Entry - #136880 - FUNDUS ALBIPUNCTATUS - OMIM - (MIRROR)
# 136880

FUNDUS ALBIPUNCTATUS


Other entities represented in this entry:

RETINITIS PUNCTATA ALBESCENS, INCLUDED

Phenotype-Gene Relationships

Location Phenotype Phenotype
MIM number
Inheritance Phenotype
mapping key
Gene/Locus Gene/Locus
MIM number
3q22.1 Retinitis punctata albescens 136880 AD, AR 3 RHO 180380
6p21.1 Retinitis punctata albescens 136880 AD, AR 3 PRPH2 179605
12q13.2 Fundus albipunctatus 136880 AD, AR 3 RDH5 601617
15q26.1 Retinitis punctata albescens 136880 AD, AR 3 RLBP1 180090
15q26.1 Fundus albipunctatus 136880 AD, AR 3 RLBP1 180090
Clinical Synopsis
 

INHERITANCE
- Autosomal dominant
- Autosomal recessive
HEAD & NECK
Eyes
- Fleck retina disease
- Discrete uniform white dots over entire fundus
- Cone dysfunction seen on ERG (in some patients)
- Macular involvement (in some patients)
- Absent rod responses seen on ERG (in some patients)
- Night blindness
MOLECULAR BASIS
- Caused by mutation in the retinaldehyde-binding protein-1, cellular gene (RLBP1, 180090.0001)
- Caused by mutation in the retinol dehydrogenase-5 gene (RDH5, 601617.0001)
- Caused by mutation in the peripherin 2 gene (PRPH2, 179605.0005)

TEXT

A number sign (#) is used with this entry because an autosomal dominant form of fundus albipunctatus can be caused by mutation in the RDS gene (PRPH2; 179605) and an autosomal recessive form can be caused by mutation in the RDH5 gene (601617). Furthermore, this fundus picture also occurs in Bietti crystalline corneoretinopathy (210370), an autosomal recessive. See also 180380.0012, which describes an association between this disorder and a mutation in the rhodopsin gene segregating with the APOE epsilon-4 allele (107741) (Souied et al., 1996). Mutation in the RLBP1 gene (180090) has been shown to cause fundus albipunctatus and retinitis punctata albescens.


Description

This form of fleck retina disease (see 228980) is characterized by discrete uniform white dots over the entire fundus with greatest density in the midperiphery and no macular involvement. Night blindness occurs. Both autosomal dominant and autosomal recessive inheritance had been suggested (Krill and Folk, 1962; Krill, 1977).


Clinical Features

Pearce et al. (1984) described retinitis punctata albescens in association with Bardet-Biedl syndrome (see 209900) in an isolated community in northern Canada.

Fishman et al. (2004) described autosomal recessive retinitis punctata albescens in 5 patients from 3 families. The 3 probands had similar clinical findings: a history of poor night vision, the presence of punctate white deposits in the retina, and substantially reduced or absent rod responses on electroretinogram (ERG) testing.

Niwa et al. (2005) investigated the frequency of cone and rod dysfunction in patients with fundus albipunctatus due to RDH5 mutation. Cone electroretinography showed considerable variability in b-wave amplitudes, and 6 (38%) of 16 patients had b-wave amplitudes smaller than that seen in controls, suggesting extensive cone dysfunction. Cone dysfunction was more severe in older patients. In patients with reduced standard cone ERGs, cone a-wave analysis showed significantly smaller maximal response amplitudes, and rod ERGs were also reduced. Niwa et al. (2005) concluded that reduced full-field cone ERGs were mainly due to loss of cone photoreceptors and the rod system was also affected.


Molecular Genetics

Yamamoto et al. (1999) and Gonzalez-Fernandez et al. (1999) identified mutations in the RDH5 gene in patients with fundus albipunctatus (see 601617.0001-601617.0004).

Nakamura and Miyake (2002) reported fundus albipunctatus and a novel macular dystrophy in a 9-year-old boy who was a compound heterozygote for mutations in the RDH5 gene (601617.0006-601617.0007). The authors described the patient's macular findings, visual acuity, and electrophysiologic responses. They concluded that the macular dystrophy was caused by the RDH5 mutations as a phenotype variation of fundus albipunctatus.

Fishman et al. (2004) evaluated the molecular genetic defects associated with autosomal recessive retinitis punctata albescens in 5 patients from 3 families. One of the probands was compound heterozygous for mutations in the RLBP1 gene; her parents manifested round white deposits in the retina. The other 2 probands had no detected pathogenic mutations in the RLBP1 gene or in 3 other genes evaluated: RDH5, RBP3 (180290), and RDH8 (608575).

