519 Matching Annotations
  1. Aug 2026
    1. son (the proband of Family #3, pedigree in Figure 1C)

      Case#: Male, Family#3, Proband M1, M2: II,1 on pedigree

      DiseaseAssertion: STGD

      FamilyInfo: mother of proband has p.N18681 and p.P1380L mutations and is asymptomatic with no changes to NIR-AF and SD-OCT. Treated with 400mg of hydroxychloroquine for lupus prior to imaging. Non-affected father.

      CasePresentingHPOs:HP:0007663, HP:0000493

      CaseHPOFreeText: Proband has reduced visual acuity and issues reading with BCVA 20/200 in R.E and 20/50-2 in L.E. Oval foveal lesions with stage 2 flecks. Visual acuity reducing starting at age 10.

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: n/a

      Genotyping Method: Genotyping performed at Columbia University, sequencing technology used is not disclosed.

      PreviouslyPublished: n/a

      Variant: M1:p.P1380L, complex allele: M2: p.N18681 and IVS38:c.5461-10T>C. M3: c.4139C>T(p.P1380L)

      ClinVar: M1) 99390 M2) 99067 M3) Variation ID: 7904

      CAID: n/a

      SupplementalData: Fig 1: Pedigree illustrating ABCA4 variants and the associated Stargardt phenotype for 5 families. Proband Labeled w/ white arrow for each family. Fig 2: retinal scan measuring melanin in 4 patients of family 2. Panel shows bull's-eye ring of RPE atropy. Fig 3: Macular SD-OCT line profile from b-scans. Reflectivity plotted against function of retinal depth. Table 1: table shows patients with p.N18681 variant, type of mutation, and pathogenicity class. Table 2: Patients, age on-set and first symptom

    1. Case 1

      Case#: Case1, Sex:Female, Age:35

      DiseaseAssertion: STGD

      FamilyInfo: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: Clinical Notes: the patient reported an ocular trauma in the right eye, which required hospitalization and caused sudden loss of vision at the age of 9 years. In 1998, at our first observation, visual acuity was 20/1,000 in the right eye and 20/600 in the left eye.

      CaseNotHPOs:n/a

      CaseNotHPOFreeText: n/a

      Genotyping Method: genetic analysis

      PreviouslyPublished: n/a

      Variant: Variant is a heterozygous mutation given as (N965S/G1961E); NM_000350.3(ABCA4):c.2894A>G (p.Asn965Ser) /NM_000350.3(ABCA4):c.5882G>A (p.Gly1961Glu)

      ClinVar: Variation ID: 236096 / Variation ID: 7888

      SupplementalData: n/a

    2. Case 3

      Case#: Case 3, Sex: Male, Age:21

      DiseaseAssertion: STGD

      FamilyInfo: n/a

      CasePresentingHPOs:

      CaseHPOFreeText: Text mentions BCVA of 20/200 in both eyes. Pigmentary changes in macula associated with flecks, small inferior juxta-papillar area of subretinal fibrosis in right eye, left eye legion localized in posterior pole macula temporally. Instable fixation in right eye. Low retinal mean sensitivity in both eyes.

      CaseNotHPOs:n/a

      CaseNotHPOFreeText: Healthy ocular adnexa and specular transparent and 'in situ' lens. Visual acuity stable. Stable fixation in left eye.

      Genotyping Method: genetic analysis

      PreviouslyPublished: n/a

      Variant: Variant is a heterozygous mutation given as NM_000350.3(ABCA4):c.3212C>T (p.Ser1071Leu) / NM_000350.3(ABCA4):c.667A>C (p.Lys223Gln) / NM_000350.3(ABCA4):c.3607G>A (p.Gly1203Arg)

      ClinVar: Variation ID: 99208 / Variation ID: 845426/ Variation ID: 417989

      SupplementalData: n/a

    1. The proband (K206–2) was 25-years-old

      Case#: 25-year old female, juvenile onset

      DiseaseAssertion: STGD1

      FamilyInfo: Figure 1 shows family pedigree. Table 1 shows clinical features of a Chinese pedigree. Cosegregation analysis was done and shown in Figure 1A, C.

      CasePresentingHPOs: HP:0007663, HP:0007722, HP:0007401, HP:0030329, HP:0030610, HP:0003621, HP:0011507, HP:0007984

      CaseHPOFreeText: The uncorrected visual acuity of each eye was 20/400, which has progressively decreased for 13 years.

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: The retinal vessels were normal.

      Genotyping Method: Whole Exome Sequencing, Sanger Sequencing

      PreviouslyPublished: n/a

      Variant: NM_000350.3(ABCA4):c.3523-2A>G, NM_000350.3(ABCA4):c.5646G>A (p.Met1882Ile)

      ClinVar: 866764, 377407

      SupplementalData: n/a

    1. the model would predict foveal disease in the first decade of life for three alleles (P68L;G1961E, L541P;A1038V, and T1019M)

      Case#: Cideciyan Case #86, male, 20.5yo at report

      DiseaseAssertion: "clinical diagnosis within the spectrum of Stargardt disease or cone–rod dystrophy caused by ABCA4 mutations."

      FamilyInfo: Parental segregation of the reported alleles confirmed. P87 is the proband's sibling, affected, same genotype

      CasePresentingHPOs:

      CaseHPOFreeText: LDF eccentricity along principal meridians [deg]: superior=16.9, inferior=11.7, temporal=18.9, inner nasal=9.6, outer nasal=18.9

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: NGS

      PreviouslyPublished: PMID: 24550365

      Variant: c.203 C>T p.Pro68Leuc.5882 G>A p.(Gly1961Glu); c.5882 G>A p.(Gly1961Glu). Phase confirmed.

      ClinVar: 99113

      CAID: CA226972

      SupplementalData: table s1

    1. Whole exome sequencing identifies a novel splice-site mutation in IMPG2gene causing Stargardt-like juvenile macular dystrophy in a northIndian family

      PMID:35973334

      Gene: ABCA4

      HGNC ID: 34

      Case#: eldest sister II.2 aged 22 year

      Variant splice-site variant NC_000003.11(NM_016247.3):c.1239 + 1G > T [Chr3:100972539C > A

      FammilyInfo two-generation north Indian family with three members affected with Stargardt-like macular dys trophy

      CasePresentingHPOs:ow vision and difficulty in night vision, with symptoms starting in the early second decade of life, which progressed slowly over time

      PedrigreeIn the results section is mentioned

      CaseHPOFreeText:NA

      CaseNotHPOs:Na

      CaseNotHPOFreeText:NA

      Genotyping Method:2.3. Validation of identified variant by Sanger sequencing

      PreviouslyPublished:NA

    1. Case 3

      Case#:3, 34–year-old woman

      DiseaseAssertion:NR

      FamilyInfo: no family history of an ocular disease

      CasePresentingHPOs: HP:0007663, HP:0030506, HP:0030528, HP:0000603

      CaseHPOFreeText:bilateral markedly decreased vision (logMar BCVA OD:0.93, OS:0.95), bilateral atrophic lesions of the macula accompanied by yellow-white stellate flecks at the level of the retinal pigment epithelium, Atrophic lesions and flecks were also extending to the mid-periphery of both retinae, bilateral absolute central scotoma and relative paracentral scotomas as well in both eyes, PERG was significantly reduced, while scotopic and photopic amplitudes were also lower than normal.

      CaseNotHPOs:

      CaseNotHPOFreeText:NR

      Genotyping Method: “Analysis of the ABCA4 gene”

      PreviouslyPublished: No

      Variant: NM_000350.3:c.5882G>A, NM_000350.3:c.6709dup

      ClinVar: ​​7888, 99485

      CAID: CA119132, CA227437

      SupplementalData:

    1. Interestingly, we identified one 30-year-old patient (ARDM-247), double heterozygous for the p.Arg1129Leu and p.Cys2137Tyr alleles, who presented a CRD phenotype. This p.Cys2137Tyr change was located more towards the amino terminus. Moreover, in other study, the results showed that the changes located in this zone appear to result in altered processing of the protein and to be associated with an earlier onset of disease.16 The p.Cys2137Tyr change in combination with the p.Arg1129Leu allele produced a CRD phenotype. Therefore, we speculate that the novel p.Cys2137Tyr variant could be a severe allele which is modifying the patient’s phenotype.

      Case#: Family MD-0247/ARDM-247 Proband, 12yo at onset

      DiseaseAssertion: AR cone rod dystrophy

      FamilyInfo:

      CasePresentingHPOs:

      CaseHPOFreeText: STGD diagnosed based on "bilateral central vision loss; fundus presenting with a beaten-bronze appearance and/or the presence of orange-yellow flecks in the retina from the posterior pole to the mid-periphery; fluorescein angiography showing typical dark choroid; and normal to subnormal electroretinogram (ERGs)." VA loss, VF loss, BCVA=0.05/0.1, cone-pattern on ERG

      CaseNotHPOs:

      CaseNotHPOFreeText:

      PreviouslyPublished: n/a

      Variant: c.6410G>A (p.Cys2137Tyr); c.3386G>T (p.Arg1129Leu) found by ABCR400 + dHPLC + HRM

      ClinVar: 2202779

      CAID: CA341277358

      SupplementalData: n/a

    1. 18 5709 Mi 9 2/10 / 2/10 c.32T>C(1) / c.1804C<T(13) p.Leu11Pro/p.Arg602Thr

      Case#: Maia-Lopes Family 18 Proband 5709, Portuguese, 9yo at onset

      DiseaseAssertion: STGD

      FamilyInfo: Family 18

      CasePresentingHPOs:

      CaseHPOFreeText: mild central fundus changes, vision: 2/10 / 2/10

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: ABCR400 microarray, dHPLC

      PreviouslyPublished: n/a

      Variant: c.1804C<T/ c.32T>C(1); p.Arg602Thr/p.Leu11Pro

      ClinVar: 99217

      CAID: CA227106

      SupplementalData: n/a

    1. V1 H1 Exon 36.1–3 G>A chr1:94,484,001 c.5196+1137G>A 4 4 0 0

      Case#: Braun Family 5 Proband (from left to right, top to bottom of available pedigrees), male

      DiseaseAssertion: Stargardt

      FamilyInfo: Proband has 1 affected sister with the same genotype and 1 unaffected, heterozygous brother. Genotypes not provided for parents.

      CasePresentingHPOs:

      CaseHPOFreeText: "five or more of the following features of ABCA4-associated retinal disease: decreased visual acuity before age 20, decreased visual acuity as the first visual symptom, symmetrical fundus findings, pisciform flecks, beaten metal macular atrophy, bulls-eye maculopathy, peripapillary sparing, vermillion fundus, masked choroid on fluorescein angiography, nummular pigment overlying extensive macular atrophy, central outer retinal atrophy on optical coherence tomography and central scotomas on Goldmann perimetry."

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: one plausible disease-causing mutation detected in ABCA4 after assessing the entire coding sequence and canonical retinal splice junctions with automated bidirectional Sanger sequencing using an ABI 3730 sequencer

      PreviouslyPublished: n/a

      Variant: c.5196+1137G>A; c.4363T>C (p.C1455R)

      ClinVar: 438100

      CAID: CA26843511

      SupplementalData: pedigree in fig s2

    2. V1 H1 Exon 36.1–3 G>A chr1:94,484,001 c.5196+1137G>A 4 4 0 0

      Case#: Braun Family 1 Proband (from left to right, top to bottom of available pedigrees), female

      DiseaseAssertion: Stargardt

      FamilyInfo: Both parents are unaffected heterozygotes. c.4139C>T (p.P1380L) paternally inherited, c.5196+1137G>A maternally inherited. Proband has 2 unaffected, heterozygous children.

      CasePresentingHPOs:

      CaseHPOFreeText: "five or more of the following features of ABCA4-associated retinal disease: decreased visual acuity before age 20, decreased visual acuity as the first visual symptom, symmetrical fundus findings, pisciform flecks, beaten metal macular atrophy, bulls-eye maculopathy, peripapillary sparing, vermillion fundus, masked choroid on fluorescein angiography, nummular pigment overlying extensive macular atrophy, central outer retinal atrophy on optical coherence tomography and central scotomas on Goldmann perimetry."

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: one plausible disease-causing mutation detected in ABCA4 after assessing the entire coding sequence and canonical retinal splice junctions with automated bidirectional Sanger sequencing using an ABI 3730 sequencer

      PreviouslyPublished: n/a

      Variant: c.5196+1137G>A; c.4139C>T (p.P1380L)

      ClinVar: 438100

      CAID: CA26843511

      SupplementalData: pedigree in fig s2

    3. V1 H1 Exon 36.1–3 G>A chr1:94,484,001 c.5196+1137G>A 4 4 0 0

      Case#: Braun Family 7 Proband (from left to right, top to bottom of available pedigrees), female

      DiseaseAssertion: Stargardt

      FamilyInfo: Unaffected carrier parents. c.5196+1137G>A maternally inherited; c.4561-10T>C paternally inherited

      CasePresentingHPOs:

      CaseHPOFreeText: "five or more of the following features of ABCA4-associated retinal disease: decreased visual acuity before age 20, decreased visual acuity as the first visual symptom, symmetrical fundus findings, pisciform flecks, beaten metal macular atrophy, bulls-eye maculopathy, peripapillary sparing, vermillion fundus, masked choroid on fluorescein angiography, nummular pigment overlying extensive macular atrophy, central outer retinal atrophy on optical coherence tomography and central scotomas on Goldmann perimetry."

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: one plausible disease-causing mutation detected in ABCA4 after assessing the entire coding sequence and canonical retinal splice junctions with automated bidirectional Sanger sequencing using an ABI 3730 sequencer

      PreviouslyPublished: n/a

      Variant: c.5196+1137G>A; c.4561-10T>C

      ClinVar: 438100

      CAID: CA26843511

      SupplementalData: pedigree in fig s2

    4. V1 H1 Exon 36.1–3 G>A chr1:94,484,001 c.5196+1137G>A 4 4 0 0

      Case#: Braun Family 2 Proband (from left to right, top to bottom of available pedigrees), female

      DiseaseAssertion: Stargardt

      FamilyInfo: Both parents are unaffected carriers. c.1622T>C (p.L541P) and c.3113C>T (p.A1038V) complex variants were paternally inherited, c.5196+1137G>A maternally inherited.

      CasePresentingHPOs:

      CaseHPOFreeText: "five or more of the following features of ABCA4-associated retinal disease: decreased visual acuity before age 20, decreased visual acuity as the first visual symptom, symmetrical fundus findings, pisciform flecks, beaten metal macular atrophy, bulls-eye maculopathy, peripapillary sparing, vermillion fundus, masked choroid on fluorescein angiography, nummular pigment overlying extensive macular atrophy, central outer retinal atrophy on optical coherence tomography and central scotomas on Goldmann perimetry."

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: one plausible disease-causing mutation detected in ABCA4 after assessing the entire coding sequence and canonical retinal splice junctions with automated bidirectional Sanger sequencing using an ABI 3730 sequencer

      PreviouslyPublished: n/a

      Variant: c.5196+1137G>A; c.1622T>C (p.L541P) and c.3113C>T (p.A1038V) complex variant

      ClinVar: 438100

      CAID: CA26843511

      SupplementalData: pedigree in fig s2

    5. V1 H1 Exon 36.1–3 G>A chr1:94,484,001 c.5196+1137G>A 4 4 0 0

      Case#: Braun Family 3 Proband (from left to right, top to bottom of available pedigrees), female

      DiseaseAssertion: Stargardt

      FamilyInfo: Both parents are unaffected, but only mother has genotype information available since father is deceased. c.1622T>C (p.L541P) and c.3113C>T (p.A1038V) complex variants were maternally inherited.

