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Jonas JB, Jonas RA, Jonas SB, Panda-Jonas S. Myopia and Other Refractive Error and Their Relationships to Glaucoma Screening. J Glaucoma 2024; 33:S45-S48. [PMID: 39149950 DOI: 10.1097/ijg.0000000000002407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/17/2024] [Indexed: 08/17/2024]
Abstract
PRCIS A large disk, a large parapapillary delta zone and a long axial length may be used as screening criteria to detect glaucomatous optic neuropathy in highly myopic eyes. PURPOSE To describe aspects for screening of glaucomatous optic neuropathy in dependence of refractive error, under special consideration of high myopia. METHODS/RESULTS Studies on the anatomy of the myopic optic nerve head and results of investigations on the relationship between glaucomatous optic neuropathy and axial myopia were included. CONCLUSIONS In the range from hyperopia to moderate myopia, refractive error is not a strong glaucoma risk factor and may not be included in glaucoma screening strategies. Care should be taken, that in moderate myopia, a shift of Bruch´s membrane opening usually into the temporal direction leads to parapapillary gamma zone and a corresponding shortening of the horizontal disk diameter. In these moderately myopic eyes, a secondarily small optic disk with a correspondingly small optic cup should not lead to an overlooking of intrapapillary glaucomatous changes. Prevalence of glaucomatous or glaucoma-like optic nerve atrophy (GOA) steeply increases with longer axial length in highly myopic eyes (cutoff approximately -8 diopters/axial length 26.5 mm), with prevalences higher than 50% in extremely high myopia. Besides longer axial length, morphological parameters associated with GOA in highly myopic eyes are a secondarily enlarged disk and large parapapillary delta zone. Both parameters, together with long axial length, may be used as screening criteria in high myopia for GOA. The latter is characterized by an abnormal neuroretinal rim shape, that is, vessel kinking close to the intrapapillary disk border. Factors associated with nonglaucomatous optic neuropathy are larger gamma zone and longer axial length, potentially due to an axial elongation-related retinal nerve fiber stretching.
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Affiliation(s)
- Jost B Jonas
- Rothschild Foundation Hospital, Institut Français de Myopie, Paris, France
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
| | - Rahul A Jonas
- Department of Ophthalmology, University of Cologne, Cologne
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Rajasundaram S, Segrè AV, Gill D, Woolf B, Zekavat SM, Burgess S, Khawaja AP, Zebardast N, Wiggs JL. Independent Effects of Blood Pressure on Intraocular Pressure and Retinal Ganglion Cell Degeneration: A Mendelian Randomization Study. Invest Ophthalmol Vis Sci 2024; 65:35. [PMID: 39028976 PMCID: PMC11262474 DOI: 10.1167/iovs.65.8.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 05/29/2024] [Indexed: 07/21/2024] Open
Abstract
Purpose To investigate the causal effect of elevated blood pressure on primary open-angle glaucoma (POAG) and POAG endophenotypes. Methods Two-sample Mendelian randomization (MR) was performed to investigate the causal effect of elevated systolic blood pressure (SBP) (N = 757,601) and diastolic blood pressure (DBP) (N = 757,601) on intraocular pressure (IOP) (N = 139,555), macular retinal nerve fiber layer (mRNFL) thickness (N = 33,129), ganglion cell complex (GCC) thickness (N = 33,129), vertical cup-to-disc ratio (VCDR) (N = 111,724), and POAG liability (Ncases = 16,677, Ncontrols = 199,580). The primary analysis was conducted using the inverse-variance weighted approach. Sensitivity analyses were performed to investigate robustness to horizontal pleiotropy, winner's curse, and collider bias. Multivariable MR was performed to investigate whether any effect of blood pressure on retinal ganglion cell degeneration was mediated through increased IOP. Results Increased genetically predicted SBP and DBP associated with an increase in IOP (0.17 mm Hg [95% CI = 0.11 to 0.24] per 10 mm Hg higher SBP, P = 5.18 × 10-7, and 0.17 mm Hg [95% CI = 0.05 to 0.28 mm Hg] per 10 mm Hg higher DBP, P = 0.004). Increased genetically predicted SBP associated with a thinner GCC (0.04 µm [95% CI = -0.07 to -0.01 µm], P = 0.018) and a thinner mRNFL (0.04 µm [95% CI = -0.07 to -0.01 µm], P = 0.004), an effect that arises independently of IOP according to our mediation analysis. Neither SBP nor DBP associated with VCDR or POAG liability. Conclusions These findings support a causal effect of elevated blood pressure on retinal ganglion cell degeneration that does not require intermediary changes in IOP. Targeted blood pressure control may help preserve vision by lowering IOP and, independently, by preventing retinal ganglion cell degeneration, including in individuals with a normal IOP.
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Affiliation(s)
- Skanda Rajasundaram
- Faculty of Medicine, Imperial College London, London, United Kingdom
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - Ayellet V. Segrè
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
- Ocular Genomics Institute, Massachusetts Eye and Ear, Boston, Massachusetts, United States
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Benjamin Woolf
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- MRC Biostatistics Unit, University of Cambridge, Cambridge, United Kingdom
| | - Seyedeh M. Zekavat
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States
- Yale University School of Medicine, New Haven, Connecticut, United States
| | - Stephen Burgess
- MRC Biostatistics Unit, University of Cambridge, Cambridge, United Kingdom
| | - Anthony P. Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Nazlee Zebardast
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
- Ocular Genomics Institute, Massachusetts Eye and Ear, Boston, Massachusetts, United States
| | - Janey L. Wiggs
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
- Ocular Genomics Institute, Massachusetts Eye and Ear, Boston, Massachusetts, United States
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States
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Zhang X, Yuan W, Xu J, Zhao F. Application of mendelian randomization in ocular diseases: a review. Hum Genomics 2024; 18:66. [PMID: 38886833 PMCID: PMC11184796 DOI: 10.1186/s40246-024-00637-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 06/10/2024] [Indexed: 06/20/2024] Open
Abstract
Ocular disorders can significantly lower patients' quality of life and impose an economic burden on families and society. However, for the majority of these diseases, their prevalence and mechanisms are yet unknown, making prevention, management, and therapy challenging. Although connections between exposure factors and diseases can be drawn through observational research, it is challenging to rule out the interference of confounding variables and reverse causation. Mendelian Randomization (MR), a method of research that combines genetics and epidemiology, has its advantage to solve this problem and thus has been extensively utilized in the etiological study of ophthalmic diseases. This paper reviews the implementation of MR in the research of ocular diseases and provides approaches for the investigation of related mechanisms as well as the intervention strategies.
