, Abnormal vitreous humor morphology HP:0004327, Full-thickness macular hole HP:0031152

      CaseHPOFreeText: The patient exhibited fibrillar vitreous structure, crystalline retinopathy, and optic nerve flattening.

      CaseNotHPOs: Corneal guttata HP:0012038, Presenile cataracts HP:0007819

      CaseNotHPOFreeText: Perivascular sheathing was absent.

      CasePreviousTesting: Genotyping of the proband was not described in detail, but reportedly did not include whole exome sequencing, due to the specificity of the phenotype. Genes implied to have been possibly examined were COL2A1, COL11A1, and CSPG2.

      CaseMethod1: Sanger sequencing of KCNJ13

      CaseMethod2: N/A

      CaseGenotypingMethod: Genotyping of the proband was not described in detail, but reportedly did not include whole exome sequencing, due to the specificity of the phenotype. Genes implied to have been possibly examined were COL2A1, COL11A1, and CSPG2. Sanger sequencing of KCNJ13 was performed.

      Variant: The individual harbors the NM_002242.4(KCNJ13):c.484C>T (p.Arg162Trp) variant in the heterozygous state.

      ClinVar: 6585

      gnomAD: The variant is found in gnomAD version 4.1.0 at a frequency of 0.0000008536 (1 / 1,171,470) in the European (non-Finnish) population https://gnomad.broadinstitute.org/variant/chr2-232768790-G-A?dataset=gnomad_r4

      VariantEvidence:NM_002242.4(KCNJ13):c.484C>T (p.Arg162Trp) is a missense variant that has functional evidence of electrophysiological abnormalities and loss of sensitivity to different K+ concentrations, when exogenously expressed in CHO cells (PMID: 18179896, Figure 2).

      CaseAddInfo: The proband may or may not be a relative of the family previously reported with the same variant in PMID: 18179896, as both appear to have received medical care in the United States.

      CasePMIDs: N/A

    1. In family B, a G-to-T transversion (ORF15+1176G>T; Fig. 2B ) resulted in a nonsense mutation (G392X).

      Case#: Ebenezer_2005_Family_B_Patient_IV:11, male, age 44, family origin reported to be British

      CasePresentingHPOs: HP:0003581 (Adult onset), HP:0000654 (Decreased light- and dark-adapted electroretinogram amplitude), HP:0000662 (Nyctalopia), HP:0007663 (Reduced visual acuity), HP:0000613 (Photophobia), HP:0000545 (Myopia), HP:0000483 (Astigmatism), HP:0007803 (Monochromacy), HP:0007722 (Retinal pigment epithelial atrophy), HP:0025159 (Hypoautofluorescent retinal lesion), HP:0007814 (Retinal pigment epithelial mottling)

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

      CaseNotHPOs: HP:0000639 (Nystagmus)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The proband and family members were not genotyped outside of the RPGR locus.

      CaseMethod1: Sanger sequencing of exon 15 of RPGR

      CaseMethod2: N/A

      CaseGenotypingMethod: The proband and family members were genotyped by Sanger sequencing of exon 15 of RPGR, but not by genome-wide methods.

      Variant: The proband harbors the NM_001034853.2(RPGR):c.2929G>T (p.Gly977Ter) variant in the hemizygous state.

      ClinVar: 9918

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

      VariantEvidence: NM_001034853.2(RPGR):c.2929G>T (p.Gly977Ter) is a nonsense variant in the final exon (exon 15) that is not predicted to trigger nonsense-mediated decay, but disrupts ~15% of the C-terminus of the protein product.

      CaseAddInfo: The proband is a member of Family B (shown in Figure 1), which includes four other affected genotype-positive males and as well as four carrier females who showed reduced visual acuity and golden tapetal reflex.

      CasePMIDs: N/A

    2. In family A, two consecutive substitutions were identified in ORF15+A1094C G1095T (Fig. 2A)that created a premature stop codon that was predicted to result in a truncated protein (E364D/E365X).

      Case#: Ebenezer_2005_Family_A_Patient_III.4, male, age not specified, family origin reported to be British

      CasePresentingHPOs: HP:0025710 (Late young adult onset), HP:0000662 (Nyctalopia), HP:0007663 (Reduced visual acuity), HP:0000613 (Photophobia), HP:0007803 (Monochromacy), HP:0031624 (Moderate myopia), HP:0001103 (Abnormal macular morphology), HP:0000533 (Chorioretinal atrophy), HP:0500087 (Peripapillary atrophy), HP:0025159 (Hypoautofluorescent retinal lesion), HP:0030844 (Undetectable pattern electroretinogram), HP:0000654 (Decreased light- and dark-adapted electroretinogram amplitude)

      CaseHPOFreeText: The proband has been diagnosed with retinitis pigmentosa, with the family exhibiting an X-linked pattern of inheritance. Cone ERG was more severely reduced than rod ERG.

      CaseNotHPOs: HP:0007769 (Peripheral retinal degeneration), HP:0000639 (Nystagmus)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The proband and family members were not genotyped outside of the RPGR locus.

      CaseMethod1: Sanger sequencing of exon 15 of RPGR

      CaseMethod2: N/A

      CaseGenotypingMethod: The proband and family members were genotyped by Sanger sequencing of exon 15 of RPGR, but not by genome-wide methods.

      Variant: The proband harbors the NM_001034853.2(RPGR):c.2847_2848inv (p.Glu949_Glu950delinsAspTer) variant in the hemizygous state.

      ClinVar: 9917

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

      VariantEvidence: NM_001034853.2(RPGR):c.2847_2848inv (p.Glu949_Glu950delinsAspTer) is an indel in the final exon (exon 15) that introduces a premature stop codon. Although it is not predicted to trigger nonsense-mediated decay, it at least disrupts ~18% of the C-terminus of the protein product.

      CaseAddInfo: The proband is a member of Family A (shown in Figure 1), which includes four other affected genotype-positive males and four carrier females who showed RPE abnormalities.

      CasePMIDs: N/A

    1. P12 JP01 c.632G>A p.Trp211* c.345_349delCTGGC p.Trp116AlafsTer7

      Case#: Georgiou_2024_Family_JP01_Proband_P12, male, reported at age 6 years, family origin reported as from Japan

      CasePresentingHPOs: HP:0011003 (High myopia), HP:0030558 (Best corrected visual acuity 0.5 LogMAR)

      CaseHPOFreeText: BCVA began at 0.20 logMAR and progressed to 0.57 logMAR.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping was by either next-generation sequencing panel, whole exome sequencing, or whole genome sequencing, but was unspecified.

      CaseMethod1: NGS panel / WES / WGS

      CaseMethod2: Sanger sequencing of RBP3

      CaseGenotypingMethod: Previous genotyping by either next-generation sequencing panel, whole exome sequencing, or whole genome sequencing was followed by Sanger sequencing of RBP3.

