Choroideremia

Choroideremia
Other namesCHM, Tapetochoroidal dystrophy
An example pedigree chart, showing the inheritance of a sex-linked disorder like choroideremia.
SpecialtyOphthalmology
SymptomsProgressive vision loss
Usual onsetChildhood
DurationChronic
CausesGenetic
Diagnostic methodGenetic testing, family history, fundus examination

Choroideremia (/kɒˌrɔɪdɪˈrmiə/; CHM) is a rare, X-linked recessive form of hereditary retinal degeneration that affects roughly 1 in 50,000 males. The disease causes a gradual loss of vision, starting with childhood night blindness, followed by peripheral vision loss and progressing to loss of central vision later in life. Progression continues throughout the individual's life, but both the rate of change and the degree of visual loss are variable among those affected, even within the same family.[1]

Choroideremia is caused by a loss-of-function mutation in the CHM gene which encodes Rab escort protein 1 (REP1), a protein involved in lipid modification of Rab proteins. While the complete mechanism of disease is not fully understood, the lack of a functional protein in the retina results in cell death and the gradual deterioration of the retinal pigment epithelium (RPE), photoreceptors and the choroid.[2][3]

As of 2019, there is no treatment for choroideremia; however, retinal gene therapy clinical trials have demonstrated a possible treatment.[4]

  1. ^ Kärnä, J (1986). "Choroideremia. A clinical and genetic study of 84 Finnish patients and 126 female carriers". Acta Ophthalmologica Supplement. 176: 1–68. PMID 3014804.
  2. ^ Roberts, MF; Fishman, GA; Roberts, DK; Heckenlively, JR; Weleber, RG; Anderson, RJ; Grover, S (June 2002). "Retrospective, longitudinal, and cross sectional study of visual acuity impairment in choroideraemia". The British Journal of Ophthalmology. 86 (6): 658–62. doi:10.1136/bjo.86.6.658. PMC 1771148. PMID 12034689.
  3. ^ Aleman, TS; Han, G; Serrano, LW; Fuerst, NM; Charlson, ES; Pearson, DJ; Chung, DC; Traband, A; Pan, W; Ying, GS; Bennett, J; Maguire, AM; Morgan, JI (13 December 2016). "Natural History of the Central Structural Abnormalities in Choroideremia: A Prospective Cross-Sectional Study". Ophthalmology. 124 (3): 359–373. doi:10.1016/j.ophtha.2016.10.022. PMC 5319901. PMID 27986385.
  4. ^ Abigail Beall, 2014, "Gene therapy restores sight in people with eye disease," New Scientist (online), January 16, 2014, see [1], accessed 21 January 2017.