      CasePresentingHPOs:

      CaseHPOFreeText: "five or more of the following features of ABCA4-associated retinal disease: decreased visual acuity before age 20, decreased visual acuity as the first visual symptom, symmetrical fundus findings, pisciform flecks, beaten metal macular atrophy, bulls-eye maculopathy, peripapillary sparing, vermillion fundus, masked choroid on fluorescein angiography, nummular pigment overlying extensive macular atrophy, central outer retinal atrophy on optical coherence tomography and central scotomas on Goldmann perimetry."

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: one plausible disease-causing mutation detected in ABCA4 after assessing the entire coding sequence and canonical retinal splice junctions with automated bidirectional Sanger sequencing using an ABI 3730 sequencer

      PreviouslyPublished: n/a

      Variant: c.5196+1137G>A; c.1622T>C (p.L541P) and c.3113C>T (p.A1038V) complex variant

      ClinVar: 438100

      CAID: CA26843511

      SupplementalData: pedigree in fig s2

    1. Patient 2 (P2)

      Case#: Somali origin, 11 years of age, onset age 8

      DiseaseAssertion: STGD

      FamilyInfo: Parents were heterozygous for Arg212Cys, asymptoamtic 32 year old father was found to be homozygous for Gly1961Glu

      CasePresentingHPOs: HP:0011504, ORPHA:827, HP:0000608

      CaseHPOFreeText: BCVA 20/70 and 20/80, atrophic zone of outer retinal and RPE atrophy, Bull's Eye Maculopathy, Macular atrophy

      CaseNotHPOs: N/a

      CaseNotHPOFreeText: N/a

      Genotyping Method: Whole genome sequencing

      PreviouslyPublished: N/a

      Variant: NM_000350.3:c.5882G>A p.(Gly1961Glu) ; NM_000350.3:c.634C>T p.(Arg212Cys)

      ClinVar: 7888; 7898

      CAID: CA119132, CA203216

      SupplementalData: N/a

    1. In humans, clinical studies have implicated mutations in 19 of the 48 known ABC transporters in diseases such as cystic fibrosis and adrenoleukodystrophy.

      Annotating here since the article is a PDF.

      This variant is mentioned in table 2 as a "disease associated mutation", but only as being present in the NBD/NBD interface. No further details are provided.

    1. Patients older than 60 years or with ocular comorbidities such as diabetic retinopathy, uveitis, or glaucoma were excluded. From the remaining list, subjects for whom high-resolution SD-OCT imaging was available were selected. A review of the patient imaging and medical records was performed to identify those who received a clinical diagnosis of Stargardt macular dystrophy based on their clinical phenotype, including color fundus, infrared, FAF, and fluorescein angiography images and electroretinographic findings. 12

      Case#: P3, male, 16yo at report, 9yo at dx, US with Indian ethnicity

      DiseaseAssertion: Stargardt

      FamilyInfo: n/a

      CasePresentingHPOs:

      CaseHPOFreeText: BCVA (logMAR)= OD=20/160 (0.90), OS=20/125 (0.80)

      CaseNotHPOs:

      CaseNotHPOFreeText: ocular comorbidities such as diabetic retinopathy, uveitis, or glaucoma

      GenotypingMethod: "genetic testing"

      PreviouslyPublished: n/a

      Variant: c.2453G>A; c.4532C>A (p.Pro1511His)

      ClinVar: 99135

      CAID: CA227000

      SupplementalData: table 1

    1. Finally, we examined whether the phenotype‐associated known/candidate pathogenic variants could explain the patient's disease, andif the MAF in population‐matched control data (8.3kJPN) was relatedto disease prevalence. Patients were classified as “Solved” if theirgenotype was consistent with their clinical phenotype. Patients wereclassified as “Partially solved” when a heterozygous known/candidatepathogenic variant was detected in a recessive allele, but without anadditional variant in trans. Patients were categorized as “Unsolved” iftheir genotypes exhibited either no candidate pathogenic variants ormultiple heterozygous pathogenic variants that did not explain thephenotype clearly. Variants annotated as causal for solved patients arelisted in Supporting Information: Table S2. Novel variants identified inthis study are listed in the second sheet of Table S2. SupportingInformation: Table S3 shows the phenotypes and genotypes of solvedpatients.

      This variant is listed in supplementary tables S2 and S3. Proband KN-187 is a "solved" patient, meaning the phenotype matches the genotype. Compound heterozygous (c.6290C>T p.P2097L; c.6445C>T p.R2149X) male with Stargardt disease- all that is provided.

    1. STGD1 was determined according to initial symptoms of VA loss; fundus images showing orange-yellow flecks in the retina, a beaten-bronze appearance; and normal or cone-altered ffERG results

      Case#: MD-0790, Spanish

      DiseaseAssertion: STGD1

      FamilyInfo: n/a

      CasePresentingHPOs:

      CaseHPOFreeText: "STGD1 was determined according to initial symptoms of VA loss; fundus images showing orange-yellow flecks in the retina, a beaten-bronze appearance; and normal or cone-altered ffERG results"

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: Index cases were studied by different next-generation sequencing (NGS) strategies, including targeted gene panels, clinical exome, and/or whole-exome sequencing

      PreviouslyPublished: n/a

      Variant: c.1715G>C p.(Arg572Pro); c.4918C>T p.(Arg1640Trp)

      ClinVar: 99073

      CAID: CA226919

      SupplementalData: Table S1

    2. STGD1 was determined according to initial symptoms of VA loss; fundus images showing orange-yellow flecks in the retina, a beaten-bronze appearance; and normal or cone-altered ffERG results

      This variant was found in homozygosity 3 times in table S1 (Families MD-0991, MD-1164, and MD-1302). All with a STGD1 phenotype.

      MD-0991 had onset of VA loss at 25yo, cone-rod pattern on ERG, and BCVA was 1.2/1.2. Segregation was mentioned, but no details provided.

      MD-1164 had onset of VA loss at 42yo, no VF loss, and BCVA was 0.2/0.3. Segregation was not mentioned.

      MD-1302 had no clinical details available.

      GenotypingMethod: Index cases were studied by different next-generation sequencing (NGS) strategies, including targeted gene panels, clinical exome, and/or whole-exome sequencing

    1. MD-0723 STGD1 23 c.3386G>T p.(Arg1129Leu) 47 c.6410G>A p.(Cys2137Tyr) - 13 13 Yes 15y Cone-pattern 0.2/0.2 This study

      This variant is found in compound heterozygosity with c.3386G>T p.(Arg1129Leu) in family MD-0723 in this study. Proband is 13yo at onset of VA loss and VF loss with night blindness. 15yo at opthalmological exam. Cone pattern on ERG. BCVA=0.2/0.2. Eligible for PP4.

    1. Case 3: RP3.03

      Case#: RP3.03, 23yo, 21yo on set, Moroccan

      DiseaseAssertion: Retinitis Pigmentosa (RP19)

      FamilyInfo: Born into a consanguineous family, parents are unaffected, has five unaffected siblings

      CasePresentingHPOs: HP:0000505, HP:0007675, HP:0001133, HP:0007994, HP:0007843, HP:0000510, HP:0000580, HP:0007703

      CaseHPOFreeText: Abnormal epiretinal membrane formation, Altered ERG traces, rod and cone photoreceptor dysfunctions, hyper fuorescence ring surrounding macula and peripheral retina, absence of cystic spaces

      CaseNotHPOs: HP:0000551

      CaseNotHPOFreeText: Central vision loss

      Genotyping Method: Genomic DNA was extracted using QIAamp DND Blood Mini Kit, DNA underwent WES by BGI Tech Solutions, DNA was captured by MGIEasy Exome Capture V4 Probe Set, then Alligned using the Burrows-Wheeler Aligner and HaplotypeCaller of GAWK

      PreviouslyPublished: CRB1, PDE6B

      Variant: c.5908C>T, c.6148G>C

      ClinVar: 7892, 7884

      SupplementalData: Clinical data (table 1, figure 5), Genetic analysis (table 2), Patient Pedigree (figure 1.)

    1. ABCA4ARc.[1957C > T];[4605insT]WESHuang et al., 2013cHuang et al., 2013c, Rivera et al., 2000

      Case#: QT959, Chinese

      DiseaseAssertion: Cone-rod dystrophy

      FamilyInfo: no pedigree provided for this family in this paper

      CasePresentingHPOs:

      CaseHPOFreeText:

      CaseNotHPOs:

      CaseNotHPOFreeText:

      PreviouslyPublished: 23776498-more phenotype information available there

      Variant: c.[1957C > T];[4605insT] on WES

      ClinVar: n/a

      CAID: CA645372205

      SupplementalData: n/a

    1. The proband

      Case#: 34 y.o female proband, caucasian(German), diagnosed with Stargardt, late onset.

      DiseaseAssertion: STGD

      FamilyInfo: Unaffected father, mother exhibiting retinal disease. Biparental history of glaucoma and AMD, pattern dystrophy on maternal side.

      CasePresentingHPOs:HP:0001129, HP:0007722 ,HP:0007663, HP:0030329, HP:0007814, HP:0000608

      CaseHPOFreeText: Proband exhibits retinal thinning in all retinal layers, alongside chorioretinal atrophy. Experienced increased central vision loss over the course of a decade. At time of study, diagnosed with Stargardt disease. Visual acuity 20/200 in right eye and 20/40 in left. Additionally found granular molting of retinal pigment epithilium.

      CaseNotHPOs:n/a

      CaseNotHPOFreeText:n/a

      Genotyping Method: WES and variant calling performed at Columbia Institute for Genomic Medicine.

      PreviouslyPublished:n/a

      Variant: rs61751407, c.5714+5G>A

      ClinVar: 432057

      CAID: n/a

      SupplementalData: n/a

    1. We found statistically significant association for six variations (c.1268A>G, c.4203C>A, c.5603A>T, c.5682G>C, c.5843C>T, c.6249C>T) (FDR < 0.05, Supplementary Table S4)

      This paper is listed under the ClinVar citations for this variant, but only as a paper that references other variants in the initiator codon that have been observed in individuals with ABCA4-related conditions. The actual initiator variant included in this paper is c.1A>G

    1. Postmortem Retinal Structural and Metabolic Analysis After Human Embryonic Stem Cell–derived Retinal Pigment Epithelium Transplantation in a Patient With Stargardt Disease

      PCMID:*PMC12657203

      PMID41323838

      Gene: ABCA4

      HGNC ID: 34

      Case#:80 year old man,

      DiseaseAssertion:NA

      FamilyInfo:NA

      CasePresentingHPOs:NA

      CaseHPOFreeText:Diagnosed w/ targardt disease at the age of 18 years, medical retierment at 64 as result

      CaseNotHPOs:*parkinsons at 80

      CaseNotHPOFreeText:NA

      Genotyping Method:NA

      PreviouslyPublished:NA

      Variant:after gentic testing (unspecified) a pathogenic heterozygous mutation (G1961E) in ABCA4 gene a substiution, GAA) at amino acid position 1961, or c.5882 G>A at the complementary DNA level, or pGly1961Glu or G1961E at the protein level. No second mutation was identified. One of his 2 sisters had the same mutation.

      ClinVar:NA

      CAID:NA

      SupplementalData:this goes into how eye retina transplant results and outcomes.

    1. a 12-year-old female

      Case#: a 12-year-old female admitted to the B Department Hédi Raies institut of Ophtalmology in Tunis, Tunisia

      DiseaseAssertion: Cone rod dystrophy

      FamilyInfo: No parental consanguinity nor pathological or opthalmological history in the family

      CasePresentingHPOs: HP:0000529, HP:0000662, HP:0001141, HP:0000543,HP:0007737, HP:0030602

      CaseHPOFreeText: progressive visual loss, poor night vision, 1/20 visual acuity in both eyes, pallor of the optic disk, attenuated retinal vessels, paravascular bone spiculed pigmentations and an epimacular membrane, paravascular and macular heterogeneous hypoautofluorescence, diffuse alteration of ellipsoid zone, decreased photopic and scotopic responses.

      CaseNotHPOs: NR

      CaseNotHPOFreeText: NR

      Genotyping Method: Whole exome sequencing, Sanger sequencing

      PreviouslyPublished: NR

      Variant: c.885delC, NM_000350.3

      ClinVar: 438109

      CAID: CA958684

      SupplementalData: Karyotyping showed monosomy 45,X in the patient

    1. The landscape of genetic diseases in Saudi Arabia based on the first 1000 diagnostic panels and exomes

      PMID: 28600779

      Gene: ABCA4

      HGNCID: HGNC:34

      MonDO:

      Case: 16N-0520, Male, Saudi Arabia, 1 yo

      DiseaseAssertion:

      FamilyInfo: Consanguineous parents, positive family history

      CasePresentingHPOs: HP:0000618, HP:0000648 (Blindness, Optic atrophy)

      CaseHPOFreeText: Coloboma of eye

      GenotypingMethod: WES, analysis of Vision Panel, constituent genes are described in PMID 26112015.

      SupplementalData: Supplemental table

      Variant: ABCA4:NM_000350:exon49:c.6764G>T:p.S2255I

      CAID: CA202970

      gnomAD: 0.4845 (gnomAD v4.0.0, Grpmax Filtered AF African/African-American) https://gnomad.broadinstitute.org/variant/1-93996161-C-A?dataset=gnomad_r4

      VariantEvidence: Authors classified as VOUS. But later downgraded to LB in PMID 31130284.

    1. The study cohort consisted of 643 individuals of (mostly Eastern) European descent. Of these, 2 ABCA4 mutations were identified in 437 cases (68%), 1 mutation in 117 cases (18%) and 0 mutations in 89 cases (14%) (see online supplementary table 1), leaving ~23% of disease-associated alleles in 32% of patients yet to be identified. Almost all patients with no ABCA4 mutations and ~50% of patients with 1 mutation have been screened by whole exome sequencing to determine if variants in other genes were causal in these cases. All cases, where disease-associated variants in other genes were detected, were excluded from this cohort.

      Case#: Case #3483, likely European, 10yo at onset

      DiseaseAssertion: ABCA4 disease

      FamilyInfo: n/a

      CasePresentingHPOs:

      CaseHPOFreeText:

      CaseNotHPOs:

      CaseNotHPOFreeText: foveal sparing

      GenotypingMethod: NGS, Sanger

      PreviouslyPublished: n/a

      Variant: c.2453G>A (p.Gly818Glu); c.4462T>C (p.Cys1488Arg)

      ClinVar: 99135

      CAID: CA227000

      SupplementalData: supplemental table 1

    1. STGD47/164 IVS13+1G→A 2588G→C Yes

      Case#: STGD47/164, 10-14yo at onset, German

      DiseaseAssertion: STGD

      FamilyInfo: segregation in family

      CasePresentingHPOs:

      CaseHPOFreeText: "The diagnosis of STGD was based on the demonstration of bilateral impairment of central vision and the appearance of perimacular and/or peripheral yellow-white flecks, with or without atrophy of the central retinal-pigment epithelium and a normal or only mildly abnormal flash electroretinogram when recorded in early stages of the disease."

