Hereditary optic neuropathies are a group of heterogeneous disorders in which degeneration of the retinal ganglion cells and optic nerve atrophy are the primary characteristics. Autosomal dominant optic atrophy (ADOA; MIM [Mendelian Inheritance in Man] 165500) is the most common of these disorders and is frequently associated with mutation of the
OPA1 gene.
1,2 However, optic atrophy has also been linked to mutation in an unrelated nuclear gene,
OPA3. OPA3 is associated with two phenotypically distinct conditions. ADOA and cataract are characterized by optic atrophy, extrapyramidal signs, and blue-dot cerulean cataract (ADOAC, MIM 165300
3,4 ). Two dominant missense mutations that give rise to this disorder have been reported
4,5 : a heterozygous 277G-A transition (c.277G>A; p.G93S) and a 313C-G transversion (c.313C>G; p.Q105E), both in exon 2. Homozygous mutations in the
OPA3 gene have also been reported and are responsible for recessive 3-methylglutaconic aciduria type III or Costeff optic atrophy syndrome (3-MGCA: MIM 258501
6 ). Costeff syndrome is a neuro-ophthalmic syndrome characterized by increased urinary excretion of 3-methylglutaconic acid and 3-methylglutaric acid, with early-onset bilateral optic atrophy, reduced visual acuity, and later-onset spasticity, extrapyramidal dysfunction, and occasional cognitive defect.
7 Three homozygous mutations have been reported in
OPA3. The first mutation to be reported was homozygous in all patients of Iraqi-Jewish origin and is a splice site founder mutation, c.143–1G>C (IVS1-G>C) that abolishes mRNA in fibroblasts.
6 An in-frame 18-bp deletion in exon 2, c.320_337del (p.Q108_E113del),
8 and a homozygous nonsense mutation, c.415C>T (p.Q139X), also in exon 2,
9 have also been reported.