Isolated macular dystrophy

disease
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Summary

Isolated macular dystrophy (MONDO:0957048) is a disease with 12 cohort genes.

At a glance

  • Cohort genes: 12
  • ClinVar variants: 21

Clinical features

No curated clinical features (Orphanet) for this disease.

Identifiers

Disease identifiers

FieldValue
Canonical nameisolated macular dystrophy
Mondo IDMONDO:0957048
Orphanet519302
UMLSC5681367
MedGen1842262
GARD0022097
Is cancer (heuristic)no

Data availability: 21 ClinVar variants.

Disease family

Classification path: disease › human disease › disease by body system or component › nervous system disorderretinal disorderretinal degenerationmacular degenerationisolated macular dystrophy

Related subtypes (8): vitelliform macular dystrophy, degeneration of macula and posterior pole, macular retinal edema, autosomal recessive bestrophinopathy, occult macular dystrophy, macular degeneration, early-onset, Stargardt disease, patterned macular dystrophy

Genetics & variants

GWAS landscape

No GWAS associations recorded — common-variant (GWAS) studies don’t cover this disease (typical for Mendelian / rare diseases). See the curated gene cohort and Mendelian overlap below.

Variant details and genetic-evidence tiers

ClinVar germline variants

21 retrieved; paginated sample, class counts are floors:

7 conflicting classifications of pathogenicity, 7 pathogenic/likely pathogenic, 6 pathogenic, 1 likely pathogenic

ClinVarVariant (HGVS)GeneClassificationReview
813128NM_000350.3(ABCA4):c.1912C>T (p.Pro638Ser)ABCA4Pathogeniccriteria provided, single submitter
813130NM_000350.3(ABCA4):c.2294G>C (p.Ser765Thr)ABCA4Pathogeniccriteria provided, multiple submitters, no conflicts
813132NM_000350.3(ABCA4):c.2579T>C (p.Val860Ala)ABCA4Pathogeniccriteria provided, single submitter
813146NM_000350.3(ABCA4):c.2588-161_2615delABCA4Pathogeniccriteria provided, single submitter
444253NM_004183.4(BEST1):c.37C>G (p.Arg13Gly)BEST1Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
623772NM_004183.4(BEST1):c.247+2delBEST1Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
807800NM_033380.3(COL4A5):c.2315G>T (p.Gly772Val)COL4A5Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
802212NM_001384910.1(GUCA1A):c.359G>T (p.Arg120Leu)GUCA1APathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
493439NM_001563.4(IMPG1):c.378G>A (p.Trp126Ter)IMPG1Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
444672NM_001242957.3(MAK):c.1700_1703del (p.Asn567fs)MAKPathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
2628029NM_006204.4(PDE6C):c.2368-2A>TPDE6CPathogeniccriteria provided, single submitter
813204NM_006017.3(PROM1):c.1767+4A>GPROM1Pathogeniccriteria provided, single submitter
624247NM_000322.5(PRPH2):c.331del (p.Ile111fs)PRPH2Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
3336852NM_001163692.2(UBAP1L):c.120+1G>TUBAP1LLikely pathogeniccriteria provided, single submitter
424902NM_000350.3(ABCA4):c.2875A>T (p.Thr959Ser)ABCA4Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
806169NM_000350.3(ABCA4):c.463G>A (p.Asp155Asn)ABCA4Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
813140NM_000350.3(ABCA4):c.5329A>T (p.Met1777Leu)ABCA4Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
813148NM_000350.3(ABCA4):c.5198T>C (p.Met1733Thr)ABCA4Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
1354645NM_001098.3(ACO2):c.934C>T (p.Arg312Trp)ACO2Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
425251NM_201548.5(CERKL):c.1546_1565dup (p.Gly523fs)CERKLConflicting classifications of pathogenicitycriteria provided, conflicting classifications
425378NM_000322.5(PRPH2):c.653C>T (p.Ser218Leu)PRPH2Conflicting classifications of pathogenicitycriteria provided, conflicting classifications