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: denaturing gradient gel electrophoresis, dHPLC, and SSCP analysis, PCR amplification of individual coding exons and flanking intron sequences, direct DNA sequencing

      PreviouslyPublished: n/a

      Variant: IVS13+1G→A; 2588G→C in trans "Correct segregation of disease alleles was demonstrated in all 39 cases in which family samples were available for study"

      ClinVar: 7879

      CAID: CA119128

      SupplementalData: n/a

    1. A total of 88 eyes of 44 patients (32 female [73%]) with a mean age at examination of 37.6 ± 2.5 years (±SEM; range, 9–77 years) were included in this study (Table 1, Supplementary Table S1). Forty-one patients were found to have two disease-causing mutations. Three patients had only one disease-causing mutation but showed a phenotype consistent with ABCA4-related retinopathy.

      Case#: Patients #33 and 34, female, 63 and 61yo at report, respectively, German

      DiseaseAssertion: ABCA4-related retinopathy

      FamilyInfo: n/a but they could be related

      CasePresentingHPOs:

      CaseHPOFreeText: "Inclusion criteria comprised the presence of at least one disease-causing mutation in ABCA4 and a phenotype consistent with ABCA4-related retinopathy, including RPE atrophy and flecks." BCVA [LogMAR] for patient #33: OD= 0.4, OS= 0.1. BCVA [LogMAR] for patient #34: OD= 1.5, OS= 1.0. Reduced (over 2 SD) photopic B-wave and 30-Hz flicker amplitudes

      CaseNotHPOs:

      CaseNotHPOFreeText: Insufficient pupil dilation, additional retinal pathology, previous vitreoretinal surgery, or other ocular comorbidities substantially affecting visual function (e.g., significant media opacity, amblyopia, or optic nerve disease) led to exclusion. Abnormal responses on scotopic and photopic full-field ERG

      GenotypingMethod:

      PreviouslyPublished: likely the same patients as other Muller papers in this curation

      Variant: c.3468C>G p.(Tyr1156*) and c.5059A>T p.(Ile1687Phe)

      ClinVar: n/a

      CAID: CA341290648

      SupplementalData: Table S1 has genotype/phenotype info for probands

    1. 1545c.6221G>Tp.G2074V (D; N)16c.2453G>Ap.G818E (D)Compound heterozygous

      Case#: Sporadic Case #15, Mexican

      DiseaseAssertion: Stargardt

      FamilyInfo: n/a

      CasePresentingHPOs:

      CaseHPOFreeText: STGD diagnosis based on: "onset of symptoms in childhood or early adulthood (before 20 years of age), bilateral central vision loss (central and peripheral visual field computerized testing), a retinal “beaten-bronze” foveal appearance and/or yellow-whitish flecks from the posterior pole to the mid periphery, normal caliber of the retinal vessels, no pigmented bone spicules in the retinal periphery, a normal to subnormal electroretinogram, and a typical dark choroid in fluorescein angiography."

      CaseNotHPOs:

      CaseNotHPOFreeText:

      PreviouslyPublished: n/a

      Variant: allele 1: c.6221G>T (p.G2074V) allele 2: c.2453G>A (p. G818E); direct sequencing of exons of ABCA4

      ClinVar: 99135

      CAID: CA227000

      SupplementalData: n/a

    1. In this study, we summarized the phenotypic and genotypic characteristics of 129 Chinese patients with ABCA4-RD.

      Case#: Patient 8541, male, 10yo at presentation, 9yo at onset

      DiseaseAssertion: Stargardt

      FamilyInfo: n/a

      CasePresentingHPOs:

      CaseHPOFreeText: The inclusion criteria for patients were as follows: (1) clinical phenotypes were consistent with retinal dystrophy, and two or more ABCA4 gene mutations were identified by genetic analysis; or (2) clinical phenotypes were consistent with Stargardt disease, and one ABCA4 gene mutation was identified. The diagnosis of STGD was based on visual acuity loss with an atrophic maculopathy with or without yellowish-white flecks. BCVA= 0.92 OU. FAF type 1 ( a localized low FAF signal at fovea surrounded by a homogeneous background with or without perifoveal foci of high or low signal)

      CaseNotHPOs:

      CaseNotHPOFreeText: Yellowish-white flecks

      GenotypingMethod: Analysis by targeted panel sequencing of 256 known retinal disease genes or by clinical exome sequencing of 1651 inherited eye disease-related genes

      PreviouslyPublished: n/a

      Variant: c.2587_2587+6delGG TAAGC; c.3468C>G p.(Tyr1156*)

      ClinVar: n/a

      CAID: CA341290648

      SupplementalData: supplemental table S2

    1. STGD in 48 patients (55%) was explained by recessive ABCA4 mutations (supplemental table S2). Only 22 patients could be solved using previously known STGD causing mutations. However, we identified 35 novel mutations in ABCA4 contributing to the diagnosis of 25 STGD patients. This contained 10 novel mutations leading to amino acid substitutions already known to cause disease and mutations known to cause diseases other than STGD. In addition, we identified 13 novel nonsense mutations. The remaining 12 novel mutations are well justified, and novel mutations were either completely absent or extremely rare in controls.

      Case#: Patient #9, Canadian

      DiseaseAssertion: Stargardt

      FamilyInfo: n/a

      CasePresentingHPOs: "Clinical diagnosis of STGD was made when the patient, usually a child, developed central visual acuity loss with an atrophic maculopathy with or without flecks." No individual details

      CaseHPOFreeText: n/a

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: n/a

      PreviouslyPublished: n/a

      Variant: c.6383 A>G p.(H2128R); c.785 G>A p.(G1961E)

      ClinVar: 99455

      CAID: CA227399

      SupplementalData: info found in table S2

    1. Figure 3: Protein yield and ATP-binding capacity of 37 naturally occurring ABCR variants produced in transiently transfected 293 cells.Membranes were analysed by immunoblotting with affinity-purified anti-ABCR antibodies (top) and photoaffinity labelling with α-32P azido-ATP (bottom). We loaded 1 μg (immunoblotting) or 2.5 μg (azido-ATP labelling) of total membrane protein, as determined by Bradford assay, per track. The mutations that reside in NBD-1 and NBD-2 are indicated above the corresponding lanes. The relative levels of the different variant proteins and the extent of azido-ATP labelling were observed to be highly reproducible in multiple independent experiments. ABCR (large arrowhead); an endogenous 55-kD protein (small arrowhead) serves as an internal control for azido-ATP labelling. Molecular mass standards are shown on the left in kD.

      This variant was transfected into HEK 293 cells and appears to show reduced expression and ATP-binding capacity, but no quantities were provided

    2. Over 200 ABCA4 sequence variants have been reported so far in patients with STGD and other retinopathies1,5,6,7,8,9,10,11,12,13,14,15,16,17. We have examined 33 missense mutations, 3 small in-frame deletions and 1 frameshift near the carboxy terminus (Table 1 and Fig. 2), including those mutations most commonly encountered in STGD patients1,5,6,7,8,9,10,11 and several that were reported in AMD patients15. As an initial step in assessing protein folding and stability, we analysed each ABCR variant by immunoblotting and azido-ATP labelling (Fig. 3). Mutations that cause small deletions (delVVAIC1681 and delPAL1761) or introduce charged amino acids into predicted transmembrane domains (G851D and G1886E) produce greatly reduced amounts of protein. Among the ABCR variants that are expressed with normal or nearly normal yield, azido-ATP labelling revealed a subset that is defective in ATP binding. A variety of mutations that lie outside of the nucleotide-binding domains (NBDs) can impair azido-ATP labelling, including L541P, predicted to reside adjacent to a transmembrane domain, and W1408R, which resides between the homologous halves of ABCR (Fig. 2). These data suggest that ATP binding to the NBDs is allosterically coupled to conformational changes in or near the transmembrane regions. Moreover, some mutations within either of the two NBDs abolish or nearly abolish all azido-ATP labelling, as seen, for example, with variants T971N, L1971R, G1977S and E2096K, implying allosteric coupling between the two NBDs, as described for P-glycoprotein22,23.Table 1 Naturally occurring ABCR variants produced in transfected 293 cellsFull size tableFigure 2: Locations of 37 naturally occurring ABCR sequence variants and 4 synthetic mutations.The predicted transmembrane topography and domain structure of ABCR is based on the hydropathy profile and sequence alignment with other ABC transporters. The cytosolic face of the membrane is downward. NBD, nucleotide binding domain; HH, highly hydrophobic domain shared with other members of the ABC1/ABCR subfamily of ABC transporters. A, B and C indicate the sequence motifs characteristic of nucleotide binding folds. Asterisks denote the four synthetic mutations.Full size imageFigure 3: Protein yield and ATP-binding capacity of 37 naturally occurring ABCR variants produced in transiently transfected 293 cells.Membranes were analysed by immunoblotting with affinity-purified anti-ABCR antibodies (top) and photoaffinity labelling with α-32P azido-ATP (bottom). We loaded 1 μg (immunoblotting) or 2.5 μg (azido-ATP labelling) of total membrane protein, as determined by Bradford assay, per track. The mutations that reside in NBD-1 and NBD-2 are indicated above the corresponding lanes. The relative levels of the different variant proteins and the extent of azido-ATP labelling were observed to be highly reproducible in multiple independent experiments. ABCR (large arrowhead); an endogenous 55-kD protein (small arrowhead) serves as an internal control for azido-ATP labelling. Molecular mass standards are shown on the left in kD.Full size imageThe combination of immunoblotting and azido-ATP labelling revealed defects in more than 75% of the variants tested. Among the variants with reduced yield and/or ATP binding are G863A and delG863, the two protein products of a guanosine2588→cytosine mutation that both generates a glycine-to-alanine substitution at codon 863 and activates a cryptic splice acceptor site in exon 17 that results in the removal of codon 863 from approximately 50% of the transcripts10. This is the most common allele among STGD patients in Northern Europe, representing roughly 20% of disease-associated alleles. It is also present at a frequency of approximately 3% in the general population in Northern Europe and approximately 1% in the United States population7,9,10. Genotype-phenotype correlations suggest that it is a mild allele and that it leads to STGD only when paired with a more severe allele10. Relative to wild type, the G863A variant is subtantially impaired and the delG863 variant is mildly impaired (Fig. 3).

      This variant was transfected into HEK 293 cells and appears to show reduced expression and ATP-binding capacity, but no quantities were provided

    1. 20 c.3208_3209insGT p.S1071fs DC c.1519G>T p.D507Y

      Case#: Fujinami Patient 20, British

      DiseaseAssertion: ABCA4-Related Retinal Disease

      FamilyInfo:

      CasePresentingHPOs:

      CaseHPOFreeText: Dx of ABCA4-associated retinal disease. At least localized low AF signal at the fovea surrounded by a homogeneous background, but no specific information provided

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: ABCA4 microarray, PCR-enrichment–based next-generation sequencing (NGS) of ABCA4. Identified variants were confirmed by Sanger sequencing and assessed for pathogenicity by in silico analysis.

      PreviouslyPublished: n/a

      Variant: c.3208_3209insGT (p.S1071fs) ; c.1519G>T (p.D507Y) not confirmed in trans

      CAID: CA958508

      SupplementalData:

    1. Subjects All subjects provided written informed consent for this research study, which was approved by the University of Iowa Human Subjects Committee. The study included 176 patients with SD, 457 patients with RP, 60 patients with CRD and 272 normal control subjects. Seventeen members of this cohort (13 with SD, 1 with CRD and 3 with RP) had disease-causing mutations identified on one or both alleles in previous studies that employed single-strand conformational polymorphism analysis as the primary screening method (3). All patients and control subjects were ascertained in the outpatient ophthalmology clinic at the University of Iowa. All patients received a complete eye examination including measurement of Snellen visual acuity, slit lamp biomicroscopy of the anterior segment and fundus, and binocular indirect ophthalmoscopy. Most patients had fundus photography and Goldmann perimetry performed as well.Molecular characterization of the ABCA4 gene A multi-platform screening approach was used to genotype the ABCA4 gene in all 693 research subjects and 272 controls. Thirty-two of the most common disease-causing ABCA4 variations were selected for the initial screen. The entire research cohort was assayed for these 32 variations using a combination of SNPlex, SSCP analysis, TaqMan and automated DNA sequencing (3). The SNPlex and TaqMan assays were performed as previously described (22,23). Fourteen of the variations were compatible with Applied Biosystems SNPlex allele-specific assay platform. Nine variations were screened by SSCP analysis, three were screened using an Applied Biosystems' TaqMan assay and six were screened by automated DNA sequencing. All CRD and RP patients who had one plausible disease-causing allele identified in the first tier of screening were assayed by automated sequencing of the entire coding region of the ABCA4 gene in an effort to identify their second disease-causing allele. In addition, Stargardt patients who had one of the three most common alleles (Gly863Ala, Gly1961Glu or IVS38-10) were also sequenced through the entire coding region of the ABCA4 gene.Visual acuity The best-corrected visual acuity was recorded in each patient's medical record as a Snellen fraction (normal = 20/20). Before statistical analysis, these values were converted to the logarithm of the minimal angle of resolution (logMAR) by calculating the base 10 logarithm of the Snellen fraction [e.g. normal = log(20/20) = 0]. For patients with multiple hospital visits, the acuity measurements taken closest to the patient's 27th birthday were used for the statistical analysis. Values from the left eye and right eye were averaged.Visual field volume scores Goldmann visual fields were scanned with a Sharp scanner and analyzed with ImageJ software (available at http://rsbweb.nih.gov/ij/) as follows: transparent layers were added to each field, and the isopters of the visual fields were manually traced onto these layers. Each isopter was assigned a z-axis value according to relative luminous energy of the stimulus (I2e = 100, I3e = 31.7, I4e = 10, III4e = 0.49, V4e = 0.024, no detection = 0). The volume scores were calculated by multiplying the area of each isopter by its associated z-axis value and then summing the values for all isopters. For patients with multiple hospital visits, the visual field measurements taken closest to the patient's 27th birthday were used for the statistical analysis. Values from the left eye and right eye were averaged.Statistical analyses The frequencies of disease-causing alleles observed among the three groups of retinal disease patients were compared with the frequency in controls using Fisher's exact test. The phenotype of each patient was assumed to result from the additive effect of two alleles and one or more additional factors that were cumulatively represented by a single residual value for each subject. The values for the quantitative contribution of each allele were estimated using a multiple linear regression analysis (24). Specifically, to dissect the effect of each allele, we decomposed the mean phenotype of a person whose genotype consists of allele i and allele j into ai + aj, where ai is the effect of the i-th allele. To do this, we created a vector Yva of length 51 containing the average logMAR visual acuities for each subject, and a 51x16 matrix, X. Each cell of this matrix, Xij, indicated the number of occurrences of the j-th allele for each subject i. This system of 51 equations was solved with multiple linear regression to give estimates of a, using the statistics program R (available at http://www.R-project.org). To verify the allelic data, each row of X summed to 2, and each column summed to the corresponding number of occurrences of each allele for this cohort. These calculations were performed in the same manner for Yvol, the vector of containing each subject's visual field quantitative phenotype. The estimates of a, the coefficients for each allele, for both Yva and Yvol are given in Table 1.

