rs1169420841

Variant summary

Our verdict is Likely pathogenic. Variant got 7 ACMG points: 7P and 0B. PM3_StrongPP3PP4PM2_Supporting

This summary comes from the ClinGen Evidence Repository: The NM_000329.3(RPE65):c.982C>T (p.Leu328Phe) variant is a missense variant causing a substitution of leucine with phenylalanine at position 328. This variant is present in gnomAD v.4.1.0 at a Grpmax allele frequency of 0.000003650, with 2/91076 in the South Asian population, which is lower than the ClinGen LCA/eoRD VCEP PM2_Supporting threshold of <0.0002 (PM2_Supporting). The computational predictor REVEL gives a score of 0.737, which is above the ClinGen LCA/eoRD VCEP threshold of ≥ 0.644 and predicts a damaging effect on RPE65 function (PP3). This variant has been reported in at least 4 probands with early-onset severe retinal dystrophy who were compound heterozygous with either the p.Tyr275Ter variant confirmed in trans (Pathogenic by VCEP, 1 point, PMID:31630094); the NM_000329.3(RPE65):c.639dup (p.Ala214SerfsTer20) variant suspected in trans (Pathogenic by VCEP, 0.5 pt, PMID:28393863); the p.Glu254Asp variant suspected in trans (LP by VCEP, 0.25 pt, PMID:35129589 with additional information presented in ARVO meeting abstract https://iovs.arvojournals.org/article.aspx?articleid=2767855); or the p.Leu447Pro variant confirmed in trans (VUS by VCEP, 0.25 pt, PMID:38002999), all of which were previously classified as described above by the ClinGen LCA/eoRD VCEP (2 total points, PM3_Strong). At least one proband harboring this variant exhibits a phenotype including clinical diagnosis of Leber congenital amaurosis (0.5 pt), congenital night blindness (0.5 pt), White/yellow dot deposits (2 pt), previous exome testing that did not provide an alternative explanation for visual impairment (2 pt), and symptomatic onset between birth and 5 years (1 pt), which together are specific for RPE65-related recessive retinopathy (6 points, PMIDs: 31630094, 34830511, PP4). In summary, this variant meets the criteria to be classified as Likely Pathogenic for RPE65-related recessive retinopathy based on the ACMG/AMP criteria applied, as specified by the ClinGen LCA/eoRD VCEP: PM2_Supporting, PP3, PP4, PM3_Strong (VCEP specifications version 1.0.0; date of approval 09/21/2023). LINK:https://erepo.genome.network/evrepo/ui/classification/CA340744630/MONDO:0100368/120

Frequency

Genomes: 𝑓 0.0000066 ( 0 hom., cov: 32)
Exomes 𝑓: 0.0000027 ( 0 hom. )

Consequence

RPE65
NM_000329.3 missense

Scores

10
8
1

Clinical Significance

Likely pathogenic reviewed by expert panel P:3U:2

Conservation

PhyloP100: 6.32
Variant links:
Genes affected
RPE65 (HGNC:10294): (retinoid isomerohydrolase RPE65) The protein encoded by this gene is a component of the vitamin A visual cycle of the retina which supplies the 11-cis retinal chromophore of the photoreceptors opsin visual pigments. It is a member of the carotenoid cleavage oxygenase superfamily. All members of this superfamily are non-heme iron oxygenases with a seven-bladed propeller fold and oxidatively cleave carotenoid carbon:carbon double bonds. However, the protein encoded by this gene has acquired a divergent function that involves the concerted O-alkyl ester cleavage of its all-trans retinyl ester substrate and all-trans to 11-cis double bond isomerization of the retinyl moiety. As such, it performs the essential enzymatic isomerization step in the synthesis of 11-cis retinal. Mutations in this gene are associated with early-onset severe blinding disorders such as Leber congenital. [provided by RefSeq, Oct 2017]

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ACMG classification

Classification made for transcript

Verdict is Likely_pathogenic. Variant got 7 ACMG points.

PM2
For more information check the summary or visit ClinGen Evidence Repository.
PM3
For more information check the summary or visit ClinGen Evidence Repository.
PP3
For more information check the summary or visit ClinGen Evidence Repository.
PP4
For more information check the summary or visit ClinGen Evidence Repository.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
RPE65NM_000329.3 linkc.982C>T p.Leu328Phe missense_variant Exon 9 of 14 ENST00000262340.6 NP_000320.1 Q16518

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
RPE65ENST00000262340.6 linkc.982C>T p.Leu328Phe missense_variant Exon 9 of 14 1 NM_000329.3 ENSP00000262340.5 Q16518

Frequencies

GnomAD3 genomes
AF:
0.00000657
AC:
1
AN:
152164
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.000207
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.00
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.00000398
AC:
1
AN:
251398
Hom.:
0
AF XY:
0.00000736
AC XY:
1
AN XY:
135858
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00000880
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.00000274
AC:
4
AN:
1461782
Hom.:
0
Cov.:
33
AF XY:
0.00000275
AC XY:
2
AN XY:
727202
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.00
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.0000116
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.00000270
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
AF:
0.00000657
AC:
1
AN:
152282
Hom.:
0
Cov.:
32
AF XY:
0.0000134
AC XY:
1
AN XY:
74458
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.000207
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.00
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.0000487
Hom.:
0

ClinVar

Significance: Likely pathogenic
Submissions summary: Pathogenic:3Uncertain:2
Revision: reviewed by expert panel
LINK: link

