Purpose:
The study aimed to describe the phenotypic features of retinitis pigmentosa (RP) associated with the previously described EYS C2139Y variant in Singaporeans and establish the importance of this variant as a prevalent cause of RP among East Asians.
Methods:
A clinical phenotyping and exome sequencing study was conducted on consecutive patients with non-syndromic RP. Epidemiological analysis was performed using Singaporean and global population-based genetic data.
Results:
A study of 150 consecutive unrelated individuals with non-syndromic RP found that 87 (58%) of cases had plausible genotypes. A previously described missense variant in the EYS gene, 6416G>A (C2139Y), occurred heterozygously or homozygously in 17 of 150 families (11.3%), all with autosomal recessive RP. Symptom onset in EYS C2139Y-related RP ranged from 6 to 45 years, with visual acuity (VA) ranging from 20/20 at 21 years to no light perception by 48 years. C2139Y-related RP had typical findings, including sectoral RP in cases with EYS E2703X in trans. The median age at presentation was 45 and visual fields declined to less than 20° (Goldmann V4e isopter) by age 65. Inter-eye correlation for VA, fields, and ellipsoid band width was high (r-squared 0.77 to 0.95). Carrier prevalence was 0.66% (allele frequency of 0.33%) in Singaporean Chinese and 0.34% in East Asians, suggesting a global disease burden exceeding ten thousand individuals.
Conclusions:
The EYS C2139Y variant is common in Singaporean RP patients and other ethnic Chinese populations. Targeted molecular therapy for this single variant could potentially treat a significant proportion of RP cases worldwide.