We have studied the use of adenovirusmediated gene transfer to reverse the pathologic changes of lysosomal storage disease caused by j8-glucuronidase deficiency in the eyes of mice with mucopolysaccharidosis VII. A recombinant adenovirus carrying the human 18-glucuronidase cDNA coding region under the control of a non-tissue-specific promoter was injected intravitreally or subretinally into the eyes of mice with mucopolysaccharidosis VII. At 1-3 weeks after injection, the treated and control eyes were examined histochemically for j3-glucuronidase expression and histologically for phenotypic correction of the lysosomal storage defect. Enzymatic expression was detected 1-3 weeks after injection. Storage vacuoles in the retinal pigment epithelium (RPE) were still present 1 week after gene transfer but were reduced to undetectable levels by 3 weeks in both intravitreally and subretinally injected eyes. There was minimal evidence of ocular pathology associated with the viral injection. These data indicate that adenovirus-mediated gene transfer to the eye may provide for adjunctive therapy for lysosomal storage diseases affecting the RPE in conjunction with enzyme replacement and/or gene therapies for correction of systemic disease manifestations. The data also support the view that recombinant adenovirus may be useful as a gene therapy vector for retinal degenerations that result from a primary genetic defect in the RPE cells.The mucopolysaccharidoses (MPSs) represent a broad spectrum of inherited metabolic diseases caused by deficiencies in one of several enzymes responsible for the degradation of mucopolysaccharides. The MPS syndromes show progressive clinical involvement and are characterized by coarse faces, dysostosis multiplex, joint abnormalities, and various degrees of central nervous system (CNS) abnormalities. Depending on the particular types of MPS, ocular features may include corneal clouding, retinal degeneration, optic atrophy, and glaucoma. These phenotypic abnormalities are a result of lysosomal accumulation of glycosaminoglycans that eventually leads to cell and organ dysfunction.Genetic mutations that cause a severe reduction in the level of 0-glucuronidase (13-D-glucuronoside glucuronosohydrolase, EC 3.2