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Affiliation(s)
| | - Weichen Yuan
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
- Key Lens Research Laboratory of Liaoning Province, Shenyang, China
| | - Jun Xu
- Department of Ophthalmology, Shenyang the Fourth People's Hospital, Shenyang, China.
| | - Fangkun Zhao
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China.
- Key Lens Research Laboratory of Liaoning Province, Shenyang, China.
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Chen M, Zhang Y, Yao Y, Huang Y, Jiang L. Mendelian randomization supports causality between COVID-19 and glaucoma. Medicine (Baltimore) 2024; 103:e38455. [PMID: 38875430 PMCID: PMC11175937 DOI: 10.1097/md.0000000000038455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2024] Open
Abstract
To determine whether there is a causal relationship between Corona Virus Disease 2019 (COVID-19) and glaucoma, a 2-sample Mendelian Randomization (MR) design was applied with the main analysis method of inverse-variance-weighted. The reliability of the results was checked using the heterogeneity test, pleiotropy test, and leave-one-out method. Four sets of instrumental variables (IVs) were used to investigate the causality between COVID-19 and glaucoma risk according to data from the IEU Genome Wide Association Study (GWAS). The results showed that 2 sets of COVID-19(RELEASE) were significantly associated with the risk of glaucoma [ID: ebi-a-GCST011071, OR (95% CI) = 1.227 (1.076-1.400), P = .002259; ID: ebi-a-GCST011073: OR (95% CI) = 1.164 (1.022-1.327), P = .022450; 2 sets of COVID-19 hospitalizations were significantly associated with the risk of glaucoma (ID: ebi-a-GCST011081, OR (95% CI) = 1.156 (1.033-1.292), P = .011342; ID: ebi-a-GCST011082: OR (95% CI) = 1.097 (1.007-1.196), P = .034908)]. The sensitivity of the results was acceptable (P > .05) for the 3 test methods. In conclusion, this MR analysis provides preliminary evidence of a potential causal relationship between COVID-19 and glaucoma.
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Affiliation(s)
- Maolin Chen
- Department of Pharmacy, The Affiliated Hospital, Southwest Medical University, Luzhou, China
- School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Yinhui Zhang
- Department of Pharmacy, The Affiliated Hospital, Southwest Medical University, Luzhou, China
- School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Yu Yao
- Department of Ophthalmology, The Affiliated Hospital, Southwest Medical University, Luzhou, China
| | - Yilan Huang
- Department of Pharmacy, The Affiliated Hospital, Southwest Medical University, Luzhou, China
- School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Longyang Jiang
- Department of Pharmacy, The Affiliated Hospital, Southwest Medical University, Luzhou, China
- School of Pharmacy, Southwest Medical University, Luzhou, China
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Zhang Y, Du Y, Wang A, Zhou X, Lu Y, Zhu X. Outcomes of Cataract Surgery in Eyes With Axial Length > 33 mm. Am J Ophthalmol 2024; 265:137-146. [PMID: 38701876 DOI: 10.1016/j.ajo.2024.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/05/2024]
Abstract
PURPOSE To evaluate the visual outcomes and perioperative complications for cataract surgery in eyes with axial length (AL) >33.0 mm. DESIGN Prospective clinical cohort study. METHODS One hundred twenty-two eyes with moderate high myopia (26.0 mm ≤ AL < 28.0 mm, control group), and 118 eyes with extreme high myopia (AL > 33.0 mm, EHM group) were followed up after cataract surgery (1 week and 1 year post-op). Myopic maculopathy grading according to ATN system, best-corrected visual acuity (BCVA), and complications were compared. RESULTS Postoperatively, BCVA in the EHM group improved significantly at both visits (both P < .001), despite being worse than that of the control group (both P < .05). The EHM group exhibited greater hyperopic refractive errors (P < .001), which were found to be associated with more severe T grade, longer AL, poorer second follow-up BCVA, and smaller anterior capsular opening (ACO) area. A higher incidence of retinal detachment and a more constricted ACO were observed in the EHM group (P = .030 and <.001, respectively), with the latter being significantly associated with longer AL and the absence of capsular tension ring (both P < .05). No difference in BCVA was found between the aphakic and pseudophakic eyes in the EHM group at both visits (both P > .05). CONCLUSION Cataract surgery improves vision of eyes with AL >33 mm, yet the increased risk of perioperative complications requires attention. Leaving these eyes aphakic might be effective and safe in the long term.
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Affiliation(s)
- Yinglei Zhang
- Eye Institute, Eye and Ear, Nose, and Throat Hospital, Shanghai Medical College, Fudan University (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China; NHC Key Laboratory of Myopia (Fudan University) (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China; Key Laboratory of Myopia, Chinese Academy of Medical Sciences (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China; Shanghai Key Laboratory of Visual Impairment and Restoration (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China
| | - Yu Du
- Eye Institute, Eye and Ear, Nose, and Throat Hospital, Shanghai Medical College, Fudan University (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China; NHC Key Laboratory of Myopia (Fudan University) (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China; Key Laboratory of Myopia, Chinese Academy of Medical Sciences (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China; Shanghai Key Laboratory of Visual Impairment and Restoration (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China
| | - Anjian Wang
- Center for Postgraduate Clinical Training and Career Development, Nagoya University Hospital (A.W.), Nagoya, Aichi, Japan
| | - Xingtao Zhou
- Eye Institute, Eye and Ear, Nose, and Throat Hospital, Shanghai Medical College, Fudan University (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China; NHC Key Laboratory of Myopia (Fudan University) (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China; Key Laboratory of Myopia, Chinese Academy of Medical Sciences (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China; Shanghai Key Laboratory of Visual Impairment and Restoration (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China
| | - Yi Lu
- Eye Institute, Eye and Ear, Nose, and Throat Hospital, Shanghai Medical College, Fudan University (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China; NHC Key Laboratory of Myopia (Fudan University) (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China; Key Laboratory of Myopia, Chinese Academy of Medical Sciences (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China; Shanghai Key Laboratory of Visual Impairment and Restoration (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China
| | - Xiangjia Zhu
- Eye Institute, Eye and Ear, Nose, and Throat Hospital, Shanghai Medical College, Fudan University (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China; NHC Key Laboratory of Myopia (Fudan University) (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China; Key Laboratory of Myopia, Chinese Academy of Medical Sciences (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China; Shanghai Key Laboratory of Visual Impairment and Restoration (Y.Z., Y.D., X.Z., Y.L., X.Z.), Shanghai, People's Republic of China.
