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Peer-reviewedCC BY-NC-NDTranslational vision science & technology

Microperimetry Sensitivity Changes at the Functional Transition Zone and at the EZ Margins in X-Linked Retinitis Pigmentosa Treated With Gene Therapy.

5 affiliations
  1. 1New England Eye Center, Tufts University School of Medicine, Boston, MA, USA.
  2. 2Boston Image Reading Center, Boston, MA, USA.
  3. 3Beacon Therapeutics, Cambridge, MA, USA.
  4. 4Department of Biomedical Engineering, University at Buffalo, NY, USA.
  5. 5Retina Foundation of the Southwest, TX, USA.

Abstract

Purpose

To evaluate the structure-function relationship between the photoreceptor ellipsoid zone (EZ) and functional transition zone (FTZ) in X-linked retinitis pigmentosa (XLRP) eyes treated with gene therapy.Methods

In a post-hoc analysis of the Skyline trial, baseline OCT volumes were segmented to generate an en-face map of intact EZ, and after registration with microperimetry (MP) image, the transformed EZ map was used to delineate the EZ margin. FTZ was defined by microperimetry absolute scotomatous points. Non-scotomatous loci adjacent to FTZ, and inside the EZ margin, were analyzed. We quantified the percentage of loci with ≥7 dB sensitivity improvements over 12 months and the average treatment effect (ATE; difference in mean sensitivity change between treated and untreated eyes).Results

Twenty-four eyes (12 treated, 12 untreated; seven high-dose, five low-dose) were analyzed. Baseline distance to the EZ margin did not correlate with loci achieving ≥7 dB improvement at month 12 in either dose group. High-dose eyes showed a higher mean percentage of loci with ≥7 dB improvement than untreated eyes for the entire grid, but not on regional analysis. High-dose subjects also showed higher ATE than untreated eyes in all retinal zones.Conclusions

High-dose AAV-RPGR gene therapy was associated with improved MP outcomes and greater ATE inside FTZ and intact EZ; however, loci with ≥7 dB improvement did not correlate with baseline EZ margin distance, highlighting challenges in prespecifying localized ≥7 dB changes.Translational relevance

Identifying and selecting retinal regions that are likely to show sensitivity improvements may benefit future clinical trials of ocular gene therapy.

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BibTeX
@article{jamil2026microperimetry,
  title = {{Microperimetry Sensitivity Changes at the Functional Transition Zone and at the EZ Margins in X-Linked Retinitis Pigmentosa Treated With Gene Therapy.}},
  author = {Muhammad Usman Jamil and A Yasin Alibhai and Darin Curtiss and Lucas R De Pretto and Antonio Yaghy and Jungeun Won and David G Birch and Nadia K Waheed},
  journal = {Translational vision science \& technology},
  year = {2026},
  month = oct,
  doi = {10.1167/tvst.15.10.10},
  url = {https://europepmc.org/article/MED/42847595},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Microperimetry Sensitivity Changes at the Functional Transition Zone and at the EZ Margins in X-Linked Retinitis Pigmentosa Treated With Gene Therapy.
AU  - Muhammad Usman Jamil
AU  - A Yasin Alibhai
AU  - Darin Curtiss
AU  - Lucas R De Pretto
AU  - Antonio Yaghy
AU  - Jungeun Won
AU  - David G Birch
AU  - Nadia K Waheed
PY  - 2026
DA  - 2026/10/01
JO  - Translational vision science & technology
DO  - 10.1167/tvst.15.10.10
UR  - https://europepmc.org/article/MED/42847595
AB  - Purpose  To evaluate the structure-function relationship between the photoreceptor ellipsoid zone (EZ) and functional transition zone (FTZ) in X-linked retinitis pigmentosa (XLRP) eyes treated with gene therapy.Methods  In a post-hoc analysis of the Skyline trial, baseline OCT volumes were segmented to generate an en-face map of intact EZ, and after registration with microperimetry (MP) image, the transformed EZ map was used to delineate the EZ margin. FTZ was defined by microperimetry absolute scotomatous points. Non-scotomatous loci adjacent to FTZ, and inside the EZ margin, were analyzed. We quantified the percentage of loci with ≥7 dB sensitivity improvements over 12 months and the average treatment effect (ATE; difference in mean sensitivity change between treated and untreated eyes).Results  Twenty-four eyes (12 treated, 12 untreated; seven high-dose, five low-dose) were analyzed. Baseline distance to the EZ margin did not correlate with loci achieving ≥7 dB improvement at month 12 in either dose group. High-dose eyes showed a higher mean percentage of loci with ≥7 dB improvement than untreated eyes for the entire grid, but not on regional analysis. High-dose subjects also showed higher ATE than untreated eyes in all retinal zones.Conclusions  High-dose AAV-RPGR gene therapy was associated with improved MP outcomes and greater ATE inside FTZ and intact EZ; however, loci with ≥7 dB improvement did not correlate with baseline EZ margin distance, highlighting challenges in prespecifying localized ≥7 dB changes.Translational relevance  Identifying and selecting retinal regions that are likely to show sensitivity improvements may benefit future clinical trials of ocular gene therapy.
SN  - 2164-2591
ER  -