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Beneke AA, Wiese JD, Root KT, Taneja K, Beal CJ. Lack of genetic association of non-melanoma skin cancer and pseudoexfoliative glaucoma. Ophthalmic Genet 2024:1-3. [PMID: 39148320 DOI: 10.1080/13816810.2024.2390008] [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: 11/07/2023] [Revised: 03/27/2024] [Accepted: 08/02/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Prior research has shown a positive association of pseudoexfoliative glaucoma (PXG) in patients with non-melanoma skin cancer (NMSC), likely due to an increase in ultraviolet exposure associated with both. However, the role of NMSC as a genetic risk factor for PXG has not been examined. Thus, the goal of this study is to utilize Mendelian randomization with genome-wide association studies to evaluate for genetic causality while controlling for environmental confounders. METHODS We conducted a MR using the inverse variance weighted method (MR-IVW) as our primary analysis. Genomic data was sourced from GWASs for patients with NMSC (10,382 cases, 208,410 controls) and PXG (1,515 cases and 210,201 controls), originating from the FinnGen Biobank. RESULTS Despite previous association of history of NMSC with occurrence of PXG, we found no evidence for a causal association between SNPs associated with NMSC and risk of PXG following MR analysis (MR-IVW, odds ratio (OR): 0.98, 95% CI: 0.85-1.14, P = 0.87). CONCLUSION Here, we found no evidence for a causal association between SNPs associated with NMSC and the risk of PXG following a MR analysis.
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Affiliation(s)
- Alice A Beneke
- College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Jon D Wiese
- Department of Ophthalmology, University of Florida, Gainesville, Florida, USA
| | - Kevin T Root
- College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Kamil Taneja
- Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Casey J Beal
- Department of Ophthalmology, University of Florida, Gainesville, Florida, USA
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Sazhnyev Y, Venkat A, Zheng JJ. Somatic Mutations within Myocilin due to Aging May Be a Potential Risk Factor for Glaucoma. Genes (Basel) 2024; 15:203. [PMID: 38397193 PMCID: PMC10887703 DOI: 10.3390/genes15020203] [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: 12/28/2023] [Revised: 01/17/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024] Open
Abstract
Glaucoma is a chronic optic neuropathy that leads to irreversible vision loss. Aging and family history are the two most important risk factors of glaucoma. One of the most studied genes involved in the onset of open-angle glaucoma is myocilin (MYOC). About 105 germline mutations within MYOC are known to be associated with glaucoma and result in endoplasmic reticulum (ER) stress, which leads to trabecular meshwork (TM) cell death and subsequent intraocular pressure (IOP) elevation. However, only about 4% of the population carry these mutations. An analysis of MYOC somatic cancer-associated mutations revealed a notable overlap with pathogenic glaucoma variants. Because TM cells have the potential to accumulate somatic mutations at a rapid rate due to ultraviolet (UV) light exposure, we propose that an accumulation of somatic mutations within MYOC is an important contributor to the onset of glaucoma.
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Affiliation(s)
- Yevgeniy Sazhnyev
- Department of Ophthalmology, Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (Y.S.); (A.V.)
- Department of Ophthalmology, California Northstate University College of Medicine, 9700 West Taron Dr., Elk Grove, CA 95757, USA
- Department of Chemistry and Biochemistry, University of California, Los Angeles, CA 90095, USA
| | - Akaash Venkat
- Department of Ophthalmology, Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (Y.S.); (A.V.)
- Department of Computer Science, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, CA 90095, USA
| | - Jie J. Zheng
- Department of Ophthalmology, Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (Y.S.); (A.V.)
- Molecular Biology Institute, University of California, Los Angeles, CA 90095, USA
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Bezci Aygun F, Bagci Bosi AT, Kocabeyoglu S, Irkec M. Evaluation of the effects of environmental factors and eating habits on exfoliation syndrome and glaucoma in a Turkish population. Eur J Ophthalmol 2024; 34:168-174. [PMID: 37226472 DOI: 10.1177/11206721231178055] [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] [Indexed: 05/26/2023]
Abstract
PURPOSE This study aimed to assess the possible effect of environmental factors and eating habits on patients with the exfoliation syndrome (XFS) and exfoliative glaucoma (XFG) in a Turkish population. METHODS A questionnaire was applied to 1,000 individuals, including 290 patients with XFS, 210 patients with XFG, and 500 age- and sex-matched healthy control participants. Sociodemographic characteristics, home type and warming methods, living and working conditions (indoor-outdoor), dietary habits based on the the guidance of Turkey Dietary Guidelines, (Determination of Nutritional Status Report and Turkey National Nutrition and Health Survey) and using sunglasses were evaluated. The chi-square test, Student t test, and analysis of variance were used for the statistical analysis with SPSS v. 23.0 software. RESULTS The case-control groups were matched during data collection, and age and sex distribution in groups was analyzed; however, no difference was found. The average years and hours spent outdoor were statistically different between case and control groups (P < 0.05). The disease risk among individuals wearing sunglasses was 2.74 times less than that among those who did not wear sunglasses. Individuals born in the city had 1.46 times lower risk. Also, living out of the city until the age of 12 years increased the risk of getting the disease 1.36 times. In addition, while living in an apartment decreased the risk of disease, using a stove increased. The control groups had more healthy eating habits than the case groups. CONCLUSION This case-control study showed that time spent outdoors, wearing sunglasses, home type, heating method, and eating habits might be associated with XFS and XFG.
