Retinitis Pigmentosa Clinical Trial
Retinitis Pigmentosa (RP) is the most common form of hereditary retinal degeneration, with a
worldwide prevalence of 1:3500. It is one of the most genetically heterogenous conditions in
humans, with over 100 causative genes and loci reported to date. However, in approximately
40% of patients the underlying genetic causes are yet to be found.
The current study aims to identify causative RP genes and mutations in Israeli families of
various ethnic backgrounds. Identification of such genes will contribute significantly to
disease prevention (by identification of high risk families and appropriate genetic
counseling) and to the investigators understanding of retinal structure and function and of
the etiology of RP.
Background: Retinitis Pigmentosa (RP) is a clinically and genetically heterogeneous disease,
which causes visual loss due to the premature death of retinal photoreceptors. Over 100
genes and loci have been implicated in RP. However, the contribution of each of these genes
to the overall prevalence of RP is relatively small, and many of them are yet to be found.
These unidentified genes are likely to be very rare. The vast majority of studies on the
genetics of RP have been performed on the American and European populations. Based on the
investigators experience, the genetic makeup of the Israeli population is unique, and many
of the genetic alterations identified in Israeli patients are novel.
Working hypothesis and aims: the investigators working hypothesis is that the Israeli
population is unique in terms of the identity and relative contribution of RP genes.
Therefore, the investigators aim is to perform a comprehensive genetic analysis of affected
Israeli individuals of various ethnic backgrounds, in order to identify novel RP mutations
and genes.
Methods: RP patients and family members will be continuously recruited to the study through
the Ophthalmology Department at Hillel Yaffe Medical Center, Hadera, Israel. The relatively
high proportion of founder mutations in the Israeli population allows us to perform a quick
and efficient mutation screening and identify the cause of disease in a large number of
newly recruited families. Patients who are negative for all relevant mutations will be
studied using whole exome sequencing. Bioinformatic analysis will be used to identify
possible pathogenic variants. Following verification, the investigators will check their
co-segregation with the disease in the entire family, and their frequency in the relevant
population.
Expected results: The immediate expected outcomes include an epidemiological overview of RP
distribution and etiology in the Israeli population, and identification of novel causative
genes and mechanisms. These genes are expected to play a crucial role in retinal development
and function, and hence their identification and characterization will contribute
significantly to the investigators understanding of retinal structure and function and of
the etiology of RP. The main expected long-term outcome is reduction in the frequency of RP
in Israel. This will be achieved by a combination of prevention (by genetic screening and
counseling among high-risk populations), and treatment (by identification of patient groups
with shared genetic diagnoses, who can be recruited to clinical trials for evaluation of
various treatment strategies).
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Observational Model: Case-Only, Time Perspective: Cross-Sectional
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