Retinitis pigmentosa (RP) is a degenerative retinal disease involving progressive loss of rod and cone photoreceptor function. It represents the most common form of registered blindness among the working aged populations of developed countries. Given the immense genetic heterogeneity associated with this disease, parameters influencing cone photoreceptor survival (preservation of daytime vision) that are independent of primary mutations are exceedingly important to identify from a therapeutic standpoint. Here we identify C1q, the primary component of the classical complement pathway, as a cone photoreceptor neuronal survival factor. European Journal of Human Genetics (2012) 20, 64-68; doi:10.1038/ejhg.2011; published online 24 August 2011Keywords: C1qa; C3; retinopathy; retinitis pigmentosa; complement; cone photoreceptors INTRODUCTION Hereditary retinopathies, prominent among which is retinitis pigmentosa (RP), conditions involving progressive death of photoreceptors are amongst the most genetically heterogeneous of any group of mendelian conditions. Including Leber's congenital amaurosis (LCA), a congenital retinopathy with pathological features bearing similarities to RP, 60 genes have now been implicated in disease etiology. If syndromic forms of disease and other hereditary retinopathies are included, 202 genetic loci have been identified and a total of 161 genes so far characterized. 1 RP segregates largely in an autosomal dominant, recessive, or X-linked recessive manner, 2 whereas all of the 16 genetic forms of LCA that have been identified to date are autosomal recessive; hence, gene therapies require strategies based either on gene replacement, or on the selective suppression of dominantly mutated genes, or their transcripts. Progress is being made to the extent that clinical trials involving AAV-mediated gene replacement have now been established for one form of LCA caused by mutations within the RPE65 gene. [3][4][5] In addition, therapeutic modalities have been demonstrated for other genetic subtypes of RP and LCA in a growing number of animal models, both of recessive and dominant forms of disease. [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Notwithstanding such progress, the genetic complexity of this group of diseases represents a formidable logistic and economic hurdle in developing viable methods of prevention. Given this caveat, parameters effecting photoreceptor survival that are independent of the primary genetic lesion are critically important to identify. It has emerged over the last 5 or so years that major pathological features involving sub-retinal drusen deposition and choroidal neovascularization that are associated with one form of multifactorial retinopathy, namely age-related macular degeneration, where the central cone-rich part of the retina, or macula, degenerates, can now be explained, at least in part, by excessive complement activity on ocular surfaces. [24][25][26][27][28][29][30] However, the influence of complement on cone photoreceptor survival is...