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Retinitis Pigmentosa 38

OMIM ID:

autosomal recessive

Retinitis Pigmentosa 38

Alternate Names

childhood-onset rod-cone dystrophy
RP38

Defective Genes

MERTK

Clinical Characteristics

Ocular Features

This is a rare clinically heterogeneous condition in which both rods and cones functions are variably affected.  It is a progressive disorder with children often being aware of night vision difficulties during the latter half of the first decade of life.  Reduced vision is often present at this time as well and progressively deteriorates.  Visual fields are constricted to 20-30 degrees.  Rod responses may be nondetectable in the first decade.

Central vision is subnormal as early as childhood and progressively worsens with age.  Dyschromatopsia to some degree is often present early as well and some patients have a maculopathy with a bull’s eye pattern and thinning of the photoreceptor layer seen on OCT.  Attenuated retinal vessels, pale optic discs, and variable fundus pigmentary changes (including pigmentary mottling and bone spicules) have been seen.  The degree and course of the photoreceptor damage is variable leading some to propose that RP38 is primarily a cone-rod dystrophy.

Systemic Features

None

Genetics

Inheritance

This is an autosomal recessive disorder resulting from homozygous mutations in the MERTK gene (2q13).

Pedigree

Autosomal recessive

In order for autosomal recessive disorders to be expressed, offspring generally must inherit two mutations, one from each carrier parent.  Carriers with only one mutation, such as the parents, do not have clinical disease.  Note that carrier parents can expect that 1 in 4 children (25%) will inherit both mutations and have the disorder, 2 in 4 children (50%) will be carriers like their parents, while 1 in 4 children (25%) inherit neither mutation.

Image
Sample pedigree of autosomal recessive inheritance

In order for autosomal recessive disorders to be expressed, offspring generally must inherit two mutations, one from each carrier parent. Carriers with only one mutation, such as the parents, do not have clinical disease. Note that carrier parents can expect that 1 in 4 children (25%) will inherit both mutations and have the disorder, 2 in 4 children (50%) will be carriers like their parents, while 1 in 4 children (25%) inherit neither mutation.

Treatment & Management

No treatment has been reported but young people especially could benefit from low vision aids and special education therapy.

Publications

Displaying 1 - 2 of 2

Homozygous Mutation in MERTK Causes Severe Autosomal Recessive Retinitis Pigmentosa

PubMedID: 22180149

Novel mutations in MERTK associated with childhood onset rod-cone dystrophy

PubMedID: 20300561