<?xml version="1.0" encoding="UTF-8"?>
<article article-type="research-article" dtd-version="1.3" xml:lang="en">
  <front>
    <journal-meta>
      <journal-title-group>
        <journal-title>Czech and Slovak Ophthalmology</journal-title>
      </journal-title-group>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id">499</article-id>
      <article-categories>
        <subj-group>
          <subject>Original article</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>The Molecular Genetic Cause and Clinical Findings in two Probands with Stargardt Disease</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Kousal</surname>
            <given-names>Bohdan</given-names>
          </name>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Záhlava</surname>
            <given-names>Jiří</given-names>
          </name>
        </contrib>
      </contrib-group>
      <pub-date date-type="pub" publication-format="electronic">
        <day>20</day>
        <month>11</month>
        <year>2014</year>
      </pub-date>
      <issue>6</issue>
      <elocation-id>4</elocation-id>
      <abstract>
        <p>Purpose: The aim of our study was to describe the phenotype and to perform molecular genetic investigation in two probands of Czech origin diagnosed with Stargardt disease (STGD). Methods: Both males underwent ocular examination including assessment by high-resolution spectral domain optical coherence tomography (SD-OCT). DNA was isolated from venous blood. Mutation detection was performed using the ABCA4 genotyping microarray (Asper Ophthalmics, Estonia). Results: The best corrected visual acuity in proband 1 (aged 39 years) was 0.1 bilaterally, and 0.05 in proband 2 (aged 26 years). Fundus examination showed typical multiple yellow-white lesions and macular atrophy. Alterations of retinal pigment epithelium, retinal thinning and disruption of the photoreceptor inner segment ellipsoid band were detected with an SD-OCT. Two known diseasecausing mutations in ABCA4 were identified in proband 1; c.4234C&gt;T, p.(Gln1412*) in exon 28; and c.5882G&gt;A, p.(Gly1961Glu) in exon 42. Only one pathogenic change was detected in proband 2; c.1988G&gt;A, p.(Trp663*) in exon 14. A second change, anticipated because of the recessive status of the disease, was not identified. Conclusion: The frequency and full spectrum of ABCA4 mutations in Czech patients with inherited retinal disorders is yet to be established. The inability to detect a second pathogenic change in ABCA4 coding sequences in proband 2 warrants further investigation.</p>
      </abstract>
      <kwd-group>
        <kwd>Stargardt disease</kwd>
        <kwd>ABCA4</kwd>
        <kwd>mutation</kwd>
        <kwd>SD-OCT</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <back>
    <ref-list>
      <title>References</title>
      <ref id="R11377">
        <mixed-citation>Aguirre-Lamban, J., Riveiro-Alva- rez, R., Maia-Lopes, S., et al.: Molecular analysis of the ABCA4 gene for reliable detection of allelic variations in Spanish patients: identification of 21 novel variants. Br J Ophthalmol, 2009; 93(5): 614–21.</mixed-citation>
      </ref>
      <ref id="R11378">
        <mixed-citation>Aleman, TS., Cideciyan, AV., Wind- sor, EA., et al.: Macular pigment and lutein supplementation in ABCA4- -associated retinal degenerations. In- vest Ophthalmol Vis Sci, 2007; 48(3): 1319–29.</mixed-citation>
      </ref>
      <ref id="R11379">
        <mixed-citation>Allikmets, R.: Further evidence for an association of ABCR alleles with age-re- lated macular degeneration. The Inter- national ABCR Screening Consortium. Am J Hum Genet, 2000; 67(2): 487–91.</mixed-citation>
      </ref>
      <ref id="R11380">
        <mixed-citation>Allikmets, R.: Simple and complex ABCR: genetic predisposition to reti- nal disease. Am J Hum Genet, 2000; 67(4): 793–9.</mixed-citation>
      </ref>
      <ref id="R11381">
        <mixed-citation>Allikmets, R., Shroyer, NF., Singh, N., et al.: Mutation of the Stargardt disease gene (ABCR) in age-related macular degeneration. Science, 1997; 277(5333): 1805–7.</mixed-citation>
