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Eye genetics and inherited retinal diseases

Understanding the role of genes in eye diseases
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We investigate the genetic causes of blinding eye diseases to improve diagnosis and develop new treatments. With an international reputation in inherited retinal diseases (IRDs) such as retinitis pigmentosa, Stargardt disease, cone-rod dystrophies, and macular dystrophies, we are committed to advancing ocular gene therapy.

Our researchers collaborate closely with the NSW Ocular Gene and Cell Therapy Australia team for clinical gene therapy delivery and lead clinical trials that pave the way for therapies in Australia.

Our work also includes cataracts, anterior segment anomalies, childhood glaucoma, and developmental eye disorders, combining genomic investigations and model systems to understand disease mechanisms and develop targeted treatments.

Research areas

Growth factor signalling in lens development

Inherited retinal diseases (IRDs) are a major cause of vision loss in working-age adults, affecting more than two million people globally.

These disorders are genetically heterogeneous and often slowly progressive, which presents both diagnostic and therapeutic challenges.

Our research focuses on detailed phenotyping, genetic analysis, stem cell-derived retinal models, and development of clinical biomarkers to better understand these conditions and support emerging therapies. Functional testing and multimodal imaging are key tools in evaluating disease progression, informing clinical trial readiness, and guiding precision care.

Inherited eye diseases, including retinal and developmental disorders, are highly genetically diverse. Despite advances in sequencing technology, many patients remain without a molecular diagnosis, often due to variants in previously unknown genes or atypical presentations of known genes.

Discovering and characterising new disease genes is critical for improving diagnostic yield, enabling reproductive counselling, and informing targeted therapeutic development. Our group integrates whole genome and exome sequencing with functional studies in cell and animal models to advance this field.

  1. ALPK1 in ROSAH syndrome: We identified ALPK1 as the causative gene in ROSAH syndrome, a systemic and ocular condition characterised by retinal degeneration and inflammation. This discovery has led to the development of translational research programs, including therapeutic trials (Genet Med 2019). 
  2. SIPA1L3 and anterior segment dysgenesis: Mutations in SIPA1L3 were shown to cause defects in lens and anterior segment development through disruption of cell polarity and cytoskeletal organisation (Hum Mol Genet 2015). 
  3. WNT7B and PDAC syndrome: A newly recognised founder variant in WNT7B was found to expand the phenotype of pulmonary, digital, and ocular anomalies (PDAC) syndrome, underscoring the importance of gene discovery in multisystem eye disorders (Clin Genet 2024). 
  4. Expanding understanding of cryptic IRDs: Through combined whole genome sequencing, targeted assays, and functional validation, we have uncovered novel candidate genes and elusive pathogenic variants in inherited retinal dystrophies with atypical or unclear presentations (Nash et al., Int J Mol Sci 2022). This integrated approach continues to increase diagnostic rates and reveal new disease mechanisms.

Clinical team:

Patient Care Coordinator: Lorraine Villaret

Electrophysiology team:

Clinical Molecular and Genetic liaison team:

Laboratory/Molecular/Research Counsellor team (Children’s Medical Research Institute and Sydney Children’s Hospitals Network):

Inherited retinal disease

Over the past five years, the Eye Genetics and Inherited Retinal Disease Group has produced a substantial body of work furthering understanding of inherited retinal dystrophies through clinical, genomic, and translational research.

This includes natural history studies, biomarker development, clinical outcome measures, and patient-centred research to support emerging therapies.

Together, these contributions strengthen the translational pipeline from gene discovery to therapy readiness and patient care, reinforcing the group’s reputation as a leader in inherited retinal disease research.