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Affiliation(s)
- Figen Bezci Aygun
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ayse Tulay Bagci Bosi
- Department of Public Health, Hacettepe University School of Medicine, Ankara, Turkey
| | - Sibel Kocabeyoglu
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Murat Irkec
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
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Dai J, Suo L, Xian H, Pan Z, Zhang C. Investigating the Impact of Sun/UV Protection and Ease of Skin Tanning on the Risk of Pseudoexfoliation Glaucoma: A Mendelian Randomization Study. Invest Ophthalmol Vis Sci 2023; 64:4. [PMID: 37788000 PMCID: PMC10552876 DOI: 10.1167/iovs.64.13.4] [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: 04/21/2023] [Accepted: 09/11/2023] [Indexed: 10/04/2023] Open
Abstract
Purpose To investigate the potential causal associations between the use of sun/ultraviolet (UV) protection and ease of skin tanning and the risk of pseudoexfoliation glaucoma (PXG) in European populations. Methods Single nucleotide polymorphisms (SNPs) associated with the use of sun/UV protection and ease of skin tanning were selected from the UK Biobank genome-wide association study database consisting of 498,751 European participants. SNPs of PXG were obtained from the FinnGen study including 3424 PXG cases and 326,434 controls. Two-sample Mendelian randomization (MR) analyses were performed to assess the association between the use of sun/UV protection and ease of skin tanning and risk of PXG. Results Inverse variance weighted regression of genetic susceptibility predicted that both use of sun/UV protection and ease of skin tanning were potentially positively associated with the decreased risk of PXG in the European ancestry (use of sun/UV protection: odds ratio [OR] = 0.47; 95% confidence interval [CI], 0.24-0.92; P = 0.028; ease of skin tanning: OR = 0.81; 95% CI, 0.67-0.97; P = 0.025). Conclusions We found genetic evidence supporting a potential causal association between UV protection and a decreased risk of PXG in European population. Further research will help elucidate the underlying mechanisms and promote UV protection for eyes, especially in people with a high risk of PXG.
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Affiliation(s)
- Jinyue Dai
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Lingge Suo
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Haocheng Xian
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Zhe Pan
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Chun Zhang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Department of Ophthalmology, Peking University Eye Center, Beijing, China
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Sureshkumar I, Gunalan V, Nareshkumar RN, Sripriya K, Ronnie G, Sharada R, Asokan R. Evaluating the impact of ocular UV exposure for the development for pseudoexfoliation syndrome in a South Indian population. Clin Exp Optom 2023; 106:734-740. [PMID: 36375140 DOI: 10.1080/08164622.2022.2134762] [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: 01/18/2022] [Revised: 05/16/2022] [Accepted: 09/01/2022] [Indexed: 11/16/2022] Open
Abstract
CLINICAL RELEVANCE Pathophysiology of pseudoexfoliation syndrome (XFS) can be influenced by environmental factors such as solar exposure/occupational factors and genetic factors. BACKGROUND The study aims to assess the association of lifetime ocular UV exposure and its impact on the risk of development of XFS. METHODS All eligible subjects underwent a comprehensive ocular examination. XFS was defined as precipitates on the pupillary border, cornea, and angle of anterior chamber or lens in at least one eye without any clinical signs of glaucoma. A standardised questionnaire was administered to assess the lifetime UV exposure. Conjunctival ultraviolet autofluorescence (CUVAF) photography was taken to detect the conjunctival changes with exposure to UV radiation. Ascorbic acid concentration in the aqueous humour was measured. RESULTS A total of 404 subjects of which 274 (controls) and 130 (XFS cases) were studied. There were 204 males (50.5%) and 200 females (49.5%).Lifetime UV exposure (OR: 1.14, 95% CI: 1.02-1.30, p: 0.032), CUVAF damage (OR: 1.03, 95% CI: 1.01-1.06, p: 0.008) and outdoor worker (OR: 1.87, 95% CI: 1.18-3.00, p: 0.008) were positively associated with XFS. Usage of spectacles (OR: 0.63, 95% CI: 0.39-0.95, p: 0.030) and ascorbic acid concentration in aqueous (OR: 0.47, 95% CI: 0.23-0.99, p: 0.038) were found to be protective against XFS. CONCLUSION Besides genetic factors, environmental factors such as lifetime ocular UV exposure and outdoor work are significantly associated with the risk of XFS. CUVAF can be used as a non-invasive tool to detect preclinical sun damage in outdoor workers.
