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Optic Atrophy 4

OMIM ID:

autosomal dominant

Optic Atrophy 4

Alternate Names

OPA4
optic atrophy-4

Defective Genes

OPA4

Clinical Characteristics

Ocular Features

This form of optic atrophy is clinically heterogeneous similar to others.  It is less common than OPA1 (165500).  Visual acuity ranges from normal to 6/200.  Individuals that carry the mutation usually have some degree of bilateral optic disc pallor and dyschromatopsia even in the presence of 20/20 acuity.  This profile is present in the first decade of life in some patients with most experiencing acute or subacute loss of vision between the ages of 18 and 35 years.  Vision loss is progressive in the majority of patients but unpredictable with some experiencing rapid decline whereas others have only a slow decline.  Age and visual acuity are not strongly correlated but in general older individuals have worse acuity.

Systemic Features

There are no systemic findings in OPA4.

Genetics

Inheritance

This is an autosomal dominant disorder secondary to mutations in the OPA4 gene at 18q12.2-q12.3.

Other autosomal dominant optic atrophy disorders include OPA1 (125250, 165500) and OPA5 (610708).

Pedigree

Autosomal dominant

Autosomal dominant disorders require only one mutation for the disease to be expressed.  Since an affected parent has two chromosomes, only one of which has the mutant gene, parents can expect that half (50%) of their children will receive that one and inherit the disease.  It is common for individuals that inherit the mutation, however, to not have evidence of the disease (nonpenetrance).

Image
Sample pedigree of autosomal dominant inheritance

Autosomal dominant inheritance leads to a vertical pattern of transmission

Treatment & Management

No treatment is available for hereditary optic atrophy but low vision aids can be helpful for visual assistance.

Selected Resources

Publications

Displaying 1 - 2 of 2

Clinical features, molecular genetics, and pathophysiology of dominant optic atrophy.

PubMedID: 9783700

Genetic Heterogeneity of Dominant Optic Atrophy, Kjer Type: Identification of a Second Locus on Chromosome 18q12.2-12.3

PubMedID: 10369594