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Yun JS, Jung SH, Lee SN, Jung SM, Won HH, Kim D, Choi JA. Polygenic risk score-based phenome-wide association for glaucoma and its impact on disease susceptibility in two large biobanks. J Transl Med 2024; 22:355. [PMID: 38622600 PMCID: PMC11020996 DOI: 10.1186/s12967-024-05152-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/01/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Glaucoma is a leading cause of worldwide irreversible blindness. Considerable uncertainty remains regarding the association between a variety of phenotypes and the genetic risk of glaucoma, as well as the impact they exert on the glaucoma development. METHODS We investigated the associations of genetic liability for primary open angle glaucoma (POAG) with a wide range of potential risk factors and to assess its impact on the risk of incident glaucoma. The phenome-wide association study (PheWAS) approach was applied to determine the association of POAG polygenic risk score (PRS) with a wide range of phenotypes in 377, 852 participants from the UK Biobank study and 43,623 participants from the Penn Medicine Biobank study, all of European ancestry. Participants were stratified into four risk tiers: low, intermediate, high, and very high-risk. Cox proportional hazard models assessed the relationship of POAG PRS and ocular factors with new glaucoma events. RESULTS In both discovery and replication set in the PheWAS, a higher genetic predisposition to POAG was specifically correlated with ocular disease phenotypes. The POAG PRS exhibited correlations with low corneal hysteresis, refractive error, and ocular hypertension, demonstrating a strong association with the onset of glaucoma. Individuals carrying a high genetic burden exhibited a 9.20-fold, 11.88-fold, and 28.85-fold increase in glaucoma incidence when associated with low corneal hysteresis, high myopia, and elevated intraocular pressure, respectively. CONCLUSION Genetic susceptibility to POAG primarily influences ocular conditions, with limited systemic associations. Notably, the baseline polygenic risk for POAG robustly associates with new glaucoma events, revealing a large combined effect of genetic and ocular risk factors on glaucoma incidents.
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Affiliation(s)
- Jae-Seung Yun
- Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang-Hyuk Jung
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Su-Nam Lee
- Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seung Min Jung
- Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hong-Hee Won
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea.
- Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea.
| | - Dokyoon Kim
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Institute for Biomedical Informatics, University of Pennsylvania, Philadelphia, PA, USA.
| | - Jin A Choi
- Department of Ophthalmology, College of Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Yii FS, He M, Chappell F, Bernabeu MO, MacGillivray T, Dhillon B, Tatham A, Strang N. Higher intraocular pressure is associated with slower axial growth in children with non-pathological high myopia. Eye (Lond) 2024; 38:1208-1214. [PMID: 38081936 PMCID: PMC11009290 DOI: 10.1038/s41433-023-02872-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/21/2023] [Accepted: 11/23/2023] [Indexed: 04/13/2024] Open
Abstract
OBJECTIVES To investigate the association between intraocular pressure (IOP) and axial elongation rate in highly myopic children from the ZOC-BHVI High Myopia Cohort Study. METHODS 162 eyes of 81 healthy children (baseline spherical equivalent: -6.25 D to -15.50 D) aged 7-12 years with non-pathological high myopia were studied over five biennial visits. The mean (SD) follow-up duration was 5.2 (3.3) years. A linear mixed-effects model (LMM) was used to assess the association between IOP (at time point t-1) and axial elongation rate (annual rate of change in AL from t-1 to t), controlling for a pre-defined set of covariates including sex, age, central corneal thickness, anterior chamber depth and lens thickness (at t-1). LMM was also used to assess the contemporaneous association between IOP and axial length (AL) at t, controlling for the same set of covariates (at t) as before. RESULTS Higher IOP was associated with slower axial growth (β = -0.01, 95% CI -0.02 to -0.005, p = 0.001). There was a positive contemporaneous association between IOP and AL (β = 0.03, 95% CI 0.01-0.05, p = 0.004), but this association became progressively less positive with increasing age, as indicated by a negative interaction effect between IOP and age on AL (β = -0.01, 95% CI -0.01 to -0.003, p = 0.001). CONCLUSIONS Higher IOP is associated with slower rather than faster axial growth in children with non-pathological high myopia, an association plausibly confounded by the increased influence of ocular compliance on IOP.
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Affiliation(s)
- Fabian Sl Yii
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK.
- Curle Ophthalmology Laboratory, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK.
| | - Mingguang He
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Centre for Eye Research Australia, The University of Melbourne, Melbourne, Australia
| | - Francesca Chappell
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Miguel O Bernabeu
- Centre for Medical Informatics, Usher Institute, The University of Edinburgh, Edinburgh, UK
- The Bayes Centre, The University of Edinburgh, Edinburgh, UK
| | - Tom MacGillivray
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
- Curle Ophthalmology Laboratory, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
| | - Baljean Dhillon
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
- Curle Ophthalmology Laboratory, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
- Princess Alexandra Eye Pavilion, NHS Lothian, Edinburgh, UK
| | - Andrew Tatham
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
- Princess Alexandra Eye Pavilion, NHS Lothian, Edinburgh, UK
| | - Niall Strang
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
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Bu Q, Zhu H, Cao G, Gong G, Su Y, Ge Q, Zhu W, Li Z, Pan X. Targeting mechanics-induced trabecular meshwork dysfunction through YAP-TGFβ Ameliorates high myopia-induced ocular hypertension. Exp Eye Res 2024; 241:109853. [PMID: 38453038 DOI: 10.1016/j.exer.2024.109853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/29/2024] [Accepted: 03/03/2024] [Indexed: 03/09/2024]
Abstract
High myopia is a risk factor for primary open angle glaucoma (POAG). The pathological mechanism of high myopia induced POAG occurrence is not fully understood. In this study, we successfully established the guinea pig model of ocular hypertension with high myopia, and demonstrated the susceptibility of high myopia for the occurrence of microbead-induced glaucoma compared with non-myopia group and the effect of YAP/TGF-β signaling pathway in TM pathogenesis induced by high myopia. Moreover, we performed stretching treatment on primary trabecular meshwork (TM) cells to simulate the mechanical environment of high myopia. It was found that stretching treatment disrupted the cytoskeleton, decreased phagocytic function, enhanced ECM remodeling, and promoted cell apoptosis. The experiments of mechanics-induced human TM cell lines appeared the similar trend. Mechanically, the differential expressed genes of TM cells caused by stretch treatment enriched YAP/TGF-β signaling pathway. To inhibit YAP/TGF-β signaling pathway effectively reversed mechanics-induced TM damage. Together, this study enriches mechanistic insights of high myopia induced POAG susceptibility and provides a potential target for the prevention of POAG with high myopia.
