Novel mutations in the OPA1 gene and associated clinical features in Japanese patients with optic atrophy.
OBJECTIVE
Autosomal dominant optic atrophy (ADOA) is characterized by symmetrical bilateral optic atrophy associated with reduced corrected visual acuity (VA), central or centrocecal scotoma, and color vision disturbances. The disease is genetically heterogeneous, and the OPA1 gene has been identified as the only causative gene. The aims of this study were to identify and report mutations in the OPA1 gene in Japanese patients with ADOA and to describe the clinical features associated with the mutations.


METHODS
Molecular genetic study and observational case reports.


METHODS
Nine unrelated Japanese families with optic atrophy and 8 isolated cases of optic atrophy.


METHODS
Genomic DNA was extracted from peripheral leukocytes, and all exons containing the open reading frame of the OPA1 gene and the flanking intron splice sites were sequenced directly. Complete ophthalmologic examinations were performed.


METHODS
Direct sequencing of the OPA1 gene and clinical evaluations including VA, visual field, color vision, and disc appearance.


RESULTS
Ten different heterozygous mutations, including 6 novel mutations, were detected in the OPA1 gene. The identified mutations included 5 deletions/insertions (c.2061delA, c.2098_2103delCTTAAA, c.2538insT, c.2591insC, and c.2708_2711delTTAG), 4 nonsense mutations (c.112C>T [p.R38X], c.181C>T [p.Q61X], c.946A>T [p.R316X], and c.2713C>T [p.R905X]), and 1 missense mutation (c.1635C>A [p.S545R]). The most common mutation in Caucasians (c.2708_2711delTTAG) was found in 3 unrelated families, suggesting that it is a mutational hot spot. We detected an OPA1 mutation in 8 of 9 familial cases of optic atrophy and in 4 of 8 cases that were initially considered to be sporadic from the patients' family histories. Examinations of family members of 2 sporadic probands revealed the existence of other family members with the OPA1 mutations whose phenotype was very mild or within normal limits. This indicates that patients with ADOA sometimes seem to be sporadic because of the extensive variation in the phenotype or, alternatively, a low penetrance of ADOA.


CONCLUSIONS
OPA1 gene mutations are causative in most familial cases of ADOA in Japanese. Sporadic cases of optic atrophy frequently may be caused by OPA1 mutations in the Japanese population. Molecular genetic examinations are useful in determining the hereditary patterns in some cases of optic atrophy.
Nakamura
Makoto
M
Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan. makonaka@med.nagoya-u.ac.jp
Lin
Jian
J
Ueno
Shinji
S
Asaoka
Ryo
R
Hirai
Toshie
T
Hotta
Yoshihiro
Y
Miyake
Yozo
Y
Terasaki
Hiroko
H
D000328:Adult; D000368:Aged; D044466:Asian People / Q000235:genetics*; D002648:Child; D018389:Codon, Nonsense; D003117:Color Vision Defects / Q000209:etiology; D004252:DNA Mutational Analysis; D004251:DNA Transposable Elements; D005260:Female; D020558:GTP Phosphohydrolases / Q000235:genetics*; D017353:Gene Deletion; D005799:Genes, Dominant; D014644:Genetic Variation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D020125:Mutation, Missense; D009896:Optic Atrophy / Q000150:complications / Q000235:genetics* / Q000473:pathology; D019683:Penetrance; D010641:Phenotype; D012607:Scotoma / Q000209:etiology
D018389:Codon, Nonsense; D004251:DNA Transposable Elements; D020558:GTP Phosphohydrolases; C415198:OPA1 protein, human