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Affiliation(s)
- Ishwarya Sureshkumar
- Research Fellow, Vision Research Foundation, Glaucoma services Sankara Nethralaya, Chennai, India
| | - Vaishaali Gunalan
- Research Fellow, Vision Research Foundation, Glaucoma services Sankara Nethralaya, Chennai, India
| | - R N Nareshkumar
- RS Mehta Jain Department of Biochemistry and Cell Biology, Vision Research Foundation Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Krishnamoorthy Sripriya
- Glaucoma Services, Medical Research Foundation Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - George Ronnie
- Research Fellow, Vision Research Foundation, Glaucoma services Sankara Nethralaya, Chennai, India
- Glaucoma Services, Medical Research Foundation Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Ramasubramanyan Sharada
- RS Mehta Jain Department of Biochemistry and Cell Biology, Vision Research Foundation Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Rashima Asokan
- Research Fellow, Vision Research Foundation, Glaucoma services Sankara Nethralaya, Chennai, India
- Glaucoma Services, Medical Research Foundation Sankara Nethralaya, Chennai, Tamil Nadu, India
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Huang JJ, Geduldig JE, Jacobs EB, Tai TYT, Ahmad S, Chadha N, Buxton DF, Vinod K, Wirostko BM, Kang JH, Wiggs JL, Ritch R, Pasquale LR. Head and Neck Region Dermatological Ultraviolet-Related Cancers are Associated with Exfoliation Syndrome in a Clinic-Based Population. Ophthalmol Glaucoma 2022; 5:663-671. [PMID: 35470101 PMCID: PMC9587131 DOI: 10.1016/j.ogla.2022.04.002] [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: 02/12/2022] [Revised: 04/12/2022] [Accepted: 04/18/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE We assessed the relationship between ultraviolet (UV)-associated dermatological carcinomas (basal cell carcinoma [BCC] and squamous cell carcinoma [SCC]) and exfoliation syndrome (XFS) or exfoliation glaucoma (XFG). DESIGN Case-control study. PARTICIPANTS Between 2019 and 2021, 321 participants and control subjects (XFS or XFG = 98; primary open-angle glaucoma [POAG] = 117; controls = 106; ages 50-90 years) were recruited. METHODS A cross-sectional survey assessing medical history, maximum known intraocular pressure, cup-to-disc ratio, Humphrey visual field 24-2, the propensity to tan or burn in early life, history of BCC or SCC, and XFS or XFG diagnosis. The multivariable models adjusted for age, sex, medical history, eye color, hair color, and likeliness of tanning versus burning at a young age. MAIN OUTCOME MEASURES History of diagnosed XFS or XFG. RESULTS Any history of BCC or SCC in the head and neck region was associated with a 2-fold higher risk of having XFS or XFG versus having POAG or being a control subject (odds ratio [OR], 2.01; 95% confidence interval [CI], 1.04-3.89) in a multivariable-adjusted analysis. We observed a dose-response association in which the chance of having XFS or XFG increased by 67% per head and neck BCC or SCC occurrence (OR, 1.67; 95% CI, 1.09-2.56). When we excluded POAG participants, head and neck BCC or SCC was associated with a 2.8-fold higher risk of XFS or XFG (OR, 2.80; 95% CI, 1.12-7.02), and each additional occurrence had a 2-fold higher risk of XFS or XFG (OR, 1.97; 95% CI, 1.09-3.58). The association between head and neck region BCC or SCC and POAG compared with the control subjects was null (OR, 1.42; 95% CI, 0.58-3.48). With BCC or SCC located anywhere on the body, there was a nonsignificantly higher risk of having XFS or XFG compared with having POAG or being a control subject (OR, 1.65; 95% CI, 0.88-3.09). CONCLUSIONS Head and neck region BCCs or SCCs are associated with a higher risk of having XFS or XFG. These findings support prior evidence that head and neck UV exposure may be a risk factor for XFS.
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Affiliation(s)
- Jeff J Huang
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Jack E Geduldig
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Erica B Jacobs
- New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | - Tak Yee T Tai
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York; New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | - Sumayya Ahmad
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York; New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | - Nisha Chadha
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York; New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | - Douglas F Buxton
- New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | - Kateki Vinod
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York; New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | | | - Jae H Kang
- Channing Division of Network of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Janey L Wiggs
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Robert Ritch
- New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York; New York Eye and Ear Infirmary of Mount Sinai, New York, New York
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Kang JH, Zeleznik O, Frueh L, Lasky-Su J, Eliassen AH, Clish C, Rosner BA, Pasquale LR, Wiggs JL. Prediagnostic Plasma Metabolomics and the Risk of Exfoliation Glaucoma. Invest Ophthalmol Vis Sci 2022; 63:15. [PMID: 35951322 PMCID: PMC9386645 DOI: 10.1167/iovs.63.9.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Purpose The etiology of exfoliation glaucoma (XFG) is poorly understood. We aimed to identify a prediagnostic plasma metabolomic signature associated with XFG. Methods We conducted a 1:1 matched case-control study nested within the Nurses' Health Study and Health Professionals Follow-up Study. We collected blood samples in 1989-1990 (Nurses' Health Study) and 1993-1995 (Health Professionals Follow-up Study). We identified 205 incident XFG cases through 2016 (average time to diagnosis from blood draw = 11.8 years) who self-reported glaucoma and were confirmed as XFG cases with medical records. We profiled plasma metabolites using liquid chromatography-mass spectrometry. We evaluated 379 known metabolites (transformed for normality using probit scores) using multiple conditional logistic models. Metabolite set enrichment analysis was used to identify metabolite classes associated with XFG. To adjust for multiple comparisons, we used number of effective tests (NEF) and the false discovery rate (FDR). Results Mean age of cases (n = 205) at diagnosis was 71 years; 85% were women and more than 99% were Caucasian; controls (n = 205) reported eye examinations as of the matched cases' index date. Thirty-three metabolites were nominally significantly associated with XFG (P < 0.05), and 4 metabolite classes were FDR-significantly associated. We observed positive associations for lysophosphatidylcholines (FDR = 0.02) and phosphatidylethanolamine plasmalogens (FDR = 0.004) and inverse associations for triacylglycerols (FDR < 0.0001) and steroids (FDR = 0.03). In particular, the multivariable-adjusted odds ratio with each 1 standard deviation higher plasma cortisone levels was 0.49 (95% confidence interval, 0.32-0.74; NEF = 0.05). Conclusions In plasma from a decade before diagnosis, lysophosphatidylcholines and phosphatidylethanolamine plasmalogens were positively associated and triacylglycerols and steroids (e.g., cortisone) were inversely associated with XFG risk.
