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      Characterization of novel RS1 exonic deletions in juvenile X-linked retinoschisis

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          Abstract

          Purpose

          X-linked juvenile retinoschisis (XLRS) is a vitreoretinal dystrophy characterized by schisis (splitting) of the inner layers of the neuroretina. Mutations within the retinoschisis ( RS1) gene are responsible for this disease. The mutation spectrum consists of amino acid substitutions, splice site variations, small indels, and larger genomic deletions. Clinically, genomic deletions are rarely reported. Here, we characterize two novel full exonic deletions: one encompassing exon 1 and the other spanning exons 4–5 of the RS1 gene. We also report the clinical findings in these patients with XLRS with two different exonic deletions.

          Methods

          Unrelated XLRS men and boys and their mothers (if available) were enrolled for molecular genetics evaluation. The patients also underwent ophthalmologic examination and in some cases electroretinogram (ERG) recording. All the exons and the flanking intronic regions of the RS1 gene were analyzed with direct sequencing. Two patients with exonic deletions were further evaluated with array comparative genomic hybridization to define the scope of the genomic aberrations. After the deleted genomic region was identified, primer walking followed by direct sequencing was used to determine the exact breakpoints.

          Results

          Two novel exonic deletions of the RS1 gene were identified: one including exon 1 and the other spanning exons 4 and 5. The exon 1 deletion extends from the 5′ region of the RS1 gene (including the promoter) through intron 1 (c.(−35)-1723_c.51+2664del4472). The exon 4–5 deletion spans introns 3 to intron 5 (c.185–1020_c.522+1844del5764).

          Conclusions

          Here we report two novel exonic deletions within the RS1 gene locus. We have also described the clinical presentations and hypothesized the genomic mechanisms underlying these schisis phenotypes.

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          Most cited references19

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          A perfect message: RNA surveillance and nonsense-mediated decay.

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            X linked retinoschisis.

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              X-linked retinoschisis: clinical phenotype and RS1 genotype in 86 UK patients.

              Inactivating mutations of the gene RS1 lead to X-linked retinoschisis, a progressive retinal dystrophy characterised by schisis within the inner layers of the neuroretina. The mutation spectrum is large and the phenotype variable. To determine whether there is a correlation between mutation type and disease severity. We identified the causative mutation in 86 affected patients and examined each of these patients in detail. Different categories of mutation were compared for each phenotypic characteristic. We found a reduction in visual acuity with increasing age and worsening macular pathology in patients over 30 years old (p < or = 0.001), but there was no correlation between mutation type and severity of disease. Furthermore, we found a wide variation in phenotype even within families. Identifying the causative mutation in patients with X-linked retinoschisis is helpful in confirming diagnosis and in counselling of family members but cannot be used to predict prognosis for an individual patient.
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                Author and article information

                Journal
                Mol Vis
                Mol. Vis
                MV
                Molecular Vision
                Molecular Vision
                1090-0535
                2013
                07 November 2013
                : 19
                : 2209-2216
                Affiliations
                [1 ]Ophthalmic Genetics and Visual Function Branch, National Eye Institute (NEI), National Institutes of Health (NIH), Bethesda, MD
                [2 ]Department of Pediatrics, The University of Oklahoma, Oklahoma City, OK
                [3 ]Office of the Director, National Eye Institute (NEI), National Institutes of Health (NIH), Bethesda, MD
                Author notes
                Correspondence to: Xinjing Wang, Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, 10D43, 10 Center Drive, Bethesda, MD 20892; Phone: (301) 435 4568; FAX: (301) 451 5499; wangx6@ 123456nei.nih.gov
                Dr. Lee is now at Department of Pathology, Korea University, Seoul, Republic of Korea. Dr. Smaoui is now at GeneDx, Rockville, MD.
                Article
                221 2013MOLVIS0260
                3820431
                24227916
                9160c322-996c-4878-8ecc-00877d7a41e0
                Copyright © 2013 Molecular Vision.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited, used for non-commercial purposes, and is not altered or transformed.

                History
                : 02 May 2013
                : 05 November 2013
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                Vision sciences
                Vision sciences

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