Genes & proteins

Mendelian disease overlap and somatic drivers

GenCC: 0 · Orphanet: 39 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0

Orphanet rare-disease linkage (cohort genes)

GeneOrphanet IDRare disease
ACO2Orphanet:313850Infantile cerebellar-retinal degeneration
ACO2Orphanet:98676Autosomal recessive isolated optic atrophy
BEST1Orphanet:1243Best vitelliform macular dystrophy
BEST1Orphanet:139455Autosomal recessive bestrophinopathy
BEST1Orphanet:263347MRCS syndrome
BEST1Orphanet:3086Autosomal dominant vitreoretinochoroidopathy
BEST1Orphanet:35612Nanophthalmos
BEST1Orphanet:791Retinitis pigmentosa
BEST1Orphanet:99000Adult-onset foveomacular vitelliform dystrophy
CERKLOrphanet:791Retinitis pigmentosa
COL4A5Orphanet:1018X-linked Alport syndrome-diffuse leiomyomatosis
COL4A5Orphanet:653722Digenic Alport syndrome
COL4A5Orphanet:88917X-linked Alport syndrome
ABCA4Orphanet:1872Cone rod dystrophy
ABCA4Orphanet:791Retinitis pigmentosa
ABCA4Orphanet:827Stargardt disease
UBAP1LOrphanet:1872Cone rod dystrophy
GUCA1AOrphanet:1871Progressive cone dystrophy
GUCA1AOrphanet:1872Cone rod dystrophy
GUCA1AOrphanet:75377Central areolar choroidal dystrophy
IMPG1Orphanet:251287Benign concentric annular macular dystrophy
IMPG1Orphanet:791Retinitis pigmentosa
IMPG1Orphanet:99000Adult-onset foveomacular vitelliform dystrophy
MAKOrphanet:791Retinitis pigmentosa
PDE6COrphanet:1871Progressive cone dystrophy
PDE6COrphanet:49382Achromatopsia
PROM1Orphanet:1872Cone rod dystrophy
PROM1Orphanet:319640Retinal macular dystrophy type 2
PROM1Orphanet:791Retinitis pigmentosa
PROM1Orphanet:827Stargardt disease
PRPH2Orphanet:1872Cone rod dystrophy
PRPH2Orphanet:227796Fundus albipunctatus
PRPH2Orphanet:52427Retinitis punctata albescens
PRPH2Orphanet:75377Central areolar choroidal dystrophy
PRPH2Orphanet:791Retinitis pigmentosa
PRPH2Orphanet:827Stargardt disease
PRPH2Orphanet:99000Adult-onset foveomacular vitelliform dystrophy
PRPH2Orphanet:99001Butterfly-shaped pigment dystrophy
PRPH2Orphanet:99003Multifocal pattern dystrophy simulating fundus flavimaculatus

Cohort genes → proteins

12 cohort genes, 12 distinct canonical proteins.

Evidence partition

SubsetGenes
multi_evidence12

Cohort genes (full)

SymbolHGNCEnsemblUniProtNameEvidence
ACO2HGNC:118ENSG00000100412Q99798Aconitate hydratase, mitochondrialclinvar
BEST1HGNC:12703ENSG00000167995O76090Bestrophin-1clinvar
CERKLHGNC:21699ENSG00000188452Q49MI3Ceramide kinase-like proteinclinvar
COL4A5HGNC:2207ENSG00000188153P29400Collagen alpha-5(IV) chainclinvar
ABCA4HGNC:34ENSG00000198691P78363Retinal-specific phospholipid-transporting ATPase ABCA4clinvar
UBAP1LHGNC:40028ENSG00000246922F5GYI3Ubiquitin-associated protein 1-likeclinvar
GUCA1AHGNC:4678ENSG00000048545P43080Guanylyl cyclase-activating protein 1clinvar
IMPG1HGNC:6055ENSG00000112706Q17R60Interphotoreceptor matrix proteoglycan 1clinvar
MAKHGNC:6816ENSG00000111837P20794Serine/threonine-protein kinase MAKclinvar
PDE6CHGNC:8787ENSG00000095464P51160Cone cGMP-specific 3’,5’-cyclic phosphodiesterase subunit alpha'clinvar
PROM1HGNC:9454ENSG00000007062O43490Prominin-1clinvar
PRPH2HGNC:9942ENSG00000112619P23942Peripherin-2clinvar

Cohort function summary

Lead sentence per gene, UniProt-curated.