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Affiliation(s)
- Jae H Kang
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Oana Zeleznik
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Lisa Frueh
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Jessica Lasky-Su
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - A Heather Eliassen
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States
| | - Clary Clish
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts, United States
| | - Bernard A Rosner
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Janey L Wiggs
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
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Paulson C, Thomas SC, Gonzalez O, Taylor S, Swiston C, Herrick JS, McCoy L, Curtin K, Chaya CJ, Stagg BC, Wirostko BM. Exfoliation Syndrome in Baja Verapaz Guatemala: A Cross-Sectional Study and Review of the Literature. J Clin Med 2022; 11:1795. [PMID: 35407402 PMCID: PMC8999914 DOI: 10.3390/jcm11071795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/20/2022] [Accepted: 03/22/2022] [Indexed: 11/16/2022] Open
Abstract
There are little epidemiologic data on exfoliation syndrome (XFS) or exfoliation glaucoma (XFG) in Guatemala, especially in the underserved Baja Verapaz region. This observational study assessing XFS/XFG and demographic factors of this region aims to better understand unique exogenous and endogenous risk factors associated with XFS/XFG in Guatemala. During Moran Eye Center's global outreach medical eye camps from 2016-2017, 181 patients age 15 years and older presented for complete eye exams. These individuals were screened for eye disease and evaluated for possible surgical interventions that could occur during the camps to improve eyesight. During the dilated exams, XFS was noted as missing or present. Of those 181, 10 had insufficient data and 18 lacked a definitive diagnosis of XFS or XFG, resulting in 153 evaluable patients; 46 XFS and 9 XFG were identified. Age, gender, hometown, ancestry (languages spoken by parents and grandparents), past medical history, family medical history, and occupational data (only 2017 trip) were obtained for each patient. The most common occupations of these individuals were farming and housekeeping. Higher rates of XFS/XFG were noted in individuals of rural compared to urban settings and Mayan speaking people compared with Spanish speakers. Based on this subset of patients, with various ocular pathologies being evaluated during medical eye outreach camps, the prevalence of XFS/XFG appeared to be 36%, a high prevalence compared to other world populations. Location and higher altitude, along with a farming occupation, may contribute to XFS development and subsequent progression to XFG. To our knowledge, this is the largest study looking at the epidemiology of XFS/XFG in the Baja Verapaz region of Guatemala for those over the age of 15 years seeking eye exams and interventions.
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Affiliation(s)
- Chase Paulson
- School of Medicine, University of Utah, Salt Lake City, UT 84132, USA; (C.P.); (S.T.); (J.S.H.); (K.C.)
| | - Samuel C. Thomas
- Department of Medicine and Population Health, School of Medicine, Stanford University, Palo Alto, CA 94304, USA;
| | | | - Samuel Taylor
- School of Medicine, University of Utah, Salt Lake City, UT 84132, USA; (C.P.); (S.T.); (J.S.H.); (K.C.)
| | - Cole Swiston
- Moran Eye Center, University of Utah, Salt Lake City, UT 84132, USA; (C.S.); (L.M.); (C.J.C.); (B.C.S.)
| | - Jennifer S. Herrick
- School of Medicine, University of Utah, Salt Lake City, UT 84132, USA; (C.P.); (S.T.); (J.S.H.); (K.C.)
| | - Lori McCoy
- Moran Eye Center, University of Utah, Salt Lake City, UT 84132, USA; (C.S.); (L.M.); (C.J.C.); (B.C.S.)
| | - Karen Curtin
- School of Medicine, University of Utah, Salt Lake City, UT 84132, USA; (C.P.); (S.T.); (J.S.H.); (K.C.)
- Moran Eye Center, University of Utah, Salt Lake City, UT 84132, USA; (C.S.); (L.M.); (C.J.C.); (B.C.S.)
| | - Craig J. Chaya
- Moran Eye Center, University of Utah, Salt Lake City, UT 84132, USA; (C.S.); (L.M.); (C.J.C.); (B.C.S.)
| | - Brian C. Stagg
- Moran Eye Center, University of Utah, Salt Lake City, UT 84132, USA; (C.S.); (L.M.); (C.J.C.); (B.C.S.)
| | - Barbara M. Wirostko
- Moran Eye Center, University of Utah, Salt Lake City, UT 84132, USA; (C.S.); (L.M.); (C.J.C.); (B.C.S.)
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Hicks PM, Siedlecki A, Haaland B, Owen LA, Au E, Feehan M, Murtaugh MA, Sieminski S, Reynolds A, Lillvis J, DeAngelis MM. A global genetic epidemiological review of pseudoexfoliation syndrome. EXPLORATION OF MEDICINE 2021. [DOI: 10.37349/emed.2021.00069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Pseudoexfoliation (PXF) syndrome is an important public health concern requiring individual population level analysis. Disease prevalence differs by geographic location and ethnicity, and has environmental, demographic, genetic, and molecular risk factors have been demonstrated. Epidemiological factors that have been associated with PXF include age, sex, environmental factors, and diet. Genetic and molecular components have also been identified that are associated with PXF. Underserved populations are often understudied within scientific research, including research about eye disease such as PXF, contributing to the persistence of health disparities within these populations. In each population, PXF needs may be different, and by having research that identifies individual population needs about PXF, the resources in that population can be more efficiently utilized. Otherwise, PXF intervention and care management based only on the broadest level of understanding may continue to exacerbate health disparities in populations disproportionally burdened by PXF.
