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Cone-Rod Dystrophies are a family of genetically diverse  disorders characterized by progressive degeneration of the cone and rod cells in the retina. These are the cells responsible for vision. This leads to a spectrum of visual symptoms and challenges, making cone-rode dystrophy a complex condition.

What are the causes and risk factors of Cone-Rod Dystrophies?

CRD’s mainly result from mutations in various genes, such as ABCA4, CRX, or GUCA1A. The inheritance pattern may vary, including autosomal recessive (both parents are required to have the mutation), autosomal dominant (only one parent requires the mutation), or X-linked (mutation on the X chromosome) , depending on the specific gene involved.

The main risk factor is individuals with a family history of CRD and those carrying abnormal copies of the associated genes are at an increased risk.

Examples of CRD include:

  1. ABCA4-Related Cone-Rod Dystrophy (CRD): Genetic mutations in the ABCA4 gene. Characterized by impaired colour vision, night blindness, and progressive central vision loss.
  1. CRX-Related Cone-Rod Dystrophy: Mutations in the CRX gene. Early-onset cone dysfunction leading to impaired colour vision and subsequent rod cell involvement.
  1. GUCA1A-Related Cone-Rod Dystrophy (CACD): Mutations in the GUCA1A gene. Presents with central vision loss, difficulty adapting to bright light, and impaired colour vision.

What are the signs and symptoms of Cone-Rod Dystrophy?

Early signs of CRD include:

  • Impaired Colour Vision: Difficulty distinguishing between colours or a noticeable decrease in colour intensity.
  • Photophobia: Increased sensitivity to light, particularly in bright or changing lighting conditions.
  • Difficulties in Bright Light: Challenges in adapting to bright environments.

Signs of disease progression include:

  • Loss of Central and Peripheral Vision: Gradual deterioration in the ability to see details, both centrally and peripherally.
  • Night Blindness: Difficulty seeing in low-light conditions.
  • Impaired Contrast Sensitivity: Struggling to differentiate between objects with similar brightness.

How are Cone-Rod Dystrophies diagnosed?

At The Retina Clinic London, all patients attending an initial consultation with one of our Genetic Diseases Specialist, will undergo an array of extensive testing to help diagnose your condition whilst will include, amongst others:

  • Visual Acuity Tests: Assessing clarity and sharpness of vision.
  • Visual Field Tests: Mapping the extent of peripheral vision.
  • Electroretinography (ERG): Recording the electrical responses of photoreceptor cells. ERG is an extremely important clinical tool in providing functional measures of your retinas and to understand to what extent the cone and rod cells have deteriorated in their function. 
  • High-resolution ultrawide-field OCT and Macula OCT: Cross-sectional scans of your retina will be taken to identify what changes are happening at an anatomical level in your retinas and to know the extent of any existing conditions.
  • Ultra-widefield multi-wavelength fundus images: pictures of the back of your eye will be taken to have an en-face view of your retinas and to see the extent of any disease and to understand where the affected areas are.
  • Genetic Testing: At The Retina Clinic London, we are in the privileged position of being able to offer a genetic testing service with samples collected in-house before being sent off to the laboratory for processing. This genetic testing is specifically to identify any mutations in those genes associated with the retina and its functioning. We also offer a service to test family members to see if there are also carriers of that gene. More information can be found here.

What treatment options are there available for Cone-Rod Dystrophy?

At the moment there are no approved treatments options for Cone-Rod Dystrophies. However, at The Retina Clinic London, we are also a centre for industry-sponsored clinical trials and, led by Prof. Stanga, we aim to bring patients choice in signing up to the latest trials for their condition where possible. Please see our Clinical Trials page to understand whether or not we are currently recruiting for a trial in CRD’s. Similarly, following a consultation with us, with your consent, you will automatically be entered into our database to be contacted for future studies.

Low Vision Aids are an option for managing the symptoms of CRD and include devices like magnifiers, telescopes, and adaptive technologies to enhance remaining vision. These can be discussed in further detail during your consultation.

Coping with Cone-Rod Dystrophy

When attending a genetics consultation at our clinic, our specialists will discuss with you to variety of emotional and psychological resources to cope with CRD and the disease progression. These will include:

  • Genetic Counselling: Guidance for families on the inheritance pattern and risk.
  • Support Groups: Connecting with others facing similar challenges.
  • Orientation and Mobility Training: Learning techniques for safe navigation.
  • Psychosocial Support: Addressing the emotional impact of vision loss.