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Leber congenital amaurosis 16(LCA16)

MedGen UID:
481692
Concept ID:
C3280062
Disease or Syndrome
Synonyms: KCNJ13-Related Leber Congenital Amaurosis; LCA16
 
Gene (location): KCNJ13 (2q37.1)
 
Monarch Initiative: MONDO:0013613
OMIM®: 614186

Definition

At least 20 genetic types of Leber congenital amaurosis have been described. The types are distinguished by their genetic cause, patterns of vision loss, and related eye abnormalities.

Leber congenital amaurosis, also known as LCA, is an eye disorder that is present from birth (congenital). This condition primarily affects the retina, which is the specialized tissue at the back of the eye that detects light and color. People with this disorder typically have severe visual impairment beginning at birth or shortly afterward. The visual impairment tends to be severe and may worsen over time.

Leber congenital amaurosis is also associated with other vision problems, including an increased sensitivity to light (photophobia), involuntary movements of the eyes (nystagmus), and extreme farsightedness (hyperopia). The pupils, which usually expand and contract in response to the amount of light entering the eye, do not react normally to light. Instead, they expand and contract more slowly than normal, or they may not respond to light at all.

A specific behavior called Franceschetti's oculo-digital sign is characteristic of Leber congenital amaurosis. This sign consists of affected individuals poking, pressing, and rubbing their eyes with a knuckle or finger. Poking their eyes often results in the sensation of flashes of light called phosphenes. Researchers suspect that this behavior may contribute to deep-set eyes in affected children.

In very rare cases, delayed development and intellectual disability have been reported in people with the features of Leber congenital amaurosis. Because of the visual loss, affected children may become isolated. Providing children with opportunities to play, hear, touch, understand and other early educational interventions may prevent developmental delays in children with Leber congenital amaurosis. [from MedlinePlus Genetics]

Clinical features

From HPO
Photophobia
MedGen UID:
43220
Concept ID:
C0085636
Sign or Symptom
Excessive sensitivity to light with the sensation of discomfort or pain in the eyes due to exposure to bright light.
Nyctalopia
MedGen UID:
10349
Concept ID:
C0028077
Disease or Syndrome
Inability to see well at night or in poor light.
Nystagmus
MedGen UID:
45166
Concept ID:
C0028738
Disease or Syndrome
Rhythmic, involuntary oscillations of one or both eyes related to abnormality in fixation, conjugate gaze, or vestibular mechanisms.
Strabismus
MedGen UID:
21337
Concept ID:
C0038379
Disease or Syndrome
A misalignment of the eyes so that the visual axes deviate from bifoveal fixation. The classification of strabismus may be based on a number of features including the relative position of the eyes, whether the deviation is latent or manifest, intermittent or constant, concomitant or otherwise and according to the age of onset and the relevance of any associated refractive error.
Cataract
MedGen UID:
39462
Concept ID:
C0086543
Disease or Syndrome
A cataract is an opacity or clouding that develops in the crystalline lens of the eye or in its capsule.
Reduced visual acuity
MedGen UID:
65889
Concept ID:
C0234632
Finding
Diminished clarity of vision.
Optic disc pallor
MedGen UID:
108218
Concept ID:
C0554970
Finding
A pale yellow discoloration of the optic disk (the area of the optic nerve head in the retina). The optic disc normally has a pinkish hue with a central yellowish depression.
Visual impairment
MedGen UID:
777085
Concept ID:
C3665347
Finding
Visual impairment (or vision impairment) is vision loss (of a person) to such a degree as to qualify as an additional support need through a significant limitation of visual capability resulting from either disease, trauma, or congenital or degenerative conditions that cannot be corrected by conventional means, such as refractive correction, medication, or surgery.