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Affiliation(s)
- Patrice M. Hicks
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT 84108, USA;Department of Ophthalmology and Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
| | - Adam Siedlecki
- Department of Ophthalmology, Jacobs School of Medicine and Biomedical Engineering, SUNY-University at Buffalo, Buffalo, NY 14209, USA
| | - Benjamin Haaland
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT 84108, USA
| | - Leah A. Owen
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT 84108, USA;Department of Ophthalmology and Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT 84132, USA;Department of Ophthalmology, Jacobs School of Medicine and Biomedical Engineering, SUNY-University at Buffalo, Buffalo, NY 14209, USA
| | - Elizabeth Au
- Department of Ophthalmology, Jacobs School of Medicine and Biomedical Engineering, SUNY-University at Buffalo, Buffalo, NY 14209, USA
| | - Michael Feehan
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT 84108, USA;Department of Ophthalmology, Jacobs School of Medicine and Biomedical Engineering, SUNY-University at Buffalo, Buffalo, NY 14209, USA;Cerner Enviza, Kansas City, MO 64117, USA
| | - Maureen A. Murtaugh
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT 84108, USA;Department of Ophthalmology and Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
| | - Sandra Sieminski
- Department of Ophthalmology, Jacobs School of Medicine and Biomedical Engineering, SUNY-University at Buffalo, Buffalo, NY 14209, USA
| | - Andrew Reynolds
- Department of Ophthalmology, Jacobs School of Medicine and Biomedical Engineering, SUNY-University at Buffalo, Buffalo, NY 14209, USA
| | - John Lillvis
- Department of Ophthalmology, Jacobs School of Medicine and Biomedical Engineering, SUNY-University at Buffalo, Buffalo, NY 14209, USA;VA Western New York Healthcare System, Buffalo, NY 14215, USA
| | - Margaret M. DeAngelis
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT 84108, USA;Department of Ophthalmology and Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT 84132, USA;Department of Ophthalmology, Jacobs School of Medicine and Biomedical Engineering, SUNY-University at Buffalo, Buffalo, NY 14209, USA;VA Western New York Healthcare System, Buffalo, NY 14215, USA
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Mayro EL, Ritch R, Pasquale LR. Response to Letter to the Editor: Early-onset Exfoliation Syndrome: A Literature Synthesis. J Glaucoma 2021; 30:e377. [PMID: 34008531 DOI: 10.1097/ijg.0000000000001876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Eileen L Mayro
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Robert Ritch
- Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY
| | - Louis R Pasquale
- Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY
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Pseudoexfoliation and Cataract Syndrome Associated with Genetic and Epidemiological Factors in a Mayan Cohort of Guatemala. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147231. [PMID: 34299682 PMCID: PMC8303577 DOI: 10.3390/ijerph18147231] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/22/2021] [Accepted: 06/29/2021] [Indexed: 02/06/2023]
Abstract
The Mayan population of Guatemala is understudied within eye and vision research. Studying an observational homogenous, geographically isolated population of individuals seeking eye care may identify unique clinical, demographic, environmental and genetic risk factors for blinding eye disease that can inform targeted and effective screening strategies to achieve better and improved health care distribution. This study served to: (a) identify the ocular health needs within this population; and (b) identify any possible modifiable risk factors contributing to disease pathophysiology within this population. We conducted a cross-sectional study with 126 participants. Each participant completed a comprehensive eye examination, provided a blood sample for genetic analysis, and received a structured core baseline interview for a standardized epidemiological questionnaire at the Salama Lions Club Eye Hospital in Salama, Guatemala. Interpreters were available for translation to the patients’ native dialect, to assist participants during their visit. We performed a genome-wide association study for ocular disease association on the blood samples using Illumina’s HumanOmni2.5-8 chip to examine single nucleotide polymorphism SNPs in this population. After implementing quality control measures, we performed adjusted logistic regression analysis to determine which genetic and epidemiological factors were associated with eye disease. We found that the most prevalent eye conditions were cataracts (54.8%) followed by pseudoexfoliation syndrome (PXF) (24.6%). The population with both conditions was 22.2%. In our epidemiological analysis, we found that eye disease was significantly associated with advanced age. Cataracts were significantly more common among those living in the 10 districts with the least resources. Furthermore, having cataracts was associated with a greater likelihood of PXF after adjusting for both age and sex. In our genetic analysis, the SNP most nominally significantly associated with PXF lay within the gene KSR2 (p < 1 × 10−5). Several SNPs were associated with cataracts at genome-wide significance after adjusting for covariates (p < 5 × 10−8). About seventy five percent of the 33 cataract-associated SNPs lie within 13 genes, with the majority of genes having only one significant SNP (5 × 10−8). Using bioinformatic tools including PhenGenI, the Ensembl genome browser and literature review, these SNPs and genes have not previously been associated with PXF or cataracts, separately or in combination. This study can aid in understanding the prevalence of eye conditions in this population to better help inform public health planning and the delivery of quality, accessible, and relevant health and preventative care within Salama, Guatemala.
