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Any vitreoretinochoroidopathy caused by a heterozygous variant in the BEST1 gene.
No HPO annotations are available for this condition.
Age of onset: at birth.
Bestrophinopathies, the spectrum of ophthalmic disorders caused by pathogenic variants in BEST1, are typically characterized by retinal degeneration but may also be pan ophthalmic. The four recognized phenotypes are the three autosomal dominant disorders: Best vitelliform macular dystrophy (BVMD), BEST1 adult-onset vitelliform macular dystrophy (AVMD), and autosomal dominant vitreoretinochoroidopathy (ADVIRC); and autosomal recessive bestrophinopathy (ARB). Table 2. Bestrophinopathies: Frequency of Phenotypes
No consensus diagnostic criteria for bestrophinopathies have been published.
A bestrophinopathy should be suspected in individuals with following the ophthalmologic findings and electrophysiologic studies by phenotype, and family history. Ophthalmologic findings by phenotype
Source: GeneReviews — "Bestrophinopathies"
No approved treatments are currently available for BEST1-related vitreoretinochoroidopathy. The disease remains an area of unmet medical need.
No clinical practice guidelines for bestrophinopathies have been published.
To establish the extent of disease and needs in an individual diagnosed with a bestrophinopathy, the evaluations summarized below (if not performed as part of the evaluation that led to the diagnosis) are recommended:
Ophthalmologic examination (including best-corrected visual acuity, visual fields, and SD-OCT) should be performed annually to monitor the progression of the fundus lesions and to evaluate for coincident development of choroidal neovascularization (CNV). In children, annual examinations are important in preventing the development of amblyopia, especially if there is a significant difference in the best-corrected visual acuity of one eye. A trial of conventional patching therapy of the better-seeing eye may be able to determine if amblyopia is present. Affected individuals should be advised to see their ophthalmologist in the event of decreased vision or metamorphopsia (straight lines appearing wavy), which could be signs of CNV. In some cases, affected individuals can be advised to use an Amsler grid for self-evaluation.
Data assembled from 2 of 12 sources · Last updated Sep 20, 2026, 5:33 PM UTC
Common questions about BEST1-related vitreoretinochoroidopathy
Phenotype | Ophthalmologic Findings | Comment |
|---|---|---|
Most Common | Common | Infrequent |
BVMD | "Egg yolk"-like vitelliform lesion | Multiple vitelliform lesions; Atrophic scar |
Visual acuity can progress from 20/20 to 20/200. AVMD | Bilateral, small, circular vitelliform lesion | Atrophic scar |
Visual acuity 20/40 to 20/200 ADVIRC | Peripheral chorioretinal atrophy w/white retinal opacities | Hyperopia; Shallow anterior chamber/angle closure; Microcornea |
Fibrillar vitreous condensation | Breakdown of blood-retinal barrier w/retinal neovascularization | ARB |
Cystoid macular edema | Choroidal neovascularization | Subretinal deposits w/subretinal fluid in early stages progressing to subretinal fibrosis; Visual acuity can progress from 20/20 to 20/200. BVMD is a slowly progressive macular dystrophy typically with juvenile onset. |
Source: GeneReviews — "Bestrophinopathies"
Best vitelliform macular dystrophy (BVMD) is the second most common hereditary macular dystrophy. The most common heritable juvenile-onset macular dystrophy is Stargardt disease. Although the cause of adult-onset vitelliform macular dystrophy (AVMD) in most individuals is unknown, this phenotype is observed in the spectrum of bestrophinopathies and with heterozygous pathogenic variants in PRPH2 (encoding peripherin-2) (OMIM 179605), IMPG1 (OMIM 616151) and IMPG2 (OMIM 616152). Choroidal neovascularization is an acquired disorder.
Source: GeneReviews — "Bestrophinopathies"
Ophthalmologic examination, including best-corrected visual acuity, fundus examination, fundus photographs, and spectral-domain optical coherence tomography (SD-OCT) to determine the stage of disease
Consultation with a low vision specialist/clinic as needed
Consultation with a medical geneticist, certified genetic counselor, or certified advanced genetic nurse to inform affected individuals and their families about the nature, mode of inheritance, and implications of bestrophinopathies in order to facilitate medical and personal decision making
Low vision aids benefit those individuals with significantly reduced visual acuity. In the United States (US), educational issues for children with visual impairment can be addressed in the following:
Source: GeneReviews — "Bestrophinopathies"
Cessation of smoking helps prevent neovascularization of the retina .
Source: GeneReviews — "Bestrophinopathies"
Search ClinicalTrials.gov in the US and EU Clinical Trials Register in Europe for access to information on clinical studies for a wide range of diseases and conditions. Note: There may not be clinical trials for this disorder.
Source: GeneReviews — "Bestrophinopathies"
View trials for BEST1-related vitreoretinochoroidopathy
Source: GeneReviews — "Bestrophinopathies"
AI-curated news mentioning BEST1-related vitreoretinochoroidopathy
Updated Jul 21, 2026
FDA approved Casgevy CRISPR gene therapy for children as young as 2 with sickle cell disease on July 1, 2026. Here's what families need to know about this milestone. Approximately 5,500 additional American children are now eligible for this established one-time therapy, according to Vertex Pharmaceuticals, Casgevy's developer. Casgevy also covers transfusion-dependent beta-thalassemia in this new age indication. Sickle cell disease is a lifelong inherited blood disorder that warps red blood cells into stiff, crescent shapes that can block blood flow, starving organs and tissues of oxygen. The world's first CRISPR-based gene therapy has been approved for children as young as two years old, opening the possibility of a single, potentially curative treatment to thousands of American children with sickle cell disease before years of organ damage can narrow what medicine can do for them. Families with children aged 2 and older who have sickle cell disease should speak with their pediatric hematologist about whether Casgevy is appropriate to consider at this stage of their child's disease. Ask specifically which authorized treatment centers perform Casgevy in your region. Treatment is available only at specialized sites, and geographic access remains limited. Contact your child's insurance plan or Medicaid office to ask about coverage. Medicaid coverage for gene therapies varies by state, and some states have developed outcomes-based payment models for high-cost therapies. "With today's decision, pediatric patients as young as 2 years of age can now access a critical additional treatment option to treat these debilitating, life-threatening diseases," said Karim Mikhail, acting director of the Office of Therapeutic Products at the FDA's Center for Biologics Evaluation and Research, according to the FDA press announcement. Casgevy is a non-viral, ex vivo CRISPR/Cas9 gene-edited cell therapy.
A new treatment for children aged 2 or older with sickle cell disease has been approved by the U.S. Food & Drug Administration. In a press release on Wednesday, the FDA announced it had approved Casgevy, the first gene therapy for children with sickle cell disease. (NewsNation) — A new treatment for children aged 2 or older with sickle cell disease has been approved by the Food & Drug Administration (FDA). In a Wednesday news release, the FDA announced it had approved Casgevy, the first gene therapy for children with the disease. “Casgevy is a gene therapy consisting of the patient’s own (autologous) hematopoietic (blood) stem cells, administered as a one-time single dose for intravenous infusion,” the release noted. “Pediatric patients as young as 2 years of age can now access a critical additional treatment option to treat these debilitating, life-threatening diseases,” Karim Mikhail, the acting director of the Center for Biologics Evaluation and Research, wrote. “These disorders carry a heavy burden for children and their families, affecting growth, development, and long-term health in profound ways,” Megha Kaushal, acting deputy director of the Office of Therapeutic Products in CBER, said in the release.