“…Clinically, p.G89R and p.S90CfsX22 are also supposed to have no activity in melanogenesis, while p.F219del, p.T440A, and p.V507L are considered to have some remaining activity (Inagaki et al., , ; Rundshagen, Zuhlke, Opitz, Schwinger, & Kasmann‐Kellner, ), suggesting that the c.‐492_489delAATG variant could cause OCA4 in combination with not only the null alleles but also the alleles with some remaining activity. In contrast to OCA4 patients with no activity of SLC45A2 (e.g., patients with homozygous p.D157N), most of them show severe eye manifestation including nystagmus, amblyopia, and photophobia (Inagaki et al., ; Okamura et al., , ), their phenotype was characterized by mildness of symptoms, especially the manifestation of the disease in the eyes was mild, which primarily affects the quality of their lives. This phenotype resembles the phenotype of the medaka ( b ), traditionally called the orange–red variant, which is characterized by amelanotic skin but melanized eyes (Aida, ; Fukamachi et al., ; Shimada, Fukamachi, Wakamatsu, Ozato, & Shima, ).…”