      Variant: The individual harbors the NM_002900.3(RBP3):c.632G>A (p.Trp211Ter) and NM_002900.3(RBP3):c.345_349del (p.Trp116AlafsTer7) variants in the compound heterozygous state.

      ClinVar ID: 838965

      CAID CA2953902720

      gnomAD: The NM_002900.3(RBP3):c.345_349del (p.Trp116AlafsTer7) variant was not found in gnomAD version 4.1.1. The NM_002900.3(RBP3):c.632G>A (p.Trp211Ter) variant is found in gnomAD version 4.1.1 at a frequency of 0.00008913 (4 / 44878) in the East Asian population https://gnomad.broadinstitute.org/variant/chr10-47349116-G-A?dataset=gnomad_r4

      VariantEvidence: NM_002900.3(RBP3):c.632G>A (p.Trp211Ter) is a nonsense variant within exon 1 of 4 that is predicted to trigger nonsense-mediated decay. NM_002900.3(RBP3):c.345_349del (p.Trp116AlafsTer7) is a frameshift variant within exon 1 of 4 that is predicted to trigger nonsense-mediated decay.

      CaseAddInfo: Potential consanguinity within the proband's family has not been commented on.

      CasePMIDs: N/A

    2. P10 NY01 c.2824C>T p.Gln942* Homozygous

      Case#: Georgiou_2024_Family_NY01_Proband_P10, female, reported at age 56 years, family origin not reported

      CasePresentingHPOs: HP:0011003 (High myopia), HP:0030558 (Best corrected visual acuity 0.5 LogMAR), HP:0000518 (Cataract)

      CaseHPOFreeText: BCVA began at 0.51 logMAR and progressed to 0.54 logMAR. The proband had posterior chamber intraocular lenses. Myopia developed by age 7 years.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping was by either next-generation sequencing panel, whole exome sequencing, or whole genome sequencing, but was unspecified.

      CaseMethod1: NGS panel / WES / WGS

      CaseMethod2: Sanger sequencing of RBP3

      CaseGenotypingMethod: Previous genotyping by either next-generation sequencing panel, whole exome sequencing, or whole genome sequencing was followed by Sanger sequencing of RBP3.

      Variant: The individual harbors the NM_002900.3(RBP3):c.2824C>T (p.Gln942Ter) variant in the homozygous state.

      ClinVar ID: 1069291

      gnomAD: The variant is found in gnomAD version 4.1.1 at a frequency of 0.00001332 (1 / 75072) in the African / African-American population https://gnomad.broadinstitute.org/variant/chr10-47351308-C-T?dataset=gnomad_r4

      VariantEvidence: NM_002900.3(RBP3):c.2824C>T (p.Gln942Ter) is a nonsense variant within exon 1 of 4 that is predicted to trigger nonsense-mediated decay.

      CaseAddInfo: Potential consanguinity within the proband's family and their geographic origin have not been commented on.

      CasePMIDs: N/A

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

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

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

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

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous testing appears to have included genotyping of the

      CaseMethod1:

      CaseMethod2:

      CaseGenotypingMethod: Genotyping appears to have included

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

      ClinVar: 162136

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

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

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

      CasePMIDs: N/A

    1. A2885-II1–II2 (AKK65)

      Case#: Harville_2010_Patient_A2885–II2, sex and age not reported, family origin reportedly from Saudi Arabia

      CasePresentingHPOs: HP:0000510 (Rod-cone dystrophy), HP:0010442 (Polydactyly), HP:0001513 (Obesity), HP:0000077 (Abnormality of the kidney), HP:0001249 (Intellectual disability), HP:0004322 (Short stature), HP:0001263 (Global developmental delay), HP:0000823 (Delayed puberty)

      CaseHPOFreeText: The proband has an initial clinical diagnosis of Bardet-Biedl syndrome.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The proband was initially subjected to homozygosity mapping to identify parts of the genome to search for the basis of recessive disease.

      CaseMethod1: homozygosity mapping

      CaseMethod2: Sanger sequencing of the exons of any of the 14 BBS-associated loci (BBS1, BBS2, ARL6, BBS4, BBS5, MKKS, BBS7, TTC8, BBS9, BBS10, TRIM32, BBS12, MKS1, and CEP290) that showed homozygosity.

      CaseGenotypingMethod: The proband was initially subjected to homozygosity mapping to identify parts of the genome to search for the basis of recessive disease. This was followed by Sanger sequencing of the exons of any of the 14 BBS-associated loci (BBS1, BBS2, ARL6, BBS4, BBS5, MKKS, BBS7, TTC8, BBS9, BBS10, TRIM32, BBS12, MKS1, and CEP290) that showed homozygosity.

      Variant: The proband harbors the NM_024649.5(BBS1):c.124+1G>A variant in the homozygous state.

      ClinVar ID: 557428

      gnomAD: The NM_024649.5(BBS1):c.124+1G>A variant was not found in gnomAD v2.1.1.

      VariantEvidence: NM_024649.5(BBS1):c.124+1G>A is a canonical splice site variant in intron 2 that is predicted but not confirmed to disrupt BBS1 splicing.

      CaseAddInfo: The proband's family is reportedly consanguineous and includes a similarly affected sibling sharing the same homozygous genotype.

      CasePMIDs: N/A

    1. first reported CLN5 patients

      Case#: Lebrun_2009_Patient_2, male, age 2-3 at onset, age 15 at death, family ethnicity reported as Afghan

      CasePresentingHPOs: HP:0001251 (Ataxia), HP:0002474 (Expressive language delay), HP:0001250 (Seizure), HP:0011463 (Childhood onset), HP:0011421 (Death in adolescence)

      CaseHPOFreeText: Onset was at age 2-3, with the first presenting phenotypes being ataxia and delay in speech development. Seizures began at age 4. Death occurred at age 15.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The extent of previous testing within this patient is unclear.

      CaseMethod1: N/A

      CaseMethod2: N/A

      CaseGenotypingMethod: CLN5 mRNA was reverse transcribed, PCR-amplified, and subjected to Sanger sequencing. This process was performed for both affected and control individuals (parents).

      Variant: The patient is homozygous for the NM_006493.4(CLN5):c.990G>T (p.Trp330Cys) variant, (although this variant is referred to in the article as c.1137G>T (p.Trp379Cys)).

      ClinVar: 56530

      gnomAD: The variant is reported to have a maximum allele frequency of 0.00006484 (in the European non-Finnish population, with no homozygous individuals). https://gnomad.broadinstitute.org/variant/13-77575017-G-T

      VariantEvidence: The missense variant introduces an additional cysteine into the protein product, potentially disrupting folding and three-dimensional structure. Immunofluorescent detection of the exogenously expressed variant in COS7 cells shows aberrant localization to the ER in contrast to the wild-type localization to the lysosome (Figure 3).

      CaseAddInfo: The patient's family is consanguineous, as parents are described as first degree cousins. Parents were heterozygous for the variant. Family relationships between individuals were verified.