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Affiliation(s)
- Qianwen Bu
- Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 271016, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, Shandong, 266071, China
| | - Hai Zhu
- Department of Urology, Qingdao Municipal Hospital Affiliated to Qingdao Medical College of Qingdao University, Qingdao, Shandong, 266071, China
| | - Guangliang Cao
- Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 271016, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, Shandong, 266071, China
| | - Ganyu Gong
- Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 271016, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, Shandong, 266071, China
| | - Ying Su
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, Shandong, 266071, China
| | - Qingshu Ge
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, Shandong, 266071, China
| | - Wei Zhu
- Department of Pharmacology, School of Pharmacy, Qingdao University, Qingdao, Shandong, 266021, China
| | - Zongyi Li
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, Shandong, 266071, China.
| | - Xiaojing Pan
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, Shandong, 266071, China.
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Seo JH, Lee Y. Causal Associations of Glaucoma and Age-Related Macular Degeneration with Cataract: A Bidirectional Two-Sample Mendelian Randomisation Study. Genes (Basel) 2024; 15:413. [PMID: 38674349 PMCID: PMC11049509 DOI: 10.3390/genes15040413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 03/21/2024] [Accepted: 03/24/2024] [Indexed: 04/28/2024] Open
Abstract
Common age-related eye disorders include glaucoma, cataract, and age-related macular degeneration (AMD); however, little is known about their relationship with age. This study investigated the potential causal relationship between glaucoma and AMD with cataract using genetic data from multi-ethnic populations. Single-nucleotide polymorphisms (SNPs) associated with exposure to cataract were selected as instrumental variables (IVs) from genome-wide association studies using meta-analysis data from BioBank Japan and UK Biobank. A bidirectional two-sample Mendelian randomisation (MR) study was conducted to assess the causal estimates using inverse variance weighted, MR-Egger, and MR pleiotropy residual sum and outlier tests. SNPs with (p < 5.0 × 10-8) were selected as IVs for cataract, primary open-angle glaucoma, and AMD. We found no causal effects of cataract on glaucoma or AMD (all p > 0.05). Furthermore, there were no causal effects of AMD on cataract (odds ratio [OR] = 1.02, p = 0.400). However, glaucoma had a substantial causal effect on cataract (OR = 1.14, p = 0.020). Our study found no evidence for a causal relationship of cataract on glaucoma or AMD and a casual effect of AMD on cataract. Nonetheless, glaucoma demonstrates a causal link with cataract formation, indicating the need for future investigations of age-related eye diseases.
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Affiliation(s)
- Je Hyun Seo
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul 05368, Republic of Korea;
| | - Young Lee
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul 05368, Republic of Korea;
- Department of Applied Statistics, Chung-Ang University, Seoul 06974, Republic of Korea
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Xu FY, Lam AK. Intraocular pressure variation from ocular compression in low and high myopia. Clin Exp Optom 2024; 107:213-218. [PMID: 36975202 DOI: 10.1080/08164622.2023.2191784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/10/2023] [Indexed: 03/29/2023] Open
Abstract
CLINICAL RELEVANCE Change in intraocular pressure during acute ocular compression is related to aqueous humour dynamics. Monitoring intraocular pressure (IOP) change throughout ocular compression has potential to evaluate aqueous outflow facilities. BACKGROUND Recent studies have monitored lamina cribrosa deformation using optical coherence tomography during ocular compression. IOP was measured only once immediately after ocular compression. This study aimed to evaluate IOP changes during and after ocular compression and compare the differences between low and high myopia. METHODS Two groups of young, healthy adults were age-matched and underwent ocular compression. IOP was measured at baseline and monitored during a 2-min ocular compression followed by a 10-min recovery phase. Rebound tonometry was used and applied at 30-s intervals. RESULTS Thirty low and 30 high myopes (60 right eyes) were included in the study. They had similar baseline IOP at 14.9 mmHg. IOP was elevated to 21.7 ± 3.8 mmHg and 22.3 ± 4.2 mmHg for the low and high myopic group, respectively (p = 0.877). Low myopes had faster IOP decay during ocular compression at -3.24 mmHg/min than high myopes at -2.58 mmHg/min (p = 0.0528). The IOP dropped below the baseline level after the release of the compressive force. Low myopes had IOP that returned to baseline levels faster (at 360 s) than high myopes (at 510 s). CONCLUSION Measuring IOP once immediately after ocular compression could under-estimate the effect of IOP elevation during ocular compression. Further studies are required regarding IOP changes from ocular compression in aqueous humour dynamics.
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Affiliation(s)
- Fang-Yu Xu
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Andrew Kc Lam
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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11
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Lei S, Hu M, Wei Z. Identification of systemic biomarkers and potential drug targets for age-related macular degeneration. Front Aging Neurosci 2024; 16:1322519. [PMID: 38361503 PMCID: PMC10867226 DOI: 10.3389/fnagi.2024.1322519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/15/2024] [Indexed: 02/17/2024] Open
Abstract
Purpose Since age-related macular degeneration (AMD) is tightly associated with aging and cellular senescence, objective of this study was to investigate the association between plasma levels of senescence-related proteins (SRPs) and risk of AMD. Design The whole study was based on two-sample Mendelian randomization (MR) analysis. Methods For MR analysis, the primary approach for MR analysis was the inverse-variance weighted (IVW) method and the heterogeneity and pleiotropy of results were tested. The instrumental single-nucleotide polymorphisms (SNPs) associated with 110 SRPs were filtered and selected from a large genome-wide association study (GWAS) for plasma proteome involving 35,559 participants. The GWAS data of AMD was obtained from FinnGen consortium (6,157 AMD cases and 288,237 controls) and further validated by using data from UK Biobank consortium (3,553 AMD cases and 147,089 controls). Results The MR results at both discovery and validation stages supported the causality (IVW-P < 0.00045) between plasma levels of 4 SRPs (C3b, CTNNB1, CCL1, and CCL3L1) and the risk of AMD and supported potential causality (IVW-P < 0.05) between other 10 SRPs and risk of AMD. No heterogeneity or pleiotropy in these results was detected. Conclusion Our findings supported that high plasma levels of C3b, CTNNB1, CCL1, and CCL3L1 were associated with increased risk of AMD, thereby highlighting the role of systemic inflammation in AMD pathogenesis and providing the rationale for developing new preventative and therapeutic strategies.