In a proband with fundus albipunctatus, Cideciyan et al. (2000) found a novel arg157-to-trp (R157W) mutation in the RDH5 gene (601617.0008). Three-dimensional structure modeling and in vitro experiments suggested that this mutation destabilized proper folding and would inactivate the enzyme. Studies using RPE membranes indicated the existence of an alternative oxidizing system for the production of 11-cis-retinal in fundus albipunctatus. The authors concluded that pathways in addition to 11-cis-RDH likely provide 11-cis-retinal to rods and cones and can maintain normal kinetics of visual recovery, but only under certain constraints and less efficiently for cone than for rod function.


REFERENCES

  1. Cideciyan, A. R., Haeseleer, F., Fariss, R. N., Aleman, T. S., Jang, G.-F., Verlinde, C. L. M. J., Marmor, M. F., Jacobson, S. G., Palczewski, K. Rod and cone visual cycle consequences of a null mutation in the 11-cis-retinol dehydrogenase gene in man. Vis. Neurosci. 17: 667-678, 2000. [PubMed: 11153648, images, related citations] [Full Text]

  2. Fishman, G. A., Roberts, M. F., Derlacki, D. J., Grimsby, J. L., Yamamoto, H., Sharon, D., Nishiguchi, K. M., Dryja, T. P. Novel mutations in the cellular retinaldehyde-binding protein gene (RLBP1) associated with retinitis punctata albescens: evidence of interfamilial genetic heterogeneity and fundus changes in heterozygotes. Arch. Ophthal. 122: 70-75, 2004. [PubMed: 14718298, related citations] [Full Text]

  3. Gonzalez-Fernandez, F., Kurz, D., Bao, Y., Newman, S., Conway, B. P., Young, J. E., Han, D. P., Khani, S. C. 11-cis Retinal dehydrogenase mutations as a major cause of the congenital night-blindness disorder known as fundus albipunctatus. Molec. Vis. 5: 41, 1999. Note: Electronic Article. [PubMed: 10617778, related citations]

  4. Krill, A. E. Hereditary Retinal and Choroidal Diseases: Flecked Retina Diseases. Hagerstown: Harper and Row (pub.) 2: 1977. Pp. 739-819.

  5. Krill, A. E., Folk, M. R. Retinitis punctata albescens: a functional evaluation of an unusual case. Am. J. Ophthal. 53: 450-454, 1962. [PubMed: 14459667, related citations]

  6. Nakamura, M., Miyake, Y. Macular dystrophy in a 9-year-old boy with fundus albipunctatus. Am. J. Ophthal. 133: 278-280, 2002. [PubMed: 11812441, related citations] [Full Text]

  7. Niwa, Y., Kondo, M., Ueno, S., Nakamura, M., Terasaki, H., Miyake, Y. Cone and rod dysfunction in fundus albipunctatus with RDH5 mutation: an electrophysiological study. Invest. Ophthal. Vis. Sci. 46: 1480-1485, 2005. [PubMed: 15790919, related citations] [Full Text]

  8. Pearce, W. G., Gillan, J. G., Brosseau, L. Bardet-Biedl syndrome and retinitis punctata albescens in an isolated northern Canadian community. Can. J. Ophthal. 19: 115-118, 1984.

  9. Souied, E., Soubrane, G., Benlian, P., Coscas, G. J., Gerber, S., Munnich, A., Kaplan, J. Retinitis punctata albescens associated with the arg135-to-trp mutation in the rhodopsin gene. Am. J. Ophthal. 121: 19-25, 1996. [PubMed: 8554077, related citations] [Full Text]

  10. Yamamoto, H., Simon, A., Eriksson, U., Harris, E., Berson, E. L., Dryja, T. P. Mutations in the gene encoding 11-cis retinol dehydrogenase cause delayed dark adaptation and fundus albipunctatus. Nature Genet. 22: 188-191, 1999. [PubMed: 10369264, related citations] [Full Text]


Jane Kelly - updated : 11/1/2005
Jane Kelly - updated : 11/10/2004
Jane Kelly - updated : 11/5/2002
Jane Kelly - updated : 2/21/2001
Jane Kelly - updated : 2/20/2001
Victor A. McKusick - updated : 5/26/1999
Creation Date:
Victor A. McKusick : 6/4/1986
alopez : 12/07/2010
wwang : 12/13/2006
wwang : 11/1/2005
alopez : 11/10/2004
alopez : 4/8/2004
tkritzer : 3/22/2004
carol : 11/5/2002
alopez : 9/7/2001
carol : 3/6/2001
mcapotos : 2/21/2001
carol : 2/20/2001
carol : 2/20/2001
alopez : 9/8/2000
alopez : 5/27/1999
terry : 5/26/1999
mark : 5/10/1996
terry : 5/10/1996
terry : 5/2/1996
mimadm : 9/24/1994
davew : 7/18/1994
carol : 5/2/1994
terry : 4/27/1994
warfield : 2/17/1994
carol : 10/27/1992