SymbolProtein nameFunction (lead sentence)
ACO2Aconitate hydratase, mitochondrialCatalyzes the isomerization of citrate to isocitrate via cis-aconitate.
BEST1Bestrophin-1Ligand-gated anion channel that allows the movement of anions across cell membranes when activated by calcium (Ca2+).
CERKLCeramide kinase-like proteinHas no detectable ceramide-kinase activity.
COL4A5Collagen alpha-5(IV) chainType IV collagen is the major structural component of glomerular basement membranes (GBM), forming a ‘chicken-wire’ meshwork together with laminins, proteoglycans and entactin/nidogen.
ABCA4Retinal-specific phospholipid-transporting ATPase ABCA4Flippase that catalyzes in an ATP-dependent manner the transport of retinal-phosphatidylethanolamine conjugates like 11-cis and all-trans isomers of N-retinylidene-phosphatidylethanolamine (N-Ret-PE) from the lumen to the cytoplasmic leafl…
GUCA1AGuanylyl cyclase-activating protein 1Stimulates retinal guanylyl cyclase when free calcium ions concentration is low and inhibits guanylyl cyclase when free calcium ions concentration is elevated.
IMPG1Interphotoreceptor matrix proteoglycan 1Chondroitin sulfate-, heparin- and hyaluronan-binding protein.
MAKSerine/threonine-protein kinase MAKEssential for the regulation of ciliary length and required for the long-term survival of photoreceptors.
PDE6CCone cGMP-specific 3’,5’-cyclic phosphodiesterase subunit alpha’As cone-specific cGMP phosphodiesterase, it plays an essential role in light detection and cone phototransduction by rapidly decreasing intracellular levels of cGMP.
PROM1Prominin-1May play a role in cell differentiation, proliferation and apoptosis.
PRPH2Peripherin-2Essential for retina photoreceptor outer segment disk morphogenesis, may also play a role with ROM1 in the maintenance of outer segment disk structure.

Protein-family classification

Druggable: 4 · Difficult: 1 · Unknown: 7 · Druggable fraction: 0.33

Family distribution

Cohort families vs a genome-wide background (hypergeometric, BH-FDR; fold = observed/expected). Counts kept; sorted by enrichment, so the catch-all Other/Unknown bucket no longer leads.

FamilyGenesFoldFDR
Kinase24.6×0.338
Transporter16.5×0.360
Other/Unknown71.1×0.788
Enzyme (other)11.0×0.788
Transcription factor10.7×0.788

Per-gene assignment

SymbolFamilyDruggable?ECInterPro (top 3)
ACO2Enzyme (other)yes4.2.1.3AconitaseA/IPMdHydase_ssu_swvl, Acoase/IPM_deHydtase_lsu_aba, Aconitase_mito-like
BEST1Other/UnknownnoBestrophin, Bestrophin-like
CERKLKinaseyesDiacylglycerol_kinase_cat_dom, NAD/diacylglycerol_kinase_sf, ATP-NAD_kinase_N
COL4A5Other/UnknownnoCollagen_IV_NC, Collagen, CTDL_fold
ABCA4TransporteryesABC_transporter-like_ATP-bd, AAA+_ATPase, ABCA4/ABCR
UBAP1LOther/UnknownnoUMA, UBAP1, UBAP1_C
GUCA1AOther/UnknownnoEF_hand_dom, EF-hand-dom_pair, EF_Hand_1_Ca_BS
IMPG1Other/UnknownnoSEA_dom, EGF, SEA_dom_sf
MAKKinaseyes2.7.11.22Prot_kinase_dom, Ser/Thr_kinase_AS, Kinase-like_dom_sf
PDE6CTranscription factornoPDEase_catalytic_dom, GAF, HD/PDEase_dom
PROM1Other/UnknownnoProminin
PRPH2Other/UnknownnoPeripherin/rom-1, Tetraspanin_EC2_sf, Peripherin/rom-1_CS

Expression context

Cohort genes with no expression data: 0.