Professional guidelines

PubMed

Aoun M, Passerini I, Chiurazzi P, Karali M, De Rienzo I, Sartor G, Murro V, Filimonova N, Seri M, Banfi S
Int J Mol Sci 2021 Jul 5;22(13) doi: 10.3390/ijms22137207. PMID: 34281261Free PMC Article
Yi Z, Sun W, Xiao X, Li S, Jia X, Li X, Yu B, Wang P, Zhang Q
Exp Eye Res 2021 Jul;208:108637. Epub 2021 May 26 doi: 10.1016/j.exer.2021.108637. PMID: 34048777
Sumaroka A, Garafalo AV, Semenov EP, Sheplock R, Krishnan AK, Roman AJ, Jacobson SG, Cideciyan AV
Invest Ophthalmol Vis Sci 2019 Jun 3;60(7):2551-2562. doi: 10.1167/iovs.19-27156. PMID: 31212307Free PMC Article

Recent clinical studies

Etiology

Sallum JMF, Kaur VP, Shaikh J, Banhazi J, Spera C, Aouadj C, Viriato D, Fischer MD
Adv Ther 2022 Mar;39(3):1179-1198. Epub 2022 Jan 30 doi: 10.1007/s12325-021-02036-7. PMID: 35098484Free PMC Article
Surl D, Shin S, Lee ST, Choi JR, Lee J, Byeon SH, Han SH, Lim HT, Han J
Mol Vis 2020;26:26-35. Epub 2020 Feb 24 PMID: 32165824Free PMC Article
Xu K, Xie Y, Sun T, Zhang X, Chen C, Li Y
Br J Ophthalmol 2020 Jul;104(7):932-937. Epub 2019 Oct 19 doi: 10.1136/bjophthalmol-2019-314281. PMID: 31630094
Bertsch M, Floyd M, Kehoe T, Pfeifer W, Drack AV
Ophthalmic Genet 2017 Jan-Feb;38(1):22-33. doi: 10.1080/13816810.2016.1266667. PMID: 28177849Free PMC Article
Fulton AB, Hansen RM, Mayer DL
Arch Ophthalmol 1996 Jun;114(6):698-703. doi: 10.1001/archopht.1996.01100130690009. PMID: 8639081

Diagnosis

Sallum JMF, Kaur VP, Shaikh J, Banhazi J, Spera C, Aouadj C, Viriato D, Fischer MD
Adv Ther 2022 Mar;39(3):1179-1198. Epub 2022 Jan 30 doi: 10.1007/s12325-021-02036-7. PMID: 35098484Free PMC Article
Surl D, Shin S, Lee ST, Choi JR, Lee J, Byeon SH, Han SH, Lim HT, Han J
Mol Vis 2020;26:26-35. Epub 2020 Feb 24 PMID: 32165824Free PMC Article
Motta FL, Martin RP, Porto FBO, Wohler ES, Resende RG, Gomes CP, Pesquero JB, Sallum JMF
Genes (Basel) 2019 Dec 24;11(1) doi: 10.3390/genes11010024. PMID: 31878136Free PMC Article
Bertsch M, Floyd M, Kehoe T, Pfeifer W, Drack AV
Ophthalmic Genet 2017 Jan-Feb;38(1):22-33. doi: 10.1080/13816810.2016.1266667. PMID: 28177849Free PMC Article
Coppieters F, De Wilde B, Lefever S, De Meester E, De Rocker N, Van Cauwenbergh C, Pattyn F, Meire F, Leroy BP, Hellemans J, Vandesompele J, De Baere E
Genet Med 2012 Jun;14(6):576-85. Epub 2012 Jan 26 doi: 10.1038/gim.2011.51. PMID: 22261762

Therapy

Maurya S, Mary B, Jayandharan GR
Hum Gene Ther 2019 Dec;30(12):1461-1476. Epub 2019 Nov 26 doi: 10.1089/hum.2019.164. PMID: 31642343Free PMC Article
Zhang W, Li L, Su Q, Gao G, Khanna H
Hum Gene Ther 2018 Jan;29(1):42-50. Epub 2017 Jul 5 doi: 10.1089/hum.2017.049. PMID: 28679290Free PMC Article
Koirala A, Conley SM, Makkia R, Liu Z, Cooper MJ, Sparrow JR, Naash MI
J Control Release 2013 Dec 28;172(3):745-52. Epub 2013 Sep 11 doi: 10.1016/j.jconrel.2013.08.299. PMID: 24035979Free PMC Article
Annear MJ, Bartoe JT, Barker SE, Smith AJ, Curran PG, Bainbridge JW, Ali RR, Petersen-Jones SM
Gene Ther 2011 Jan;18(1):53-61. Epub 2010 Aug 12 doi: 10.1038/gt.2010.111. PMID: 20703309Free PMC Article
Kumar-Singh R
Vision Res 2008 Jul;48(16):1671-1680. Epub 2008 Jun 18 doi: 10.1016/j.visres.2008.05.005. PMID: 18565565Free PMC Article

