Frizzled-4 Variations Associated with Retinopathy and Intrauterine Growth Retardation

Purpose To present the association between mutations affecting the Wnt-signaling receptor protein (FZD4), inherited vitreoretinopathies, and retinopathy of prematurity (ROP). Design Retrospective analysis of prospective samples at a tertiary referral center. Participants Patients referred to our pra...

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Published inOphthalmology (Rochester, Minn.) Vol. 122; no. 9; pp. 1917 - 1923
Main Authors Dailey, Wendy A., BS, Gryc, Wojciech, BS, Garg, Pooja G., MD, Drenser, Kimberly A., MD, PhD
Format Journal Article
LanguageEnglish
Published Elsevier Inc 01.09.2015
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Summary:Purpose To present the association between mutations affecting the Wnt-signaling receptor protein (FZD4), inherited vitreoretinopathies, and retinopathy of prematurity (ROP). Design Retrospective analysis of prospective samples at a tertiary referral center. Participants Patients referred to our practice for management of a variety of pediatric vitreoretinopathies were offered participation in an ophthalmic biobank (421 participants with vitreoretinopathies were included in this study). Full-term healthy infants (n = 98) were recruited to the study as controls. Methods Patients with various vitreoretinopathies were prospectively enrolled in an ophthalmic biobank, approved by the Human Investigation Committee at William Beaumont Hospital. Retrospective genetic analysis of the FZD4 gene was performed (Sanger sequencing). Participants with a diagnosis of familial exudative vitreoretinopathy (FEVR), Norrie disease, Coats' disease, bilateral persistent fetal vasculature, and ROP were reviewed for the presence of a FZD4 variant. Data retrieval included status of retinopathy (including staging when possible), gestational age (GA), birth weight (BW) (when available), and family and birth histories. Main Outcome Measures The association of FZD4 variants with the presence of vitreoretinopathy. Results The sequence variation p.[P33S(;)P168S] is the most prevalent FZD4 variant and is statistically significant for ROP and FEVR ( P  = 4.6E-04 and P  = 2.4E-03, respectively) compared with full-term newborns ( P  = 1.7E-01). In addition, infants expressing the sequence variation tended to have significantly lower BWs for respective GA ( P  = 0.04). This suggests that the FZD4 p.[P33S(;)P168S] variant may be a risk factor for retinopathy and restricted intrauterine growth. Conclusions Testing for FZD4 gene mutations is useful in patients with suspected FEVR and ROP. The relatively high prevalence of the p.[P33S(;)P168S] variant in ROP and intrauterine growth restriction suggests that it also may be a marker for increased risk of developing ROP and preterm birth.
ISSN:0161-6420
1549-4713
DOI:10.1016/j.ophtha.2015.05.036