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Leber congenital amaurosis 11(LCA11)

MedGen UID:
326698
Concept ID:
C1840284
Disease or Syndrome
Synonyms: IMPDH1-Related Leber Congenital Amaurosis; LCA11
 
Gene (location): IMPDH1 (7q32.1)
 
Monarch Initiative: MONDO:0013454
OMIM®: 613837

Definition

Leber congenital amaurosis comprises a group of early-onset childhood retinal dystrophies characterized by vision loss, nystagmus, and severe retinal dysfunction. Patients usually present at birth with profound vision loss and pendular nystagmus. Electroretinogram (ERG) responses are usually nonrecordable. Other clinical findings may include high hypermetropia, photodysphoria, oculodigital sign, keratoconus, cataracts, and a variable appearance to the fundus (summary by Chung and Traboulsi, 2009). For a general description and a discussion of genetic heterogeneity of LCA, see 204000. [from OMIM]

Additional description

From MedlinePlus Genetics
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.

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.

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.  https://medlineplus.gov/genetics/condition/leber-congenital-amaurosis

Clinical features

From HPO
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.
Reduced visual acuity
MedGen UID:
65889
Concept ID:
C0234632
Finding
Diminished clarity of vision.
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

Weiss JS, Willoughby CE, Abad-Morales V, Turunen JA, Lisch W
Cornea 2022 Nov 1;41(11):1337-1344. Epub 2022 Jul 4 doi: 10.1097/ICO.0000000000002857. PMID: 36219210
Daich Varela M, Cabral de Guimaraes TA, Georgiou M, Michaelides M
Br J Ophthalmol 2022 Apr;106(4):445-451. Epub 2021 Mar 12 doi: 10.1136/bjophthalmol-2020-318483. PMID: 33712480Free PMC Article
Uyhazi KE, Aravand P, Bell BA, Wei Z, Leo L, Serrano LW, Pearson DJ, Shpylchak I, Pham J, Vasireddy V, Bennett J, Aleman TS
Invest Ophthalmol Vis Sci 2020 May 11;61(5):30. doi: 10.1167/iovs.61.5.30. PMID: 32428231Free PMC Article

Recent clinical studies

Etiology

Zhang Q, Sun J, Liu Z, Wang H, Zhou H, Liu W, Jia H, Li N, Li T, Wang F, Sun X
Am J Ophthalmol 2024 Oct;266:235-247. Epub 2024 Jun 15 doi: 10.1016/j.ajo.2024.06.013. PMID: 38880373
Daich Varela M, Jeste M, de Guimaraes TAC, Mahroo OA, Arno G, Webster AR, Michaelides M
Am J Ophthalmol 2024 Oct;266:255-263. Epub 2024 May 19 doi: 10.1016/j.ajo.2024.05.007. PMID: 38768745
Zobor D, Brühwiler B, Zrenner E, Weisschuh N, Kohl S
Int J Mol Sci 2023 May 17;24(10) doi: 10.3390/ijms24108915. PMID: 37240262Free PMC Article
Russell SR, Drack AV, Cideciyan AV, Jacobson SG, Leroy BP, Van Cauwenbergh C, Ho AC, Dumitrescu AV, Han IC, Martin M, Pfeifer WL, Sohn EH, Walshire J, Garafalo AV, Krishnan AK, Powers CA, Sumaroka A, Roman AJ, Vanhonsebrouck E, Jones E, Nerinckx F, De Zaeytijd J, Collin RWJ, Hoyng C, Adamson P, Cheetham ME, Schwartz MR, den Hollander W, Asmus F, Platenburg G, Rodman D, Girach A
Nat Med 2022 May;28(5):1014-1021. Epub 2022 Apr 4 doi: 10.1038/s41591-022-01755-w. PMID: 35379979Free 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

