Zebrafish Functional Screening of FDA-Approved Drugs for Autosomal Dominant Retinitis Pigmentosa Caused by RHODOPSIN Q344X Mutation

Retinitis Pigmentosa (RP) is a group of inherited retinal degenerations for which most subtypes lack effective drug treatments. This challenge is particularly critical for autosomal dominant (ad) RP, which is often unsuitable for gene replacement therapy. To address this challenge, we screened an FDA-approved compound library using a zebrafish adRP model expressing a human RHODOPSIN transgene with the Q344X mutation. The screen evaluated drug effects on larval visual behavior by assessing the visual-motor response (VMR). Four compounds significantly improved VMR in Q344X zebrafish: amitriptyline, difluprednate, maprotiline, and prednisolone. Further characterization revealed that these hits act through distinct mechanisms, including reducing rod death, promoting rod neogenesis, and enhancing the function of extraocular photoreceptors. Together, these findings demonstrate the potential to repurpose these drugs for adRP caused by the RHO Q344X mutation, providing preclinical candidates and revealing potential targets for future drug development.