      </ref>
      <ref id="R11382">
        <mixed-citation>Allikmets, R., Singh, N., Sun, H., et al.: A photoreceptor cell-specific ATP- -binding transporter gene (ABCR) is mutated in recessive Stargardt macu- lar dystrophy. Nat Genet, 1997; 15(3): 236–46.</mixed-citation>
      </ref>
      <ref id="R11383">
        <mixed-citation>Bellmann, C., Holz, FG., Schapp, O., et al.: Topography of fundus autofluorescence with a new confocal scanning laser ophthalmoscope. Oph- thalmologe, 1997; 94(6): 385–91.</mixed-citation>
      </ref>
      <ref id="R11384">
        <mixed-citation>Braun, TA., Mullins, RF., Wagner, AH., et al.: Non-exomic and synonymous variants in ABCA4 are an impor- tant cause of Stargardt disease. Hum Mol Genet, 2013; 22(25): 5136–45.</mixed-citation>
      </ref>
      <ref id="R11385">
        <mixed-citation>Briggs, CE., Rucinski, D., Rosen- feld, PJ., et al.: Mutations in ABCR (ABCA4) in patients with Stargardt macular degeneration or conerod de- generation. Invest Ophthalmol Vis Sci, 2001; 42(10): 2229–36.</mixed-citation>
      </ref>
      <ref id="R11386">
        <mixed-citation>Burke, TR., Tsang, SH., Zernant, J., et al.: Familial discordance in Stargar- dt disease. Mol Vis, 2012; 18: 227–33.</mixed-citation>
      </ref>
      <ref id="R11387">
        <mixed-citation>Cella, W., Greenstein, VC., Zernant- -Rajang, J., et al.: G1961E mutant allele in the Stargardt disease gene ABCA4 causes bull’s eye maculopathy. Exp Eye Res, 2009; 89(1): 16–24.</mixed-citation>
      </ref>
      <ref id="R11388">
        <mixed-citation>Cremers, FP., Van de Pol, DJ., Van Driel, M., et al.: Autosomal recessive retinitis pigmentosa and cone-rod dys- trophy caused by splice site mutations in the Stargardt’s disease gene ABCR. Hum Mol Genet, 1998; 7(3): 355–62.</mixed-citation>
      </ref>
      <ref id="R11389">
        <mixed-citation>Downs, K., Zacks, DN., Caruso, R., et al.: Molecular testing for heredi - tary retinal disease as part of clinical care. Arch Ophthalmol, 2007; 125(2): 252–8.</mixed-citation>
      </ref>
      <ref id="R11390">
        <mixed-citation>Edwards, AO., Donoso, LA., Ritter, R., 3rd. A novel gene for autosomal dominant Stargardt-like macular dys- trophy with homology to the SUR4 pro- tein family. Invest Ophthalmol Vis Sci, 2001; 42(11): 2652–63.</mixed-citation>
      </ref>
      <ref id="R11391">
        <mixed-citation>Ergun, E., Hermann, B., Wirtitsch, M., et al.: Assessment of central visual function in Stargardt’s disease/fundus flavimaculatus with ultrahigh-resolution optical coherence tomography. In- vest Ophthalmol Vis Sci, 2005; 46(1): 310–6.</mixed-citation>
      </ref>
      <ref id="R11392">
        <mixed-citation>Fishman, GA.: Historical evolution in the understanding of Stargardt ma- cular dystrophy. Ophthalmic Genet, 2010; 31(4): 183–9.</mixed-citation>
      </ref>
      <ref id="R11393">
        <mixed-citation>Fishman, GA., Stone, EM., Eliason, DA., et al.: ABCA4 gene sequence variations in patients with autosomal recessive cone-rod dystrophy. Arch Ophthalmol, 2003; 121(6): 851–5.</mixed-citation>
      </ref>
      <ref id="R11394">
        <mixed-citation>Fishman, GA., Stone, EM., Grover, S., et al.: Variation of clinical expression in patients with Stargardt dys- trophy and sequence variations in the ABCR gene. Arch Ophthalmol, 1999; 117(4): 504-10.</mixed-citation>
      </ref>
      <ref id="R11395">
        <mixed-citation>Fujinami, K., Zernant, J., Chana, RK., et al.: ABCA4 gene screening by next-generation sequencing in a Bri- tish cohort. Invest Ophthalmol Vis Sci, 2013; 54(10): 6662–74.</mixed-citation>
      </ref>
      <ref id="R11396">
        <mixed-citation>Hargitai, J., Zernant, J., Somfai, GM., et al.: Correlation of clinical and genetic findings in Hungarian patients with Stargardt disease. Invest Oph- thalmol Vis Sci. 2005; 46(12): 4402–8.</mixed-citation>
      </ref>
      <ref id="R11397">
        <mixed-citation>Hentze, MW., Kulozik, AE.: A perfect message: RNA surveillance and non- sense-mediated decay. Cell, 1999; 96(3): 307–10.</mixed-citation>