Submissions by phenotype

Leber congenital amaurosis 2;C3151086:Retinitis pigmentosa 20 Pathogenic:1Uncertain:1
Jun 06, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

This sequence change replaces leucine, which is neutral and non-polar, with phenylalanine, which is neutral and non-polar, at codon 328 of the RPE65 protein (p.Leu328Phe). This variant is present in population databases (no rsID available, gnomAD 0.0009%). This missense change has been observed in individual(s) with autosomal recessive early onset retinal dystrophy (PMID: 28393863, 31630094, 35129589). In at least one individual the data is consistent with being in trans (on the opposite chromosome) from a pathogenic variant. ClinVar contains an entry for this variant (Variation ID: 556178). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is not expected to disrupt RPE65 protein function with a negative predictive value of 80%. For these reasons, this variant has been classified as Pathogenic. -

Jan 16, 2018
Counsyl
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

RPE65-related recessive retinopathy Pathogenic:1
Dec 12, 2024
ClinGen Leber Congenital Amaurosis/early Onset Retinal Dystrophy Variant Curation Expert Panel, ClinGen
Significance: Likely pathogenic
Review Status: reviewed by expert panel
Collection Method: curation

The NM_000329.3(RPE65):c.982C>T (p.Leu328Phe) variant is a missense variant causing a substitution of leucine with phenylalanine at position 328. This variant is present in gnomAD v.4.1.0 at a Grpmax allele frequency of 0.000003650, with 2/91076 in the South Asian population, which is lower than the ClinGen LCA/eoRD VCEP PM2_Supporting threshold of <0.0002 (PM2_Supporting). The computational predictor REVEL gives a score of 0.737, which is above the ClinGen LCA/eoRD VCEP threshold of ≥ 0.644 and predicts a damaging effect on RPE65 function (PP3). This variant has been reported in at least 4 probands with early-onset severe retinal dystrophy who were compound heterozygous with either the p.Tyr275Ter variant confirmed in trans (Pathogenic by VCEP, 1 point, PMID: 31630094); the NM_000329.3(RPE65):c.639dup (p.Ala214SerfsTer20) variant suspected in trans (Pathogenic by VCEP, 0.5 pt, PMID: 28393863); the p.Glu254Asp variant suspected in trans (LP by VCEP, 0.25 pt, PMID: 35129589 with additional information presented in ARVO meeting abstract https://iovs.arvojournals.org/article.aspx?articleid=2767855); or the p.Leu447Pro variant confirmed in trans (VUS by VCEP, 0.25 pt, PMID: 38002999), all of which were previously classified as described above by the ClinGen LCA/eoRD VCEP (2 total points, PM3_Strong). At least one proband harboring this variant exhibits a phenotype including clinical diagnosis of Leber congenital amaurosis (0.5 pt), congenital night blindness (0.5 pt), White/yellow dot deposits (2 pt), previous exome testing that did not provide an alternative explanation for visual impairment (2 pt), and symptomatic onset between birth and 5 years (1 pt), which together are specific for RPE65-related recessive retinopathy (6 points, PMIDs: 31630094, 34830511, PP4). In summary, this variant meets the criteria to be classified as Likely Pathogenic for RPE65-related recessive retinopathy based on the ACMG/AMP criteria applied, as specified by the ClinGen LCA/eoRD VCEP: PM2_Supporting, PP3, PP4, PM3_Strong (VCEP specifications version 1.0.0; date of approval 09/21/2023). -

Leber congenital amaurosis 2;C3151086:Retinitis pigmentosa 20;C5231465:Retinitis pigmentosa 87 with choroidal involvement Pathogenic:1
Mar 04, 2024
Fulgent Genetics, Fulgent Genetics
Significance: Likely pathogenic
Review Status: criteria provided, single submitter
Collection Method: clinical testing

- -

not provided Uncertain:1
May 16, 2024
GeneDx
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

Reported in the published literature in at least two patients with fundus albipunctatus who also harbored an additional variant in the RPE65 gene (PMID: 28393863, 35129589); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; This variant is associated with the following publications: (PMID: Brunetti-Pierri 2020[Abstract], 34830511, 35129589, 36460718, 28393863, 33952291, 31273949, 29681726, 38002999, 31630094) -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
0.66
BayesDel_addAF
Pathogenic
0.25
D
BayesDel_noAF
Uncertain
0.12
CADD
Pathogenic
28
DANN
Uncertain
1.0
DEOGEN2
Pathogenic
0.92
D
Eigen
Pathogenic
0.76
Eigen_PC
Pathogenic
0.71
FATHMM_MKL
Pathogenic
0.97
D
LIST_S2
Uncertain
0.95
D
M_CAP
Uncertain
0.17
D
MetaRNN
Pathogenic
0.86
D
MetaSVM
Pathogenic
0.88
D
MutationAssessor
Pathogenic
3.0
M
PrimateAI
Uncertain
0.67
T
PROVEAN
Uncertain
-3.0
D
REVEL
Pathogenic
0.74
Sift
Uncertain
0.0050
D
Sift4G
Uncertain
0.0090
D
Polyphen
1.0
D
Vest4
0.75
MutPred
0.51
Gain of methylation at K332 (P = 0.1276);
MVP
0.98
MPC
0.35
ClinPred
0.99
D
GERP RS
4.9
Varity_R
0.61
gMVP
0.89

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.0
Details are displayed if max score is > 0.2

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Publications

LitVar

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs1169420841; hg19: chr1-68904641; API