Diagnosis

Yang P, Pardon LP, Ho AC, Lauer AK, Yoon D, Boye SE, Boye SL, Roman AJ, Wu V, Garafalo AV, Sumaroka A, Swider M, Viarbitskaya I, Aleman TS, Pennesi ME, Kay CN, Fujita KP, Cideciyan AV
Lancet 2024 Sep 7;404(10456):962-970. doi: 10.1016/S0140-6736(24)01447-8. PMID: 39244273
Zhang Q, Sun J, Liu Z, Wang H, Zhou H, Liu W, Jia H, Li N, Li T, Wang F, Sun X
Am J Ophthalmol 2024 Oct;266:235-247. Epub 2024 Jun 15 doi: 10.1016/j.ajo.2024.06.013. PMID: 38880373
Daich Varela M, Jeste M, de Guimaraes TAC, Mahroo OA, Arno G, Webster AR, Michaelides M
Am J Ophthalmol 2024 Oct;266:255-263. Epub 2024 May 19 doi: 10.1016/j.ajo.2024.05.007. PMID: 38768745
Russell SR, Drack AV, Cideciyan AV, Jacobson SG, Leroy BP, Van Cauwenbergh C, Ho AC, Dumitrescu AV, Han IC, Martin M, Pfeifer WL, Sohn EH, Walshire J, Garafalo AV, Krishnan AK, Powers CA, Sumaroka A, Roman AJ, Vanhonsebrouck E, Jones E, Nerinckx F, De Zaeytijd J, Collin RWJ, Hoyng C, Adamson P, Cheetham ME, Schwartz MR, den Hollander W, Asmus F, Platenburg G, Rodman D, Girach A
Nat Med 2022 May;28(5):1014-1021. Epub 2022 Apr 4 doi: 10.1038/s41591-022-01755-w. PMID: 35379979Free PMC Article
Daich Varela M, Cabral de Guimaraes TA, Georgiou M, Michaelides M
Br J Ophthalmol 2022 Apr;106(4):445-451. Epub 2021 Mar 12 doi: 10.1136/bjophthalmol-2020-318483. PMID: 33712480Free PMC Article

Therapy

Yang P, Pardon LP, Ho AC, Lauer AK, Yoon D, Boye SE, Boye SL, Roman AJ, Wu V, Garafalo AV, Sumaroka A, Swider M, Viarbitskaya I, Aleman TS, Pennesi ME, Kay CN, Fujita KP, Cideciyan AV
Lancet 2024 Sep 7;404(10456):962-970. doi: 10.1016/S0140-6736(24)01447-8. PMID: 39244273
Russell SR, Drack AV, Cideciyan AV, Jacobson SG, Leroy BP, Van Cauwenbergh C, Ho AC, Dumitrescu AV, Han IC, Martin M, Pfeifer WL, Sohn EH, Walshire J, Garafalo AV, Krishnan AK, Powers CA, Sumaroka A, Roman AJ, Vanhonsebrouck E, Jones E, Nerinckx F, De Zaeytijd J, Collin RWJ, Hoyng C, Adamson P, Cheetham ME, Schwartz MR, den Hollander W, Asmus F, Platenburg G, Rodman D, Girach A
Nat Med 2022 May;28(5):1014-1021. Epub 2022 Apr 4 doi: 10.1038/s41591-022-01755-w. PMID: 35379979Free PMC Article
Napier MP, Selvan K, Hayeems RZ, Shuman C, Chitayat D, Sutherland JE, Day MA, Héon E
Eye (Lond) 2022 Nov;36(11):2088-2093. Epub 2021 Sep 16 doi: 10.1038/s41433-021-01763-z. PMID: 34531550Free PMC Article
Daich Varela M, Cabral de Guimaraes TA, Georgiou M, Michaelides M
Br J Ophthalmol 2022 Apr;106(4):445-451. Epub 2021 Mar 12 doi: 10.1136/bjophthalmol-2020-318483. PMID: 33712480Free PMC Article
Stein L, Roy K, Lei L, Kaushal S
Expert Opin Biol Ther 2011 Mar;11(3):429-39. doi: 10.1517/14712598.2011.557358. PMID: 21299439