      </ref>
      <ref id="R11398">
        <mixed-citation>Holz, FG.: Autofluorescence imaging of the macula. Ophthalmologe, 2001; 98(1): 10-8.</mixed-citation>
      </ref>
      <ref id="R11399">
        <mixed-citation>Itabashi, R., Katsumi, O., Mehta, MC., et al.: Stargardt’s disease/fun- dus flavimaculatus: psychophysical and electrophysiologic results. Grae- fes Arch Clin Exp Ophthalmol, 1993; 231(10): 555–62.</mixed-citation>
      </ref>
      <ref id="R11400">
        <mixed-citation>Jaakson, K., Zernant, J., Kulm, M., et al.: Genotyping microarray (gene chip) for the ABCR (ABCA4) gene. Hum Mutat, 2003; 22(5): 395–403.</mixed-citation>
      </ref>
      <ref id="R11401">
        <mixed-citation>Lachapelle, P., Little, JM., and Roy, MS.: The electroretinogram in Star- gardt’s disease and fundus flavima- culatus. Doc Ophthalmol, 1989; 73(4): 395–404.</mixed-citation>
      </ref>
      <ref id="R11402">
        <mixed-citation>Martinez-Mir, A., Paloma, E., Allik- mets, R., et al.: Retinitis pigmentosa caused by a homozygous mutation in the Stargardt disease gene ABCR. Nat Genet, 1998; 18(1): 11–2.</mixed-citation>
      </ref>
      <ref id="R11403">
        <mixed-citation>Mata, NL., Weng, J., Travis, GH.: Biosynthesis of a major lipofuscin flu- orophore in mice and humans with ABCR-mediated retinal and macular degeneration. Proc Natl Acad Sci U S A, 2000; 97(13): 7154–9.</mixed-citation>
      </ref>
      <ref id="R11404">
        <mixed-citation>Maugeri, A., van Driel, MA., Van de Pol, DJ., et al.: The 2588G—&gt;C mutation in the ABCR gene is a mild frequent founder mutation in the Western European population and allows the classification of ABCR mutations in patients with Stargardt disease. Am J Hum Genet, 1999; 64(4): 1024–35.</mixed-citation>
      </ref>
      <ref id="R11405">
        <mixed-citation>Molday, RS., Zhang, K.: Defective lipid transport and biosynthesis in recessive and dominant Stargardt macular degeneration. Prog Lipid Res, 2010; 49(4): 476–92.</mixed-citation>
      </ref>
      <ref id="R11406">
        <mixed-citation>Radu, RA., Han, Y., Bui, TV., et al.: Reductions in serum vitamin A arrest accumulation of toxic retinal fluorophores: a potential therapy for treatment of lipofuscin-based retinal diseases. Invest Ophthalmol Vis Sci, 2005; 46(12): 4393–401.</mixed-citation>
      </ref>
      <ref id="R11407">
        <mixed-citation>Radu, RA., Yuan, Q., Hu, J., et al.: Accelerated accumulation of lipofuscin pigments in the RPE of a mouse model for ABCA4-mediated retinal dystrophies following Vitamin A supplementation. Invest Ophthalmol Vis Sci, 2008; 49(9): 3821–9.</mixed-citation>
      </ref>
      <ref id="R11408">
        <mixed-citation>Rencová, E., Studnička, J., Marák, J., et al.: Koincidence lokalizace defektů vrstvy junkce IS/OS fotoreceptorů na SD OCT s funkčními poruchami v případû Stargardtovy choroby. Čes a slov Oftal, 2012; 68(2): 84–88.</mixed-citation>
      </ref>
      <ref id="R11409">
        <mixed-citation>Rivera, A., White, K., Stohr, H., et al.: A comprehensive survey of sequence variation in the ABCA4 (ABCR) gene in Stargardt disease and age-related macular degeneration. Am J Hum Genet, 2000; 67(4): 800–13.</mixed-citation>
      </ref>
      <ref id="R11410">
        <mixed-citation>Roberts, LJ., Ramesar, RS., reenberg, J.: Clinical utility of the ABCR400 microarray: basing a genetic service on a commercial gene chip. Arch Ophthalmol, 2009; 127(4): 549–54.</mixed-citation>
      </ref>
      <ref id="R11411">
        <mixed-citation>Rosenberg, T., Klie, F., Garred, P., et al.: N965S is a common ABCA4 variant in Stargardt-related retinopathies in the Danish population. Mol Vis, 2007; 13: 1962–9.</mixed-citation>
      </ref>
      <ref id="R11412">
        <mixed-citation>Shroyer, NF., Lewis, RA., Lupski, JR.: Complex inheritance of ABCR mutations in Stargardt disease: linkage disequilibrium, complex alleles, and pseudodominance. Hum Genet, 2000; 106(2): 244–8.</mixed-citation>