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Affiliation(s)
- Shizhen Lei
- Department of Ophthalmology, Wuhan No. 1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Mang Hu
- Department of Ophthalmology, Wuhan No. 1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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12
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Kyei S, Kwasi Gyaami R, Abowine JB, Zaabaar E, Asiedu K, Boadi-Kusi SB, Mesuh JM, Assiamah F, Armah A, Ayerakwah PA. Risk of major myopia-associated non-communicable ocular health disorders in Ghana. PLoS One 2024; 19:e0297052. [PMID: 38236924 PMCID: PMC10795978 DOI: 10.1371/journal.pone.0297052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 12/24/2023] [Indexed: 01/22/2024] Open
Abstract
OBJECTIVE To assess the differential association of myopia with major non-communicable ocular diseases in an African clinical cohort. METHODS A five-year hospital-based retrospective study of myopia cases. Patients' folders, Optical Coherence Tomography scans, and fundus photographs were reviewed for the abstraction of relevant data. Only records that employed recognized standards and classification systems for diagnosing and staging the various ocular conditions were included. Demographic characteristics, non-cycloplegic objective refractive findings, and non-communicable eye diseases were retrieved from the records. Myopia-associated risk factors were then determined using logistic regression and correlation. RESULTS Some 16018 patients (32027 eyes) met the inclusion criteria for at least one eye comprising 50.8% males (n = 8137) and 49.2% females (n = 7881). The mean age of the patients was 43.14 ± 17.88 years (range: 2-98 years). The mean spherical equivalent± Standard deviation for myopia was -2.30±3.23 DS (range: -0.50 to -25DS). Binary logistic regression analysis showed that myopic eyes had a higher odd of AC (OR, 0.53; 95% CI, 0.50-0.57), POAG (OR, 6.0; 95% CI, 5.26-6.82), DR (OR, 10.70; 95% CI, 3.91-29.27) and cataracts (OR, 20; 95% CI, 15.32-26.20) but not dry eye (OR, 0.74, 95% CI, 0.68-0.81), macular degeneration and pterygium (OR, 0.36; 95% CI, 0.32-0.40). CONCLUSION Africans with myopia are more at risk of developing allergic conjunctivitis, cataracts, POAG, and DR but not for dry eye, macular degeneration, and pterygium.
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Affiliation(s)
- Samuel Kyei
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- Biomedical and Clinical Research Center, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Rexford Kwasi Gyaami
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | | | - Ebenezer Zaabaar
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Kofi Asiedu
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Samuel Bert Boadi-Kusi
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | | | - Frank Assiamah
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Anthony Armah
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Patience Ansomah Ayerakwah
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
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13
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Vinod K, Salim S. Addressing Glaucoma in Myopic Eyes: Diagnostic and Surgical Challenges. Bioengineering (Basel) 2023; 10:1260. [PMID: 38002384 PMCID: PMC10669452 DOI: 10.3390/bioengineering10111260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 10/23/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023] Open
Abstract
Epidemiological and genetic studies provide strong evidence supporting an association between myopia and glaucoma. The accurate detection of glaucoma in myopic eyes, especially those with high myopia, remains clinically challenging due to characteristic morphologic features of the myopic optic nerve in addition to limitations of current optic nerve imaging modalities. Distinguishing glaucoma from myopia is further complicated by overlapping perimetric findings. Therefore, longitudinal follow-up is essential to differentiate progressive structural and functional abnormalities indicative of glaucoma from defects that may result from myopia alone. Highly myopic eyes are at increased risk of complications from traditional incisional glaucoma surgery and may benefit from newer microinvasive glaucoma surgeries in select cases.
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Affiliation(s)
- Kateki Vinod
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA
| | - Sarwat Salim
- Department of Ophthalmology, Tufts University School of Medicine, Boston, MA 02116, USA
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14
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Jiang C, Melles RB, Sangani P, Hoffmann TJ, Hysi PG, Glymour MM, Jorgenson E, Lachke SA, Choquet H. Association of Behavioral and Clinical Risk Factors With Cataract: A Two-Sample Mendelian Randomization Study. Invest Ophthalmol Vis Sci 2023; 64:19. [PMID: 37459064 PMCID: PMC10362921 DOI: 10.1167/iovs.64.10.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 06/26/2023] [Indexed: 07/20/2023] Open
Abstract
Purpose To investigate the association of genetically determined primary open-angle glaucoma (POAG), myopic refractive error (RE), type 2 diabetes (T2D), blood pressure (BP), body mass index (BMI), cigarette smoking, and alcohol consumption with the risk of age-related cataract. Methods To assess potential causal effects of clinical or behavioral factors on cataract risk, we conducted two-sample Mendelian randomization analyses. Genetic instruments, based on common genetic variants associated with risk factors at genome-wide significance (P < 5 × 10-8), were derived from published genome-wide association studies (GWAS). For age-related cataract, we used GWAS summary statistics from our previous GWAS conducted in the Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort (28,092 cataract cases and 50,487 controls; all non-Hispanic whites) or in the UK Biobank (31,852 cataract cases and 428,084 controls; all European-descent individuals). We used the inverse-variance weighted (IVW) method as our primary source of Mendelian randomization estimates and conducted common sensitivity analyses. Results We found that genetically determined POAG and mean spherical equivalent RE were significantly associated with cataract risk (IVW model: odds ratio [OR] = 1.04; 95% confidence interval [CI], 1.01-1.08; P = 0.018; per diopter more hyperopic: OR = 0.92; 95% CI, 0.89-0.93; P = 6.51 × 10-13, respectively). In contrast, genetically determined T2D, BP, BMI, cigarette smoking, or alcohol consumption were not associated with cataract risk (P > 0.05). Conclusions Our results provide evidence that genetic risks for POAG and myopia may be causal risk factors for age-related cataract. These results are consistent with previous observational studies reporting associations of myopia with cataract risk. This information may support population cataract risk stratification and screening strategies.