Prognosis

Chiu W, Lin TY, Chang YC, Isahwan-Ahmad Mulyadi Lai H, Lin SC, Ma C, Yarmishyn AA, Lin SC, Chang KJ, Chou YB, Hsu CC, Lin TC, Chen SJ, Chien Y, Yang YP, Hwang DK
Int J Mol Sci 2021 Apr 26;22(9) doi: 10.3390/ijms22094534. PMID: 33926102Free PMC Article
Ma DJ, Lee HS, Kim K, Choi S, Jang I, Cho SH, Yoon CK, Lee EK, Yu HG
BMC Med Genomics 2021 Mar 10;14(1):74. doi: 10.1186/s12920-021-00874-6. PMID: 33691693Free PMC Article
Uyhazi KE, Aravand P, Bell BA, Wei Z, Leo L, Serrano LW, Pearson DJ, Shpylchak I, Pham J, Vasireddy V, Bennett J, Aleman TS
Invest Ophthalmol Vis Sci 2020 May 11;61(5):30. doi: 10.1167/iovs.61.5.30. PMID: 32428231Free PMC Article
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
Dharmaraj SR, Silva ER, Pina AL, Li YY, Yang JM, Carter CR, Loyer MK, El-Hilali HK, Traboulsi EK, Sundin OK, Zhu DK, Koenekoop RK, Maumenee IH
Ophthalmic Genet 2000 Sep;21(3):135-50. PMID: 11035546

Clinical prediction guides

Upadhyaya A, Padhy SK, Teja N, Chattannavar G, Dutta S, Pochaboina V, Balasubramanian J, Kannabiran C, Takkar B, Bhate M, Jalali S, Parameswarappa DC
Indian J Ophthalmol 2025 May 1;73(5):683-690. Epub 2024 Dec 27 doi: 10.4103/IJO.IJO_545_24. PMID: 39728598Free PMC Article
Yang P, Pardon LP, Ho AC, Lauer AK, Yoon D, Boye SE, Boye SL, Roman AJ, Wu V, Garafalo AV, Sumaroka A, Swider M, Viarbitskaya I, Aleman TS, Pennesi ME, Kay CN, Fujita KP, Cideciyan AV
Lancet 2024 Sep 7;404(10456):962-970. doi: 10.1016/S0140-6736(24)01447-8. PMID: 39244273
Zhang Q, Sun J, Liu Z, Wang H, Zhou H, Liu W, Jia H, Li N, Li T, Wang F, Sun X
Am J Ophthalmol 2024 Oct;266:235-247. Epub 2024 Jun 15 doi: 10.1016/j.ajo.2024.06.013. PMID: 38880373
Rodriguez-Martinez AC, Higgins BE, Tailor-Hamblin V, Malka S, Cheloni R, Collins AM, Bladen J, Henderson R, Moosajee M
Int J Mol Sci 2023 Sep 11;24(18) doi: 10.3390/ijms241813932. PMID: 37762234Free PMC Article
Ma DJ, Lee HS, Kim K, Choi S, Jang I, Cho SH, Yoon CK, Lee EK, Yu HG
BMC Med Genomics 2021 Mar 10;14(1):74. doi: 10.1186/s12920-021-00874-6. PMID: 33691693Free PMC Article

Recent systematic reviews

Sobh M, Lagali PS, Ghiasi M, Montroy J, Dollin M, Hurley B, Leonard BC, Dimopoulos I, Lafreniere M, Fergusson DA, Lalu MM, Tsilfidis C
Transl Vis Sci Technol 2023 Nov 1;12(11):24. doi: 10.1167/tvst.12.11.24. PMID: 37982768Free PMC Article
Burgess FR, Hall HN, Megaw R
Asia Pac J Ophthalmol (Phila) 2022 Jul-Aug 01;11(4):380-391. Epub 2022 Aug 30 doi: 10.1097/APO.0000000000000545. PMID: 36041151
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
Tuohy GP, Megaw R
Biomolecules 2021 May 19;11(5) doi: 10.3390/biom11050760. PMID: 34069580Free PMC Article

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