      Case#: Patient on line 28, US

      DiseaseAssertion: retinitis pigmentosa (RP)

      FamilyInfo:

      CasePresentingHPOs:

      CaseHPOFreeText:

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: Thirty-two of the most common disease-causing ABCA4 variations were selected for the initial screen. The entire research cohort was assayed for these 32 variations using a combination of SNPlex, SSCP analysis, TaqMan and automated DNA sequencing. All CRD and RP patients who had one plausible disease-causing allele identified in the first tier of screening were assayed by automated sequencing of the entire coding region of the ABCA4 gene in an effort to identify their second disease-causing allele. In addition, Stargardt patients who had one of the three most common alleles (Gly863Ala, Gly1961Glu or IVS38-10) were also sequenced through the entire coding region of the ABCA4 gene.

      PreviouslyPublished: n/a

      Variant: c.6601_6602del (p.Arg2201AlafsTer?) "Glu2200del2 aggGA"; c.5461-10T>C "IVS38-10 T>C"

      CAID: CA227421

      SupplementalData: genotype in supplemental table 1

    1. 14F/34320/200, 20/250OU: Severe RPE and choroidal atrophic changes in macula and throughout posterior pole and midperiphery, flecks throughout posterior poleCompound heterozygous: G818E and C1488RSubnormal rod, subnormal cone

      Case#: Patient #14, female, 34yo

      DiseaseAssertion: Stargardt

      FamilyInfo:

      CasePresentingHPOs:

      CaseHPOFreeText: stage 3, BCVA: OD=20/200 OS=20/250, fundus findings: OU: Severe RPE and choroidal atrophic changes in macula and throughout posterior pole and midperiphery, flecks throughout posterior pole, full field ERG: Subnormal rod, subnormal cone,

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: direct sequencing of the ABCA4 gene

      PreviouslyPublished:

      Variant: Compound heterozygous: G818E and C1488R

      ClinVar:

      CAID:

      SupplementalData:

    1. Summary genetic testing data is available on the eyeGENE website (eyeGENE.nih.gov/data), including the number of participants for each of the 38 diagnostic categories, variants detected per gene, and variant classification by gene. As of the time of this writing, 3,448 eyeGENE participants have been reported to have at least one pathogenic or likely pathogenic genetic variant. The 10 most frequently reported genes were ABCA4 (1799, 37%), USH2A (316, 7%), RPGR (283, 6%), CHM (219, 5%), PRPH2 (161, 3%), RS1 (142, 3%), RHO (130, 3%), BEST1 (114, 2%), EYS (67, 1%), and PRPF31 (62, 1%). These 10 genes represent 68% of all pathogenic and likely pathogenic variants in eyeGENE. Two thousand one hundred and four participants have genetic results where no pathogenic or likely pathogenic variant was found. Variants of uncertain significance were identified in 1,712 individuals.

      This paper was listed under this variant in LOVD, but I cannot find it in the main text or supplemental documents.

    1. AR197197–057CF 3 feet OD; CF 2 feet OSRP[L541P; A1038V][L541P; A1038V]197–069CF 5 feet OD; HM OSRP[L541P; A1038V][L541P; A1038V]

      Case#: Family AR197 Proband 05, male, 7yo at onset

      DiseaseAssertion: arRP

      FamilyInfo: parents are het carriers, sibling (06) is affected and has the same genotype

      CasePresentingHPOs:

      CaseHPOFreeText: "diagnosed by clinical criteria (44) consistent with international standards and confirmed by review of ophthalmic records and retinal photographs. The clinical criteria included visual impairment at early age, progressive loss of peripheral visual functions and typical retinal changes of vascular attenuation, disc pallor and bone spicule accumulation." CF 3 feet OD; CF 2 feet OS

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: microarray chip, ABCR-400, PCR

      PreviouslyPublished: n/a

      Variant: [L541P; A1038V] and[L541P; A1038V]

      ClinVar: 99067

      CAID: CA226911

      SupplementalData: n/a

    2. The measurement of ATPase activity has been the only assay available to study the effects of mutations on ABCA4 function. We employed this assay to examine the effects of [L541P; A1038V], R602W and C1490Y mutations on in vitro ATP hydrolysis. Constructs containing wild-type and mutated ABCA4 cDNAs, tagged with the eight amino acid bovine opsin C-terminal epitope (1D4), were expressed in COS7 cells and proteins were purified on a 1D4 affinity column. CHAPS-solubilized ABCA4 was incubated subsequently with ATP, and the hydrolysis rate was estimated with the charcoal method (31).The rate of ATP hydrolysis of the complex allele [L541P; A1038V] was decreased to 68.1% of wild-type ABCA4 (Fig. 3).

      ATPase activity in COS7 cells showed decreased activity (68.1% of wild-type), indicating that this variant impacts protein function (PS3_Supporting; PMIDs). However, this is not a cell type that is counted for PS3 evidence by the ABCA4 VCEP.

    1. Case report: Disease phenotype associated with simultaneous biallelic mutations in ABCA4 and USH2A due to uniparental disomy of chromosome 1

      Case#: Patient 9, female, Mexican, symptoms onset 6 yrs. ago, Mexico City

      DiseaseAssertion: IRD

      FamilyInfo: parents are non-sanguineous and asymptomatic, they also denied any history related to ocular diseases. Information disclosed that the mother had one stillbirth and three miscarriages, but denied any related diseases/health issues to this child.

      CasePresentingHPOs: HP:00305, HP:00080, HP:0000493, HP:0025586, HP:0030329, HP:0012713

      CaseHPOFreeText: Proband presented with light sensitivity as well as adaptation difficulties when going from dark-to-light. Right eye was 20/200 and left eye was 20/160 from the visual acuity test. Macular bull's eye appearance. Subnormal rod and cone responses. Peripapillary sparing retina.

      CaseNotHPOs: HP:0007737, HP:0000750, HP:0000510

      CaseNotHPOFreeText: No afferent pupillary defect. No anomalies in anterior segment.

      Genotyping Method: QIAamp DNA Blood Kit was used to extract gDNA and quantification/purity of the sample was found using a NanoDrop 2000 spectrophotometer. 293 genes were sequenced. gDNA was sequenced via Illumina technology. Following, certain sequences were additionally analyzed against a reference genome in order to identify changes and interpret.

      PreviouslyPublished: n/a

      Variant: NM_000350.3(ABCA4):c.4926C>G (p.Ser1642Arg), NM_000350.3(ABCA4):c.5044_5058del (p.Val1682_Val1686del)

      ClinVar: 99332, 99340

      CAID: n/a

      SupplementalData: Phenotype data in results section as well as figures 1, 2, and 3 showing phenotypic testing results.

    1. Case 5

      Case#: a 46-year-old male

      DiseaseAssertion: Stargardt Disease

      FamilyInfo:visual acuity loss by his brother and father

      CasePresentingHPOs: HP:0007663

      CaseHPOFreeText: visual acuity measured 20/400 bilaterally

      CaseNotHPOs: NR

      CaseNotHPOFreeText:NR

      Genotyping Method: ABCA4 microarray (ABCR5000 chip)

      PreviouslyPublished: NR

      Variant: c.5714+5G>A

      ClinVar: 99403

      CAID: CA227338

      SupplementalData:NR

    1. A 66-year-old man

      Case#: Patient 66yo, M, Japan, Symptoms in teens

      DiseaseAssertion: Stargardt (STGD) Heterozygous, Autosomal recessive

      FamilyInfo: No family with similar symptoms

      CasePresentingHPOs: HP:0008002, HP:0007722, HP:0000610, HP:0000602

      CaseHPOFreeText: Ring shaped paracentral scotoma

      CaseNotHPOs: HP: 0030329, HP:0000608, HP:0000493

      CaseNotHPOFreeText: Well preserved foveal function, well preserved retinal, and normal thickness RPE

      Genotyping Method: N/A

      PreviouslyPublished: 4 other polymorphisms

      Variant: c.839T>C p.Met280Thr Heterozygous

      ClinVar: 1349490

      SupplementalData: see tables 1 for gene variant and found polymorphisms

    1. A 37-year-old man presented with a 3-year history of decreased vision in the right eye, which had recently become worse.

      Case#: single case, 37-year-old male, ethnicity not specified although family originally from the Middle East, examined in the UK

      DiseaseAssertion: STGD

      FamilyInfo: No history of consanguinity. No history of inherited retinal disease, poor vision or colour vision disturbance. Father had recent diagnosis of chronic central serous retinopathy, not consistent with STGD

      CasePresentingHPOs: n/a

      CaseHPOFreeText: Late-onset Stargardt disease with slowly progressive phenotype. The patient present with a 3-year history of decreased vision in the right eye that had recently significantly worsened. Visual acuity was 6.24 in right eye and 6/6 in left eye. Fundus examination reveled scattered atrophy and pisiform fundal flecks in both eye, right worse than left. Fluorescein angiography showed a silent choroid and partial bull's eye maculopathy, right worse than left. OCT showed loss of photoreceptors in both eyes and partial central sparing in the left eye. Photopic and scotopic ERG showed reduced amplitude of responses in the right eye and lower range amplitudes in the left eye, normal implicit times in both eyes. Pattern ERG and multifocal ERD showed central retinal dysfunction with preserved peripheral function. No change in vision or retinal appearance over the next 14 months of follow up.

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: No night vision symptoms. No history of retinotoxic drug exposure.

      Genotyping Method: Next-generation sequence analysis with the Oxford Genetics Testing Laboratory Macular Gene Panel.

      PreviouslyPublished: Thr829Met missense mutation had been previously reported in an individual with autosomal recessive retinitis pigmentosa, but not previously associated with STGD phenotype.

      Variant: ABCA4 NM_000350 c.5882G>A, p.(Gly1961Glu) c.2486C>T, p.(Thr829Met)

      ClinVar: n/a

      CAID: CA958261, CA119132

      SupplementalData: n/a

    1. An uncommon case of retinitis pigmentosa patients basedon clinical and genetic study

      PMID:39215425

      Gene: ABCA4

      HGNC ID: 34

      Case#:1 this ia family but the 20 year old son is the firs tone spoken about a herdirtary eye disease, shows phenotype for years till syptmos worsned with age

      DiseaseAssertion: Table 1 The summary of the clinical assessment of IRD patients’ family in this research fro there down they did a whole pannel on the family

      Pedigree one can be fore form the beggginnings of case presention section?

      CasePresentingHPOs: suffered from tunnel vision and blurry night vision began 13 years ago

      CaseHPOFreeText:NA

      CaseNotHPOs:NA

      CaseNotHPOFreeText:NA

      Genotyping Method:NA

      PreviouslyPublished:NA

      Variant:NA

      ClinVar:

      CAID:NA

      SupplementalData:NA

      Inheritance pattern Autosomal Recessive

    1. Eighty-four unrelated STGD1 patients were found to carry two or more disease-causing ABCA4 mutations, and cosegregation analyses were performed in 54 (64.3%). (See Supplementary Table S3 for a summary of clinical phenotype of STGD1 patients). The mean disease onset age of the patients was 13.1 years (range, 2–44 years), and half of these patients experienced their symptoms of visual impairment in their first decade. We classified the patients into three groups by their disease onset age. For the patients in the first group, whose disease onset ages were between 1 and 10 years, the fraction (45.3%, 19/42) of patients carrying compound heterozygous or homozygous deleterious mutations (nonsense, frameshift insertion or deletion, or splicing mutations) or complex alleles was much higher than those observed for the patients in the group 2 (24.1%, 7/29) and group 3 (15.4%, 2/13), whose disease onset ages were from 11 to 20 years or older than 20 years, respectively. In contrast, the percentage of patients carrying compound heterozygous or homozygous missense mutations was higher in group 3 than in group 1 or group 2 (Table 2). The most common mutation (p.Y808X) was detected in 12 patients, and all were heterozygous compound with missense (6 patients), splicing (1 patient), and insertion or deletion (5 patients) mutations. The two most frequent missense mutations (p.F2188S and p.N965S) were identified as heterozygous. In 84 patients, 9 patients carried complex mutations, and 4 of those 9 patients carried a common complex allele p.E328V/p.E1036K. All these patients had early onset age and relatively severe visual acuity defects. One patient (010222) also carried three heterozygous mutations (p.E328, p.E1036K, and p.R1843W); however, he did not harbor the common complex allele p.E328V/p.E1036K, as only p.E1036K was detected in his son in the subsequent cosegregation analysis. Compared to the four patients carrying the common complex alleles (p.E328V/p.E1036K), patient 010221 had a late onset age (44 years old).  Table 2 View Table Correlations Between Onset Age of STGD Patients and Their Carrying Mutations

      Per ClinVar entry, this variant was associated with this paper. however, after reading through the genotypes, this variant was not found. Likely this paper was mentioned to support the statement that "Loss-of-function variants in ABCA4 are known to be pathogenic"

    1. Patient 1

      Case#: Patient 1, Female, age 40

      DiseaseAssertion: STGD1

      FamilyInfo: n/a

      CasePresentingHPOs: HP:0007722, HP:0000608, HP:0000007

      CaseHPOFreeText: Patient diagnosed with STGD type 1, presenting with retinal pigment atrophy as well as other symptoms typical of STGD1 with reduced visual acuity. Patient daignosed at age 16.

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: n/a

      Genotyping Method: Patient ABCA-4 gene sequenced via Sanger sequencing of all 50 exons, Splice variants were identified by synthesized cDNA from RNA isolation with RT-PCR analysis with exonic primers.

      PreviouslyPublished: Variant 1 identified in association with retinal dystrophy in these PMC articles: 23982839, 25082829, 25082885, 28327576

      Variant: NM_000350.3(ABCA4):c.859-9T>C, NM_000350.3(ABCA4):c.303-3C>G

      ClinVar: 3249248, 859348

      gnomAD total allele frequency: 0.005% of var . 1

      CAID: n/a

      SupplementalData: Fig 1: Minigene RNA analysis of splice variants. A: genomic region of exon 40 on ABCA-4. B: genomic regions of exons 39-41 to investigate specific variant:oncanonical splice site variant c.5714+5G>A Fig 2: overview of wild-type midigene splice constructs of ABCA-4 and locations of 47 different non canonical splice site variants Fig 3: Overview of splice defects from nine different non canonnical splice variants in ABCA-4 gene. Fig 4: percentages of normal ABCA-4 transcripts as a result of noncanonical splice variants using electrophoresis system analysis. Table 1: Non canonical splice variants and observed protein affects.

    1. 48-year-old woman

      Case#: Patient female, 48y, ethnicity not reported

      DiseaseAssertion: Stargardt disease (STGD1) with unusual phenotype resembling pattern dystrophy

      FamilyInfo: autosomal recessive inheritance; segregation analysis confirms each parent carries one variant (heterozygous). Pedigree shown in Figure 3. Proband is compound heterozygous for ABCA4 variants.

