20PURPOSE. We previously found a dominant mutation, Rwhs, causing white spots on the 21 retina accompanied by retinal folds. Here we identify the mutant gene to be Tmem98. In 22 humans, mutations in the orthologous gene cause nanophthalmos. We modelled these 23 mutations in mice and characterised the mutant eye phenotypes of these and Rwhs. 24
METHODS.The Rwhs mutation was identified to be a missense mutation in Tmem98 by 25 genetic mapping and sequencing. The human TMEM98 nanophthalmos missense mutations 26 were made in the mouse gene by CRISPR-Cas9. Eyes were examined by indirect 27 ophthalmoscopy and the retinas imaged using a retinal camera. Electroretinography was 28 used to study retinal function. Histology, immunohistochemistry and electron microscopy 29 techniques were used to study adult eyes. 30 RESULTS. An I135T mutation of Tmem98 causes the dominant Rwhs phenotype and is 31 perinatally lethal when homozygous. Two dominant missense mutations of TMEM98, A193P 32 and H196P are associated with human nanophthalmos. In the mouse these mutations cause 33 recessive retinal defects similar to the Rwhs phenotype, either alone or in combination with 34 each other, but do not cause nanophthalmos. The retinal folds did not affect retinal function 35 as assessed by electroretinography. Within the folds there was accumulation of disorganised 36 outer segment material as demonstrated by immunohistochemistry and electron microscopy, 37 and macrophages had infiltrated into these regions. 38 CONCLUSIONS. Mutations in the mouse orthologue of the human nanophthalmos gene 39 TMEM98 do not result in small eyes. Rather, there is localised disruption of the laminar 40 structure of the photoreceptors. 41 42