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The dot-and-fleck retinopathy of X linked Alport syndrome is independent of complement factor H (CFH) gene polymorphisms
  1. J Liu1,
  2. D Colville1,
  3. Y Y Wang1,
  4. P N Baird2,
  5. R H Guymer2,
  6. J Savige1
  1. 1
    The University of Melbourne, Department of Medicine (Northern Health), Epping, Australia
  2. 2
    Centre for Eye Research Australia, East Melbourne, Australia
  1. Professor J Savige, The University of Melbourne, Department of Medicine (Northern Health), The Northern Hospital, Epping VIC 3076, Australia; jasavige{at}


Background and aims: X linked Alport syndrome is characterised by renal failure, hearing loss, lenticonus, and a central and peripheral dot-and-fleck retinopathy. complement factor H (CFH) gene variants are strongly associated with retinal drusen in macular degeneration and mesangiocapillary glomerulonephritis, and this study examines their role in the development of the Alport retinopathy.

Methods: Twenty-three males and 27 females from 27 unrelated families were examined and their DNA tested for the CFH risk allele (1277 T>C, h1, Y402H) and protective haplotypes (h2 and h4) using a MALDI-TOF-based method.

Results: The prevalence of the CFH risk allele was not increased in males with a central or peripheral retinopathy. Three of the nine (33%) with the central retinopathy had at least one copy of the risk allele, and five of the 14 (36%) without the retinopathy did (NS, OR 0.900, CI 0.154 to 5.259). Four of the 12 (33%) with either retinopathy had the risk allele, and two of the six (33%) with none did (NS OR 1.0, CI 0.125 to 7.996).

Conclusion: The pathogenesis of the retinal dots and flecks in Alport syndrome is independent of CFH-dependent mechanisms and, like other clinical features, may depend on the nature of the underlying COL4A5 mutations.

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  • Funding: This study was supported by the National Health and Medical Research Council of Australia and Kidney Health Australia.

  • Competing interests: None.

  • Ethics approval: Ethics approval was provided by the Human Research Ethics Committee of Northern Health.

  • Patient consent: Obtained.