Inherited Optic Neuropathies: Real-World Experience in the Paediatric Neuro-Ophthalmology Clinic

Inherited optic neuropathies affect around 1 in 10,000 people in England; in these conditions, vision is lost as retinal ganglion cells lose function or die (usually due to pathological variants in genes concerned with mitochondrial function). Emerging gene therapies for these conditions have emphas...

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Main Authors: Michael James Gilhooley, Naz Raoof, Patrick Yu-Wai-Man, Mariya Moosajee
Format: Article
Language:English
Published: MDPI AG 2024-01-01
Series:Genes
Subjects:
Online Access:https://www.mdpi.com/2073-4425/15/2/188
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author Michael James Gilhooley
Naz Raoof
Patrick Yu-Wai-Man
Mariya Moosajee
author_facet Michael James Gilhooley
Naz Raoof
Patrick Yu-Wai-Man
Mariya Moosajee
author_sort Michael James Gilhooley
collection DOAJ
description Inherited optic neuropathies affect around 1 in 10,000 people in England; in these conditions, vision is lost as retinal ganglion cells lose function or die (usually due to pathological variants in genes concerned with mitochondrial function). Emerging gene therapies for these conditions have emphasised the importance of early and expedient molecular diagnoses, particularly in the paediatric population. Here, we report our real-world clinical experience of such a population, exploring which children presented with the condition, how they were investigated and the time taken for a molecular diagnosis to be reached. A retrospective case-note review of paediatric inherited optic neuropathy patients (0–16 years) in the tertiary neuro-ophthalmology service at Moorfields Eye Hospital between 2016 and 2020 identified 19 patients. Their mean age was 9.3 ± 4.6 (mean ± SD) years at presentation; 68% were male, and 32% were female; and 26% had comorbidities, with diversity of ethnicity. Most patients had undergone genetic testing (95% (<i>n</i> = 18)), of whom 43% (<i>n</i> = 8) received a molecular diagnosis. On average, this took 54.8 ± 19.5 weeks from presentation. A cerebral MRI was performed in 70% (<i>n</i> = 14) and blood testing in 75% (<i>n</i> = 15) of patients as part of their workup. Continual improvement in the investigative pathways for inherited optic neuropathies will be paramount as novel therapeutics become available.
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spelling doaj.art-5861452d3a3c491caf17fc6e6c61f7232024-02-23T15:17:46ZengMDPI AGGenes2073-44252024-01-0115218810.3390/genes15020188Inherited Optic Neuropathies: Real-World Experience in the Paediatric Neuro-Ophthalmology ClinicMichael James Gilhooley0Naz Raoof1Patrick Yu-Wai-Man2Mariya Moosajee3Institute of Ophthalmology, University College London, 11 Bath Street, London EC1V 9EL, UKInstitute of Ophthalmology, University College London, 11 Bath Street, London EC1V 9EL, UKInstitute of Ophthalmology, University College London, 11 Bath Street, London EC1V 9EL, UKInstitute of Ophthalmology, University College London, 11 Bath Street, London EC1V 9EL, UKInherited optic neuropathies affect around 1 in 10,000 people in England; in these conditions, vision is lost as retinal ganglion cells lose function or die (usually due to pathological variants in genes concerned with mitochondrial function). Emerging gene therapies for these conditions have emphasised the importance of early and expedient molecular diagnoses, particularly in the paediatric population. Here, we report our real-world clinical experience of such a population, exploring which children presented with the condition, how they were investigated and the time taken for a molecular diagnosis to be reached. A retrospective case-note review of paediatric inherited optic neuropathy patients (0–16 years) in the tertiary neuro-ophthalmology service at Moorfields Eye Hospital between 2016 and 2020 identified 19 patients. Their mean age was 9.3 ± 4.6 (mean ± SD) years at presentation; 68% were male, and 32% were female; and 26% had comorbidities, with diversity of ethnicity. Most patients had undergone genetic testing (95% (<i>n</i> = 18)), of whom 43% (<i>n</i> = 8) received a molecular diagnosis. On average, this took 54.8 ± 19.5 weeks from presentation. A cerebral MRI was performed in 70% (<i>n</i> = 14) and blood testing in 75% (<i>n</i> = 15) of patients as part of their workup. Continual improvement in the investigative pathways for inherited optic neuropathies will be paramount as novel therapeutics become available.https://www.mdpi.com/2073-4425/15/2/188optic neuropathypaediatricLeber hereditary optic neuropathydominant optic atrophy
spellingShingle Michael James Gilhooley
Naz Raoof
Patrick Yu-Wai-Man
Mariya Moosajee
Inherited Optic Neuropathies: Real-World Experience in the Paediatric Neuro-Ophthalmology Clinic
Genes
optic neuropathy
paediatric
Leber hereditary optic neuropathy
dominant optic atrophy
title Inherited Optic Neuropathies: Real-World Experience in the Paediatric Neuro-Ophthalmology Clinic
title_full Inherited Optic Neuropathies: Real-World Experience in the Paediatric Neuro-Ophthalmology Clinic
title_fullStr Inherited Optic Neuropathies: Real-World Experience in the Paediatric Neuro-Ophthalmology Clinic
title_full_unstemmed Inherited Optic Neuropathies: Real-World Experience in the Paediatric Neuro-Ophthalmology Clinic
title_short Inherited Optic Neuropathies: Real-World Experience in the Paediatric Neuro-Ophthalmology Clinic
title_sort inherited optic neuropathies real world experience in the paediatric neuro ophthalmology clinic
topic optic neuropathy
paediatric
Leber hereditary optic neuropathy
dominant optic atrophy
url https://www.mdpi.com/2073-4425/15/2/188
work_keys_str_mv AT michaeljamesgilhooley inheritedopticneuropathiesrealworldexperienceinthepaediatricneuroophthalmologyclinic
AT nazraoof inheritedopticneuropathiesrealworldexperienceinthepaediatricneuroophthalmologyclinic
AT patrickyuwaiman inheritedopticneuropathiesrealworldexperienceinthepaediatricneuroophthalmologyclinic
AT mariyamoosajee inheritedopticneuropathiesrealworldexperienceinthepaediatricneuroophthalmologyclinic