{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T03:42:38Z","timestamp":1793504558951,"version":"4.5.0"},"reference-count":46,"publisher":"American Society for Clinical Investigation","issue":"2","license":[{"start":{"date-parts":[[2022,1,25]],"date-time":"2022-01-25T00:00:00Z","timestamp":1643068800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Intramural Research Program of the National Eye Institute","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}]},{"DOI":"10.13039\/501100001659","name":"German Research Foundation","doi-asserted-by":"crossref","award":["PF950\/1-1"],"award-info":[{"award-number":["PF950\/1-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,25]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>\n                      Outcome measures sensitive to disease progression are needed for ATP-binding cassette, sub-family A, member 4\u2013associated (\n                      <jats:italic>ABCA4<\/jats:italic>\n                      -associated) retinopathy. We aimed to quantify ellipsoid zone (EZ) loss and photoreceptor degeneration beyond\n                      <jats:italic>EZ-loss<\/jats:italic>\n                      in\n                      <jats:italic>ABCA4<\/jats:italic>\n                      -associated retinopathy and investigate associations between photoreceptor degeneration, genotype, and age.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      We analyzed 132 eyes from 66 patients (of 67 enrolled) with molecularly confirmed\n                      <jats:italic>ABCA4<\/jats:italic>\n                      -associated retinopathy from a prospective natural history study with a median [IQR] follow-up of 4.2 years [3.1, 5.1]. Longitudinal spectral-domain optical coherence tomography volume scans (37 B-scans, 30\u00b0 \u00d7 15\u00b0) were segmented using a deep learning (DL) approach. For genotype-phenotype analysis, a model of\n                      <jats:italic>ABCA4<\/jats:italic>\n                      variants was applied with the age of criterion\n                      <jats:italic>EZ-loss<\/jats:italic>\n                      (6.25 mm\n                      <jats:sup>2<\/jats:sup>\n                      ) as the dependent variable.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Patients exhibited an average (square-root-transformed)\n                      <jats:italic>EZ-loss<\/jats:italic>\n                      progression rate of [95% CI] 0.09 mm\/y [0.06, 0.11]. Outer nuclear layer (ONL) thinning extended beyond the area of\n                      <jats:italic>EZ-loss<\/jats:italic>\n                      . The average distance from the\n                      <jats:italic>EZ-loss<\/jats:italic>\n                      boundary to normalization of ONL thickness (to \u00b12\n                      <jats:italic>z<\/jats:italic>\n                      score units) was 3.20\u00b0 [2.53, 3.87]. Inner segment (IS) and outer segment (OS) thinning was less pronounced, with an average distance from the\n                      <jats:italic>EZ-loss<\/jats:italic>\n                      boundary to layer thickness normalization of 1.20\u00b0 [0.91, 1.48] for the IS and 0.60\u00b0 [0.49, 0.72] for the OS. An additive model of allele severity explained 52.7% of variability in the age of criterion\n                      <jats:italic>EZ-loss<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>\n                      Patients with\n                      <jats:italic>ABCA4<\/jats:italic>\n                      -associated retinopathy exhibited significant alterations of photoreceptors outside of\n                      <jats:italic>EZ-loss<\/jats:italic>\n                      . DL-based analysis of photoreceptor laminae may help monitor disease progression and estimate the severity of\n                      <jats:italic>ABCA4<\/jats:italic>\n                      variants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>TRIAL REGISTRATION<\/jats:title>\n                    <jats:p>ClinicalTrials.gov identifier: NCT01736293.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>FUNDING<\/jats:title>\n                    <jats:p>National Eye Institute Intramural Research Program and German Research Foundation grant PF950\/1-1.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1172\/jci.insight.155373","type":"journal-article","created":{"date-parts":[[2022,1,24]],"date-time":"2022-01-24T14:00:46Z","timestamp":1643032846000},"source":"Crossref","is-referenced-by-count":26,"title":["Photoreceptor degeneration in ABCA4-associated retinopathy and its genetic correlates"],"prefix":"10.1172","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9761-9640","authenticated-orcid":true,"given":"Maximilian","family":"Pfau","sequence":"first","affiliation":[{"name":"National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA."},{"name":"Department of Ophthalmology, University of Bonn, Bonn, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine A.","family":"Cukras","sequence":"additional","affiliation":[{"name":"National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0309-9419","authenticated-orcid":true,"given":"Laryssa A.","family":"Huryn","sequence":"additional","affiliation":[{"name":"National Eye Institute, National Institutes of Health, Bethesda, Maryland, 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