      CasePMIDs: N/A

    2. affected children

      Case#: Lebrun_2009_Patient_1, male, age 5 at onset, U.K. origin with family ethnicity reported as Pakistani

      CasePresentingHPOs: HP:0007010 (Poor fine motor coordination), HP:0007015 (Poor gross motor coordination), HP:0100952 (Enlarged sylvian cistern), HP:0001251 (Ataxia), HP:0001250 (Seizure), HP:0002465 (Poor speech), HP:0007064 (Progressive language deterioration), HP:0011463 (Childhood onset), HP:0000572 (Visual loss), HP:0030511 (Bradyopsia), HP:0000550 (Undetectable electroretinogram), HP:0003208 (Fingerprint intracellular accumulation of autofluorescent lipopigment storage material), HP:0002120 (Cerebral cortical atrophy), HP:0001272 (Cerebellar atrophy)

      CaseHPOFreeText: Onset was at age 5, with the first presenting phenotypes being motor problems. Marked cerebellar sulcal widening with subarachnoidal space expansion was seen by brain MRI at age 5. Ataxia and language degradation were observed at age 6. Cortical and cerebellar atrophy presented by brain MRI scan at age 7. Visual problems presented at age 7.5, specifically with inability to focus on moving objects. Seizures first presented at age 8.5, along with bilaterally extinguished ERG. Skin biopsy showed fingerprint-type intralysosomal inclusions.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Genome-wide methods were not initially used, as clinical phenotypes were consistent with diagnosis of neuronal ceroid lipofuscinosis (NCL). Enzymatic tests ruled out defects in the CLN1, CLN2, and CLN10 loci, while CLN3, CLN6, and CLN8 defects were ruled out by Sanger sequencing of the coding regions. SNP array-based homozygosity mapping was performed, revealing 7 homozygous candidate regions in the affected members from the (consanguineous) family. These regions were analyzed for candidate NCL genes, finding CLN5 as the most likely locus to harbor the causative variant.

      CaseMethod1: SNP array-based homozygosity mapping was performed, revealing 7 homozygous candidate regions in the affected members from the (consanguineous) family. These regions were analyzed for candidate NCL genes, finding CLN5 as the most likely candidate for further genotyping.

      CaseMethod2: N/A

      CaseGenotypingMethod: CLN5 mRNA was reverse transcribed, PCR-amplified, and subjected to Sanger sequencing. This process was performed for both affected and control individuals (parents and unaffected sibling).

      Variant: Patient is homozygous for NM_006493.4(CLN5):c.924_925del (p.Leu309fs), (although this variant is referred to in the article as c.1072_1073delTT (p.Leu358AlafsX4)).

      ClinVar: 56526

      gnomAD: The variant is reported to have a maximum allele frequency of 0.0002603 (in the Latino / Admixed American population, with no homozygous individuals). https://gnomad.broadinstitute.org/variant/13-77574801-AAT-A

      VariantEvidence: The frameshift variant results in premature truncation and disrupts approximately 14% of the protein product at the C-terminus. Immunofluorescent detection of the exogenously expressed variant in COS7 cells shows aberrant localization to the ER in contrast to the wild-type localization to the lysosome (Figure 3).

      CaseAddInfo: The patient's family has some degree of consanguinity, as parents are described as distantly related. Parents were heterozygous for the variant. Family relationships between individuals were verified.

      CasePMIDs: N/A

    1. The c.554T>C mutation is homozygous in patient 741 and heterozygous in both parents.

      Case#: Wang_2013_Proband_741, female, age 30 years at time of report, family origin not reported

      CasePresentingHPOs: Retinal dystrophy HP:0000556, Attenuation of retinal blood vessels HP:0007843, Retinal pigment epithelial mottling HP:0007814, Patchy atrophy of the retinal pigment epithelium HP:0007791, Abnormality of macular pigmentation HP:0008002, Perifoveal ring of hyperautofluorescence HP:0030629, Abnormal retinal morphology on macular OCT HP:0030612, Mildly reduced visual acuity HP:0032037, Subretinal deposits HP:0031528

      CaseHPOFreeText: The proband has a diagnosis of juvenile retinitis pigmentosa.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The proband was subjected to capture-based next-generation sequencing panel that included 163 known retinal disease genes.

      CaseMethod1: next-generation sequencing panel

      CaseMethod2: SNP array and Sanger sequencing of PRPH2

      CaseGenotypingMethod: The proband was genotyped by capture-based next-generation sequencing panel that included 163 known retinal disease genes. Sanger sequencing of PRPH2 was subsequently used to confirm the presence of the variant.

      Variant: The proband harbors the NM_000322.5(PRPH2):c.554T>C (p.Leu185Pro) variant in the homozygous state.

      ClinVar ID: 13165

      gnomAD: The NM_000322.5(PRPH2):c.554T>C (p.Leu185Pro) variant is found in gnomAD v4.0.0 at a frequency of 0.00003587 in the European (non-Finnish) population, with 15 alleles / 418142 total alleles (0 homozygotes) https://gnomad.broadinstitute.org/variant/6-42721781-A-G?dataset=gnomad_r4

      VariantEvidence: NM_000322.5(PRPH2):c.554T>C (p.Leu185Pro) is a missense variant with mouse knock-in evidence of a disease-causing effect in the heterozygous state (PMID: 11427722). Mouse phenotypes from PMID: 11427722 included reduced amplitude of dark-adapted bright flash electroretinogram a-wave HP:0030483 (Figure 4), Reduced OCT-measured macular thickness HP:0030607 (Figure 2), and immunoblot analysis showing reduced L185P in retinas, indicating instability or reduced transport to the outer segment (Figure 5b). Other experiments from PMID: 11297544 showed that the p.Leu185Pro variant successfully forms dimers but fails to assemble into higher order oligomers, particularly in the absence of wild-type PRPH2 (Figures 3, 5).

      CaseAddInfo: The proband's parents are each heterozygous carriers of the variant who appear to be sub-clinically affected. The 56-year-old father showed macular pattern dystrophy with clear foveal changes, but normal visual acuity.

      CasePMIDs: N/A

    1. affected members

      Case#: Huang_1995_Family_#3397_Patient_AR76, male, age and ethnic origin note mentioned

      CasePresentingHPOs: 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)

      CaseHPOFreeText: The proband and his affected family members have been diagnosed with autosomal retinitis pigmentosa.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Sanger sequencing of PDE6A has been performed in the patient and her affected family members.

      CaseMethod1: SSCP

      CaseMethod2: Sanger sequencing of PDE6A

      CaseGenotypingMethod: The patient and his affected sibling were subjected to SSCP of PDE6A PCR products followed by Sanger sequencing to identify the variant.

      Variant: The proband harbors the NM_000440.3(PDE6A):c.1032C>A (p.Ser344Arg) and NM_000440.3(PDE6A):c.1683G>A (p.Trp561Ter) variants in the compound heterozygous state.

