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Leber congenital amaurosis 18(LCA18)

MedGen UID:
861539
Concept ID:
C4013102
Finding
Synonym: LCA18
 
OMIM®: 179605; 608133

Definition

Leber congenital amaurosis, also known as LCA, is an eye disorder that is present from birth (congenital). This condition primarily affects the retina, which is the specialized tissue at the back of the eye that detects light and color. People with this disorder typically have severe visual impairment beginning at birth or shortly afterward. The visual impairment tends to be severe and may worsen over time.

Leber congenital amaurosis is also associated with other vision problems, including an increased sensitivity to light (photophobia), involuntary movements of the eyes (nystagmus), and extreme farsightedness (hyperopia). The pupils, which usually expand and contract in response to the amount of light entering the eye, do not react normally to light. Instead, they expand and contract more slowly than normal, or they may not respond to light at all.

A specific behavior called Franceschetti's oculo-digital sign is characteristic of Leber congenital amaurosis. This sign consists of affected individuals poking, pressing, and rubbing their eyes with a knuckle or finger. Poking their eyes often results in the sensation of flashes of light called phosphenes. Researchers suspect that this behavior may contribute to deep-set eyes in affected children.

In very rare cases, delayed development and intellectual disability have been reported in people with the features of Leber congenital amaurosis. Because of the visual loss, affected children may become isolated. Providing children with opportunities to play, hear, touch, understand and other early educational interventions may prevent developmental delays in children with Leber congenital amaurosis.

At least 20 genetic types of Leber congenital amaurosis have been described. The types are distinguished by their genetic cause, patterns of vision loss, and related eye abnormalities. [from MedlinePlus Genetics]

Professional guidelines

PubMed

Lorenz B, Tavares J, van den Born LI, Marques JP, Scholl HPN; EVICR.net Group
Ophthalmic Res 2021;64(5):740-753. Epub 2021 Mar 8 doi: 10.1159/000515688. PMID: 33684911
Mackay DS, Borman AD, Sui R, van den Born LI, Berson EL, Ocaka LA, Davidson AE, Heckenlively JR, Branham K, Ren H, Lopez I, Maria M, Azam M, Henkes A, Blokland E, Qamar R, Webster AR, Cremers FPM, Moore AT, Koenekoop RK; [LCA5 Study Group (see acknowledgements for Universities), Andreasson S, de Baere E, Bennett J, Chader GJ, Berger W, Golovleva I, Greenberg J, den Hollander AI, Klaver CCW, Klevering BJ, Lorenz B, Preising MN, Ramsear R, Roberts L, Roepman R, Rohrschneider K, Wissinger B
Hum Mutat 2013 Nov;34(11):1537-1546. Epub 2013 Sep 17 doi: 10.1002/humu.22398. PMID: 23946133Free PMC Article
Casteels I, Spileers W, Demaerel P, Casaer P, De Cock P, Dralands L, Missotten L
Neuropediatrics 1996 Aug;27(4):189-93. doi: 10.1055/s-2007-973785. PMID: 8892367

Recent clinical studies

Etiology

Zhang Q, Sun J, Liu Z, Wang H, Zhou H, Liu W, Jia H, Li N, Li T, Wang F, Sun X
Am J Ophthalmol 2024 Oct;266:235-247. Epub 2024 Jun 15 doi: 10.1016/j.ajo.2024.06.013. PMID: 38880373
Daich Varela M, Jeste M, de Guimaraes TAC, Mahroo OA, Arno G, Webster AR, Michaelides M
Am J Ophthalmol 2024 Oct;266:255-263. Epub 2024 May 19 doi: 10.1016/j.ajo.2024.05.007. PMID: 38768745
Rodriguez-Martinez AC, Higgins BE, Tailor-Hamblin V, Malka S, Cheloni R, Collins AM, Bladen J, Henderson R, Moosajee M
Int J Mol Sci 2023 Sep 11;24(18) doi: 10.3390/ijms241813932. PMID: 37762234Free PMC Article
Gange WS, Sisk RA, Besirli CG, Lee TC, Havunjian M, Schwartz H, Borchert M, Sengillo JD, Mendoza C, Berrocal AM, Nagiel A
Ophthalmol Retina 2022 Jan;6(1):58-64. Epub 2021 Apr 8 doi: 10.1016/j.oret.2021.03.016. PMID: 33838313Free PMC Article
Hunter JJ, Morgan JI, Merigan WH, Sliney DH, Sparrow JR, Williams DR
Prog Retin Eye Res 2012 Jan;31(1):28-42. Epub 2011 Nov 10 doi: 10.1016/j.preteyeres.2011.11.001. PMID: 22085795Free PMC Article

