Evaluation of Ocular Gene Therapy in an Italian Patient Affected by Congenital Leber Amaurosis Type 2 Treated in Both Eyes

Adv Exp Med Biol. 2016:854:533-9. doi: 10.1007/978-3-319-17121-0_71.

Abstract

Gene therapy clinical trials with gene augmentation therapy for Leber Congenital Amaurosis have shown partial reversal of retinal dysfunction. Most studies described the effect of treatment in a single eye and limited evidence is reported in literature about patients treated in both eyes. In this chapter, we present the findings of a young patient treated in both eyes. Efficacy of the treatment was assessed with Best Corrected Visual Acuity, Goldman Visual Field testing, Esterman computerized binocular visual field and Microperimetric testing. Post-treatment results showed improvement of visual function in both eyes, in particular, a strong amelioration was observed after the first injection, by using conventional monocular tests. Moreover, the treatment in the second eye resulted in a further improvement of binocular visual functionality, as easily detected by computerized binocular visual field. In conclusion, our data suggest that gene therapy can inhibit retinal degeneration and can be safe and effective in restoring visual functionality in young subjects treated in both eyes. Finally, new outcome measurements, in particular binocular computerized visual field parameters, can therefore be useful to quantify overall visual gain in patients undergoing gene therapy in both eyes.

Keywords: Binocular computerized visual field; Gene therapy; Leber’s Congenital Amaurosis; Microperimetry; Optical coherence tomography.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Dependovirus / genetics
  • Eye / metabolism*
  • Follow-Up Studies
  • Genetic Therapy / methods*
  • Genetic Vectors / administration & dosage
  • Genetic Vectors / genetics
  • Humans
  • Injections
  • Italy
  • Leber Congenital Amaurosis / genetics
  • Leber Congenital Amaurosis / physiopathology
  • Leber Congenital Amaurosis / therapy*
  • Treatment Outcome
  • Vision, Binocular / physiology
  • Vision, Ocular / physiology
  • Visual Acuity / physiology
  • Visual Fields / physiology
  • cis-trans-Isomerases / genetics
  • cis-trans-Isomerases / metabolism*

Substances

  • retinoid isomerohydrolase
  • cis-trans-Isomerases

Supplementary concepts

  • Amaurosis congenita of Leber, type 2