      ClinVar: 13111, 13112

      gnomAD: NM_000440.3(PDE6A):c.1032C>A (p.Ser344Arg) was not found in gnomAD v2.1.1, while NM_000440.3(PDE6A):c.1683G>A (p.Trp561Ter) was found at a frequency of 0.000008792 (1/113736) in the European non-Finnish population. https://gnomad.broadinstitute.org/variant/5-149274791-C-T

      VariantEvidence: NM_000440.3(PDE6A):c.1032C>A (p.Ser344Arg) is a missense variant in exon 7 of 22 total, and does not have evidence of a functional effect on the protein product. NM_000440.3(PDE6A):c.1683G>A (p.Trp561Ter) is a nonsense variant in exon 13 of 22 total, and is predicted to trigger NMD or to at least disrupt the C-terminal 35% of the protein product.

      CaseAddInfo: The proband is from a family with an affected sibling and unaffected parents.

      CasePMIDs: N/A

    2. three point mutations in PDEA

      Case#: Huang_1995_Family_#3526_Patient_AR23, female, age and ethnic origin note mentioned

      CasePresentingHPOs: 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)

      CaseHPOFreeText: The proband and her affected family members have been diagnosed with autosomal retinitis pigmentosa.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Sanger sequencing of PDE6A has been performed in the patient and her affected family members.

      CaseMethod1: SSCP

      CaseMethod2: Sanger sequencing of PDE6A

      CaseGenotypingMethod: The patient and her affected family members were subjected to SSCP of PDE6A PCR products followed by Sanger sequencing to identify the variant.

      Variant: The proband harbors the NM_000440.3(PDE6A):c.1749C>G (p.Tyr583Ter) variant in the homozygous state.

      ClinVar: 13110

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

      VariantEvidence: NM_000440.3(PDE6A):c.1749C>G (p.Tyr583Ter) is a nonsense variant in exon 14 of 22 total, and is predicted to trigger NMD or to at least truncate ~32% of the protein product.

      CaseAddInfo: The proband is from a family with two affected siblings, two unaffected siblings, and unaffected parents.

      CasePMIDs: N/A

    1. Ten of our patients with CSNB2 showed no mutation in CACNA1F. To identify the disease-causing mutations, we used a candidate-gene approach. CABP4, a member of the calcium-binding protein (CABP) family, is located in photoreceptor synaptic terminals and is directly associated with the C-terminal domain of the Cav1.4 alpha . Mice lacking either Cabp4 or Cav1.4 alpha display a CSNB2-like phenotype. Here, we report for the first time that mutations in CABP4 lead to autosomal recessive CSNB. Our studies revealed homozygous and compound heterozygous mutations in two families

      Case#: Zeitz_2006_Family_A_II-5, male, onset in early childhood, family ancestry reported as Swiss

      CasePresentingHPOs: HP:0011463 (Childhood onset), HP:0000639 (Nystagmus), HP:0007663 (Reduced visual acuity), HP:0000613 (Photophobia)

      CaseHPOFreeText: The proband and his sibling have diagnosis of congenital stationary night blindness, in the absence of family history of the disease. BCVA was 20/100 at age 15 years. Disease course was stationary for 30 years but later included a decrease in visual acuity and development of moderate photophobia.

      CaseNotHPOs: HP:0000662 (Nyctalopia)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping was limited to Sanger sequencing of PCR products from the CACNA1F gene. The authors also implied that similarly screening was performed all other known genes associated CSNB, which at the time included RHO, GNAT1, PDE6B, GRK1, SAG, NYX, and GRM6.

      CaseMethod1: Sanger sequencing of CABP4

      CaseMethod2: N/A

      CaseGenotypingMethod: Genotyping was limited to Sanger sequencing of PCR products from the CACNA1F and CABP4 genes, with possible sequencing of other known CSNB-associated genes RHO, GNAT1, PDE6B, GRK1, SAG, NYX, and GRM6.

      Variant: The individual harbors the NM_145200.3(CABP4):c.800_801delAG variant in the homozygous state.

      ClinVar ID: 1952

      gnomAD: The variant is found in gnomAD version 4.1.1 at a frequency of 0.00007043 in the European (non-Finnish) population, with 0 homozygotes https://gnomad.broadinstitute.org/variant/11-67226099-CAG-C?dataset=gnomad_r2_1

      VariantEvidence: NM_145200.3(CABP4):c.800_801delAG is a frameshift variant within exon 6 of 6 that is predicted not to trigger nonsense-mediated decay but rather to disrupt the C-terminal 9 amino acids (3%) of the protein product and to extend the remaining protein by 91 additional amino acids. Analysis of patient mRNA indicates that splicing occurs normally but that expression at the mRNA level is decreased by more than 50% relative to the unaffected family member control.

      CaseAddInfo: The proband's family is reportedly non-consanguineous, and includes a similarly affected brother who is also homozygous for the variant, as well as unaffected parents and 4 unaffected siblings who are heterozygous or lacking the variant (Figure 2A). Family history was negative for CSNB.

      CasePMIDs: N/A

    1. identified point mutations

      Case: Weber_1994_Family_B_Patient_V-1, male, country of origin Canada (PMID:7920634), genealogy indicating Irish descent (PMID: 2695876)

      DiseaseAssertion: Sorsby's fundus dystrophy

      FamilyInfo:

      CasePresentingHPOs: HP:0030506 (Yellow/white lesions of the retina), HP:0030604 (Abnormal fundus fluorescein angiography), HP:0011506 (Choroidal neovascularization), HP:0000533 (Chorioretinal atrophy), HP:0200070 (Peripheral retinal atrophy)

      CaseHPOFreeText: Yellow/white lesions were present within fundus specifically. Angiography showed mottled hypofluorescence. Chorioretinal atrophy was described as showing peripheral progression.

      CaseNOTHPOs: N/A

      CaseNOTHPOFreeText: N/A

      CasePreviousTesting: Linkage analysis using short tandem repeat markers derived from genomic regions shown to contain loci involved in macular degeneration (PMID:7920634).

      GenotypingMethod: Sanger sequencing

      PreviouslyPublished: PMID:2695876, PMID:7920634

      SupplementalData: N/A

      Variant: The variant is NM_000362.5(TIMP3):c.610A>T, p.Ser204Cys, which was first referred to in PMID:7894485 as "Ser181Cys" (due to the removal of a 23-amino acid N-terminal signal peptide from the polypeptide sequence) but encodes Ser204Cys in the full/updated polypeptide sequence.

      ClinVar: 12676

      gnomAD: Variant is absent from gnomAD.

      VariantEvidence: Variant adds a Cys residue to TIMP3 and is predicted to disrupt tertiary structure.

    1. five probands from family 1 (IV:31, IV:56, IV:59, V:30, and V:33)

      Case: Naessens_2019_Family_1_Patient_IV:31, female, age of onset 51 years old, country of origin Belgium

      DiseaseAssertion: Sorsby's fundus dystrophy

      FamilyInfo: Familial variant appears to come from a founder mutation shared by other families in Belgium and northern France with a distant common ancestor.