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Affiliation(s)
- Chen Jiang
- Kaiser Permanente Northern California (KPNC), Division of Research, Oakland, California, United States
| | - Ronald B. Melles
- KPNC, Department of Ophthalmology, Redwood City, California, United States
| | - Poorab Sangani
- KPNC, Department of Ophthalmology, South San Francisco, California, United States
| | - Thomas J. Hoffmann
- Institute for Human Genetics, UCSF, San Francisco, California, United States
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, California, United States
| | - Pirro G. Hysi
- King's College London, Section of Ophthalmology, School of Life Course Sciences, London, United Kingdom
- King's College London, Department of Twin Research and Genetic Epidemiology, London, United Kingdom
- University College London, Great Ormond Street Hospital Institute of Child Health, London, United Kingdom
| | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, California, United States
| | - Eric Jorgenson
- Regeneron Genetics Center, Tarrytown, New York, United States
| | - Salil A. Lachke
- Department of Biological Sciences, University of Delaware, Newark, Delaware, United States
- Center for Bioinformatics and Computational Biology, University of Delaware, Newark, Delaware, United States
| | - Hélène Choquet
- Kaiser Permanente Northern California (KPNC), Division of Research, Oakland, California, United States
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15
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Jiang C, Melles RB, Yin J, Fan Q, Guo X, Cheng CY, He M, Mackey DA, Guggenheim JA, Klaver C, Nair KS, Jorgenson E, Choquet H. A multiethnic genome-wide analysis of 19,420 individuals identifies novel loci associated with axial length and shared genetic influences with refractive error and myopia. Front Genet 2023; 14:1113058. [PMID: 37351342 PMCID: PMC10282939 DOI: 10.3389/fgene.2023.1113058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 05/25/2023] [Indexed: 06/24/2023] Open
Abstract
Introduction: Long axial length (AL) is a risk factor for myopia. Although family studies indicate that AL has an important genetic component with heritability estimates up to 0.94, there have been few reports of AL-associated loci. Methods: Here, we conducted a multiethnic genome-wide association study (GWAS) of AL in 19,420 adults of European, Latino, Asian, and African ancestry from the Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort, with replication in a subset of the Consortium for Refractive Error and Myopia (CREAM) cohorts of European or Asian ancestry. We further examined the effect of the identified loci on the mean spherical equivalent (MSE) within the GERA cohort. We also performed genome-wide genetic correlation analyses to quantify the genetic overlap between AL and MSE or myopia risk in the GERA European ancestry sample. Results: Our multiethnic GWA analysis of AL identified a total of 16 genomic loci, of which 5 are novel. We found that all AL-associated loci were significantly associated with MSE after Bonferroni correction. We also found that AL was genetically correlated with MSE (rg = -0.83; SE, 0.04; p = 1.95 × 10-89) and myopia (rg = 0.80; SE, 0.05; p = 2.84 × 10-55). Finally, we estimated the array heritability for AL in the GERA European ancestry sample using LD score regression, and found an overall heritability estimate of 0.37 (s.e. = 0.04). Discussion: In this large and multiethnic study, we identified novel loci, associated with AL at a genome-wide significance level, increasing substantially our understanding of the etiology of AL variation. Our results also demonstrate an association between AL-associated loci and MSE and a shared genetic basis between AL and myopia risk.
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Affiliation(s)
- Chen Jiang
- Division of Research, Kaiser Permanente Northern California (KPNC), Oakland, CA, United States
| | - Ronald B. Melles
- KPNC, Department of Ophthalmology, Redwood City, CA, United States
| | - Jie Yin
- Division of Research, Kaiser Permanente Northern California (KPNC), Oakland, CA, United States
| | - Qiao Fan
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore
| | - Xiaobo Guo
- Department of Statistical Science, School of Mathematics, Sun Yat-Sen University, Guangzhou, China
- Southern China Center for Statistical Science, Sun Yat-Sen University, Guangzhou, China
| | - Ching-Yu Cheng
- Ocular Epidemiology Research Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
- Centre for Eye Research Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, WA, Australia
| | - David A. Mackey
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, WA, Australia
| | - Jeremy A. Guggenheim
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom
| | - Caroline Klaver
- Department Ophthalmology, Department Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands
| | | | - K. Saidas Nair
- Department of Ophthalmology and Department of Anatomy, School of Medicine, University of California, San Francisco, CA, United States
| | | | - Hélène Choquet
- Division of Research, Kaiser Permanente Northern California (KPNC), Oakland, CA, United States
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16
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Vera-Diaz FA, Jnawali A, Panorgias A, Bex PJ, Kerber KL. Baseline metrics that may predict future myopia in young children. Ophthalmic Physiol Opt 2023; 43:466-481. [PMID: 36892148 PMCID: PMC10416753 DOI: 10.1111/opo.13113] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 03/10/2023]
Abstract
PURPOSE We used baseline data from the PICNIC longitudinal study to investigate structural, functional, behavioural and heritable metrics that may predict future myopia in young children. METHODS Cycloplegic refractive error (M) and optical biometry were obtained in 97 young children with functional emmetropia. Children were classified as high risk (HR) or low risk (LR) for myopia based on parental myopia and M. Other metrics included axial length (AXL), axial length/corneal radius (AXL/CR) and refractive centile curves. RESULTS Based on the PICNIC criteria, 46 children (26 female) were classified as HR (M = +0.62 ± 0.44 D, AXL = 22.80 ± 0.64 mm) and 51 (27 female) as LR (M = +1.26 ± 0.44 D, AXL = 22.77 ± 0.77 mm). Based on centiles, 49 children were HR, with moderate agreement compared with the PICNIC classification (k = 0.65, p < 0.01). ANCOVA with age as a covariate showed a significant effect for AXL (p < 0.01), with longer AXL and deeper anterior chamber depth (ACD) (p = 0.01) in those at HR (differences AXL = 0.16 mm, ACD = 0.13 mm). Linear regression models showed that central corneal thickness (CCT), ACD, posterior vitreous depth (PVD) (=AXL - CCT - ACD-lens thickness (LT)), corneal radius (CR) and age significantly predicted M (R = 0.64, p < 0.01). Each 1.00 D decrease in hyperopia was associated with a 0.97 mm elongation in PVD and 0.43 mm increase in CR. The ratio AXL/CR significantly predicted M (R = -0.45, p < 0.01), as did AXL (R = -0.25, p = 0.01), although to a lesser extent. CONCLUSIONS Although M and AXL were highly correlated, the classification of pre-myopic children into HR or LR was significantly different when using each parameter, with AXL/CR being the most predictive metric. At the end of the longitudinal study, we will be able to assess the predictability of each metric.
