PAX6 missense variants in two families with isolated foveal hypoplasia and nystagmus: evidence of paternal postzygotic mosaicism

Eur J Hum Genet. 2021 Feb;29(2):349-355. doi: 10.1038/s41431-020-00737-1. Epub 2020 Oct 6.

Abstract

PAX6 is considered the master regulator of eye development, the majority of variants affecting this gene cause the pan-ocular developmental eye disorder aniridia. Although no genotype-phenotype correlations are clearly established, missense variants affecting the DNA-binding paired domain of PAX6 are usually associated with non-aniridia phenotypes like microphthalmia, coloboma or isolated foveal hypoplasia. In this study, we report two missense heterozygous variants in the paired domain of PAX6 resulting in isolated foveal hypoplasia with nystagmus in two independent families: c.112 C > G; p.(Arg38Gly) and c.214 G > C; p.(Gly72Arg) in exons 5 and 6, respectively. Furthermore, we provide evidence that paternal postzygotic mosaicism is the cause of inheritance, with clinically unaffected fathers and reduced affected allele fraction. This work contributes to increase the phenotypic spectrum caused by PAX6 variants, and to our knowledge, is the first report to describe the presence of postzygotic parental mosaicism causing isolated foveal hypoplasia with nystagmus. These results support the growing evidence that suggest an overestimation of sporadic cases with PAX6 variants, which has strong implications for both genetic counselling and family planning.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aniridia / genetics
  • Coloboma
  • Eye Diseases, Hereditary / genetics*
  • Eye Proteins / genetics
  • Female
  • Fovea Centralis / abnormalities*
  • Genetic Association Studies
  • Genetic Testing
  • Genotype
  • Humans
  • Male
  • Microphthalmos / genetics
  • Middle Aged
  • Mosaicism*
  • Mutation
  • Mutation, Missense*
  • Nystagmus, Congenital / genetics*
  • Nystagmus, Pathologic / genetics*
  • PAX6 Transcription Factor / genetics*
  • Parents
  • Pedigree
  • Phenotype
  • Young Adult

Substances

  • Eye Proteins
  • PAX6 Transcription Factor
  • PAX6 protein, human

Supplementary concepts

  • Foveal Hypoplasia, Isolated