      CasePresentingHPOs: HP:0011510 (Drusen), HP:0000613 (Photophobia), HP:0000572 (Visual loss)

      CaseHPOFreeText: Relatively late onset of phenotypes (at age 51, presenting with photophobia). Drusen was described as widespread around the vascular arcades.

      CaseNOTHPOs: N/A

      CaseNOTHPOFreeText: Pulmonary involvement

      CasePreviousTesting: Yes, SSCP and Sanger sequencing were both previously performed (PMID:10873973), but results were negative (no TIMP3 variant found).

      CaseMethod1: SSCP of all five exons, plus the promoter and 3'UTR of TIMP3

      CaseMethod2: Sanger sequencing of PCR-amplified exon 5 of TIMP3

      GenotypingMethod: PCR amplification of all 5 coding exons of TIMP3, followed by Sanger sequencing

      PreviouslyPublished: PMID:10873973

      SupplementalData: Supplementary Table S3 from this paper (PMID: 30668888) provides some of the proband phenotype details.

      Variant: The variant is NM_000362.5(TIMP3):c.113C>G (p.Ser38Cys), a missense variant predicted to introduce a new cysteine-encoding codon into exon 1.

      ClinVar: 843268

      gnomAD: Variant is absent from gnomAD.

      VariantEvidence: Variant adds a Cys residue to TIMP3 and is predicted to disrupt tertiary structure. Patient fibroblasts reveal no change in expression of the variant at the mRNA level, no dimerization of the variant under non-reducing conditions, and no defect in its localization to the ECM. Variant showed a minor increase in glycosylation. An in vitro transcription and translation study found that the variant forms an aberrant intramolecular disulfide bond between the introduced Ser38Cys residue and Cys36 of TIMP3 (Figure 7). Aberrant intramolecular disulfide bonding caused by this variant would be consistent gain-of-function and an autosomal dominant mechanism of inheritance.

    2. Family 3 consists of only the index patient

      Case: Naessens_2019_Family_3_Patient_II:1, male, age of onset 53 years old, country of origin Belgium

      DiseaseAssertion: Sorsby's fundus dystrophy

      FamilyInfo: Family member genotypes and phenotypes are not available, but variant appears to come from a founder mutation shared by other families in Belgium and northern France with a distant common ancestor.

      CasePresentingHPOs: HP:0011510 (Drusen), HP:0000572 (Visual loss), HP:0007401 (Macular atrophy), HP:0011506 (choroidal neovascularization), HP:0007703 (Abnormality of retinal pigmentation)

      CaseHPOFreeText: Relatively late onset of phenotypes (at age 53, presenting with nyctalopia). Drusen was described as calcified around the vascular arcades. CNV was active. Macular atrophy was patchy. Intraretinal pigment migration was observed from midperiphery towards periphery.

      CaseNOTHPOs: N/A

      CaseNOTHPOFreeText: Pulmonary involvement

      CasePreviousTesting: N/A

      GenotypingMethod: PCR amplification of all 5 coding exons of TIMP3, followed by Sanger sequencing

      PreviouslyPublished: N/A

      SupplementalData: Supplementary Table S3 from this paper (PMID: 30668888) provides some of the proband phenotype details.

      Variant: The variant is NM_000362.5(TIMP3):c.113C>G (p.Ser38Cys), a missense variant predicted to introduce a new cysteine-encoding codon into exon 1.

      ClinVar: 843268

      gnomAD: Variant is absent from gnomAD.

      VariantEvidence: Variant adds a Cys residue to TIMP3 and is predicted to disrupt tertiary structure. Patient fibroblasts reveal no change in expression of the variant at the mRNA level, no dimerization of the variant under non-reducing conditions, and no defect in its localization to the ECM. Variant showed a minor increase in glycosylation. An in vitro transcription and translation study found that the variant forms an aberrant intramolecular disulfide bond between the introduced Ser38Cys residue and Cys36 of TIMP3 (Figure 7). Aberrant intramolecular disulfide bonding caused by this variant would be consistent gain-of-function and an autosomal dominant mechanism of inheritance.

    1. Here, we used whole-exome sequencing to detect mutations in the genes of the probands of the retinitis pigmentosa families, and Sanger sequencing to confirm the causal mutations identified by whole exome sequencing. In addition, we report two cases with retinitis pigmentosa caused by RDH12 (c.524C > T) and PRPF4 (c.1273G > A) pathogenic mutations.

      Case#: Xiao_2023_Family_2_Proband, male, age 0.5 years, family origin reported as from Yi ethnic group from Yunnan, China

      CasePresentingHPOs: Infantile onset HP:0003593, Pigmentary retinopathy HP:0000580, Mild myopia HP:0025573

      CaseHPOFreeText: The proband has been diagnosed with retinitis pigmentosa with onset at 0.3 years of age.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous testing in the proband consisted of whole exome sequencing.

      CaseMethod1: whole exome sequencing

      CaseMethod2: Sanger sequencing of the coding regions of PRPF4

      CaseGenotypingMethod: Genotyping of the proband initially consisted of whole exome sequencing, followed by Sanger sequencing of the coding regions of PRPF4.

      Variant: The proband harbors the NM_001244926.2(PRPF4):c.1270G>A (p.Gly424Ser) variant in the heterozygous state.

      ClinVar ID: 1395419

      gnomAD: The NM_001244926.2(PRPF4):c.1270G>A (p.Gly424Ser) variant is found in gnomAD v4.1.0 at a frequency of 0.00008729 (103 alleles / 1180028 total alleles, with 0 homozygotes) in the European (non-Finnish) population https://gnomad.broadinstitute.org/variant/9-113290914-G-A?dataset=gnomad_r4

      VariantEvidence: NM_001244926.2(PRPF4):c.1270G>A (p.Gly424Ser) is a missense variant with no direct evidence of an abnormal impact on the PRPF4 protein.

      CaseAddInfo: The proband has apparently unaffected parents.