Natural history studies and clinical biomarkers:
  1. Longitudinal tracking of disease progression in KCNV2-associated retinopathy, GUCY2D cone-rod dystrophy, and IMPDH1 retinitis pigmentosa has helped define structural and functional biomarkers for clinical trials (Sakti et al., 2023–2024; Scopelliti et al., 2023). 
  2. New multimodal biomarkers for CLN3 disease and MERTK retinopathy improve diagnostic accuracy (Sakti et al., 2021, 2023). 
Functional and imaging diagnostics:
  1. Extensive work on visual electrophysiology, including updated ISCEV standards and FST guidelines, strengthens international protocol standardisation (Robson et al., 2022; Jolly et al., 2024). 
  2. Correlation of Hardy-Rand-Rittler colour testing with OCT and electrophysiology in cone dystrophies offers new outcome measures for therapy monitoring (Tharmarajah et al., 2025). 
Molecular diagnostics and variant interpretation:
  1. Human iPSC-derived retinal organoids have been used to assess variants in RPGR, RPE65, and other genes for therapeutic relevance (Chahine Karam et al., 2022; Nash et al., 2022). 
Health economics and patient perspectives:
  1. The team led key studies on the economic burden of IRDs in Australia and patient attitudes toward gene therapy (Schofield et al., 2023;). 
  2. Standardised quality of life (EQ-5D-5L) utility data was established for use in health policy and access planning (McGuinness et al., 2024). 
Registry and global engagement:
  1. We co-developed the FIGHT INHERITED RETINAL BLINDNESS! natural history and outcome registry for IRDs (Simunovic et al., 2025). 
  2. Collaborative research through the Asia-Pacific Inherited Eye Disease (APIED) Network has evaluated practice patterns and challenges in IRD management across Asia-Pacific (Wong et al., 2024).
New genotype-phenotype associations:
  1. Expanded understanding of PRPH2-associated dystrophies and rare phenotypes like NMNAT1 mutations in cone and cone-rod dystrophy (Heath Jeffery et al., 2024; Nash et al EJHG 2018).

Clinical team:

Patient Care Coordinator: Lorraine Villaret

Electrophysiology team:

Clinical Molecular and Genetic liaison team:

Laboratory/Molecular/Research Counsellor team (Children’s Medical Research Institute and Sydney Children’s Hospitals Network):

Clinical Trials

Clinical trials are essential for developing and delivering effective treatments for inherited retinal diseases (IRDs). These conditions often progress slowly, requiring sensitive and standardised outcome measures to assess therapeutic effects.

Our group is actively involved in both investigator-led and industry-sponsored clinical trials, supported by advanced imaging, electrophysiology, and patient-centred metrics. We collaborate with local and global partners to ensure readiness for trial participation and to help translate research into therapies.

Natural history and biomarker studies:
  1. Stargardt disease, Cone-rod dystrophy, Achromatopsia, and Retinitis Pigmentosa (rod-cone dystrophy): Longitudinal studies assessing disease progression using multimodal imaging and functional assessments. 
  2. KCNV2-associated retinopathy, IMPDH1-associated RP, and GUCY2D-associated cone-rod dystrophy: Deep phenotyping to support endpoint validation for future therapies. 
  3. CLN3 disease and MERTK retinopathy: Use of imaging and visual electrophysiology for early detection and monitoring. 
Industry-sponsored clinical trials:
  1. VISTA Study (Beacon Therapeutics) – A gene therapy trial targeting RP2-related X-linked retinitis pigmentosa, evaluating safety and efficacy of subretinal gene delivery. 
  2. ABACUS-1 and ABACUS-2 (Kiora Pharmaceuticals) – Investigating KIO-301, a photoswitch molecule designed to restore light perception in patients with advanced retinitis pigmentosa. 
  3. ALPK1 Study (Drugfarm Therapeutics) – Translational study into ROSAH syndrome, a retinal-inflammatory disease we helped define through discovery of ALPK1 gene mutations. 
  4. Usher Syndrome – Nacuity Trial i. A placebo-controlled trial evaluating NPI-001, an oral antioxidant therapy for retinitis pigmentosa associated with Usher syndrome.

Clinical team:

Patient Care Coordinator: Lorraine Villaret

Electrophysiology team:

Clinical Molecular and Genetic liaison team:

Laboratory/Molecular/Research Counsellor team (Children’s Medical Research Institute and Sydney Children’s Hospitals Network):

Contact us

Mailing address
South Block, Sydney Eye Hospital
8 Macquarie Street
Sydney, NSW 2000