11 cohort genes are a single-cell marker in ≥1 SCXA experiment.

Breadth distribution (Bgee present_calls)

BucketGenes
narrow (1-5 tissues)0
moderate (6-20)0
broad (>20)12
unknown0

Top tissues across cohort

TissueCohort genes
male germ line stem cell (sensu Vertebrata) in testis4
pigmented layer of retina2
cerebellar hemisphere2
nucleus accumbens2
secondary oocyte2
apex of heart1
heart right ventricle1
left ventricle myocardium1
inferior olivary complex1
lateral globus pallidus1
islet of Langerhans1
olfactory segment of nasal mucosa1
lower esophagus muscularis layer1
mucosa of stomach1
ventricular zone1
primordial germ cell in gonad1
cerebellar cortex1
right hemisphere of cerebellum1
hypothalamus1
putamen1

Per-gene tissue summary (top 30)

SymbolBgee breadthFANTOM5 breadthSCXATop tissues
ACO2291ubiquitousmarkerheart right ventricle, apex of heart, left ventricle myocardium
BEST1209ubiquitousmarkerpigmented layer of retina, lateral globus pallidus, inferior olivary complex
CERKL122tissue_specificmarkerislet of Langerhans, olfactory segment of nasal mucosa, male germ line stem cell (sensu Vertebrata) in testis
COL4A5267ubiquitousmarkermucosa of stomach, ventricular zone, lower esophagus muscularis layer
ABCA4164tissue_specificmarkerpigmented layer of retina, primordial germ cell in gonad, male germ line stem cell (sensu Vertebrata) in testis
UBAP1L171tissue_specificyesright hemisphere of cerebellum, cerebellar hemisphere, cerebellar cortex
GUCA1A52broadmarkernucleus accumbens, putamen, hypothalamus
IMPG1155tissue_specificmarkermale germ line stem cell (sensu Vertebrata) in testis, nucleus accumbens, secondary oocyte
MAK184broadmarkersperm, male germ cell, choroid plexus epithelium
PDE6C159tissue_specificmarkersecondary oocyte, male germ line stem cell (sensu Vertebrata) in testis, cerebellar hemisphere
PROM1252broadmarkerbronchial epithelial cell, epithelium of bronchus, bronchus
PRPH2176tissue_specificmarkerquadriceps femoris, vastus lateralis, hindlimb stylopod muscle

Protein interactions among cohort

Intra-cohort edges: 9.

Hub genes (top 10 by interactor count)

SymbolInteractor count
ACO24,776
PROM13,302
COL4A51,738
ABCA41,532
GUCA1A1,434
PRPH21,234
MAK966
BEST1959
CERKL959
PDE6C903

Intra-cohort edges

ABSources
ABCA4BEST1string_interaction
ABCA4CERKLstring_interaction
ABCA4IMPG1string_interaction
ABCA4PROM1string_interaction
ABCA4PRPH2string_interaction
BEST1IMPG1string_interaction
BEST1PRPH2string_interaction
IMPG1PRPH2string_interaction
MAKPRPH2string_interaction

Structural data

PDB: 5 · AlphaFold-only: 7 · No structure: 0

Cohort genes with PDB structures (top 30)

SymbolUniProtPDB entries
BEST1O7609019
ABCA4P783638
PDE6CP511607
COL4A5P294002
PRPH2P239421

AlphaFold-only cohort genes (top 30 by pLDDT)

SymbolUniProtpLDDT
ACO2Q9979895.44
PROM1O4349085.68
CERKLQ49MI379.82
GUCA1AP4308071.28
UBAP1LF5GYI366.48
MAKP2079462.74
IMPG1Q17R6059.26

Function

Pathway analysis

Distinct Reactome pathways touched by cohort: 37. Enrichment computed across 12 evidence-associated genes (6 with Reactome annotation).