      CasePMIDs: N/A

    1. A 16-year-old girl presented with symptoms at the age of 10 years; these included photophobia, photosensitivity, photopsia, and nyctalopia. Examination revealed visual acuities of 6/4 OD and 6/5 OS with refraction of +0.75/−0.75 × 30 OD and L +1.00/−1.00 × 140 OS. Fundoscopy revealed an atrophic concentric band with white punctate dots and minimal pigment extending from the vascular arcades to the mid-peripheral retina circumferential to the macula. Visual fields showed decreased sensitivity from 10 degrees to 40 degrees on Goldmann visual field testing. Colour vision testing with colour contrast sensitivity showed reduced protan thresholds and normal tritan responses. An increased (AF) signal was seen at the macula and extending to the nasal area. Optical coherence tomography (OCT) showed loss of the EZ in the area of the band, with preservation of the central retina (Figure 2C). The ERG results demonstrated extinguished rod-specific dim flash responses and reduced and delayed responses to standard flash under both photopic and scotopic conditions. Response to the 30 Hz flicker stimulus was abnormal but the PERG was relatively well preserved. Isolated S-cone responses were not measured. The marked reduction to rod stimuli and 30 Hz flicker with reduced responses to standard flash is consistent with an ESCS phenotype (Figure 3). Genetic molecular analysis showed compound heterozygosity for NR2E3 c.119−2A > C [1] (see Supplementary Table S1 for other references) and a novel mutation c.639_640insT, p.(P214SfsX39). Segregation analysis in her parents identified the NR2E3 variant c.639_640insT, p.(P214SfsX39) in her father, and the c.119-2A > C variant in her mother.

      Case#: Al-khuzaei_2020_Patient_III, female, 10 years old at presentation of symptoms, 16 years old at time of report, racial origin indicated as Caucasian

      CasePresentingHPOs: Photophobia HP:0000613, Photopsia HP:0030786, Nyctalopia HP:0000662, Constriction of peripheral visual field HP:0001133, Yellow/white lesions of the macula HP:0030500, Hyperautofluorescent retinal lesion HP:0025158, Photoreceptor layer loss on macular OCT (ellipsoid zone loss with preservation of the central retina) HP:0030609, Undetectable dark-adapted electroretinogram HP:0030474, Abnormal timing of light-adapted single flash electroretinogram HP:0030482, Abnormal amplitude of light-adapted single flash electroretinogram HP:0030481, Abnormal dark-adapted dim flash electroretinogram HP:0030471, Abnormal amplitude of dark-adapted dim flash electroretinogram HP:0030476, Ring scotoma HP:0030529, Patchy atrophy of the retinal pigment epithelium HP:0007791

      CaseHPOFreeText: The proband has a diagnosis of enhanced S-cone sensitivity.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping was performed by next-generation sequencing with a 111-gene panel.

      CaseMethod1: Next-generation sequencing with a 111-gene panel.

      CaseMethod2: Sanger sequencing of NR2E3

      CaseGenotypingMethod: Genotyping was performed by next-generation sequencing with a 111-gene panel, followed by Sanger sequencing of NR2E3.

      Variant: The individual harbors the maternal NM_014249.4(NR2E3):c.119-2A>C and paternal NM_014249.4(NR2E3):c.639_640insT (p.Pro214fs) variants in the compound heterozygous state.

      ClinVarID: 191059, 1455685

      gnomAD: The NM_014249.4(NR2E3):c.119-2A>C variant is found in gnomAD version 4.1.0 at a frequency of 0.001359 in the Ashkenazi Jewish population and 0.0007992 in the European (non-Finnish) population (919 / 1,149,942), with no homozygotes observed. https://gnomad.broadinstitute.org/variant/chr15-71811481-A-C?dataset=gnomad_r4 The NM_014249.4(NR2E3):c.639_640insT (p.Pro214fs) variant is found in gnomAD v4.1.1 at a frequency of 0.000008846 (1 allele / 113,042 total alleles) in the European (non-Finnish) population, with 0 homozygotes. https://www.ncbi.nlm.nih.gov/clinvar/variation/1455685/

      VariantEvidence: NM_014249.4(NR2E3):c.119-2A>C is a canonical splice acceptor site variant adjacent to exon 2 of 6, which is an out-of-frame exon that could potentially trigger nonsense-mediated decay if skipped. This paper shows mRNA evidence that the variant triggers exon 2 skipping and introduces a premature stop codon in exon 3. NM_014249.4(NR2E3):c.639_640insT (p.Pro214fs) is a frameshift variant in exon 5 of 8 that introduces a premature stop codon and is predicted to trigger nonsense-mediated decay.

      CaseAddInfo: The proband has unaffected heterozygous carrier parents.

      CasePMIDs: N/A

    1. 103 unrelated subjects with different retinal diseases

      Case#: Bernal_2008_Proband_B-256, male, age 13 years at time of report, national origin from Spain

      CasePresentingHPOs: Nyctalopia HP:0000662, Progressive visual loss HP:0000529, Reduced visual acuity HP:0007663, Retinoschisis HP:0030502, Nummular pigmentation of the fundus HP:0030505, Undetectable light- and dark-adapted electroretinogram HP:0007688

      CaseHPOFreeText: The proband has a diagnosis of Goldmann–Favre syndrome, and had peripheral retinoschisis and macular cysts in both eyes.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping was limited to Sanger sequencing of NR2E3.

      CaseMethod1: Sanger sequencing of NR2E3

      CaseMethod2: N/A

      CaseGenotypingMethod: Genotyping was performed by Sanger sequencing of NR2E3.

      Variant: The individual harbors the NM_014249.4(NR2E3):c.932G>A (p.Arg311Gln) variant in the homozygous state.

      ClinVarID: 5532

      gnomAD: The variant is found in gnomAD version 4.1.0 at a frequency of 0.003986 in the Ashkenazi Jewish population, with a 118 alleles / 29604 total alleles and 1 homozygote. The variant also has a frequency of 0.0009829 in the Admixed American population. https://gnomad.broadinstitute.org/variant/chr15-71813573-G-A?dataset=gnomad_r4

      VariantEvidence: NM_014249.4(NR2E3):c.932G>A (p.Arg311Gln) is a missense variant that is a well-known founder and has been reported in patients from multiple studies with diverse presentations. The variant partially disrupts the ability of NR2E3 to form stable dimers (PMID: 11071390).

      CaseAddInfo: The proband has two unaffected heterozygous parents.

      CasePMIDs: N/A

    2. c.1034_1038del5bp

      Case#: Bernal_2008_Proband_B-316, female, age 47 years at time of report, national origin from Spain

      CasePresentingHPOs: Nyctalopia HP:0000662, Progressive visual loss HP:0000529, Reduced visual acuity HP:0007663, Severe constriction of peripheral visual field HP:0030526, Undetectable light- and dark-adapted electroretinogram HP:0007688

      CaseHPOFreeText: The proband has a diagnosis of retinitis pigmentosa, and had clusters of large, clumped pigment deposits in the midperiphery of both eyes.

      CaseNotHPOs: Macular schisis HP:0011511

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: Previous genotyping was limited to Sanger sequencing of NR2E3.

      CaseMethod1: Sanger sequencing of NR2E3

      CaseMethod2: N/A

      CaseGenotypingMethod: Genotyping was performed by Sanger sequencing of NR2E3.

      Variant: The individual harbors the NM_014249.4(NR2E3):c.1034_1038del (p.Ala344_Leu345insTer) variant in the homozygous state.

      ClinVarID: 5534

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

      VariantEvidence: NM_014249.4(NR2E3):c.1034_1038del (p.Ala344_Leu345insTer) is a frameshift variant that introduces a premature stop codon in exon 7 of 8 and is predicted to trigger nonsense-mediated decay.