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Mansour AM, Konstas AGP, Mansour HA, Charbaji AR, El Jawhari KM. A Case-Cohort Study of Exfoliation Risk Factors and Literature Review. Middle East Afr J Ophthalmol 2021; 28:36-50. [PMID: 34321821 PMCID: PMC8270020 DOI: 10.4103/meajo.meajo_358_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 02/08/2021] [Accepted: 02/16/2021] [Indexed: 12/27/2022] Open
Abstract
The purpose of the study is to evaluate the risk factors associated with exfoliation in a case-cohort setting and literature review. This single-center, prospective, case-cohort study was carried out from January 2010 to April 2020 on patients operated for cataract surgery by a single surgeon in Lebanon. Forty-nine consecutive patients with exfoliation syndrome (XFS) and 62 consecutive control patients were identified and further investigated for selected systemic (diabetes mellitus, systemic hypertension, asthma, or atopy) and ocular variables (baseline vision, severity of nuclear sclerosis, glaucoma, eye rubbing, history of dry eye, or allergic eye disease). The mean baseline Snellen visual acuity was 20/283 in XFS versus 20/145 in control cases (P = 0.012). XFS also demonstrated significantly denser nuclear sclerosis than controls (P = 0.00958). By univariate analysis, allergic conjunctivitis (15 [30.6%] vs. 2 [3.2%]; P < 0.001), dry eye (20 [40.8%] vs. 13 [21.0%]; P = 0.0133), and habitual rubbing of the eyes (33 [67.3%] vs. 19 [30.6%]; P < 0.001) were associated with the presence of XFS. Habitual ocular rubbing was closely associated with allergic conjunctivitis (odds ratio [OR] = 13.0; 95% confidence interval [CI]: 2.8–58.8; P = 0.032). After multivariable analysis, the following variables showed significant results: glaucoma (OR = 34.5; 95% CI: 4.4–250; P = 0.010), duration of surgery (OR = 5.6; 95% CI 2.43–12.9; P < 0.001), and habitual ocular rubbing (OR = 4.42; 95% CI: 1.97–9.90; P = 0.029). This study shows a novel potential correlation between eye rubbing and XFS in a Lebanese cohort. Chronic eye rubbing induces or may exacerbate preexistent zonular damage in subjects with XFS, hence the need to better manage concurrent ocular surface disorder in these patients.
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Affiliation(s)
- Ahmad M Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon.,Department of Ophthalmology, Rafic Hariri University Hospital, Beirut, Lebanon
| | | | - Hana A Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
| | - Abdul R Charbaji
- Department of Statistics and Research Methodology, Lebanese American University, Beirut, Lebanon.,Department of Statistics and Research Methodology, Lebanese University, Beirut, Lebanon
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Mayro EL, Ritch R, Pasquale LR. Early-onset Exfoliation Syndrome: A Literature Synthesis. J Glaucoma 2021; 30:e164-e168. [PMID: 33449585 DOI: 10.1097/ijg.0000000000001784] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/20/2020] [Indexed: 01/13/2023]
Abstract
PRECIS We conducted a literature review of younger patients with exfoliation syndrome (XFS) in an attempt to identify case similarities and better understand disease etiology. PURPOSE XFS that predisposes to secondary glaucoma is a strongly age-related condition. We performed a literature review of XFS and exfoliation glaucoma (XFG) in patients aged younger than 40 years to examine potential common characteristics and gain clues to its etiology. METHODS We conducted a broad literature search with appropriate keywords and manually extracted key demographic and ocular features on younger XFS and XFG cases. Articles that did not provide past ocular history on early-onset XFS/XFG were excluded. RESULTS We identified 12 cases of XFS and XFG in patients from 13 to 40 years old (8 females; 11 White; 5 from Iran). All had past ocular history remarkable for intraocular surgery for other glaucoma conditions (7 cases), other ocular diseases (3 cases), or ocular trauma (2 cases). CONCLUSIONS All reported early-onset XFS and XFG cases arise in the setting of events that produced a significant disruption of the blood-aqueous barrier. Understanding the metabolic alterations of aqueous humor from such cases could provide clues regarding how exfoliation material forms.
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Affiliation(s)
- Eileen L Mayro
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Robert Ritch
- Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY
| | - Louis R Pasquale
- Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY
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Abstract
PRECIS In a cohort study of 120,307 participants with 25+ years of follow-up, a history of nonmelanoma skin cancer (NMSC) was associated with a 40% higher exfoliation glaucoma (XFG) risk. PURPOSE The purpose of this study was to evaluate the relationship between NMSC (a marker of ultraviolet radiation exposure) and XFG. METHODS We performed a cohort study of US women (n=79,102; 1980-2014) and men (n=41,205; 1986-2014), aged 40+ years and at risk for glaucoma who reported eye examinations. From 1984 (women)/1988 (men), we asked about basal cell carcinoma or squamous cell carcinoma history separately; in prior years, we asked about any NMSC history in a single question. Squamous cell carcinoma was confirmed with histopathology reports while basal cell carcinoma and any early (<1984/<1988) NMSC history was self-reported. Incident XFG cases (362 women and 83 men) were confirmed with medical records. Using pooled data, we estimated multivariable-adjusted relative risks [MVRRs; 95% confidence intervals (CIs)] with Cox proportional hazards models that were stratified by age (in mo), 2-year time period at risk and average lifetime residential latitude. RESULTS In multivariable-adjusted analyses, we observed a 40% higher XFG risk with any NMSC history (MVRR=1.40; 95% CI=1.08-1.82); the association was observed even with 4 and 8-year lags in NMSC history. Also, the NMSC association was stronger in younger (below 65 y; MVRR=2.56; 95% CI=1.62-4.05) versus older participants (65 y and above; MVRR=1.25; 95% CI=0.94-1.66; P for interaction=0.01) and those living in the northern latitudes (≥42°N; MVRR=1.92; 95% CI=1.28-2.88) versus more southern latitudes (<42°N; MVRR=1.19; 95% CI=0.86-1.66; P for interaction=0.04). CONCLUSION NMSC was associated with higher XFG risk, particularly among younger participants and those living in the Northern US.