Diagnosis

Zhang Q, Sun J, Liu Z, Wang H, Zhou H, Liu W, Jia H, Li N, Li T, Wang F, Sun X
Am J Ophthalmol 2024 Oct;266:235-247. Epub 2024 Jun 15 doi: 10.1016/j.ajo.2024.06.013. PMID: 38880373
Daich Varela M, Jeste M, de Guimaraes TAC, Mahroo OA, Arno G, Webster AR, Michaelides M
Am J Ophthalmol 2024 Oct;266:255-263. Epub 2024 May 19 doi: 10.1016/j.ajo.2024.05.007. PMID: 38768745
Malvasi M, Casillo L, Avogaro F, Abbouda A, Vingolo EM
Int J Mol Sci 2023 Sep 6;24(18) doi: 10.3390/ijms241813756. PMID: 37762059Free PMC Article
Gange WS, Sisk RA, Besirli CG, Lee TC, Havunjian M, Schwartz H, Borchert M, Sengillo JD, Mendoza C, Berrocal AM, Nagiel A
Ophthalmol Retina 2022 Jan;6(1):58-64. Epub 2021 Apr 8 doi: 10.1016/j.oret.2021.03.016. PMID: 33838313Free PMC Article
Fazzi E, Signorini SG, Scelsa B, Bova SM, Lanzi G
Eur J Paediatr Neurol 2003;7(1):13-22. doi: 10.1016/s1090-3798(02)00135-6. PMID: 12615170

Therapy

Bommakanti N, Young BK, Sisk RA, Berrocal AM, Duncan JL, Bakall B, Mathias MT, Ahmed I, Chorfi S, Comander J, Nagiel A, Besirli CG
Ophthalmol Retina 2024 Jan;8(1):42-48. Epub 2023 Sep 3 doi: 10.1016/j.oret.2023.08.017. PMID: 37660736Free PMC Article
Patrício MI, Barnard AR, Xue K, MacLaren RE
Expert Opin Biol Ther 2018 Jul;18(7):807-820. Epub 2018 Jun 22 doi: 10.1080/14712598.2018.1484448. PMID: 29932012
Moore NA, Morral N, Ciulla TA, Bracha P
Expert Opin Biol Ther 2018 Jan;18(1):37-49. Epub 2017 Oct 23 doi: 10.1080/14712598.2018.1389886. PMID: 29057663
Borrás T
Asia Pac J Ophthalmol (Phila) 2017 Jan-Feb;6(1):80-93. doi: 10.22608/APO.2016126. PMID: 28161916Free PMC Article
Hunter JJ, Morgan JI, Merigan WH, Sliney DH, Sparrow JR, Williams DR
Prog Retin Eye Res 2012 Jan;31(1):28-42. Epub 2011 Nov 10 doi: 10.1016/j.preteyeres.2011.11.001. PMID: 22085795Free PMC Article

Prognosis

Ayash J, Woods RL, Akula JD, Rajabi F, Alwattar BK, Altschwager P, Fulton AB
Am J Ophthalmol 2024 Jul;263:168-178. Epub 2024 Mar 10 doi: 10.1016/j.ajo.2024.02.028. PMID: 38461945
Murro V, Banfi S, Testa F, Iarossi G, Falsini B, Sodi A, Signorini S, Iolascon A, Russo R, Mucciolo DP, Caputo R, Bacci GM, Bargiacchi S, Turco S, Fortini S, Simonelli F
Orphanet J Rare Dis 2023 Jul 31;18(1):223. doi: 10.1186/s13023-023-02798-z. PMID: 37525225Free PMC Article
Weisschuh N, Wissinger B, Gramer E
Mol Vis 2012;18:751-7. Epub 2012 Mar 29 PMID: 22509105Free PMC Article
Russell-Eggitt IM, Clayton PT, Coffey R, Kriss A, Taylor DS, Taylor JF
Ophthalmology 1998 Jul;105(7):1274-80. doi: 10.1016/S0161-6420(98)97033-6. PMID: 9663233
Casteels I, Spileers W, Demaerel P, Casaer P, De Cock P, Dralands L, Missotten L
Neuropediatrics 1996 Aug;27(4):189-93. doi: 10.1055/s-2007-973785. PMID: 8892367

Clinical prediction guides

Zhang Q, Sun J, Liu Z, Wang H, Zhou H, Liu W, Jia H, Li N, Li T, Wang F, Sun X
Am J Ophthalmol 2024 Oct;266:235-247. Epub 2024 Jun 15 doi: 10.1016/j.ajo.2024.06.013. PMID: 38880373
Rodriguez-Martinez AC, Higgins BE, Tailor-Hamblin V, Malka S, Cheloni R, Collins AM, Bladen J, Henderson R, Moosajee M
Int J Mol Sci 2023 Sep 11;24(18) doi: 10.3390/ijms241813932. PMID: 37762234Free PMC Article
Habibi I, Falfoul Y, Turki A, Hassairi A, El Matri K, Chebil A, Schorderet DF, El Matri L
Sci Rep 2020 Jul 8;10(1):11199. doi: 10.1038/s41598-020-67792-y. PMID: 32641690Free PMC Article
Weisschuh N, Wissinger B, Gramer E
Mol Vis 2012;18:751-7. Epub 2012 Mar 29 PMID: 22509105Free PMC Article
Sun W, Gerth C, Maeda A, Lodowski DT, Van Der Kraak L, Saperstein DA, Héon E, Palczewski K
Vision Res 2007 Jul;47(15):2055-66. Epub 2007 May 21 doi: 10.1016/j.visres.2007.04.005. PMID: 17512964Free PMC Article

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