Abstract

Stargardt disease (STGD) is the most common hereditary macular degeneration in juveniles, with loss of central vision occurring in the first or second decade of life. The aim of this study is to identify the genetic defects in 33 probands with Stargardt disease. Clinical data and genomic DNA were collected from 33 probands from unrelated families with STGD. Variants in coding genes were initially screened by whole exome sequencing. Candidate variants were selected from all known genes associated with hereditary retinal dystrophy and then confirmed by Sanger sequencing. Putative pathogenic variants were further validated in available family members and controls. Potential pathogenic mutations were identified in 19 of the 33 probands (57.6%). These mutations were all present in ABCA4, but not in the other four STGD-associated genes or in genes responsible for other retinal dystrophies. Of the 19 probands, ABCA4 mutations were homozygous in one proband and compound heterozygous in 18 probands, involving 28 variants (13 novel and 15 known). Analysis of normal controls and available family members in 12 of the 19 families further support the pathogenicity of these variants. Clinical manifestation of all probands met the diagnostic criteria of STGD. This study provides an overview of a genetic basis for STGD in Chinese patients. Mutations in ABCA4 are the most common cause of STGD in this cohort. Genetic defects in approximately 42.4% of STGD patients await identification in future studies.

Highlights

  • Stargardt Disease (STGD), with a world-wide prevalence of at least 1:10,000 [1], is the most common hereditary macular degeneration in juveniles

  • We identified 28 mutations of ABCA4 in 19 of 33 (57.6%) unrelated probands with STGD

  • No potential pathogenic variations were detected in other four STGD-related genes and 209 genes responsible for other forms of retinal dystrophies listed in RetNet (S3 Table)

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Summary

Introduction

Stargardt Disease (STGD), with a world-wide prevalence of at least 1:10,000 [1], is the most common hereditary macular degeneration in juveniles. It is characterized by macular dystrophy associated with loss of central visual in the first or second decade of life, a “beaten-metal” appearance in the fovea or parafoveal region, yellowish flecks around the macula or in posterior area of the retina, progressive atrophy of the bilateral foveal retinal pigment epithelium, and the “dark choroid” sign on Fundus Fluorescein Angiography (FFA) in 80% of patients [2,3]. Mutations Detection in 33 Probands with STGD

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