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Greene AG, Eivers SB, Dervan EWJ, O'Brien CJ, Wallace DM. Lysyl Oxidase Like 1: Biological roles and regulation. Exp Eye Res 2020; 193:107975. [PMID: 32070696 DOI: 10.1016/j.exer.2020.107975] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 01/12/2020] [Accepted: 02/13/2020] [Indexed: 12/11/2022]
Abstract
Lysyl Oxidase Like 1 (LOXL1) is a gene that encodes for the LOXL1 enzyme. This enzyme is required for elastin biogenesis and collagen cross-linking, polymerising tropoelastin monomers into elastin polymers. Its main role is in elastin homeostasis and matrix remodelling during injury, fibrosis and cancer development. Because of its vast range of biological functions, abnormalities in LOXL1 underlie many disease processes. Decreased LOXL1 expression is observed in disorders of elastin such as Cutis Laxa and increased expression is reported in fibrotic disease such as Idiopathic Pulmonary Fibrosis. LOXL1 is also downregulated in the lamina cribrosa in pseudoexfoliation glaucoma and genetic variants in the LOXL1 gene have been linked with an increased risk of developing pseudoexfoliation glaucoma and pseudoexfoliation syndrome. However the two major risk alleles are reversed in certain ethnic groups and are present in a large proportion of the normal population, implying complex genetic and environmental regulation is involved in disease pathogenesis. It also appears that the non-coding variants in intron 1 of LOXL1 may be involved in the regulation of LOXL1 expression. Gene alteration may occur via a number of epigenetic and post translational mechanisms such as DNA methylation, long non-coding RNAs and microRNAs. These may represent future therapeutic targets for disease. Environmental factors such as hypoxia, oxidative stress and ultraviolet radiation exposure alter LOXL1 expression, and it is likely a combination of these genetic and environmental factors that influence disease development and progression. In this review, we discuss LOXL1 properties, biological roles and regulation in detail with a focus on pseudoexfoliation syndrome and glaucoma.
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Affiliation(s)
- Alison G Greene
- UCD Clinical Research Centre, School of Medicine, University College Dublin, Ireland.
| | - Sarah B Eivers
- UCD Clinical Research Centre, School of Medicine, University College Dublin, Ireland
| | - Edward W J Dervan
- Dept. of Ophthalmology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - Colm J O'Brien
- UCD Clinical Research Centre, School of Medicine, University College Dublin, Ireland; Dept. of Ophthalmology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - Deborah M Wallace
- UCD Clinical Research Centre, School of Medicine, University College Dublin, Ireland
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Zadravec P, Braunger BM, Melzer B, Kroeber M, Bösl MR, Jägle H, Schlötzer-Schrehardt U, Tamm ER. Transgenic lysyl oxidase homolog 1 overexpression in the mouse eye results in the formation and release of protein aggregates. Exp Eye Res 2019; 179:115-124. [DOI: 10.1016/j.exer.2018.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/31/2018] [Accepted: 11/01/2018] [Indexed: 01/08/2023]
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Pasquale LR. The Good News and the Bad News Regarding the Systemic Impact of Exfoliation Syndrome. Ophthalmol Glaucoma 2019; 2:1-2. [PMID: 32672552 DOI: 10.1016/j.ogla.2018.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 12/03/2018] [Accepted: 12/05/2018] [Indexed: 06/11/2023]
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Pasquale LR, Kang JH, Fan B, Levkovitch-Verbin H, Wiggs JL. LOXL1 Polymorphisms: Genetic Biomarkers that Presage Environmental Determinants of Exfoliation Syndrome. J Glaucoma 2018; 27 Suppl 1:S20-S23. [PMID: 29965898 PMCID: PMC6032530 DOI: 10.1097/ijg.0000000000000915] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
An agnostic high throughput search of the genome revealed a robust association between LOXL1 genetic polymorphisms and exfoliation syndrome (XFS), a discovery that likely would not have been possible with candidate or family-based gene search strategies. While questions remain regarding how LOXL1 gene variants contribute to XFS pathogenesis, it is clear that the frequencies of disease-related alleles do not track with the varying disease burden throughout the world, prompting a search for environmental risk factors. A geo-medicine approach revealed that disease load seemed to increase as a function of the distance from the equator. The exact reason for this extraequatorial disease distribution pattern remains unclear, but a greater amount of time spent outdoors is a robust risk factor for XFS, suggesting climatic factors such as ocular solar exposure and colder ambient temperature may be involved in disease pathogenesis. Prospective studies have also implicated higher coffee consumption and lower dietary folate intake in association with incident XFS. The discovery of environmental risk factors for XFS suggests that preventive measures may help to reduce ocular morbidity from XFS.