Prognosis

Wang S, Zhang Q, Zhang X, Wang Z, Zhao P
Graefes Arch Clin Exp Ophthalmol 2016 Nov;254(11):2227-2238. Epub 2016 Jul 16 doi: 10.1007/s00417-016-3428-5. PMID: 27422788
Kuniyoshi K, Sakuramoto H, Yoshitake K, Abe K, Ikeo K, Furuno M, Tsunoda K, Kusaka S, Shimomura Y, Iwata T
Doc Ophthalmol 2014 Jun;128(3):219-28. Epub 2014 Apr 22 doi: 10.1007/s10633-014-9436-z. PMID: 24752437
Chen Y, Zhang Q, Shen T, Xiao X, Li S, Guan L, Zhang J, Zhu Z, Yin Y, Wang P, Guo X, Wang J, Zhang Q
Invest Ophthalmol Vis Sci 2013 Jun 26;54(6):4351-7. doi: 10.1167/iovs.13-11606. PMID: 23661368
Dharmaraj S, Leroy BP, Sohocki MM, Koenekoop RK, Perrault I, Anwar K, Khaliq S, Devi RS, Birch DG, De Pool E, Izquierdo N, Van Maldergem L, Ismail M, Payne AM, Holder GE, Bhattacharya SS, Bird AC, Kaplan J, Maumenee IH
Arch Ophthalmol 2004 Jul;122(7):1029-37. doi: 10.1001/archopht.122.7.1029. PMID: 15249368
Fulton AB, Hansen RM, Mayer DL
Arch Ophthalmol 1996 Jun;114(6):698-703. doi: 10.1001/archopht.1996.01100130690009. PMID: 8639081

Clinical prediction guides

Wang S, Zhang Q, Zhang X, Wang Z, Zhao P
Graefes Arch Clin Exp Ophthalmol 2016 Nov;254(11):2227-2238. Epub 2016 Jul 16 doi: 10.1007/s00417-016-3428-5. PMID: 27422788
Kuniyoshi K, Sakuramoto H, Yoshitake K, Abe K, Ikeo K, Furuno M, Tsunoda K, Kusaka S, Shimomura Y, Iwata T
Doc Ophthalmol 2014 Jun;128(3):219-28. Epub 2014 Apr 22 doi: 10.1007/s10633-014-9436-z. PMID: 24752437
Chen Y, Zhang Q, Shen T, Xiao X, Li S, Guan L, Zhang J, Zhu Z, Yin Y, Wang P, Guo X, Wang J, Zhang Q
Invest Ophthalmol Vis Sci 2013 Jun 26;54(6):4351-7. doi: 10.1167/iovs.13-11606. PMID: 23661368
Galvin JA, Fishman GA, Stone EM, Koenekoop RK
Ophthalmology 2005 Feb;112(2):349-56. doi: 10.1016/j.ophtha.2004.08.023. PMID: 15691574
Fulton AB, Hansen RM, Mayer DL
Arch Ophthalmol 1996 Jun;114(6):698-703. doi: 10.1001/archopht.1996.01100130690009. PMID: 8639081

Recent systematic reviews

Sallum JMF, Kaur VP, Shaikh J, Banhazi J, Spera C, Aouadj C, Viriato D, Fischer MD
Adv Ther 2022 Mar;39(3):1179-1198. Epub 2022 Jan 30 doi: 10.1007/s12325-021-02036-7. PMID: 35098484Free PMC Article

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