      CaseAddInfo: The proband has two affected siblings who share the same homozygous genotype and one unaffected heterozygous sibling. Parents have not been genotyped, but were indicated as consanguineous.

      CasePMIDs: N/A

    1. Affected members of this family had childhood-onset visual acuity impairment. The disease progressed over decades to major loss of central and then peripheral visual function. At late stages of disease, patients retained only islands of vision in the midperiphery. Funduscopic appearance (Fig. 2) and visual function test results (Fig. 3) in two affected family members in the fifth decade of life are shown. Visual acuities in both patients were 20/200 or worse, and the refractive error was modest myopia with astigmatism. There were small posterior subcapsular cataracts.  In the central retina of the right eye of patient A (Fig. 2A) , there was a large area of discoloration, suggesting retinal pigmented epithelial disturbances. Patient B showed a macular coloboma-like lesion with a central atrophic scar surrounded by a ring of pigmentary change (Fig. 2B) . The central retinal area was discolored as in patient A; there were, in addition, small, discrete, white-yellow patches. In both patients, the fundus temporal to the macula was less pathologic appearing (Figs. 2C 2D) . Both patients had attenuated retinal vessels. Patient B showed temporal pallor of the optic nerve head, whereas this was not as evident in patient A.  Visual function test results are shown in Figure 3 . Compared with ERGs of a representative normal subject, all waveforms of the two patients were severely abnormal (Fig. 3A) . Patient A showed reduced amplitudes but normal timing of both rod and cone ERGs. Patient B had greater reductions in amplitude. Figure 3B shows kinetic perimetry (top panels) and static threshold perimetry in the dark-adapted (middle panels) and light-adapted (bottom panels) states. Sensitivity losses for rods (500-nm stimulus, dark-adapted) and long- (L) and middle (M)-wavelength cones (600-nm stimulus, light-adapted) were calculated from locus-specific normal values and are shown as gray-scale maps (0–3 log units). The psychophysical tests were conducted to position the anatomic fovea at the central fixation target (central scotoma thus truly “central”). Patients otherwise used eccentric fixation loci of approximately 20° from the fovea. By kinetic perimetry, both patients retained midperipheral islands of vision and could see both a large bright target (V-4e) and a smaller bright target (I-4e). Static perimetry also indicated detectable rod and cone sensitivity mainly in the nasal midperiphery. Some loci had no loss of rod or cone sensitivity, whereas other loci showed losses of 1 to 3 log units. 

      Case#: Danciger_2001_Family_Patient_A, gender not specified, age 48 years at the time of the report, family origin reported to be Brazilian

      CasePresentingHPOs: HP:0011463 (Childhood onset), HP:0001141 (Severely reduced visual acuity), HP:0007994 (Peripheral visual field loss), HP:0000545 (Myopia), HP:0007703 (Abnormality of retinal pigmentation), HP:0007843 (Attenuation of retinal blood vessels), HP:0000654 (Decreased light- and dark-adapted electroretinogram amplitude), HP:0000483 (Astigmatism), HP:0000523 (Subcapsular cataract)

      CaseHPOFreeText: The proband was diagnosed with severe cone-rod dystrophy.

      CaseNotHPOs: HP:0000543 (Optic disc pallor)

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The proband and his family have been initially genotyped by linkage mapping using short tandem repeat markers across the genome.

      CaseMethod1: Linkage mapping using short tandem repeat markers

      CaseMethod2: Sanger sequencing

      CaseGenotypingMethod: The proband and his family have been initially genotyped by linkage mapping using short tandem repeat markers across the genome. Haplotype analysis was then performed within the linkage region. Finally, a subsequent publication on the same family sequenced 10 out of 34 genes within the linkage region and found homozygous variants in ADAM9 in particular (PMID: 19409519).

      Variant: The affected family members harbor the NM_003816.3(ADAM9):c.1130+1G>A variant in the homozygous state.

      ClinVar: 6876

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

      VariantEvidence: The NM_003816.3(ADAM9):c.1130+1G>A variant is predicted to disrupt a canonical splice site in intron 11.

      CaseAddInfo: The proband's family is known to be consanguineous, with the parents being second cousins.

      CasePMIDs: PMID: 19409519

    1. Twelve subjects with confirmed homozygous mutations were identified (11 consanguineous families; 7 boys; assessed at age 10 months to 20 years, average and median age 6.5 and 4 years). All were homozygous for the same IFT140 mutation (c.1990G>A; p.Glu664Lys)

      Case#: Bifari_2016_Patient_3, male, 1 year of age at time of onset, of Saudi ethnicity

      CasePresentingHPOs: HP:0003577 (Congenital onset), HP:0000505 (Visual impairment), HP:0000639 (Nystagmus), HP:0040082 (Happy demeanor), HP:0012758 (Neurodevelopmental delay), HP:0001483 (Eye poking), HP:0031729 (Moderate hypermetropia), HP:0025404 (Abnormal visual fixation), HP:0000550 (Undetectable electroretinogram), HP:0000556 (Retinal dystrophy)

      CaseHPOFreeText: This proband exhibited photophilia / staring at lights.

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: It is not clear whether the patient was previously subjected to genotyping.

    1. We now report the occurrence of the Tyr168Cys mutation in an SFD patient of Austrian descent and show that this mutation found earlier in an American SFD family arose independently.

      Case: Felbor_1996_Patient_G, female, age 33 at onset of symptoms, country of origin Austria

      DiseaseAssertion: Sorsby's fundus dystrophy

      FamilyInfo:

      CasePresentingHPOs: HP:0025582 (Submacular hemorrhage), HP:0025094 (Disciform macular scar), HP:0007663 (Reduced visual acuity), HP:0007722 (Retinal pigment epithelial atrophy), HP:0030491 (Choriocapillaris atrophy), HP:0011510 (Drusen), HP:0000603 (Central scotoma), HP:0011506 (Choroidal neovascularization), HP:0012231 (Exudative retinal detachment), HP:0000512 (Abnormal electroretinogram)

      CaseHPOFreeText: N/A

      CaseNOTHPOs: N/A

      CaseNOTHPOFreeText: Normal rod and cone signals

      CasePreviousTesting: N/A

      GenotypingMethod: SSCP analysis detecting mobility shift in exon 5 PCR product, followed by Sanger sequencing of exon 5.

      PreviouslyPublished: N/A

      SupplementalData: N/A

      Variant: The variant is NM_000362.5(TIMP3):c.572A>G, p.Tyr191Cys, which is referred to in the paper as "Tyr168Cys" (due to the removal of a 23-amino acid N-terminal signal peptide from the polypeptide sequence). The corrected variant is p.Tyr191Cys in the full/updated polypeptide sequence.

      ClinVar: 12677

      gnomAD: Variant is absent from gnomAD.

      VariantEvidence: Variant adds a Cys residue to TIMP3 and is predicted to disrupt tertiary structure.