      CasePresentingHPOs: HP:0007663, HP:0007754, HP:0030636, HP:0000548

      CaseHPOFreeText: mild visual impairment (BCVA 20/25 and 20/20), perifoveal yellow fleck-like lesions, hyperautofluorescent lesions with lipofuscin accumulation, foveal sparing, subretinal material accumulation, phenotype resembling pattern dystrophy, bilateral macular involvement, decreased p50 values on pattern ERG

      CaseNotHPOs: HP:0000510 (normal ERG responses except pattern ERG component)

      CaseNotHPOFreeText: normal full-field ERG (scotopic and photopic responses), normal electrooculography, preserved outer retina structure, minimal photoreceptor disruption at fovea

      Genotyping Method: targeted next-generation sequencing (Illumina NextSeq500) with SeqCap EZ enrichment panel; Sanger sequencing used for confirmation and segregation analysis

      PreviouslyPublished: n/a

      Variant: ABCA4 NM_000350.2: c.428C>T (p.Pro143Leu); c.3113C>T (p.Ala1038Val)

      ClinVar: 99273; 7894

      CAID: n/a

      SupplementalData: clinical imaging and genetic/segregation data in supplemental data (Figures 1–3, Table 1)

    1. We identified 1319 distinct causative variants (Supplementary Table S1) in 132 different genes (Table ​(Table3).3). The ten most commonly mutated genes were ABCA4 (n = 535 [26.3%]), USH2A (n = 228 [11.2%]), RPGR (n = 102 [5%]), CHM (n = 72 [3.5%]), RHO (n = 72 [3.5%]), MYO7A (n = 69 [3.4%]), CRB1 (n = 55 [2.7%]), RPE65 (n = 40 [2%]), RP1 (n = 37 [1.8%]), and GUCY2D (n = 34 [1.7%]) (Table ​(Table3,3, Fig. 2a). The other 122 genes had a lower contribution to IRDs. One hundred genes were mutated in 15 patients or less and were collectively responsible for disease pathogenesis in 18% of the solved cohort (Fig. 2a, Table ​Table3).3). Thirty-two genes were mutated in only one patient (Table ​(Table3).3). Mutations in the mitochondrial DNA accounted for 2.1% of the cohort and were implicated almost exclusively in the pathogenesis of LHON.

      This variant is in supplementary table S1 as being found in an Italian IRD "solved" case with AR inheritance, but no further details are provided.

    1. Rp125 arRP ABCA4 NM_000350 Heterozygous c.6416G > C p.(Arg2139Pro) Novel Heterozygous c.1519G > T p.(Asp507Tyr) (Fujinami et al. 2013b)

      Case#: Zhao Case Rp125, N. Ireland

      DiseaseAssertion: arRP

      FamilyInfo: familial case. affected sister with the same genotype

      CasePresentingHPOs:

      CaseHPOFreeText: "Retinitis pigmentosa was diagnosed on the basis of the typical fundal features (bone spicule retinal pigmentation, arteriolar attenuation, and optic disc pallor), visual field constriction, and an attenuated or abolished electroretinogram." 7yo at onset. BCVA= CF, HM. ERG findings: extinguished OU

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: Targeted next-generation sequencing using a retinal capture panel to test 55 RP genes and 131 other retinal disease genes. All putative mutations identified by NGS were validated using Sanger sequencing and tested for co-segregation if additional affected family members are available

      PreviouslyPublished: n/a

      Variant: NM_000350 c..6416G>C p.(Arg2139Pro); c.1519G>T p.(Asp507Tyr)

      CAID: CA956878

      SupplementalData: table s6, figure s1

    1. ABCA4-associated retinopathy complicated by didanosine-associated retinal toxicity

      PMID: 41561667

      Gene: ABCA4

      HGNC ID: 34

      Case#: patient 66, male, Italy

      DiseaseAssertion: STGD

      FamilyInfo: N/A

      CasePresentingHPOs: HP:0000505, HP:0000551, HP:0000546

      CaseHPOFreeText: best-corrected visual acuity (BCVA) was 20/400 in both eyes, mild myopia, both eyes were pseudophakic, extensive bilateral chorioretinal atrophy involving both the posterior pole and the peripheral retina, widespread mottled hypoautofluorescence in the mid-periphery, along with pronounced macular hypoautofluorescence, significant central retinal thinning, an enlarged foveal depression, outer retinal hyper-reflectivity associated with extensive atrophy of both the RPE and the underlying choroid, dense epiretinal membrane (ERM) was also identified in the right eye, large central hypofluorescent zone involving the macular region and extending beyond the vascular arcades

      CasePreviousTesting: n/a

      GenotypingMethod: Next-Generation Sequencing

      PreviouslyPublished: n/a

      Variant: c.1714C > T p. (Arg572∗)

      ClinVar: 620085 https://www.ncbi.nlm.nih.gov/clinvar/variation/620085/?term=620085%5BVariation+ID%5D

      gnomAD: 0.000001859 https://gnomad.broadinstitute.org/variant/1-94063158-G-A?dataset=gnomad_r4

      Variant: c.2461T > A p. (Trp821Arg)

      ClinVar: 99136 https://www.ncbi.nlm.nih.gov/clinvar/variation/99136/?term=99136%5BVariation+ID%5D

      gnomAD: 0.000008054 https://gnomad.broadinstitute.org/variant/1-94055237-A-T?dataset=gnomad_r4

      Variant: c.4417C>А p. (Leu1473Met)

      ClinVar: 546600 https://www.ncbi.nlm.nih.gov/clinvar/variation/546600/?term=546600%5BVariation+ID%5D

      gnomAD: 0.00005762 https://gnomad.broadinstitute.org/variant/1-94029567-G-T?dataset=gnomad_r4

    1. Antioxidant Saffron and Central Retinal Function in ABCA4-Related Stargardt Macular Dystrophy

      PMID: 31618812

      Gene: ABCA4

      HGNCID: HGNC:34

      Patients: a group of 31 Stargardt disease/fundus flavimaculatus patients (14 males, 17 females) with an established ABCA4 genotype, accumulated prospectively over an interval of 12 months at the outpatient service of the Institution, were included in this study.

      MonDO: MONDO:0019353

      CaseInfo: Case 11, Male, 12yo. Compound het c.5882G > A; p.Gly1961glu (Pathogenic in ClinVar); c.6764G > T,p.Ser2255Ile

      DiseaseAssertion: Stargardt disease/fundus flavimaculatus

      FamilyInfo: Not provided

      CasePresentingHPOs: HP:0007769, HP:0000608, HP:0012045 (Peripheral retinal degeneration, Macular degeneration, Retinal flecks)

      CaseHPOFreeText: cone-rod pattern of retinal dysfunction

      GenotypingMethod: Mutation screening was performed by single-strand conformation polymorphism (SSCP) strategy of the whole coding region of ABCA4. Direct sequencing was also performed on siblings of probands and parents, when available, to confirm segregation of alleles.

      MultipleGeneVariants: (1) GeneName: ABCA4

      (1)Variant: c.5882G > A; p.Gly1961glu

      (1) CAID: CA119132

      (1) gnomAD: 0.01250 (gnomadv4.0.0, Grpmax Filtering AF, South Asian) https://gnomad.broadinstitute.org/variant/1-94008251-C-T?dataset=gnomad_r4

      (2) GeneName: ABCA4

      (2) Variant: c.6764G>T (p.Ser2255Ile)

      (2) CAID: CA202970

      (2) gnomAD: 0.4845 (gnomadv4.0.0, Grpmax Filtering AF, African/African-American) https://gnomad.broadinstitute.org/variant/1-93996161-C-A?dataset=gnomad_r4

    1. 13. 34/F31.021.06OD−68.3−23.32p.Gly818Glu; p.Cys1488Arg

      Case#: Pt 13, 34yo, female

      DiseaseAssertion: Stargardt

      FamilyInfo: n/a

      CasePresentingHPOs:

      CaseHPOFreeText: stage 3 (resorbed flecks), logMAR acuity: OD=1.02 OS 1.06, FST Rod Blue Stimulus (dB) OD= −68.3, FST Cone Red stimulus (dB) OD=−23.3, FST Group 2 (elevated cone and normal rod FST thresholds)

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod:

      PreviouslyPublished:

      Variant: p.Gly818Glu; p.Cys1488Arg

      ClinVar: 99135

      CAID: CA227000

      SupplementalData: n/a

    1. Patient 4, a 30-year-old individual with the deleterious c.213dupG/p.Ile73Asnfs*26 frameshift mutation and the c.1654G>A/p.Val552Ile missense mutation, displayed mild STGD1 with stage 2 FC and 20/30 VA. The p.Ile73Asnfs*26 mutation is classified as a pathogenic mutation, whereas the p.Val552Ile mutation is classified as likely neutral. Biochemical analysis of the p.Val552Val, however, suggests that this is a mild mutation at a functional level consistent with the clinical assessment of patient 4 (see Discussion section for additional information).

      Case#: Garces Patient 4, Canada

      DiseaseAssertion: mild STGD1

      FamilyInfo:

      CasePresentingHPOs:

      CaseHPOFreeText: 30yo, VA=20/30, FC=Stage 2 (flecks throughout the posterior pole, anterior to the vascular arcades and nasal to the optic disc and relatively normal ERGs but with prolonged dark adaptation)

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: screened for mutations in the ABCA4, CNGB3, and ELOVL4 genes

      PreviouslyPublished: n/a

      Variant: c.213dupG/p.Ile73Asnfs*26; c.1654G>A/p.Val552Ile

      CAID: CA239745

      SupplementalData:

    1. The proband of family 31, F31:II.1, carries a homozygous missense variant within exon 42 of the ABCA4 gene.

      This variant is well-known in exon 42, [M2]: c.5882G > A; p.(Gly1961Glu), rs1800553. The father of the affected patient was deceased; however, the mother was found to be homozygous for the wild type (WT) allele. According to the ACMG standards, M2 is likely pathogenic.

    1. The plots of fluorescence anisotropy changes of 11-cis-retinal with wild type and mutant NBD1 protein titrations are shown in Fig. 6, A–C. The binding of mutant G863A was significantly attenuated as indicated by the drastic right shift of the binding isotherm as well as its inability to achieve saturation in the presence of a high concentration of protein (Fig. 6A). Nonlinear regression analysis gave Kd of 8.0 ± 1.3 × 10−8 m, 8.0 ± 2.0 × 10−6 m, and 4.0 ± 1.4 × 10−6 m for the wild type and R943Q and P940R mutations, respectively (Fig. 6 and Table 1). As a consequence of Stargardt disease mutations, 100-fold (R943Q) to 50-fold (P940R) decreases in the binding affinity of the NBD1 domain for 11-cis-retinal were observed. The retinal binding of the G863A mutant was severely attenuated, and the Kd was ≥1.0 × 10−5 m.

      The effects of this variant on 11-cis-retinal interaction with the NBD1 was evaluated via fluorescence anisotropy. The binding of mutant G863A was significantly attenuated (Kd was ≥1.0 × 10−5 m) as indicated by the drastic right shift of the binding isotherm as well as its inability to achieve saturation in the presence of a high concentration of protein (Fig. 6A).

    1. All reported ABCA4 variants (Supplementary Table S1) were classified as follows:

      Patient 38 has this variant and also c.5882G>A p.(Gly1961Glu) (Supplement 4-supplementary table 1). Phase is unknown and more specific phenotype information is not provided.

      clinical diagnosis of STGD1 was supported by the presence of ≥1 (likely) pathogenic ABCA4 variants with a follow-up data of ≥6 months on FAF imaging.

  2. Jul 2026
    1. Patient 2, a 46-year-old Caucasian woman, presented in July 1998 with a history of progressive decline in visual acuity since the age of 16

      PMID: 10612508

      Gene: ABCA4

      Case#: Patient 2, 46-year-old female

      DiseaseAssertion: STGD1

      FamilyInfo: One of four affected siblings in a family consistent with autosomal recessive inheritance.

      CasePresentingHPOs: HP:0000545 — Decreased visual acuity HP:0007754 — Macular atrophy HP:0030638 — Retinal flecks HP:0000512 — Abnormal fundus morphology

      CaseHPOFreeText: Progressive visual decline since age 16. Best-corrected visual acuity 20/400 in both eyes. Fundus examination showed bilateral symmetrical central chorioretinal atrophy (~3 disc diameters) with prominent pigment deposits and numerous yellow flecks in the posterior pole. Fluorescein angiography demonstrated central hypofluorescence with surrounding hyperfluorescence and peripheral dark choroid.

      CaseNotHPOs: Not reported

      CaseNotHPOFreeText: Not reported

      GenotypingMethod: PCR amplification and direct sequencing of ABCA4 after SSCP screening

      PreviouslyPublished: Yes

      Variant: NM_000350.2:c.2588G>C (p.Gly863Ala) NM_000350.2:c.161G>A (p.Cys54Tyr)

      ClinVar: Not reported

      CAID: Not reported

      SupplementalData: Segregation and sequencing data shown in Figures 1 and 4

    2. Patient 3, a 37-year-old Caucasian woman, presented in July 1998 with a gradual decline in visual acuity that began at the age of 12.

      Case#: Patient 3, 37-year-old female

      PMID: 10612508

      DiseaseAssertion: STGD1

      FamilyInfo: Affected sibling in autosomal recessive family.

      CasePresentingHPOs: HP:0000545 — Decreased visual acuity HP:0007754 — Macular atrophy HP:0030638 — Retinal flecks HP:0000512 — Abnormal fundus morphology

      CaseHPOFreeText: Gradual visual decline beginning at age 12. Visual acuity 20/400 in both eyes. Fundus examination revealed bilateral macular atrophy with pigment deposits and numerous yellow flecks in the posterior pole and midperiphery. Fluorescein angiography showed large hypofluorescent regions with surrounding hyperfluorescence and peripheral dark choroid.

      CaseNotHPOs: Not reported

      CaseNotHPOFreeText: Not reported

      GenotypingMethod: PCR and direct sequencing of ABCA4

      PreviouslyPublished: Yes

      Variant: NM_000350.2:c.2588G>C (p.Gly863Ala) NM_000350.2:c.161G>A (p.Cys54Tyr)

      ClinVar: Not reported

      CAID: Not reported

      SupplementalData: Segregation and sequencing data (Figures 1, 4)

    1. A cohort of 500 unrelated IRD patients was sequenced with the targeted NGS panel Genetic Eye Disease test (GEDi)3 and analyzed with a comprehensive approach, which included a standard NGS analysis pipeline detecting single-nucleotide variants (SNVs) and small insertions and deletions (indels),16 interrogation of sequence reads to detect the known pathogenic MAK-Alu insertion,21 and application of NGS read-depth algorithms (ExomeDepth15 and gCNV16) to detect larger deletions and duplications, or CNVs (Fig. 1). In this study we define CNVs as deletions or duplications that range from an average size of an exon (≈50–200 bp) and that are not detectable by standard NGS pipelines, to megabases of DNA.22

      Case#: OGI802_001554

      DiseaseAssertion: IRD

      FamilyInfo: n/a

      CasePresentingHPOs:

      CaseHPOFreeText:

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: detection of CNVs on the panel-based NGS Genetic Eye Disease (GEDi) diagnostic test that involves sequencing the exons of all known IRD disease genes

      PreviouslyPublished: n/a

      Variant: c.1715G>C; c.5196+1137G>A

      ClinVar: 99073

      CAID: CA226919

      SupplementalData: Table S2

    1. two cases from two additional families (case 3, 11 years and case 4, 11 years).

      Case#:two cases from two additional families (case 3, 11 years and case 4, 11 years).

      DiseaseAssertion: Stargardt’s Disease

      FamilyInfo: NR

      ParentalTesting: NR

      CasePresentingHPOs: HP:0030500, HP:0011507

      CasePhenotypeFreeText: LogMAR visual acuity for the right and left eye of cases 1–4 was 0.3 and 0.2, 0.1 and 0.1, 0.5 and 0.4, and 0.3 and 0.4, respectively. Gross disruption of the outer retinal layers at the macula in all cases; in two (cases 2 and 4), the presumed external limiting membrane (ELM) peak was broadened with the inner segment ellipsoid band (ISe) missing. Subtle white-yellowish fine dots at the macula and numerous white-yellowish flecks extending anterior to the arcade are shown in the colour fundus photograph of case 1. Autofluorescence (AF) imaging of case 1 detected well-defined dots with high signal at the central macula surrounded by a ring of increased signal and numerous foci with high or low signal extending to the peripheral retina. Case 2 also had subtle white-yellowish fine dots at the central macula and numerous white-yellowish flecks extending anterior to the arcade, both associated with high signal on AF imaging. In addition, case 3 had white-yellowish fine dots at the macula and numerous white-yellowish flecks extending to the periphery, both of which had high or low signal on AF imaging. Case 4 showed subtle fine macular dots mainly in a para-foveal location, which are well-defined on AF imaging.

