Abstract

NR2E3-associated recessive disease in humans is historically defined by congenital night blinding retinopathy, characterized by an initial increase in short-wavelength (S)-cone sensitivity and progressive loss of rod and cone function. The retinal degeneration 7 (rd7) murine model, harboring a recessive mutation in the mouse ortholog of NR2E3, has been a well-studied disease model and recently evaluated as a therapeutic model for NR2E3-associated retinal degenerations. This study aims to draw parallels between human and mouse NR2E3-related disease through examination of spectral domain optical coherence tomography (SD-OCT) imaging between different stage of human disease and its murine counterpart. We propose that SD-OCT is a useful non-invasive diagnostic tool to compare human clinical dystrophy presentation with that of the rd7 mouse and make inference that may be of therapeutically relevance. Additionally, a longitudinal assessment of rd7 disease progression, utilizing available clinical data from our patients as well as extensive retrospective analysis of visual acuity data from published cases of human NR2E3-related disease, was curated to identify further valuable correlates between human and mouse Nr2e3 disease. Results of this study validate the slow progression of NR2E3-associated disease in humans and the rd7 mice and identify SD-OCT characteristics in patients at or near the vascular arcades that correlate well with the whorls and rosettes that are seen also in the rd7 mouse and point to imaging features that appear to be associated with better preserved S-cone mediated retinal function. The correlation of histological findings between rd7 mice and human imaging provides a solid foundation for diagnostic use of pathophysiological and prognostic information to further define characteristics and a relevant timeline for therapeutic intervention in the field of NR2E3-associated retinopathies.

Highlights

  • Previous studies have shown that rod and cone photoreceptor differentiation is heavily regulated by the nuclear hormone receptor (NHR) superfamily, a group of transcription factors that aid in maintaining the homeostatic state of retinal cell processes [16,17,18]

  • We evaluated the ionized calcium molecule 1 (Iba1) to determine microglia or macrophage are found in the binding whorls ofadaptor rd7 retinas, (Iba1)

  • We suggest that the discrepancy between our imaging correlates and those identified by Wang et al [54] may be due to the younger age of the patient in which it was reported and may, represent an early and perhaps transient characteristic of enhanced S-cone syndrome (ESCS) patients

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Summary

Introduction

Development of the neural retina is characterized by the mitotic division and terminal differentiation of pluripotent progenitor cells to produce several distinct classes of cell types in the retina (ganglion, amacrine, cone photoreceptors, bipolar, horizontal, rod photoreceptors, and Müller glia) [1,2,3,4,5,6,7,8,9]. Normal retinogenesis for the various cell types is maintained by both intrinsic transcriptional machinery and extrinsic mitogenic factors to ensure correct cell-fate specification [10,11,12,13,14,15]. Previous studies have shown that rod and cone photoreceptor differentiation is heavily regulated by the nuclear hormone receptor (NHR) superfamily, a group of transcription factors that aid in maintaining the homeostatic state of retinal cell processes [16,17,18].

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