RESUMO
Pathogenic mutations in USH2A are a leading cause of visual loss secondary to non-syndromic or Usher syndrome-associated retinitis pigmentosa (RP). With an increasing number of RP-targeted clinical trials in progress, we sought to evaluate the photoreceptor topography underlying patterns of loss observed on clinical retinal imaging to guide surrogate endpoint selection in USH2A retinopathy. In this prospective cross-sectional study, twenty-five patients with molecularly confirmed USH2A-RP underwent fundus autofluorescence (FAF), spectral-domain optical coherence tomography (SD-OCT) and adaptive optics scanning laser ophthalmoscopy (AOSLO) retinal imaging. Analysis comprised measurement of FAF horizontal inner (IR) and outer (OR) hyperautofluorescent ring diameter; SD-OCT ellipsoid zone (EZ) and external limiting membrane (ELM) width, normalised EZ reflectance; AOSLO foveal cone density and intact macular photoreceptor mosaic (IMPM) diameter. Thirty-two eyes from 16 patients (mean age ± SD, 36.0 ± 14.2 years) with USH2A-associated Usher syndrome type 2 (n = 14) or non-syndromic RP (n = 2) met the inclusion criteria. Spatial alignment was observed between IR-EZ and OR-ELM diameters/widths (p < 0.001). The IMPM border occurred just lateral to EZ loss (p < 0.001), although sparser intact photoreceptor inner segments were detected until ELM disruption. EZ width and IR diameter displayed a biphasic relationship with cone density whereby slow cone loss occurred until retinal degeneration reached ~1350 µm from the fovea, beyond which greater reduction in cone density followed. Normalised EZ reflectance and cone density were significantly associated (p < 0.001). As the strongest correlate of cone density (p < 0.001) and best-corrected visual acuity (p < 0.001), EZ width is the most sensitive biomarker of structural and functional decline in USH2A retinopathy, rendering it a promising trial endpoint.
Assuntos
Retinose Pigmentar , Síndromes de Usher , Biomarcadores , Estudos Transversais , Proteínas da Matriz Extracelular/genética , Humanos , Estudos Prospectivos , Retinose Pigmentar/diagnóstico por imagem , Retinose Pigmentar/genética , Tomografia de Coerência Óptica/métodos , Síndromes de Usher/diagnóstico por imagem , Síndromes de Usher/genética , Acuidade VisualRESUMO
AIMS: Using optical coherence tomography angiography (OCTA) to characterise microvascular changes in the retinal plexuses and choriocapillaris (CC) of patients with MYO7A and USH2A mutations and correlate with genotype, retinal structure and function. METHODS: Twenty-seven patients with molecularly confirmed USH2A (n=21) and MYO7A (n=6) mutations underwent macular 6×6 mm OCTA using the AngioVue. Heidelberg spectral-domain OCT scans and MAIA microperimetry were also performed, the preserved ellipsoid zone (EZ) band width and mean macular sensitivity (MS) were recorded. OCTA of the inner retina, superficial capillary plexus (SCP), deep capillary plexus (DCP) and CC were analysed. Vessel density (VD) was calculated from the en face OCT angiograms of retinal circulation. RESULTS: Forty-eight eyes with either USH2A (n=37, mean age: 34.4±12.2 years) or MYO7A (n=11, mean age: 37.1±12.4 years), and 35 eyes from 18 age-matched healthy participants were included. VD was significantly decreased in the retinal circulation of patients with USH2A and MYO7A mutations compared with controls (p<0.001). Changes were observed in both the SCP and DCP, but no differences in retinal perfusion were detected between USH2A and MYO7A groups. No vascular defects were detected in CC of the USH2A group, but peripheral defects were detected in older MYO7A patients from the fourth decade of life. VD in the DCP showed strong association with MS and EZ width (Spearman's rho =0.64 and 0.59, respectively, p<0.001). CONCLUSION: OCTA was able to detect similar retinal microvascular changes in patients with USH2A and MYO7A mutations. The CC was generally affected in MYO7A mutations. OCT angiography may further enhance our understanding of inherited eye diseases and their phenotype-genotype associations.
Assuntos
Proteínas da Matriz Extracelular/genética , Mutação , Miosina VIIa/genética , Doenças Retinianas/diagnóstico , Vasos Retinianos/patologia , Síndromes de Usher/patologia , Adulto , Corioide/irrigação sanguínea , Corioide/diagnóstico por imagem , Feminino , Angiofluoresceinografia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Retinianas/genética , Doenças Retinianas/fisiopatologia , Vasos Retinianos/diagnóstico por imagem , Tomografia de Coerência Óptica , Síndromes de Usher/diagnóstico por imagem , Síndromes de Usher/genética , Acuidade Visual/fisiologia , Testes de Campo Visual , Adulto JovemRESUMO
Today, silicon is the most used material in photovoltaics, with the maximum conversion efficiency getting very close to the Shockley-Queisser limit for single-junction devices. Integrating silicon with higher band-gap ternary III-V absorbers is the path to increase the conversion efficiency. Here, we report on the first monolithic integration of Ga xIn(1- x)P vertical nanowires, and the associated p-n junctions, on silicon by the Au-free template-assisted selective epitaxy (TASE) method. We demonstrate that TASE allows for a high chemical homogeneity of ternary alloys through the nanowires. We then show the influence of doping on the chemical composition and crystal phase, the latter previously attributed to the role of the contact angle in the liquid phase in the vapor-liquid-solid technique. Finally, the emission of the p-n junction is investigated, revealing a shift in the energy of the intraband levels due to the incorporation of dopants. These results clarify some open questions on the effects of doping on ternary III-V nanowire growth and provide the path toward their integration on the silicon platform in order to apply them in next-generation photovoltaic and optoelectronic devices.