NM_000329.3(RPE65):c.137G>A (p.Gly46Glu) is a missense variant that replaces the glycine at position p.46 with glutamic acid. This variant is absent from gnomAD v4.1.0 (PM2_Supporting). The computational predictor REVEL gives a score of 0.98, which is above the ClinGen LCA / eoRD VCEP threshold of ≥0.773 and predicts a damaging effect on RPE65 function (PP3_Moderate). This variant has been reported in 1 proband with early-onset severe retinal dystrophy who was compound heterozygous with the p.Arg91Gln variant confirmed in trans (PMIDs: 32865313, 30268864), which was previously classified pathogenic by the ClinGen LCA / eoRD VCEP (1 point). A second proband was compound heterozygous with the p.Tyr122Ter variant confirmed in trans (unpublished), which was previously classified likely pathogenic by the ClinGen LCA / eoRD VCEP (1 point). (2 total points, PM3_Strong.) The variant has also been reported to segregate with childhood-onset severe retinal dystrophy through the proband plus 1 similarly affected relative, with the variant present in the compound heterozygous state (PP1; PMID:32865313). In summary, this variant meets the criteria to be classified as Likely Pathogenic for RPE65-related recessive retinopathy based on the ACMG/AMP criteria applied, as specified by the ClinGen LCA/eoRD VCEP: PM2_Supporting, PP3_Moderate, PP1, and PM3_Strong. (VCEP specifications version 1.0.0; date of approval 09/21/2023).