Pathways by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 6 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

PathwayCohort genesFoldFDRSample cohort genes
Defective visual phototransduction due to ABCA4 loss of function11903.3×0.019ABCA4
Retinoid cycle disease events1475.8×0.019ABCA4
Diseases associated with visual transduction1475.8×0.019ABCA4
Diseases of the neuronal system1475.8×0.019ABCA4
Anchoring fibril formation1126.9×0.044COL4A5
Fibronectin matrix formation195.2×0.044COL4A5
Crosslinking of collagen fibrils195.2×0.044COL4A5
Maturation of TCA enzymes and regulation of TCA cycle195.2×0.044ACO2
The canonical retinoid cycle in rods (twilight vision)186.5×0.044ABCA4
Attachment of bacteria to epithelial cells182.8×0.044COL4A5
Citric acid cycle (TCA cycle)170.5×0.047ACO2
Laminin interactions163.4×0.048COL4A5
Inactivation, recovery and regulation of the phototransduction cascade152.9×0.049GUCA1A
Visual phototransduction143.3×0.049ABCA4
Collagen chain trimerization143.3×0.049COL4A5
Signaling by PDGF142.3×0.049COL4A5
NCAM1 interactions141.4×0.049COL4A5
Transport of small molecules28.4×0.049BEST1, ABCA4
Developmental Lineage of Pancreatic Ductal Cells138.1×0.051PROM1
Assembly of collagen fibrils and other multimeric structures133.4×0.054COL4A5
Protein localization131.7×0.054ACO2
Collagen degradation129.3×0.054COL4A5
Collagen biosynthesis and modifying enzymes128.4×0.054COL4A5
Mitochondrial protein import128.0×0.054ACO2
Non-integrin membrane-ECM interactions125.7×0.056COL4A5
ECM proteoglycans125.0×0.056COL4A5
Stimuli-sensing channels122.7×0.058BEST1
Integrin cell surface interactions122.4×0.058COL4A5
ABC-family protein mediated transport120.2×0.062ABCA4
Mitochondrial protein degradation119.0×0.063ACO2

GO biological processes by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 12 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

GO termCohort genesFoldFDRSample cohort genes
visual perception639.8×2e-07BEST1, ABCA4, GUCA1A, IMPG1, PDE6C, PRPH2
photoreceptor cell maintenance389.6×1e-04ABCA4, MAK, PROM1
phototransduction, visible light2216.1×7e-04ABCA4, PDE6C
detection of light stimulus involved in visual perception2108.0×0.002BEST1, PRPH2
response to low light intensity stimulus11404.3×0.007PRPH2
positive regulation of guanylate cyclase activity11404.3×0.007GUCA1A
gamma-aminobutyric acid secretion, neurotransmission1702.2×0.010BEST1
glomerular parietal epithelial cell differentiation1702.2×0.010PROM1
negative regulation of non-motile cilium assembly1702.2×0.010MAK
phospholipid transfer to membrane1468.1×0.012ABCA4
positive regulation of nephron tubule epithelial cell differentiation1468.1×0.012PROM1
citrate metabolic process1351.1×0.014ACO2
camera-type eye photoreceptor cell differentiation1280.9×0.017PROM1
obsolete positive regulation of cGMP-mediated signaling1200.6×0.022GUCA1A
transepithelial chloride transport1156.0×0.024BEST1
retina morphogenesis in camera-type eye1156.0×0.024PROM1
glutamate secretion1140.4×0.025BEST1
retinal cone cell development1117.0×0.027PDE6C
podocyte differentiation1117.0×0.027PROM1
collagen-activated tyrosine kinase receptor signaling pathway1108.0×0.028COL4A5
photoreceptor cell outer segment organization187.8×0.031PRPH2
protein heterooligomerization187.8×0.031PRPH2
sphingolipid metabolic process182.6×0.032CERKL
retinal metabolic process178.0×0.032ABCA4
regulation of calcium ion transport166.9×0.036BEST1
protein complex oligomerization156.2×0.041BEST1
retina layer formation154.0×0.041PROM1
phospholipid translocation152.0×0.042ABCA4
negative regulation of cAMP/PKA signal transduction150.1×0.042PDE6C
intraciliary transport146.8×0.042MAK

Therapeutics

Drug target analysis

Approved (phase 4): 1 · Phase ≥3: 2 · Phased (≥1): 2 · Undrugged: 10

Druggability breadth: 3 of 12 evidence-associated genes (25%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).