      CaseNotHPOs: HP:0007401, HP:0000505

      CaseNotPhenotypeFreeText: Most cases with STGD have central macular atrophy with numerous more peripheral flecks (Michaelides et al. 2003). Given their relatively good visual acuity, it is likely that the central macular dots observed in our cases may be an early sign of macular dysfunction before the development of macular atrophy. Similar fine macular dots or a ‘mottled macula’ have also been reported in other inherited retinal diseases

      CasePreviousTesting: The age of disease onset in cases 1–4, defined as either the age at which visual loss was first noted by the subject or in the asymptomatic subjects when abnormal retinal appearance was first detected, was 5, 7, 8, and 6 years old, respectively.

      GenotypingMethod: After informed consent was obtained, blood samples were taken from probands of 2/3 families for ABCA4 screening. A full medical history was obtained, and a full ophthalmologic examination was performed in all cases. Mutation screening of ABCA4 was performed in two probands of the three families, and two likely disease-causing variants were identified in each case; c.768G > T, p.V256V (a previously reported splicing-altering synonymous variant) and c.4363T > C, p.C1455R (a missense variant) in case 1, and c.1906C > T, p.Q636* (a non-sense variant) and c.5461-10 T > C (a disease-associated intronic variant with uncertain effect) in case 3. A blood sample was not available in one proband (case 4).

      Variant: NM_000350.3(ABCA4):c.1906C>T (p.Gln636Ter) and NM_000350.3:c.5461-10T>C

      LegacyVariant: c.1906C>T (p.Gln636Ter) and c.5461-10T>C

      ClinVar: 265012 and 92870

      CAID: CA10588302 and CA220687

      gnomeAD: 1:94528164 G / A and 1:94476951 A / G

      MultipleGeneVariants:No

      PreviouslyPublished: No

      AdditionalInfo: Most symptoms/diagnoses are consistent with Stargardt’s Disease 3, however the probands in the study were younger in age, so many of the symptoms hadn’t progressed much. Also, all of the cases had decent visual acuity, which contradicts a symptom of Stargardt’s Disease 3. Similar fine macular dots or a ‘mottled macula’ have also been reported in other inherited retinal diseases, for example, in those caused by mutations in RDH5 or RPE65, both of which encode proteins with known function in the visual cycle. The thickening of the ELM may be an OCT abnormality that precedes atrophy in the early stages of STGD

    1. ABCA4P28592/1STGDc.6285T>Cp.D2095Drs1801555

      Case#: Patient P28592/1,

      DiseaseAssertion: STGD

      FamilyInfo: n/a

      CasePresentingHPOs:

      CaseHPOFreeText:

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: Custom 300-kb retinal resequencing chip. PCR amplification, DNA fragmentation, and chip hybridization. Hybridization signals were analyzed using Sequence pilot module seq-C mutation detection software (2009). This resequencing approach was validated by Sanger sequence technology.

      PreviouslyPublished: n/a

      Variant: c.635G>A p.(R212H); c.6445C>T p.(R2149X); c.6285T>C p.(D2095D)

      CAID: CA285825

      SupplementalData: n/a

    1. Seventy eyes (38 patients), of which 46 (66%) were female and 24 (34%) male, with RPE atrophy secondary to ABCA4 -related retinopathy (age [years], 45.51 ± 16.70; range 14–78) were included in the study ( Table 1 and see Table, Supplemental Digital Content 2 , http://links.lww.com/IAE/B170 , which shows the individual baseline and progression data of all included eyes).

      Case#: Patient #34, female, 61yo at baseline visit, "intermediate" age of onset

      DiseaseAssertion: ABCA4-related retinopathy with secondary RPE atrophy

      FamilyInfo: n/a

      CasePresentingHPOs:

      CaseHPOFreeText: Inclusion criteria were defined as 1) presence of at least one mutated allele in ABCA4 (NM_000350.2) in Sanger sequencing with multiplex ligation-dependent probe amplification analysis or next-generation sequencing 2) a compatible phenotype with flecks at the level of the RPE consistent with ABCA4 -related Stargardt disease 3) presence of RPE atrophy, and 4) serial examinations with an interval of at least 6 months. RPE atrophy to the end-stage (i.e., demarcated lesions with ≥90% darkness of the optic disc under short-wavelength excitation light, DDAF) that previously showed highest interreader agreement.7 The size of DDAF has to be at least 0.05 mm 2 (each single atrophic area in cases of multifocality), and the entire lesion must be completely visualized on the AF image at each visit to be advanced for analysis. Self-reported symptom onset into early-onset (≤10 years), intermediate-onset (11–44 years), and late-onset (≥45 years). ff-ERG based Category: Group 1 contained eyes with normal scotopic and photopic responses; Group 2, eyes with normal scotopic responses, but reduced (over 2 SDs) photopic B-wave and 30-Hz flicker amplitudes; and Group 3, eyes with impairment of both rod- and cone-driven responses. BCVA: OD=n/a, OS=1 [LogMAR] .

      CaseNotHPOs:

      CaseNotHPOFreeText: Insufficient pupil dilation, additional retinal pathology, previous retinal treatment, or other ocular comorbidities substantially affecting image quality led to exclusion from the study

      GenotypingMethod: Sanger sequencing with multiplex ligation-dependent probe amplification analysis or next-generation sequencing

      PreviouslyPublished: possible since Birtel is an author on this paper and the probands both have the same second variant as in PMID: 29555955

      Variant: allele 1: c.3468C>G p.(Tyr1156*) allele 2: c.5059A>T p.(Ile1687Phe)

      ClinVar: n/a

      CAID: CA341290648

      SupplementalData: The supplemental table linked here contains genotype and phenotype information.

    2. Seventy eyes (38 patients), of which 46 (66%) were female and 24 (34%) male, with RPE atrophy secondary to ABCA4 -related retinopathy (age [years], 45.51 ± 16.70; range 14–78) were included in the study ( Table 1 and see Table, Supplemental Digital Content 2 , http://links.lww.com/IAE/B170 , which shows the individual baseline and progression data of all included eyes).

      Case#: Patient #32, male, 60yo at baseline visit, "late" age of onset

      DiseaseAssertion: ABCA4-related retinopathy with secondary RPE atrophy

      FamilyInfo: n/a

      CasePresentingHPOs:

      CaseHPOFreeText: Inclusion criteria were defined as 1) presence of at least one mutated allele in ABCA4 (NM_000350.2) in Sanger sequencing with multiplex ligation-dependent probe amplification analysis or next-generation sequencing 2) a compatible phenotype with flecks at the level of the RPE consistent with ABCA4 -related Stargardt disease 3) presence of RPE atrophy, and 4) serial examinations with an interval of at least 6 months. RPE atrophy to the end-stage (i.e., demarcated lesions with ≥90% darkness of the optic disc under short-wavelength excitation light, DDAF) that previously showed highest interreader agreement.7 The size of DDAF has to be at least 0.05 mm 2 (each single atrophic area in cases of multifocality), and the entire lesion must be completely visualized on the AF image at each visit to be advanced for analysis. Self-reported symptom onset into early-onset (≤10 years), intermediate-onset (11–44 years), and late-onset (≥45 years). ff-ERG based Category: Group 1 contained eyes with normal scotopic and photopic responses; Group 2, eyes with normal scotopic responses, but reduced (over 2 SDs) photopic B-wave and 30-Hz flicker amplitudes; and Group 3, eyes with impairment of both rod- and cone-driven responses. BCVA: OD=0, OS=0 [LogMAR] .

      CaseNotHPOs:

      CaseNotHPOFreeText: Insufficient pupil dilation, additional retinal pathology, previous retinal treatment, or other ocular comorbidities substantially affecting image quality led to exclusion from the study

      GenotypingMethod: Sanger sequencing with multiplex ligation-dependent probe amplification analysis or next-generation sequencing

      PreviouslyPublished: n/a

      Variant: allele 1: c.52C>T/p.(Arg18Trp) // c.1715G>A/p.(Arg572Gln) // c.2828G>A/p.(Arg943Gln) allele 2: c.1588G>A/p.(Gly863Ala) // c.5603A>T/p.(Asn1868Ile)

      ClinVar: 7900

      CAID: CA226918

      SupplementalData: The supplemental table linked here contains genotype and phenotype information.

    3. Seventy eyes (38 patients), of which 46 (66%) were female and 24 (34%) male, with RPE atrophy secondary to ABCA4 -related retinopathy (age [years], 45.51 ± 16.70; range 14–78) were included in the study ( Table 1 and see Table, Supplemental Digital Content 2 , http://links.lww.com/IAE/B170 , which shows the individual baseline and progression data of all included eyes).

      Case#: Patient #33, female, 64yo at baseline visit, "late" age of onset

      DiseaseAssertion: ABCA4-related retinopathy with secondary RPE atrophy

      FamilyInfo:

      CasePresentingHPOs:

      CaseHPOFreeText: Inclusion criteria were defined as 1) presence of at least one mutated allele in ABCA4 (NM_000350.2) in Sanger sequencing with multiplex ligation-dependent probe amplification analysis or next-generation sequencing,9 2) a compatible phenotype with flecks at the level of the RPE consistent with ABCA4 -related Stargardt disease,9 3) presence of RPE atrophy, and 4) serial examinations with an interval of at least 6 months. RPE atrophy to the end-stage (i.e., demarcated lesions with ≥90% darkness of the optic disc under short-wavelength excitation light, DDAF) that previously showed highest interreader agreement.7 The size of DDAF has to be at least 0.05 mm 2 (each single atrophic area in cases of multifocality), and the entire lesion must be completely visualized on the AF image at each visit to be advanced for analysis. Self-reported symptom onset into early-onset (≤10 years), intermediate-onset (11–44 years), and late-onset (≥45 years). ff-ERG based Category: Group 1 contained eyes with normal scotopic and photopic responses; Group 2, eyes with normal scotopic responses, but reduced (over 2 SDs) photopic B-wave and 30-Hz flicker amplitudes; and Group 3, eyes with impairment of both rod- and cone-driven responses. BCVA: OD=0.4, OS=1.1 [LogMAR] .

      CaseNotHPOs:

      CaseNotHPOFreeText: Insufficient pupil dilation, additional retinal pathology, previous retinal treatment, or other ocular comorbidities substantially affecting image quality led to exclusion from the study

      GenotypingMethod: Sanger sequencing with multiplex ligation-dependent probe amplification analysis or next-generation sequencing

      PreviouslyPublished: possible since Birtel is an author on this paper and the probands both have the same second variant as in PMID: 29555955

      Variant: allele 1: c.3468C>G p.(Tyr1156*) allele 2: c.5059A>T p.(Ile1687Phe); c.4297G>A p.(Val1433Ile)

      ClinVar: n/a

      CAID: CA341290648

      SupplementalData: The supplemental table linked here contains genotype and phenotype information.

    1. Disease-causing mutations were identified in 74% of 251 consecutive MD/CCRD patients

      Case#: Patient #9, female, 23yo at onset, 32yo at report, German

      DiseaseAssertion: macular dystrophy or cone-rod dystrophy

      FamilyInfo: inheritance= sporadic. phase not confirmed, but no other affected family members and no parental consanguinity

      CasePresentingHPOs:

      CaseHPOFreeText: reduced visual acuity, erg scotopic= reduced, erg-photopic=reduced

      CaseNotHPOs:

      CaseNotHPOFreeText: syndromic retinal disease, age-related macular degeneration, central serous retinopathy, autoimmune retinopathy, retinal vascular disease, achromatopsia, X-linked retinoschisis, North Carolina macular dystrophy

      CasePreviousTesting: n/a

      GenotypingMethod: Sanger sequencing of ABCA4

      PreviouslyPublished: n/a

      Variant: c.1654G>A p.Val552Ile; c.4771G>A p.Gly1591Arg; c.1622T>C p.Leu541Pro; c.3113C>T p.Ala1038Val

      CAID: CA239745

      SupplementalData: Supplementary table 1

    2. Disease-causing or likely disease-causing mutations were identified in 185 out of 251 patients (74%) with MD/CCRD (Supplementary Table 1).

      Case#: Patient #42, female, 31yo at onset, German

      DiseaseAssertion: macular dystrophy or cone-rod dystrophy

      FamilyInfo: phase not confirmed, but assumed in case of parental consanguinity or if only siblings were affected

      CasePresentingHPOs: HP:0012508

      CaseHPOFreeText:

      CaseNotHPOs:

      CaseNotHPOFreeText: syndromic retinal disease, age-related macular degeneration, central serous retinopathy, autoimmune retinopathy, retinal vascular disease, achromatopsia, X-linked retinoschisis, North Carolina macular dystrophy

      PreviouslyPublished: n/a

      Variant: c.3468C>G (p.Tyr1156Ter); c.5059A>T (p.Ile1687Phe) Sanger sequencing of ABCA4

      ClinVar: n/a

      CAID: CA341290648

      SupplementalData: Supplementary table 1

    1. Supplementary data. bjophthalmol-2018-312064supp004.pdf

      This variant is found on pg 2 in proband 11019. Compound heterozygous for c.4532C>A, (p.Pro1511His). JHU institute (US). Said to have Stargardt based on the following criteria: "(1) patients (at least 6 years old) with at least two ABCA4 variants or one ABCA4 variant associated with a typical STGD1 phenotype and (2) presence of a well-defined atrophic lesion with/without flecks at the most recent visit of at least 300 µm in diameter (the total area of all lesions <12 mm2)." No additional details provided

    2. Supplementary data. bjophthalmol-2018-312064supp004.pdf

      This variant is found on pg 21 in proband 13047. Compound heterozygous for c.5882G>A p.Gly1961Glu. Said to have Stargardt based on the following criteria: "(1) patients (at least 6 years old) with at least two ABCA4 variants or one ABCA4 variant associated with a typical STGD1 phenotype and (2) presence of a well-defined atrophic lesion with/without flecks at the most recent visit of at least 300 µm in diameter (the total area of all lesions <12 mm2)." No additional details provided

    1. We identified 255 patients (87.9 %) harboring biallelic ABCA4 variants, 27 probands (9.3 %) with two or three variants but lacking familial segregation analysis, and eight patients (2.8 %) with monoallelic ABCA4 variants (Supplemental Table S4). We detected 268 distinct ABCA4 variants, consisting of 114 missense, 35 nonsense, 34 frameshift deletion or insertion, 31 canonical splice variants, 13 noncanonical splice site variants, 9 in-frame deletion or insertion, 9 DIVs, 4 structural variations, and 19 complex variants (Fig. 2).