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Affiliation(s)
| | | | | | - Peter J. Bex
- College of Science, Northeastern University, Boston, Massachusetts, USA
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17
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Gao XR, Chiariglione M, Choquet H, Arch AJ. 10 Years of GWAS in intraocular pressure. Front Genet 2023; 14:1130106. [PMID: 37124618 PMCID: PMC10130654 DOI: 10.3389/fgene.2023.1130106] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/05/2023] [Indexed: 05/02/2023] Open
Abstract
Intraocular pressure (IOP) is the only modifiable risk factor for glaucoma, the leading cause of irreversible blindness worldwide. In this review, we summarize the findings of genome-wide association studies (GWASs) of IOP published in the past 10 years and prior to December 2022. Over 190 genetic loci and candidate genes associated with IOP have been uncovered through GWASs, although most of these studies were conducted in subjects of European and Asian ancestries. We also discuss how these common variants have been used to derive polygenic risk scores for predicting IOP and glaucoma, and to infer causal relationship with other traits and conditions through Mendelian randomization. Additionally, we summarize the findings from a recent large-scale exome-wide association study (ExWAS) that identified rare variants associated with IOP in 40 novel genes, six of which are drug targets for clinical treatment or are being evaluated in clinical trials. Finally, we discuss the need for future genetic studies of IOP to include individuals from understudied populations, including Latinos and Africans, in order to fully characterize the genetic architecture of IOP.
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Affiliation(s)
- Xiaoyi Raymond Gao
- Department of Ophthalmology and Visual Sciences, The Ohio State University, Columbus, OH, United States
- Department of Biomedical Informatics, The Ohio State University, Columbus, OH, United States
- Division of Human Genetics, The Ohio State University, Columbus, OH, United States
| | - Marion Chiariglione
- Department of Ophthalmology and Visual Sciences, The Ohio State University, Columbus, OH, United States
| | - Hélène Choquet
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Alexander J. Arch
- Department of Ophthalmology and Visual Sciences, The Ohio State University, Columbus, OH, United States
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18
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Chong RS, Li H, Cheong AJY, Fan Q, Koh V, Raghavan L, Nongpiur ME, Cheng CY. Mendelian Randomization Implicates Bidirectional Association between Myopia and Primary Open-Angle Glaucoma or Intraocular Pressure. Ophthalmology 2023; 130:394-403. [PMID: 36493903 DOI: 10.1016/j.ophtha.2022.11.030] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/08/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Observational studies suggest that myopic eyes carry a greater risk of primary open-angle glaucoma (POAG); however, the evidence for this association is inconsistent. This may be the result of confounding factors that arise from myopia that complicate clinical tests for glaucoma. This study used Mendelian randomization (MR) analysis to determine genetic causal associations among myopia, glaucoma, and glaucoma-related traits that overcome the effects of external confounders. DESIGN Bidirectional genetic associations between myopia and refractive spherical equivalent (RSE), POAG, and POAG endophenotypes were investigated. PARTICIPANTS Data from the largest publicly available genetic banks (n = 216,257-542,934) were analyzed. METHODS Multiple MR models and multivariate genomic structural modeling to identify significant mediators for the relationship between myopia and POAG. MAIN OUTCOME MEASURES Genetic causal associations between myopia and POAG and POAG endophenotypes. RESULTS We found consistent bidirectional genetic associations between myopia and POAG and between myopia and intraocular pressure (IOP) using multiple MR models at Bonferroni-corrected levels of significance. Intraocular pressure showed the most significant mediation effect on RSE and POAG (Sobel test, 0.13; 95% confidence interval, 0.09-0.17; P = 1.37 × 10-8). CONCLUSIONS A strong bidirectional genetic causal link exists between myopia and POAG that is mediated mainly by IOP. Our findings suggest that IOP-lowering treatment for glaucoma may be beneficial in myopic eyes, despite the challenges of establishing a clear clinical diagnosis. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Rachel S Chong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Ophthalmology & Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Hengtong Li
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore
| | - Alex J Y Cheong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Qiao Fan
- Centre for Innovation and Precision Eye Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Victor Koh
- Centre for Innovation and Precision Eye Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Lavanya Raghavan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore
| | - Monisha E Nongpiur
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Ophthalmology & Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Ophthalmology & Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Republic of Singapore; Centre for Innovation and Precision Eye Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore.
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19
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Sun MT, Tran M, Singh K, Chang R, Wang H, Sun Y. Glaucoma and Myopia: Diagnostic Challenges. Biomolecules 2023; 13:biom13030562. [PMID: 36979497 PMCID: PMC10046607 DOI: 10.3390/biom13030562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/06/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
The rising global prevalence of myopia is a growing concern for clinicians, as it predisposes patients to severe ocular pathologies including glaucoma. High myopia can be associated with clinical features that resemble glaucomatous damage, which make an accurate glaucoma diagnosis challenging, particularly among patients with normal intraocular pressures. These patients may also present with established visual field defects which can mimic glaucoma, and standard imaging technology is less useful in disease detection and monitoring due to the lack of normative data for these anatomically unique eyes. Progression over time remains the most critical factor in facilitating the detection of early glaucomatous changes, and thus careful longitudinal follow-up of high-risk myopic patients is the most important aspect of management. Here, we review our current understanding of the complex relationship between myopia and glaucoma, and the diagnostic challenges and limitations of current testing protocols including visual field, intraocular pressure, and imaging. Furthermore, we discuss the clinical findings of two highly myopic patients with suspected glaucoma.
