Clinical expression of RP exhibits a high degree of heterogeneity. In attempts to simplify, adRP-carrying families have been classified as type 1 (early onset and diffuse retinal involvement), type 2 (late onset and regional retinal involvement),
25 or a variable intrafamilial expression. Thus, mutations in the rhodopsin gene, such as Pro347Leu, represent an extreme of type 1 diffuse adRP phenotype, whereas Pro23His shows a type 2 mild RP phenotype.
26 Some mutations in the
RP1 gene causing a truncated protein have been found in adRP-carrying families with variable intrafamilial expression (Carballo M, unpublished results, 2003). Mutations in the pre-mRNA splicing-factor genes
PRPF3 and
PRPF8 identified in adRP-affected Spanish families display a type 1 phenotype. The phenotypes observed in the previously reported families linked to RP13 (
PRPF8) and RP18 (
PRPF3) loci are also indicative of type 1 adRP.
27 28 29 30 However, two families with mutations in the
PRPF31 gene have been reported with variable interfamily expression as in the Spanish M368 and M637 families.
10 22 The phenotype observed for Spanish patients with RP who have mutations in
PRPF8 and
PRPF31 showed early onset, diffuse pigmentary changes, and visual fields with concentric depression; most fields were constricted to 10°. The ERG is abolished in most patients from the second decade of life. The patient carrying the mutation T494M in the
PRPF3 gene showed a late onset and less severe RP phenotype than the patients with mutations in
PRPF8 or
PRPF31. Because we have clinically examined only one patient carrying the mutation T494M, limited conclusions can be made about the RP phenotype causing by this mutation in the family.