Leber Hereditary Optic Neuropathy Gene Therapy: Longitudinal Relationships Among Visual Function and Anatomical Measures.

Autor: Lam BL; From the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA. Electronic address: blam@med.miami.edu., Feuer WJ; From the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA., Porciatti V; From the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA., Davis JL; From the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA., Zheng DD; From the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA., Vanner EA; From the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA., Savatovsky EJ; From the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA., Alba DE; From the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA., Guy J; From the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.
Jazyk: angličtina
Zdroj: American journal of ophthalmology [Am J Ophthalmol] 2024 Jan; Vol. 257, pp. 113-128. Date of Electronic Publication: 2023 Sep 15.
DOI: 10.1016/j.ajo.2023.09.005
Abstrakt: Purpose: To assess longitudinal relationships among visual function and anatomical measures of gene therapy in G11778A Leber hereditary optic neuropathy (LHON).
Design: Phase 1 clinical trial.
Methods: This was a single-institution study of patients with G11778A LHON. Patients with chronic bilateral visual loss >12 months (group 1, n = 11), acute bilateral visual loss <12 months (group 2, n = 9), or unilateral visual loss (group 3, n = 8) were administered unilateral intravitreal AAV2(Y444,500,730F)-P1ND4v2 injection with low, medium, high, and higher doses to worse eye for groups 1 and 2 and better eye for group 3. Oucome measures were best-corrected visual acuity (BCVA), visual field mean deviation (VF MD), steady-state pattern electroretinogram (SS-PERG), optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness and ganglion cell+inner plexiform layer (GCIPL) thickness, and National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) scores. Mean follow-up was 33.6 months (range = 18-36 months).
Results: Baseline SS-PERG amplitude was much reduced in both eyes of all groups including asymptomatic eyes of group 3, and showed no appreciable changes irrespective of disease stage and treatment. Significant and progressive GCIPL and RNFL thinning occurred in all eyes; BCVA and VF MD fluctuated in treated and fellow eyes, with some eyes having modest improvement that may be related to natural history or to gene therapy. Mean NEI-VFQ-25 scores declined in group 3 subjects (P = .023), CONCLUSION: Asymptomatic eyes in LHON patients with unilateral visual loss may be beyond the window of effective neuroprotection given reduced GCIPL and SS-PERG. Randomization of patients to an untreated control group would help to assess treatment effect by accounting for variable natural history. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.
(Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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