      </ref>
      <ref id="R11413">
        <mixed-citation>Schindler, EI., Nylen, EL., Ko, AC., et al.: Deducing the pathogenic contribution of recessive ABCA4 alleles in an outbred population. Hum Mol Genet. 2010; 19(19): 3693–701.</mixed-citation>
      </ref>
      <ref id="R11414">
        <mixed-citation>Simonelli, F., Testa, F., Zernant, J., et al.: Genotype-phenotype correlation in Italian families with Stargardt disease. Ophthalmic Res, 2005; 37(3): 159–67.</mixed-citation>
      </ref>
      <ref id="R11415">
        <mixed-citation>Sohrab, MA., Allikmets, R., Guarnaccia, MM., et al.: Preimplantation genetic diagnosis for stargardt disease. Am J Ophthalmol, 2010; 149(4): 651–655 e2.</mixed-citation>
      </ref>
      <ref id="R11416">
        <mixed-citation>Stanga, PE., Downes, SM., Ahuja, RM., et al.: Comparison of optical coherence tomography and fluorescein angiography in assessing macular edema in retinal dystrophies: preliminary results. Int Ophthalmol, 2001; 23(4-6): 321-5.</mixed-citation>
      </ref>
      <ref id="R11417">
        <mixed-citation>Stavrou, P., Good, PA., Misson, GP., et al.: Electrophysiological findings in Stargardt’s-fundus flavimaculatus disease. Eye (Lond), 1998; 12 ( Pt 6): 953–8.</mixed-citation>
      </ref>
      <ref id="R11418">
        <mixed-citation>Stone, EM., Webster, AR., Vandenburgh, K., et al.: Allelic variation in ABCR associated with Stargardt disease but not age-related macular degeneration. Nat Genet, 1998; 20(4): 328–9.</mixed-citation>
      </ref>
      <ref id="R11419">
        <mixed-citation>Sun, H., Nathans, J.: ABCR: rod photoreceptor-specific ABC transporter responsible for Stargardt disease. Methods Enzymol, 2000; 315: 879–97.</mixed-citation>
      </ref>
      <ref id="R11420">
        <mixed-citation>Valverde, D., Riveiro-Alvarez, R., Aguirre-Lamban, J., et al.: Spectrum of the ABCA4 gene mutations implicated in severe retinopathies in Spanish patients. Invest Ophthalmol Vis Sci, 2007; 48(3): 985–90.</mixed-citation>
      </ref>
      <ref id="R11421">
        <mixed-citation>Vasireddy, V., Wong, P., Ayyagari, R.: Genetics and molecular pathology of Stargardt-like macular degeneration. Prog Retin Eye Res, 2010; 29(3): 191–207.</mixed-citation>
      </ref>
      <ref id="R11422">
        <mixed-citation>Voigt, M., Querques, G., Atmani, K., et al.: Analysis of retinal flecks in fundus flavimaculatus using high-definition spectral-domain optical coherence tomography. Am J Ophthalmol, 2010; 150(3): 330–7.</mixed-citation>
      </ref>
      <ref id="R11423">
        <mixed-citation>Von Ruckmann, A., Fitzke, FW., Bird, AC.: In vivo fundus autofluorescence in macular dystrophies. Arch Ophthalmol, 1997; 115(5): 609–15.</mixed-citation>
      </ref>
      <ref id="R11424">
        <mixed-citation>Webster, AR., Heon, E., Lotery, AJ., et al.: An analysis of allelic variation in the ABCA4 gene. Invest Ophthalmol Vis Sci, 2001; 42(6): 1179–89.</mixed-citation>
      </ref>
      <ref id="R11425">
        <mixed-citation>Yang, Z., Chen, Y., Lillo, C., et al.: Mutant prominin 1 found in patients with macular degeneration disrupts photoreceptor disk morphogenesis in mice. J Clin Invest, 2008; 118(8): 2908–16.</mixed-citation>
      </ref>
      <ref id="R11426">
        <mixed-citation>Yatsenko, AN., Shroyer, NF., Lewis, RA., et al.: Late-onset Stargardt disease is associated with missense mutations that map outside known functional regions of ABCR (ABCA4). Hum Genet, 2001; 108(4): 346–55.</mixed-citation>
      </ref>
      <ref id="R11427">
        <mixed-citation>Zernant, J., Schubert, C., Im, KM., et al.: Analysis of the ABCA4 gene by next-generation sequencing. Invest Ophthalmol Vis Sci. 2011; 52(11): 8479–87.</mixed-citation>
      </ref>
      <ref id="R11428">
        <mixed-citation>Zhang, K., Kniazeva, M., Han, M., et al.: A 5-bp deletion in ELOVL4 is associated with two related forms of autosomal dominant macular dystrophy. Nat Genet, 2001; 27(1): 89–93.</mixed-citation>
      </ref>
    </ref-list>
  </back>
</article>
