Table 3. Clinical differences between disorders caused by bestrophin-1 (BEST1) mutations.
Clinical signs | Best disease [28,33-35,38,39] | ARB [8-10] | ADVIRC [3-7] | Concentric RP [13] | AVMD [11,12] |
---|---|---|---|---|---|
Mode of inheritance |
Autosomal dominant |
Autosomal recessive |
Autosomal dominant |
Autosomal dominant |
Autosomal dominant |
Fundus lesion |
Central macula vitelliform lesions |
Diffuse RPE disturbance and dispersed punctate flecks, subretinal fluid may fluctuate |
Peripheral circumferential pigmentation, and peripapillary chorioretinal atrophy |
Foveal deposits, prone to serous retinal detachments. Intraretinal bone spicule pigmentation - often showing an abrupt change between normal and abnormal retina |
Milder phenotype characterized by RPE atrophy; small drusen-like deposits in the paracentral region |
Lens changes |
Not known |
Not known |
Spherophakia and cataract |
Cataract |
Nil |
Refraction |
One third ≥ +3.00 DS |
Range from +0.25 to +4.75 DS |
−2.50 DS to +15.00 DS depending on axial biometry / presence of posterior staphyloma |
Limited data suggest marked interfamilial variability from high hyperopia to high myopia |
Unknown |
Other features |
ACG |
ACG |
ACG, microcornea, iris dysgenesis, and posterior staphyloma |
Nil |
Nil |
EOG findings of relevance to this study | Normal/ near-normal EOGs reported for p.F305S/L, p.A243V, p.I295del | No cases of affected individuals with normal EOGs to date | Marked inter and intra-familial variability for EOG findings | EOGs not tested | Mildly reduced EOG for p.A243V |
Abbreviations: ARB represents autosomal recessive bestrophinopathy; ADVIRC represents autosomal dominant vitreoretinochoroidopathy; RP represents retinitis pigmentosa; AVMD represents adult vitelliform macular dystrophy; RPE represents retinal pigment epithelium; DS represents diopters sphere; ACG represents angle-closure glaucoma; EOG represents electrooculography.