      Case#: Patient#010046, Chinese, female, 28yo at onset

      DiseaseAssertion: stargardt

      FamilyInfo: n/a

      CasePresentingHPOs: STGD1 diagnosis based on the following criteria: "a bilateral central vision defect; fundus displaying a beaten-bronze appearance and/or orange-yellow flecks in the retina from the macula to the midperiphery; fluorescein angiography presenting with a typical dark choroid; and normal to subnormal ERG results." stage 2( numerous yellow-whitish flecks throughout the posterior pole) BCVA=0.05/ 0.05

      CaseHPOFreeText:

      CaseNotHPOs:

      CaseNotHPOFreeText:

      PreviouslyPublished: PMID: 26780318

      Variant: p.P2097S; p.A1773V phase unknown

      ClinVar: 2202780

      CAID: CA341277622

      SupplementalData: supplementary table S4 has phenotype information

    2. We identified 255 patients (87.9 %) harboring biallelic ABCA4 variants, 27 probands (9.3 %) with two or three variants but lacking familial segregation analysis, and eight patients (2.8 %) with monoallelic ABCA4 variants (Supplemental Table S4). We detected 268 distinct ABCA4 variants, consisting of 114 missense, 35 nonsense, 34 frameshift deletion or insertion, 31 canonical splice variants, 13 noncanonical splice site variants, 9 in-frame deletion or insertion, 9 DIVs, 4 structural variations, and 19 complex variants (Fig. 2).

      Case#: Patient#010633, Chinese, female, 20yo at onset

      DiseaseAssertion: stargardt

      FamilyInfo: n/a

      CasePresentingHPOs: STGD1 diagnosis based on the following criteria: "a bilateral central vision defect; fundus displaying a beaten-bronze appearance and/or orange-yellow flecks in the retina from the macula to the midperiphery; fluorescein angiography presenting with a typical dark choroid; and normal to subnormal ERG results." BCVA=0.05/ 0.05

      CaseHPOFreeText:

      CaseNotHPOs:

      CaseNotHPOFreeText:

      PreviouslyPublished: n/a

      Variant: p.P2097S; c.3468C>G p.(Tyr1156*) phase unknown

      ClinVar: 2202780;

      CAID: CA341277622;

      SupplementalData: supplementary table S4 has phenotype information

    1. V1 H1 Exon 36.1–3 G>A chr1:94,484,001 c.5196+1137G>A 4 4 0 0

      Case#: Braun Family 4 Proband (from left to right, top to bottom of available pedigrees), male

      DiseaseAssertion: Stargardt

      FamilyInfo: Both parents are unaffected, but only mother has genotype information available since father is deceased. c.5196+1137G>A maternally inherited. c.1022-1035fs inferred to be inherited from the father since other siblings also have this variant. Proband has 1 affected sister with the same genotype, and 2 siblings that were unaffected heterozygotes

      CasePresentingHPOs:

      CaseHPOFreeText: "five or more of the following features of ABCA4-associated retinal disease: decreased visual acuity before age 20, decreased visual acuity as the first visual symptom, symmetrical fundus findings, pisciform flecks, beaten metal macular atrophy, bulls-eye maculopathy, peripapillary sparing, vermillion fundus, masked choroid on fluorescein angiography, nummular pigment overlying extensive macular atrophy, central outer retinal atrophy on optical coherence tomography and central scotomas on Goldmann perimetry."

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: one plausible disease-causing mutation detected in ABCA4 after assessing the entire coding sequence and canonical retinal splice junctions with automated bidirectional Sanger sequencing using an ABI 3730 sequencer

      PreviouslyPublished: n/a

      Variant: c.5196+1137G>A; c.1022-1035fs

      ClinVar: 438100

      CAID: CA26843511

      SupplementalData: pedigree in fig s2

    1. MD-0324ABCA423c.3386G>Tp.Arg1129Leu1c.3G>Ap.Met1Ile ^15YesABCR400 + NGSThis study

      Case#: MD-0324 Proband,

      DiseaseAssertion: STGD

      FamilyInfo: Family MD-0324

      CasePresentingHPOs:

      CaseHPOFreeText: STGD diagnosed based on "bilateral central vision loss; fundus presenting with a beaten-bronze appearance and/or the presence of orange-yellow flecks in the retina from the posterior pole to the mid-periphery; fluorescein angiography showing typical dark choroid; and normal to subnormal electroretinogram (ERGs)."

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: Haplotype analysis, ABCR400, NGS

      PreviouslyPublished: n/a

      Variant:c.3386G>T p.Arg1129Leu; c.3G>A p.Met1Ile

      ClinVar: n/a

      CAID: CA341289040

      SupplementalData: n/a

    2. MD-0247ABCA423c.3386G>Tp.Arg1129Leu47c.6410G>Ap.Cys2137Tyr12YesABCR400 + dHPLC + HRMAguirre-Lamban et al. 2009 (8); Aguirre-Lamban et al. 2010 (16)

      Case#: Family MD-0247 Proband, 12yo at onset

      DiseaseAssertion: AR cone rod dystrophy

      FamilyInfo:

      CasePresentingHPOs:

      CaseHPOFreeText: STGD diagnosed based on "bilateral central vision loss; fundus presenting with a beaten-bronze appearance and/or the presence of orange-yellow flecks in the retina from the posterior pole to the mid-periphery; fluorescein angiography showing typical dark choroid; and normal to subnormal electroretinogram (ERGs)." VA loss, VF loss, BCVA=0.05/0.1, cone-pattern on ERG

      CaseNotHPOs:

      CaseNotHPOFreeText:

      PreviouslyPublished: Aguirre-Lamban et al. 2009 (8); PMID: 19959634

      Variant: c.6410G>A (p.Cys2137Tyr); c.3386G>T (p.Arg1129Leu) found by ABCR400 + dHPLC + HRM

      ClinVar: 2202779; 99224

      CAID: CA341277358; CA227116

      SupplementalData:

    1. Peripheral venous blood was obtained from 24 clinically diagnosed Korean STGD patients, followed by extraction of genomic DNAs. Using exome sequencing we investigated gene mutations for the adenosine triphosphate-binding cassette, subfamily A, member 4 (ABCA4) elongation of very-long-chain fatty acids 4 (ELOVL4), and prominin 1 (PROM1), and confirmed gene mutations by the direct sequencing of polymerase chain reaction products.

      Paper is said to contain this variant based on LOVD entry, but this paper is not publicly available. Requested from library. Annotation on stable PDF. No individual phenotype provided

    1. ABCA4

      Case#: 1 male, 6 years old, from Taiwanese and Korean decent.

      DiseaseAssertion: ABCA4-related retinopathy Stargardt disease

      FamilyInfo: Single affected individual. Paternal uncle presented with Stargart disease previously, and Taiwanese and Korean descent underwent genetic testing to identify two pathogenic variants in the ABCA4 gene. One of the variants found was the same ABCA4 variant from the originally affected individual. No additional family information is provided in text.

      CasePresentingHPOs: HP:0000529 - progressive visual loss, HP:0025010 - Foveal atrophy, HP:0000603 - Central scotoma, HP:0007663 - Decreased visual acuity, HP:0030602 - Abnormal fundus autofluorescence imaging, HP:0007984 - ERG: Reduced dark-adapted b-wave amplitude, HP:0000512 - Abnormal electroretinogram, HP:0020032 - Hyperreflective retinal dots on OCT

      CaseHPOFreeText: peripapillary sparing was observed on fundus autofluorescence imaging.

      CaseNotHPOs: HP:0012045 - Retinal flecks

      CaseNotHPOFreeText: N/A

      Genotyping Method: Genetic testing was used and after sequencing two variants were found on the ABCA4 gene.

      PreviouslyPublished: N/A

      Variant: NM_000350.3(ABCA4):c.3523-2A>G

      Variant: NM_000350.3(ABCA4):c.2249T>C (p.Leu750Pro)

      ClinVar: Variation ID: 866764

      ClinVar: Variation ID: 417984

      CAID: N/A

      SupplementalData: N/A

    1. STGD-4F30ABCA4c.4555delAp.T1519Rfs*5HeteroARN/AN/AN/AN/AYABCA4c.6397T>Cp.C2133RHeteroD1D2D322.80Y

      Case#: Sporadic Patient #4, female, Chinese, 30yo at report

      DiseaseAssertion: STGD

      FamilyInfo: n/a, sporadic case

      CasePresentingHPOs:

      CaseHPOFreeText:

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: WES with Sanger sequencing confirmation

      PreviouslyPublished: no

      Variant: c.4555delA p.(T1519Rfs*5); c.6397T>C p.(C2133R)

      ClinVar: 2021273; 2733921

      CAID: CA341277387; CA645372203

      SupplementalData:

    1. 10-year-old girl

      Case#: Patient female, 10y, ethnicity not reported

      DiseaseAssertion: Stargardt disease (STGD1), early onset

      FamilyInfo: autosomal recessive inheritance; co-segregation of variants in parents (each heterozygous). Pedigree shown in Figure 1A. One unaffected sibling reported.

      CasePresentingHPOs: HP:0007663, HP:0007754, HP:0002587, HP:0030636, HP:0000548

      CaseHPOFreeText: early-onset visual decline (age 7), symmetric disease in both eyes, hyperautofluorescent ring surrounding macular atrophy, lipofuscin accumulation, photoreceptor degeneration.

      CaseNotHPOs: HP:0007707

      CaseNotHPOFreeText: normal anterior segment on slit lamp exam; no external ocular abnormalities reported.

      Genotyping Method: Sanger sequencing confirmation; variant identification likely via next-generation sequencing (not explicitly stated).

      PreviouslyPublished: n/a

      Variant: ABCA4 NM_000350.2: c.6817-713A>G; c.3259G>A (p.Glu1087Lys)

      ClinVar: n/a

      CAID: CA2837995439, CA227097

      SupplementalData: phenotype and validation data in Figures 1–5 and Supplemental Figures S1–S5

    1. Case 1A 55-year-old male was examined for long-standing central visual impairment since age 18. Family history was not significant for ocular disease. His best-corrected visual acuity of 20/350 OD and 20/200 OS was consistent with measurements over the last 20 years. Spherical refractive error measured −3.5 OD and −2.0 OS. Anterior segment examination was unremarkable and applanation tonometry measured 17 mmHg OD and 14 mmHg OS. Posterior segment examination and autofluorescence imaging were significant for sharply demarcated central and peripapillary zones of atrophy and the absence of fleck lesions (Figure 1, A–D). Humphrey visual fields demonstrated bilateral central scotomas with eccentric fixation at the inferior border. ERG examination was subnormal and similar to results obtained 22 years ago.Open in a separate windowFig. 1Case 1. STGD with peripapillary atrophy and mutations P1380L and IVS40 + 5G>A. A, Autofluorescence OD. B, Color Photo OD. C, Autofluorescence OS. D, Color Photo OS. All show marked peripapillary and macular atrophy with a sharply demarcated zone of sparing between them. These characteristics caused initial diagnostic confusion with choroidal sclerosis.Genetic testing was employed for further diagnostic information and two heterozygous ABCA4 mutations, P1380L and IVS40 + 5G>A, were identified and classified as disease-causing alleles, thereby confirming the diagnosis of STGD.

      Case#: Hwang Case 1, US, male, 55yo at report, 18yo at onset

      DiseaseAssertion: Stargardt disease

      FamilyInfo: Family history was not significant for ocular disease

      CasePresentingHPOs: HP:0007663, HP:0500087, HP:0000603, HP:0000512

      CaseHPOFreeText: BCVA of 20/350 OD and 20/200 OS. Spherical refractive error measured −3.5 OD and −2.0 OS. Posterior segment examination and autofluorescence imaging were significant for sharply demarcated central and peripapillary zones of atrophy and the absence of fleck lesions (Figure 1, A–D). Humphrey visual fields demonstrated bilateral central scotomas with eccentric fixation at the inferior border.

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: Genotyping was performed by the ABCR400 microarray followed by direct sequencing to confirm identified variants.

      PreviouslyPublished: n/a

      Variant: P1380L and IVS40 + 5G>A

      ClinVar: 7904

      CAID: CA129033

      SupplementalData: n/a

    1. A nationwide genetic analysis of inherited retinal diseases in Israel as assessed by the Israeli inherited retinal disease consortium (IIRDC)

      PMID: 31456290

      Gene: ABCA4

      HGNCID: HGNC:34

      SupplementalData: as applicable Table S2. Variant found in cohort of 2,420 families including 3,413 individuals with inherited retinal diseases in Israel. Likely, this is the same family reported in PMID 29706639.

      Total number of families: 1; phenotype/s: CRD; NM_000350.2:c.4895dup, p.(Asn1632Lysfs*14)

    1. 5137 Mo 25 3/10 / FC ND / c.32T>C(1) ND/p.Leu11Pro

      Case#: Maia-Lopes Family 17 Proband 5137, Portuguese, 25yo at onset

      DiseaseAssertion: STGD

      FamilyInfo: Family 17

      CasePresentingHPOs:

      CaseHPOFreeText: moderate central fundus changes, vision: 3/10 / FC

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: ABCR400 microarray, dHPLC

      PreviouslyPublished: n/a

      Variant: ND / c.32T>C(1); ND/p.Leu11Pro

      ClinVar: 99217

      CAID: CA227106

      SupplementalData: n/a

    1. Panel-based NGS testing was performed for all recruited patients for the identification of disease-causing variants. All patients recruited in this present cohort had two allele disease-causing ABCA4 variants confirmed according to the American College of Medical Genetics and Genomics guidelines (Supplementary Table S2).

      Case#: Family F23 Patient P26, 42yo

      DiseaseAssertion: MD-C

      FamilyInfo: family f23

      CasePresentingHPOs:

      CaseHPOFreeText:

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: capture-based next-generation sequencing (NGS) testing

      PreviouslyPublished: n/a

      Variant: c.4555del(;)6119G>A genotype b (a patient harboring a severe/null variant and a missense or in-frame insertion/deletion variant)

      CAID: CA232815

      SupplementalData: table s2

    1. Supplement 4Click here for additional data file.(480K, pdf)Supplement 5Click here for additional data file.(460K, pdf)

      This variant was found in 92 of the 670 alleles in this cohort (Supplement 4). Supplement 5 has the individuals listed with their genotypes, but only mentions variants that were classified as VUS/LP/P, so it is unknown which individuals specifically had this variant or which other variants they also had.

    1. G818EER51 ± 1363 ± 5111 ± 825 ± 312 ± 32Moderate/Severe

      When expressed in transfected HEK293T cells and quantified by Western blotting, this variant was in the range of 40%-52%. This variant has a basal ATPase activity of 63% ± 5% compared to WT (100%) and was categorized as class 2 (partial reduction in expression and basal ATPase activity that was modestly stimulated by N-Ret-PE) with a moderate/severe predicted severity.

