The Invitae Aniridia Test analyzes the primary gene associated with aniridia, PAX6. Aniridia is a condition that is associated with underdevelopment or absence of iris tissue. Gillespie syndrome is also caused by pathogenic variants in PAX6 and is characterized by aniridia, cerebellar ataxia, and mental retardation. In addition, pathogenic variants in PAX6 have been implicated in disorders with findings such as coloboma, cataracts, keratitis, foveal hypoplasia, optic nerve hypoplasia, and Peters anomaly.
Analysis of the PAX6 gene may help guide treatment and management decisions. Identification of a disease-causing variant would also guide testing and diagnosis of at-risk relatives.
About a third of individuals with aniridia have a contiguous gene deletion that encompasses both the PAX6 and WT1 genes and that causes Wilms tumor, aniridia, genitourinary anomalies, and mental retardation (WAGR) syndrome. In the presence of any of these additional features, the WAGR syndrome test may be more appropriate.
Aniridia is a congenital sight-threatening disorder that is caused by haploinsufficiency of the PAX6 gene and is characterized by bilateral underdevelopment or absence of iris tissue. Most individuals with aniridia have foveal hypoplasia with reduced visual acuity and nystagmus, and many develop keratopathy, cataracts, or glaucoma, leading to a progressive decline in vision. Some affected individuals can also have microcornea, ectopia pupillae, optic nerve coloboma, ptosis, hypermetropia, myopia, Peters anomaly, anophthalmia, or microphthalmia. Aniridia can occasionally be associated with non-ocular findings, including hearing abnormalities and reduced olfaction. Rare individuals with more severe congenital abnormalities and compound heterozygous mutations in PAX6 have been reported.
About a third of individuals with aniridia have a contiguous gene deletion that encompasses both the PAX6 and WT1 genes and that causes Wilms tumor, aniridia, genitourinary anomalies, and mental retardation (WAGR) syndrome. Individuals with WAGR syndrome are at an increased risk of Wilms tumor: Approximately 50%–70% of these individuals develop Wilms tumor.
Pathogenic variants in PAX6 account for 77% of isolated aniridia without family history and approximately 80% of isolated aniridia with family history.
The disorders associated with PAX6 are inherited in an autosomal dominant manner.
Aniridia is 100% penetrant, although expressivity is variable and some features may not be readily apparent without a detailed clinical assessment.
The prevalence of aniridia is approximately 1 in 40,000 to 1 in 100,000 individuals, with a lower prevalence of about 1 in 133,931 individuals noted in the Chinese population.
Invitae is a College of American Pathologists (CAP)-accredited and Clinical Laboratory Improvement Amendments (CLIA)-certified clinical diagnostic laboratory performing full-gene sequencing and deletion/duplication analysis using next-generation sequencing technology (NGS).
Our sequence analysis covers clinically important regions of each gene, including coding exons, +/- 10 base pairs of adjacent intronic sequence, and select noncoding variants. Our assay provides a Q30 quality-adjusted mean coverage depth of 350x (50x minimum, or supplemented with additional analysis). Variants classified as pathogenic or likely pathogenic are confirmed with orthogonal methods, except individual variants that have high quality scores and previously validated in at least ten unrelated samples.
Our analysis detects most intragenic deletions and duplications at single exon resolution. However, in rare situations, single-exon copy number events may not be analyzed due to inherent sequence properties or isolated reduction in data quality. If you are requesting the detection of a specific single-exon copy number variation, please contact Client Services before placing your order.
|Gene||Transcript reference||Sequencing analysis||Deletion/Duplication analysis|