    1. Eye pain was noted in A1 in early childhood but resolved; in C1 and C2 mild eye pain was still present at the time of this report (ages 4 years and 6 months). All had grossly normal intelligence, white sclerae and normal joint mobility. Height was normal in all except for A1 and A2, both below 5th percentile.

      Case#: Streeten_2010_patient_A1, male, age 8 years at report, ethnicity reported as Conservative Mennonite from Pennsylvania

      CasePresentingHPOs: HP:0011463 (Childhood onset), HP:0200026 (Ocular pain), HP:0004322 (Short stature), HP:0000541 (Retinal detachment), HP:0002757 (Recurrent fractures), HP:0004349 (Reduced bone mineral density)

      CaseHPOFreeText: The patient has been diagnosed with osteoporosis-pseudoglioma syndrome, and had positive responses to bisphosphonates such as pamidronate.

      CaseNotHPOs: HP:0001249 (Intellectual disability), HP:0007832 (Pigmentation of the sclera), HP:0011729 (Abnormality of joint mobility)

      CaseNotHPOFreeText: N/A

      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.1275G>A (p.Trp425Ter) variant in the homozygous state.

      ClinVar: 1459979

      gnomAD: The NM_002335.4(LRP5):c.1275G>A (p.Trp425Ter) variant was not found in gnomAD v2.1.1.

      VariantEvidence: NM_002335.4(LRP5):c.1275G>A (p.Trp425Ter) is a nonsense variant in exon 6 of 23 that is predicted to trigger nonsense-mediated decay or to at least disrupt the C-terminal 74% of the protein product.

      CaseAddInfo: The patient is part of a large multi-generation extended family with multiple affected homozygous and compound heterozygous members (Figure 1).

      CasePMIDs: N/A

    1. Case#: Downes_2019_BSS, male, age unknown, South-Asian ancestry reported

      DiseaseAssertion: BSS

      FamilyInfo: NR

      ParentalGenotype: NR

      CasePresentingHPOs: NR

      PlateletAggregation: NR

      CaseHPOFreeText: NR

      CaseNotHPOs:

      CaseNotHPOFreeText:

      ProteinExpression: NR

      CasePreviousTesting:

      GenotypingMethod: HTS panel described in supplementary table 3

      PreviouslyPublished:

      Gene: ITGA2B

      Variant: homozygous c.1005_1013del (p.His335_Leu338delinsGln)

      HGVS: NM_000419.5(ITGA2B):c.1005_1013del

      ClinVarID: 626948

      CAID:

      gnomAD: not found in v.2.1.1

      MultipleGeneVariants:

    1. 12258M19866 years726<0.5Intermediate?S97fs

      Case# Patient 12, Male, Turkish, 6yo diagnosis

      CasePresentingHPOs HP:0004923

      CasePreviousTesting screened for BH4 deficiency using dried blood and urine spots, Final di-agnosis was made by measurements of neurotransmitter and pterinmetabolites in cerebrospinal fluid (CSF) and urine, in addition toDHPR enzyme activity, which was assessed in whole red bloodcells

      CaseMethod1 PCR

      CaseMethod2 DGGE

      Variant NM_000320.2:c.371delC(p.S97fs)

      CAID CA658795310

      VariantEvidence frameshift

    2. 17182F19842 months9080SevereExitusR221X

      Case# Patient 17, Female, Turkish, 2mo diagnosis

      CasePresentingHPOs HP:0004923

      CasePreviousTesting screened for BH4 deficiency using dried blood and urine spots, Final di-agnosis was made by measurements of neurotransmitter and pterinmetabolites in cerebrospinal fluid (CSF) and urine, in addition toDHPR enzyme activity, which was assessed in whole red bloodcells

      CaseMethod1 PCR

      CaseMethod2 DGGE

      Variant NM_000320.2:c.741A>T(p.R221Ter)

      CAID CA658795309

      VariantEvidence null

    1. c.1A > T

      Case# PB1, Saudi Arabia

      CasePresentingHPOs HP:0000707, HP:0003011, HP:0025031, HP:0001939, HP:0002715

      CasePreviousTesting Blood spot newborn screen/presented symptoms in Hospital

      CaseMethod1 PCR

      CaseGenotypingMethod PCR of coding exons of BCKDHA (9 exons), BCKDHB (11 exons) DBT (11 exons) and DLD (14 exons).

      Variant NM_000056.3:c.1A>T

      CAID CA364657845

      gnomAD 0.00003656 (European (Non-Finnish)), 0.00001346 (Overall)

      VariantEvidence none

      CaseAddInfo consanguineous family

    1. 16392

      Case# 16392, Spanish, 4yo report

      Variant NM_000709.3(BCKDHA):c.659C>T (p.Ala220Val), NM_000709.3(BCKDHA):c.853G>C (p.Ala285Pro)

      ClinVar 93367(c.659), 93375(c.853)

      gnomAD c.659=0.00005805(East Asian), 0.000008156(Overall), c.853=0.00007896(European (Non-Finnish)), 0.00003970(Overall)

      VariantEvidence 4% of normal BCKD activity in patient fibroblasts

      CaseAddInfo in trans

    1. Case Description

      Case#: Ma_Proband

      Demographics: east Asian? referenced in passing in discussion section

      CasePresentingHPOs: HP:0003182, HP:0008812, HP:0002655, HP:0003621, HP:0000943, HP:0001498, HP:0003049, HP:0002857, HP:0004689,

      CaseNotHPOs: HP:0008445, HP:0002751, HP:0000768, HP:0008445

      CasePreviousTesting: Previous diagnosis Developmental dysplasia of the hip (DDH)

      CaseMethod1: quantify urinary excretion of glycosaminoglycans using dimethylmethylene blue

      CaseMethod2:

      CaseGenotypingMethod: Whole exome sequencing

      Variant HGVS: 1) NM_000512.5:c.1156C>T 2) NM_000512.5:c.1288C>G

      ClinVar: 1) 700 2) N/A

      CAID: 1) CA221040 2) CA397096290

      gnomAD v2: 1) 16-88891261-G-A 2) N/A

      VariantEvidence:

      CaseAddInfo: Onset of symptoms age 8, compound het

      CasePMIDs:

    1. As summarized in Table 2, the JPH2 genotype positive subjects were diagnosed with HCM at 27, 24 and 30 years with septal wall thicknesses of 22, 38 and 18 mm for each mutation respectively.

      Case 2: male, diagnosed at 24 yrs, 38mm septal wall thickness, no mutations in HCM associated genes, no family history

      HP:0002094, HP:0001681, HP:0001962, (dyspnea, angina pectoris, palpitations)

      Variant: NM_020433.4(JPH2):c.421T>C (p.Tyr141His)

      Clinvar ID: 30456

      https://www.ncbi.nlm.nih.gov/clinvar/variation/30456/

      ExAC Freq: 1.772e-05