    1. 19 F 16 c.5714+5G>A c.4469G>A

      Case#: Patient 19, female, age 16

      DiseaseAssertion: STGD

      FamilyInfo: diagnosis of autosomal recessive STGD based on the pedigree and clinical phenotype of fleck deposits with or without genetic testing

      CasePresentingHPOs: HP:0000608, HP:0000007, HP:0030610, HP:0030500

      CaseHPOFreeText: Macular degeneration. autosomal recessive, Photoreceptor outer segment loss on macular OCT, Yellow/white lesions of the macula

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: n/a

      Genotyping Method: n/a

      PreviouslyPublished: n/a

      Variant: Allele 1: NM_000350.3:c.5714+5G>A Allele 2: NM_000350.3:c.4469G>A

      ClinVar: Allele 1: NM_000350.3(ABCA4):c.5714+5G>A Allele 2: NM_000350.3(ABCA4):c.4469G>A (p.Cys1490Tyr)

      CAID: Allele 1: CA227338 Allele 2: CA227198

      SupplementalData: composite mask analysis shown in figure 3 for patient 19, show large areas of matched degeneration and isolated IS/OS loss

    1. Table S9. List of unique causative variants detected in 858 STGD probands mmc8.xlsx (19.3KB, xlsx) Table S11. STGD1 cases with at least two (likely) causal ABCA4 variants mmc9.xlsx (39.6KB, xlsx)

      Case#: DNAID 072962/Pat272, male

      DiseaseAssertion: STGD1

      FamilyInfo: n/a

      CasePresentingHPOs:

      CaseHPOFreeText: "In classic STGD1, loss of central vision starts around the second decade of life, but both early- and late-onset subtypes have been extensively described." No patient-specific details provided

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: smMIPs sequencing of the complete ABCA4 locus

      PreviouslyPublished: n/a

      Variant: c.6416G>A (p.Arg2139Gln); c.6445C>T (p.Arg2149Ter)

      CAID: CA956878

      SupplementalData: tables s9 and s11

    1. 14-year-old patient

      Case#: 14-year-old, female, asian (Chinese) patient

      DiseaseAssertion: ABCA-4 associated retinal dystrophy

      FamilyInfo: The effect of the deep intronic variant on splicing was validated by a minigene assay in our previous study (Tian et al., 2022). Co-segregation analysis result exhibited that the variant c.1222C>T p.(Arg408Ter) came from the female parent, and the deep intronic variant c.2919-884G>T p.[Phe973LeufsTer3,=] from the male parent

      ParentalTesting: Co-segregation analysis result exhibited that the variant c.1222C>T p.(Arg408Ter) came from the female parent, and the deep intronic variant c.2919-884G>T p.[Phe973LeufsTer3,=] from the male parent

      CasePresentingHPOs: HP:0000556

      CasePhenotypeFreeText: ABCA4-associated retinal dystrophy

      CaseNotHPOs: NR

      CaseNotPhenotypeFreeText: NR

      CasePreviousTesting:NR

      GenotypingMethod:

      In the present study, we recruited a 14-year-old female patient diagnosed with ABCA4-RD. Biallelic variants were found in this patient, including the nonsense variant c.1222C>T p.(Arg408Ter) detected by Sanger sequencing and the deep intronic variant c.2919-884G>T p.[Phe973LeufsTer3,=] identified by next-generation sequencing.

      We isolated peripheral blood mononuclear cells (PBMCs) from the patient’s peripheral venous blood and introduced three episomal plasmids containing transcription factors OCT4, SOX2, NANOG, LIN28, c-MYC, KLF4, and SV40LT into PBMCs. The reprogramming iPSC line, named BIOi003-A, showed stabilized morphology (Fig. 1A) and a normal karyotype in culture (Fig. 1B). Then, the endogenous expression of two pluripotent biomarkers, POU5F1 and NANOG, was detected (Table 2). The expression levels were compared with human embryonic stem cell line H1(hESC-H1) and mesenchymal stem cell line P3 (MSC-P3) by qRT-PCR (Fig. 1C). Surface markers SSEA4 and TRA-1–81 were analyzed by flow cytometry (Fig. 1D). the ABCA4 compound heterozygous variants c.(1222C>T;2919-884G>T) p.[Arg408Ter;Phe973LeufsTer3,=] were verified by Sanger sequencing (Fig. 1E). Furthermore, the teratoma assay exhibited the differentiation capacity of this iPSC line in vivo (Fig. 1F). Short tandem repeats (STR) analysis exhibited that the PBMCs and the iPSC line came from the same patient. PCR proved negative for mycoplasma contamination

      Variant: NM_000350.3(ABCA4):c.1222C>T (p.Arg408Ter) and NM_000350.3(ABCA4):c.2919G>T (p.Leu973Phe)

      LegacyVariant: c.1222C>T (p.Arg408Ter) and c.2919G>T (p.Leu973Phe)

      ClinVar: 99035 and NR

      CAID: CA179692 and CA341275270

      gnomeAD: 1:94544895 G / A and NR

      MultipleGeneVariants: No

      PreviouslyPublished:No

      AdditionalInfo: One patient was homozygous at the ABCA-4 gene, so there is information about both variants in one annotation because there is only one patient.

    1. 23-year-old female with a history of STGD oculus uterque (OU) and severe myopia OU who presented for refractive surgery evaluation. The patient’s STGD was double allele ABCA4 genotype proven with two different mutations, p.Arg2107Cys:c.6319C>T and p.Gly607Arg:c.1819G>A

      Case#: Patient 23, Female

      DiseaseAssertion: STGD

      FamilyInfo: Not evaluated

      CasePresentingHPOs: HP:0000609, HP:0012632, HP:0007906

      CaseHPOFreeText: The patient also had a history of bilateral optic nerve hypoplasia, labile intraocular pressure (IOP), and ocular hypertension without glaucoma.

      CaseNotHPOs: n/a

      CaseNotHPOFreeText:n/a

      Genotyping Method: Not listed

      PreviouslyPublished: n/a

      Variant: p.Arg2107Cys:c.6319C>T and p.Gly607Arg:c.1819G>A

      ClinVar: 635988, 99087

      CAID: CA956906, CA226936

      SupplementalData: Phenotype shown in case report with continued treatment below

    1. A 37-year-old East Asian woman

      Case#: Patient 37 yo, F, Eastern Asian, onset at 8yo (early onset), Heterozygous, AR inheritance patterns

      DiseaseAssertion:Retinitis Pigmentosa (RP)

      FamilyInfo: Two brothers with RP and father with poor vision at 30 yo but no formal diagnosis

      CasePresentingHPOs: HP:0003581, HP:0007737, HP:0000510, HP:000133

      CaseHPOFreeText: N/A

      CaseNotHPOs: HP: 0000007, HP:0007663, HP:0000505, HP:0000662

      CaseNotHPOFreeText: N/A

      Genotyping Method: N/A

      PreviouslyPublished: Panel of genes; RP1L1, RP-GRIP1, ABCA4, and GRM6

      Variant: c.5501T>C p.(Met1019Ille)

      ClinVar: 1481089

      SupplementalData: see tables 1 and 2 for genetic variant panel

    1. proband at age 5, targeted testing of ABCA4

      Case#: 1

      DiseaseAssertion: stargardt disease originally but didn;t have fishtail flecks

      FamilyInfo: both unaffected parents carrying heterozygous MFSD8 variants

      CasePresentingHPOs:HP:0001272

      CaseHPOFreeText:at 5 years old BCVA was measured at a Snellen equivalent at 0.13 in both eyes, at age 8, BCVA had decreased to 0.07 in both eyes, complete absence of all retinal responses on full‐field flash ERG, No fishtail flecks typical of Stargardt disease were observed

      CaseNotHPOs: n/a

      CaseNotHPOFreeText:n/a

      Genotyping Method: HaloPlex target enrichment kit amplified and sequenced using illumina, then WES

      PreviouslyPublished: n/a

      Variant: c.3113C>T p.(Ala1038Val)

      ClinVar: https://www.ncbi.nlm.nih.gov/clinvar/variation/7894/

      SupplementalData: MFSD8 variants identified

    1. In 20 patients (19 STGD and 1 CRD), 18 different genotypes were identified (Table 1). Except p.Arg187His and p.Tyr954Ser variants, the rest of changes were previously reported as disease-associated allele. 14 The p.Arg187His and p.Tyr954Ser variants were not found in 100 ethnically matched control chromosomes. All the mutations identified in the 20 patients except one were detected by HRM for sensitivity of 95%; however, only 16 variants were identified by dHPLC for sensitivity of 80%.  Table 1. View Table Mutations AnalyzedTable 1. Mutations Analyzed Family Exon Genotype Mutation Detected by dHPLC Mutation Detected by HRM Nucleotide Change Amino Acid Change ARDM-167 5 c.560G>A p.Arg187His No Yes ARDM-257 5 c.560G>A p.Arg187His No Yes ARDM-164 6 c.700C>T p.Gln234X Yes Yes ARDM-135 8 c.1029_1030insT p.Asn344fsX Yes No ARDM-240 15 c.2285C>A p.Ala762Glu Yes Yes ARDM-248 19 c.2861A>C p.Tyr954Ser Yes Yes ARDM-90 — IVS21-2A>T — Yes Yes ARDM-40 27 c.3943C>T p.Gln1315X Yes Yes ARDM-158 30 c.4537delC p.Gln1513fsX1525 Yes Yes ARDM-38 33 c.4739delT p.Leu1580fs Yes Yes ARDM-163 36 c.5172G>T p.Trp1724Cys Not Yes ARDM-197 36 c.5172G>T p.Trp1724Cys Yes Yes ARDM-181 — IVS38+5G>A — Yes Yes ARDM-125 40 — p.KNLFA1876dup Yes Yes ARDM-183 43 c.5929G>A(False −) p.Gly1977Ser(False −) Yes Yes ARDM-146 44 c.6140T>A p.lle2047Asn Yes Yes ARDM-174 — IVS44+2T>A — Yes Yes ARDM-247 47 c.6410G>A p.Cys2137Tyr* Yes Yes ARDM-84 47 c.6410G>A p.Cys2137Tyr† No Yes ARDM-225 48 c.6559C>T p.Gln2187X Yes Yes  Previously unreported mutations are shown in bold. *  Mutation in heterozygous. †  Mutation in homozygous. Homozygous sequence alteration (p.Cys2137Tyr) could be identified from wild-type by HRM analyses (Fig. 1). In contrast, dHPLC did not distinguish any homozygous mutation, except when we mixed it, in a 1:1 proportion, with a previously sequenced wild-type sample at the end of each PCR session and before heteroduplex formation.

      Case#: Family MD-0247/ARDM-247 Proband, 12yo at onset

      DiseaseAssertion: AR cone rod dystrophy

      FamilyInfo:

      CasePresentingHPOs:

      CaseHPOFreeText: STGD diagnosed based on "bilateral central vision loss; fundus presenting with a beaten-bronze appearance and/or the presence of orange-yellow flecks in the retina from the posterior pole to the mid-periphery; fluorescein angiography showing typical dark choroid; and normal to subnormal electroretinogram (ERGs)." VA loss, VF loss, BCVA=0.05/0.1, cone-pattern on ERG

      CaseNotHPOs:

      CaseNotHPOFreeText:

      PreviouslyPublished: PMID: 19028736

      Variant: c.6410G>A (p.Cys2137Tyr); c.3386G>T (p.Arg1129Leu) found by ABCR400 + dHPLC + HRM

      ClinVar: 2202779

      CAID: CA341277358

      SupplementalData: n/a

    1. Case 2

      Case#:2, 29-year-old woman

      DiseaseAssertion:NR

      FamilyInfo:NR

      CasePresentingHPOs:

      CaseHPOFreeText:decreased ability to focus, increasing difficulty to adapt in the dark, normal visual acuity in both eyes (logMar BCVA OD/OS: 0.02), PERG responses were diminished in both eyes.

      CaseNotHPOs:

      CaseNotHPOFreeText:

      Genotyping Method: ”Analysis of the ABCA4 gene”

      PreviouslyPublished:No

      Variant:NM_000350.3:c.1805G>A, NM_000350.3:c.6079C>T

      ClinVar: 99085, 7882

      CAID:CA226933, CA119129

      SupplementalData:

    1. Microarray-based mutation analysis of the ABCA4 gene in Spanish patients with Stargardt disease: evidence of a prevalent mutated allele

      PMID: 16917483

      Gene: ABCA4

      Disease: Stargardt

      This paper was referenced by PMID: 23755871 as containing variant c.6410G>A (p.Cys2137Tyr), but this variant foes not appear to be in the text or tables

    1. 13/8 35 0.017 163 0 – 3 – 3 4 L541P R1098C

      Case#: Patient 13, 35yo

      DiseaseAssertion: STGD

      FamilyInfo: Family 8

      CasePresentingHPOs:

      CaseHPOFreeText: Visual acuity=0.017. OCT ft (μm)=163. MP (dB)=0. Fundus=3(extensive atrophic-appearing RPE changes). ERG=3(abnormal responses involving both rods and cones). mfERG=4(subnormal mfERG in the entire test field (0°–30°) plus pathologic Ganzfeld ERG).

      CaseNotHPOs:

      CaseNotHPOFreeText:

      GenotypingMethod: PCR of coding regions, intron/exon boundaries, and 5′ and 3′ regions of ABCA4; Standard cycle-sequencing reactions with BigDye Terminator

      PreviouslyPublished:

      Variant: L541P; R1098C

      CAID: CA226911;

      SupplementalData: n/a

    1. 48-year-old man

      Case#:48-year old man, onset at 13-years old

      DiseaseAssertion: STGD1

      FamilyInfo: n/a

      CasePresentingHPOs: HP:0003621, HP:0025147, HP:0011507, HP:0030329, HP:0030610, HP:0007722, HP:0007703, HP:0007663

      CaseHPOFreeText: BCVA was 20/200 bilaterally and refractive error was OD: −1.50/+0.50 × 149° and OS: −1.50/+0.25 × 161°. Hyperautofluorescent transitional zone in each eye more pronounced in right eye. The left eye showed a complete defect of the RPE-Bruch membrane complex with herniation of the outer retina. Maximum horizontal diameter of this RPE-Bruch membrane complex defect was 266um.

      CaseNotHPOs: HP:0000510, HP:0000548, HP:0007984

      CaseNotHPOFreeText: No defect observed in the RPE and Bruch membrane in right eye. Patient had normal cone and rod responses on ERG

      Genotyping Method: ABCR 600 micro-array chip

      PreviouslyPublished: n/a

      Variant: NM_000350.3(ABCA4):c.4216C>T (p.His1406Tyr), NM_000350.3(ABCA4):c.5882G>A (p.Gly1961Glu)

      ClinVar: 99259, 7888

      SupplementalData: n/a

    1. STGD-02

      Case#: Case2, Sex:Female, Age:15

      DiseaseAssertion: STGD

      FamilyInfo: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: Clinical Notes: Few yellowish Flecks without autofluorescence. General notes: participant presented with atypical macular degeneration.

      CaseNotHPOs:n/a

      CaseNotHPOFreeText: n/a

      Genotyping Method: Exome sequencing data generation. Additional sequencing targeted amplification fo PRPH2 and ELOVL4 using PCR.

      PreviouslyPublished: n/a

      Variant: Variant 1 given as p.G1961E; NM_000350.3:c.5882G>A p.(Gly1961Glu) . Variant 2 given as p.Q636X; NM_000350.3(ABCA4):c.1906C>T (p.Gln636Ter).

      ClinVar: Variation ID: 7888 ; Variation ID: 265012

      CAID: ; CA10588302

      SupplementalData: Proband variant information given in Table 1.

    1. 3 39 6/6 1 RCD Val552Ile 6/6

      Case#: Case 3, 39yo

      DiseaseAssertion: BEM, RCD

      FamilyInfo: n/a

      CasePresentingHPOs:

      CaseHPOFreeText: a ring of increased AF surrounding decreased foveal AF, visual acuity= 6/6, 6/6

      CaseNotHPOs:

      CaseNotHPOFreeText: acquired toxic aetiology

      GenotypingMethod: The entire coding sequence (50 exons), including exon–intron boundaries, of the ABCA4 gene of each patient was screened using single‐stranded conformational polymorphism (SSCP) analysis and direct sequencing.

      PreviouslyPublished: n/a

      Variant: Val552Ile heterozygous

      CAID: CA239745

      SupplementalData: n/a