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Affiliation(s)
- Michelle T Sun
- Department of Ophthalmology, School of Medicine, Stanford University, Palo Alto, CA 94305, USA
| | - Matthew Tran
- Department of Ophthalmology, School of Medicine, Stanford University, Palo Alto, CA 94305, USA
- School of Medicine, University of Nevada, Reno, NV 89557, USA
| | - Kuldev Singh
- Department of Ophthalmology, School of Medicine, Stanford University, Palo Alto, CA 94305, USA
| | - Robert Chang
- Department of Ophthalmology, School of Medicine, Stanford University, Palo Alto, CA 94305, USA
| | - Huaizhou Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Yang Sun
- Department of Ophthalmology, School of Medicine, Stanford University, Palo Alto, CA 94305, USA
- Palo Alto Veterans Administration, Palo Alto, CA 94304, USA
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20
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Song DJ, Fan B, Li GY. Blood cell traits and risk of glaucoma: A two-sample mendelian randomization study. Front Genet 2023; 14:1142773. [PMID: 37124610 PMCID: PMC10130872 DOI: 10.3389/fgene.2023.1142773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/03/2023] [Indexed: 05/02/2023] Open
Abstract
Importance: Glaucoma is the second leading cause of blindness in the world. The causal direction and magnitude of the association between blood cell traits and glaucoma is uncertain because of the susceptibility of observational studies to confounding and reverse causation. Objective: To explore whether there is a causal relationship of blood cell traits including white blood cell (WBC) count (WBCC) and its subtypes [basophil cell count (BASO), monocyte cell count (MONO), lymphocyte cell count (LYMPH), eosinophil cell count (EOS), neutrophil cell count (NEUT)], red blood cell (RBC) count (RBCC), red blood distribution width (RDW), platelet count (PLT), and plateletcrit (PCT) on glaucoma risk. Methods: A two-sample Mendelian randomization (MR) analysis was conducted. Genome-wide significant single nucleotide polymorphisms (SNPs) from published genome-wide association studies (GWAS) on human blood cell traits were utilized as exposure instruments and the dataset for outcome was from the GWAS summary data of glaucoma. In the univariable MR analysis, we examined the association between genetic evidence of blood cell traits and glaucoma. To further investigate the potential causal mechanisms underlying the observed association, we performed multivariable MR analysis with three models, taking into account the mediator effect of inflammation and oxidative stress. According to Bonferroni-corrected for the 10 exposures in 3 methods, the MR study yielded a statistically significant p-value of 0.0017. Results: Genetically BASO, PCT, LYMPH, and PLT were potentially positively associated with glaucoma in the European ancestry [BASO: Odds ratio (OR) = 1.00122, 95% confidence interval (CI), 1.00003-1.00242, p = 0.045; PCT: OR = 1.00078, 95% CI, 1.00012-1.00143, p = 0.019; LYMPH: OR = 1.00076, 95% CI, 1.00002-1.00151, p = 0.045; PLT: OR = 1.00065, 95% CI, 1.00006-1.00123, p = 0.030], There was insufficient evidence to support a causal association of MONO, NEUT, EOS, WBCC, RBCC and RDW (MONO: OR = 1.00050, p = 0.098; NEUT: OR = 1.00028, p = 0.524; EOS: OR = 1.00020, p = 0.562; WBCC: OR = 1.00008, p = 0.830; RBCC: OR = 0.99996, p = 0.920; RDW: OR = 0.99987, p = 0.734) with glaucoma. The multivariable MR with model 1, 2, and 3 demonstrated that BASO, PCT, LYMPH, and PLT were still potentially genetically associated with the risk of glaucoma. Conclusion: Our study reveals a genetic predisposition to higher LYMPH, BASO, PLT, and PCT are associated with a higher risk of glaucoma, whereas WBCC, MONO, EOS, NEUT, RBCC, and RDW are not associated with the occurrence of glaucoma. This finding also supports previous observational studies associating immune components with glaucoma, thus provide guidance on the predication and prevention for glaucoma.
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Liu J, Lei Y, Diao Y, Lu Y, Teng X, Chen Q, Liu L, Zhong J. Altered whole-brain gray matter volume in form-deprivation myopia rats based on voxel-based morphometry: A pilot study. Front Neurosci 2023; 17:1113578. [PMID: 37144093 PMCID: PMC10151753 DOI: 10.3389/fnins.2023.1113578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/30/2023] [Indexed: 05/06/2023] Open
Abstract
Background Myopia is one of the major public health problems worldwide. However, the exact pathogenesis of myopia remains unclear. This study proposes using voxel-based morphometry (VBM) to investigate potential morphological alterations in gray matter volume (GMV) in form-deprivation myopia (FDM) rats. Methods A total of 14 rats with FDM (FDM group) and 15 normal controls (NC group) underwent high-resolution magnetic resonance imaging (MRI). Original T2 brain images were analyzed using VBM method to identify group differences in GMV. Following MRI examination, all rats were perfused with formalin, and immunohistochemical analysis of NeuN and c-fos levels was performed on the visual cortex. Results In the FDM group, compared to the NC group, significantly decreased GMVs were found in the left primary visual cortex, left secondary visual cortex, right subiculum, right cornu ammonis, right entorhinal cortex and bilateral molecular layer of the cerebellum. Additionally, significantly increased GMVs were found in the right dentate gyrus, parasubiculum, and olfactory bulb. Conclusions Our study revealed a positive correlation between mGMV and the expression of c-fos and NeuN in the visual cortex, suggesting a molecular relationship between cortical activity and macroscopic measurement of visual cortex structural plasticity. These findings may help elucidate the potential neural pathogenesis of FDM and its relationship to changes in specific brain regions.
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Affiliation(s)
- Jiayan Liu
- Department of Ophthalmology, First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
- Department of Ophthalmology, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People’s Hospital, Qingyuan, China
| | - Yahui Lei
- Department of Ophthalmology, First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
| | - Yuyao Diao
- Department of Ophthalmology, First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
| | - Yamei Lu
- Department of Ophthalmology, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People’s Hospital, Qingyuan, China
| | - Xingbo Teng
- Department of Ophthalmology, First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
| | - Qingting Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Lian Liu
- Department of Ophthalmology, First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
| | - Jingxiang Zhong
- Department of Ophthalmology, First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
- The Sixth Affiliated Hospital of Jinan University, Jinan University, Dongguan, China
- *Correspondence: Jingxiang Zhong,
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