# 136880

FUNDUS ALBIPUNCTATUS


Other entities represented in this entry:

RETINITIS PUNCTATA ALBESCENS, INCLUDED

SNOMEDCT: 764939004;   ORPHA: 227796, 52427;   DO: 11105;  


Phenotype-Gene Relationships

Location Phenotype Phenotype
MIM number
Inheritance Phenotype
mapping key
Gene/Locus Gene/Locus
MIM number
3q22.1 Retinitis punctata albescens 136880 Autosomal dominant; Autosomal recessive 3 RHO 180380
6p21.1 Retinitis punctata albescens 136880 Autosomal dominant; Autosomal recessive 3 PRPH2 179605
12q13.2 Fundus albipunctatus 136880 Autosomal dominant; Autosomal recessive 3 RDH5 601617
15q26.1 Retinitis punctata albescens 136880 Autosomal dominant; Autosomal recessive 3 RLBP1 180090
15q26.1 Fundus albipunctatus 136880 Autosomal dominant; Autosomal recessive 3 RLBP1 180090

TEXT

A number sign (#) is used with this entry because an autosomal dominant form of fundus albipunctatus can be caused by mutation in the RDS gene (PRPH2; 179605) and an autosomal recessive form can be caused by mutation in the RDH5 gene (601617). Furthermore, this fundus picture also occurs in Bietti crystalline corneoretinopathy (210370), an autosomal recessive. See also 180380.0012, which describes an association between this disorder and a mutation in the rhodopsin gene segregating with the APOE epsilon-4 allele (107741) (Souied et al., 1996). Mutation in the RLBP1 gene (180090) has been shown to cause fundus albipunctatus and retinitis punctata albescens.


Description

This form of fleck retina disease (see 228980) is characterized by discrete uniform white dots over the entire fundus with greatest density in the midperiphery and no macular involvement. Night blindness occurs. Both autosomal dominant and autosomal recessive inheritance had been suggested (Krill and Folk, 1962; Krill, 1977).


Clinical Features

Pearce et al. (1984) described retinitis punctata albescens in association with Bardet-Biedl syndrome (see 209900) in an isolated community in northern Canada.

Fishman et al. (2004) described autosomal recessive retinitis punctata albescens in 5 patients from 3 families. The 3 probands had similar clinical findings: a history of poor night vision, the presence of punctate white deposits in the retina, and substantially reduced or absent rod responses on electroretinogram (ERG) testing.

Niwa et al. (2005) investigated the frequency of cone and rod dysfunction in patients with fundus albipunctatus due to RDH5 mutation. Cone electroretinography showed considerable variability in b-wave amplitudes, and 6 (38%) of 16 patients had b-wave amplitudes smaller than that seen in controls, suggesting extensive cone dysfunction. Cone dysfunction was more severe in older patients. In patients with reduced standard cone ERGs, cone a-wave analysis showed significantly smaller maximal response amplitudes, and rod ERGs were also reduced. Niwa et al. (2005) concluded that reduced full-field cone ERGs were mainly due to loss of cone photoreceptors and the rod system was also affected.


Molecular Genetics

Yamamoto et al. (1999) and Gonzalez-Fernandez et al. (1999) identified mutations in the RDH5 gene in patients with fundus albipunctatus (see 601617.0001-601617.0004).

Nakamura and Miyake (2002) reported fundus albipunctatus and a novel macular dystrophy in a 9-year-old boy who was a compound heterozygote for mutations in the RDH5 gene (601617.0006-601617.0007). The authors described the patient's macular findings, visual acuity, and electrophysiologic responses. They concluded that the macular dystrophy was caused by the RDH5 mutations as a phenotype variation of fundus albipunctatus.

Fishman et al. (2004) evaluated the molecular genetic defects associated with autosomal recessive retinitis punctata albescens in 5 patients from 3 families. One of the probands was compound heterozygous for mutations in the RLBP1 gene; her parents manifested round white deposits in the retina. The other 2 probands had no detected pathogenic mutations in the RLBP1 gene or in 3 other genes evaluated: RDH5, RBP3 (180290), and RDH8 (608575).

In a proband with fundus albipunctatus, Cideciyan et al. (2000) found a novel arg157-to-trp (R157W) mutation in the RDH5 gene (601617.0008). Three-dimensional structure modeling and in vitro experiments suggested that this mutation destabilized proper folding and would inactivate the enzyme. Studies using RPE membranes indicated the existence of an alternative oxidizing system for the production of 11-cis-retinal in fundus albipunctatus. The authors concluded that pathways in addition to 11-cis-RDH likely provide 11-cis-retinal to rods and cones and can maintain normal kinetics of visual recovery, but only under certain constraints and less efficiently for cone than for rod function.