Genes with an approved drug

The molecule shown is one approved compound that hits the gene — not necessarily a drug of choice or one indicated for this disease.

SymbolExample approved molecule
PDE6CVARDENAFIL

Top cohort targets by molecule count

SymbolMoleculesMax phase
MAK73
PDE6C64
ACO200
BEST100
CERKL00
COL4A500
ABCA400
UBAP1L00
GUCA1A00
IMPG100

Drugs targeting cohort genes (top 30)

MoleculeMax phaseTargets in cohort
VARDENAFIL4PDE6C
SILDENAFIL4PDE6C
TADALAFIL4PDE6C
DIPYRIDAMOLE4PDE6C
ALVOCIDIB3MAK
LESTAURTINIB3MAK
FORETINIB2MAK
RG-5472MAK
AT-75192MAK
ZAPRINAST2PDE6C
TBA-73712PDE6C
BMS-3870321MAK
AST-4871MAK

Bioactivity and enzyme data

Enzyme cohort genes (≥1 EC): 2.

Cohort genes with ChEMBL bioactivity (full, sorted by assay count)

SymbolAssaysType breakdown
PDE6C103Binding:97, ADMET:6
MAK94Binding:94

Cohort enzymes (BRENDA EC)

SymbolEC numbersNames
ACO24.2.1.3aconitate hydratase
MAK2.7.11.22cyclin-dependent kinase

Cohort genes with high screening signal

≥100 ChEMBL assays — a studied-ness signal; see Therapeutics for approved-drug status.

SymbolChEMBL assays
PDE6C103

Pharmacogenomics

Cohort genes with a PharmGKB record: 12; with CPIC/DPWG dosing guidelines: 0.

No cohort gene has a CPIC/DPWG genotype-guided dosing guideline (PharmGKB).

Chemical tractability of cohort targets

13 approved/phased compounds have measured bioactivity against a cohort gene (and aren’t yet in disease-level trials). This is a research / tractability signal, NOT a therapeutic recommendation — a bioactivity row often reflects off-target or screening binding (e.g. promiscuous kinase inhibitors against a cohort kinase), implying no disease mechanism.

CompoundMax phaseCohort target (bioactivity)
VARDENAFIL4PDE6C
SILDENAFIL4PDE6C
TADALAFIL4PDE6C
DIPYRIDAMOLE4PDE6C
ALVOCIDIB3MAK
LESTAURTINIB3MAK
FORETINIB2MAK
RG-5472MAK
AT-75192MAK
ZAPRINAST2PDE6C
TBA-73712PDE6C
BMS-3870321MAK
AST-4871MAK

Druggability pyramid

Cohort genes binned by druggability tier (high → low):

TierDefinitionGenesSymbols
AApproved (phase 4 drug)1PDE6C
BPhased (≥1) drug, not yet approved1MAK
CDruggable family + PDB, no drug1ABCA4
DDruggable family + AlphaFold only, no drug2ACO2, CERKL
EDifficult family or no structure, no drug7BEST1, COL4A5, UBAP1L, GUCA1A, IMPG1, PROM1, PRPH2

Undrugged target profiles

10 cohort genes are undrugged. Ranked by ‘starting-point quality’ (assay depth + drugged-partner adjacency).

SymbolChEMBL assaysDrugged partners (top 3)
ACO20
BEST10
CERKL0
COL4A50
ABCA40
UBAP1L0
GUCA1A0
IMPG10
PROM10
PRPH20

Clinical trials & evidence

Clinical trials

Clinical trials: 0.