REFERENCES

  1. Cideciyan, A. R., Haeseleer, F., Fariss, R. N., Aleman, T. S., Jang, G.-F., Verlinde, C. L. M. J., Marmor, M. F., Jacobson, S. G., Palczewski, K. Rod and cone visual cycle consequences of a null mutation in the 11-cis-retinol dehydrogenase gene in man. Vis. Neurosci. 17: 667-678, 2000. [PubMed: 11153648] [Full Text: https://doi.org/10.1017/s0952523800175029]

  2. Fishman, G. A., Roberts, M. F., Derlacki, D. J., Grimsby, J. L., Yamamoto, H., Sharon, D., Nishiguchi, K. M., Dryja, T. P. Novel mutations in the cellular retinaldehyde-binding protein gene (RLBP1) associated with retinitis punctata albescens: evidence of interfamilial genetic heterogeneity and fundus changes in heterozygotes. Arch. Ophthal. 122: 70-75, 2004. [PubMed: 14718298] [Full Text: https://doi.org/10.1001/archopht.122.1.70]

  3. Gonzalez-Fernandez, F., Kurz, D., Bao, Y., Newman, S., Conway, B. P., Young, J. E., Han, D. P., Khani, S. C. 11-cis Retinal dehydrogenase mutations as a major cause of the congenital night-blindness disorder known as fundus albipunctatus. Molec. Vis. 5: 41, 1999. Note: Electronic Article. [PubMed: 10617778]

  4. Krill, A. E. Hereditary Retinal and Choroidal Diseases: Flecked Retina Diseases. Hagerstown: Harper and Row (pub.) 2: 1977. Pp. 739-819.

  5. Krill, A. E., Folk, M. R. Retinitis punctata albescens: a functional evaluation of an unusual case. Am. J. Ophthal. 53: 450-454, 1962. [PubMed: 14459667]

  6. Nakamura, M., Miyake, Y. Macular dystrophy in a 9-year-old boy with fundus albipunctatus. Am. J. Ophthal. 133: 278-280, 2002. [PubMed: 11812441] [Full Text: https://doi.org/10.1016/s0002-9394(01)01304-6]

  7. Niwa, Y., Kondo, M., Ueno, S., Nakamura, M., Terasaki, H., Miyake, Y. Cone and rod dysfunction in fundus albipunctatus with RDH5 mutation: an electrophysiological study. Invest. Ophthal. Vis. Sci. 46: 1480-1485, 2005. [PubMed: 15790919] [Full Text: https://doi.org/10.1167/iovs.04-0638]

  8. Pearce, W. G., Gillan, J. G., Brosseau, L. Bardet-Biedl syndrome and retinitis punctata albescens in an isolated northern Canadian community. Can. J. Ophthal. 19: 115-118, 1984.

  9. Souied, E., Soubrane, G., Benlian, P., Coscas, G. J., Gerber, S., Munnich, A., Kaplan, J. Retinitis punctata albescens associated with the arg135-to-trp mutation in the rhodopsin gene. Am. J. Ophthal. 121: 19-25, 1996. [PubMed: 8554077] [Full Text: https://doi.org/10.1016/s0002-9394(14)70530-6]

  10. Yamamoto, H., Simon, A., Eriksson, U., Harris, E., Berson, E. L., Dryja, T. P. Mutations in the gene encoding 11-cis retinol dehydrogenase cause delayed dark adaptation and fundus albipunctatus. Nature Genet. 22: 188-191, 1999. [PubMed: 10369264] [Full Text: https://doi.org/10.1038/9707]


Contributors:
Jane Kelly - updated : 11/1/2005
Jane Kelly - updated : 11/10/2004
Jane Kelly - updated : 11/5/2002
Jane Kelly - updated : 2/21/2001
Jane Kelly - updated : 2/20/2001
Victor A. McKusick - updated : 5/26/1999

Creation Date:
Victor A. McKusick : 6/4/1986

Edit History:
alopez : 12/07/2010
wwang : 12/13/2006
wwang : 11/1/2005
alopez : 11/10/2004
alopez : 4/8/2004
tkritzer : 3/22/2004
carol : 11/5/2002
alopez : 9/7/2001
carol : 3/6/2001
mcapotos : 2/21/2001
carol : 2/20/2001
carol : 2/20/2001
alopez : 9/8/2000
alopez : 5/27/1999
terry : 5/26/1999
mark : 5/10/1996
terry : 5/10/1996
terry : 5/2/1996
mimadm : 9/24/1994
davew : 7/18/1994
carol : 5/2/1994
terry : 4/27/1994
warfield : 2/17/1994
carol : 10/27/1992