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Affiliation(s)
- Louis R. Pasquale
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Jae Hee Kang
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - BaoJian Fan
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Hani Levkovitch-Verbin
- Goldschleger Eye Institute, Tel Hashomer, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Janey L. Wiggs
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
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Wiggs JL, Kang JH, Fan B, Levkovitch-Verbin H, Pasquale LR. A Role for Clusterin in Exfoliation Syndrome and Exfoliation Glaucoma? J Glaucoma 2018; 27 Suppl 1:S61-S66. [PMID: 29965900 PMCID: PMC8035929 DOI: 10.1097/ijg.0000000000000916] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The multifunctional protein clusterin (CLU) is a secreted glycoprotein ubiquitously expressed throughout the body, including in the eye. Its primary function is to act as an extracellular molecular chaperone, preventing the precipitation and aggregation of misfolded extracellular proteins. Clusterin is commonly identified at fluid-tissue interfaces, and has been identified in most body fluids. It is a component of exfoliation material, and CLU mRNA is reduced in eyes with exfoliation syndrome compared with controls. SNPs located in the CLU genomic region have been associated with Alzheimer disease (AD) at the genome-wide level and several CLU SNPs located in an apparent regulatory region have been nominally associated with XFS/XFG in Caucasians with European ancestry and in south Indians. Interestingly, clusterin associates with altered elastic fibers in human photoaged skin and prevents UV-induced elastin aggregation in vitro. In light of the known geographic risk factors for XFS/XFG, which could include UV light, investigations of CLU-geographic interactions could be of interest. Future studies investigating rare CLU variation and other complex interactions including gene-gene interactions in XFS/XFG cases and controls may also be fruitful. Although CLU has been considered as a therapeutic target in AD, cancer and dry eye, a role for clusterin in XFS/XFG needs to be better defined before therapeutic approaches involving CLU can be entertained.
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Affiliation(s)
- Janey L. Wiggs
- Department of Ophthalmology, Mass Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Jae Hee Kang
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - BaoJian Fan
- Department of Ophthalmology, Mass Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Hani Levkovitch-Verbin
- Goldschleger Eye Institute, Tel Hashomer, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Louis R. Pasquale
- Department of Ophthalmology, Mass Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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Schweitzer C. [Pseudoexfoliation syndrome and pseudoexfoliation glaucoma]. J Fr Ophtalmol 2018; 41:78-90. [PMID: 29329947 DOI: 10.1016/j.jfo.2017.09.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 09/16/2017] [Indexed: 01/26/2023]
Abstract
Pseudoexfoliation syndrome is an age-related systemic disease that mainly affects the anterior structures of the eye. Despite a worldwide distribution, reported incidence and prevalence of this syndrome vary widely between ethnicities and geographical areas. The exfoliative material is composed mainly of abnormal cross-linked fibrils that accumulate progressively in some organs such as the heart, blood vessels, lungs or meninges, and particularly in the anterior structures of the eye. The exact pathophysiological process still remains unclear but the association of genetic and environmental factors are thought to play a role in the development and progressive extracellular accumulation of exfoliative material. Hence, LOXL1 gene polymorphisms, responsible for metabolism of some components of elastic fibers and extracellular matrix, and increased natural exposure to ambient ultraviolet or caffeine consumption have been associated with pseudoexfoliation syndrome. Ophthalmological manifestations are commonly bilateral with an asymmetric presentation and can lead to severe visual impairment and blindness more frequently than in the general population, mainly related to glaucoma and cataract. Pseudoexfoliation glaucoma is a major complication of pseudoexfoliation syndrome and represents the main cause of identifiable glaucoma worldwide. Visual field progression is more rapid than that observed in primary open angle glaucoma, and filtering surgery is more frequently required. Nuclear cataract is more frequent and occurs earlier than in the general population. Owing to poorer pupil dilation and increased zonular instability, cataract surgery with pseudoexfoliation is associated with a 5- to 10-fold increase in surgical complications compared to cataract surgery without pseudoexfoliation. Some specific treatments targeting production, formation or accumulation of exfoliative material could improve the prognosis of this syndrome.
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Affiliation(s)
- C Schweitzer
- Service d'ophtalmologie, CHU de Bordeaux, 33000 Bordeaux, France; UMR 1219, Inserm, Bordeaux Population Health Research Center, team LEHA, université Bordeaux, 33000 Bordeaux, France.
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Wiggs JL, Pasquale LR. Genetics of glaucoma. Hum Mol Genet 2017; 26:R21-R27. [PMID: 28505344 DOI: 10.1093/hmg/ddx184] [Citation(s) in RCA: 229] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 05/08/2017] [Indexed: 12/15/2022] Open
Abstract
Genetic and genomic studies, including genome-wide association studies (GWAS) have accelerated the discovery of genes contributing to glaucoma, the leading cause of irreversible blindness world-wide. Glaucoma can occur at all ages, with Mendelian inheritance typical for the rare early onset disease (before age 40) and complex inheritance evident in common adult-onset forms of disease. Recent studies have suggested possible therapeutic targets for some patients with early-onset glaucoma based on the molecular and cellular events caused by MYOC, OPTN and TBK1 mutations. Diagnostic genetic tests using early-onset glaucoma genes are also proving useful for pre-symptomatic disease detection and genetic counseling. Recent GWAS completed for three types of common adult-onset glaucoma have identified novel loci for POAG (primary-open-angle glaucoma) (ABCA1, AFAP1, GMDS, PMM2, TGFBR3, FNDC3B, ARHGEF12, GAS7, FOXC1, ATXN2, TXNRD2); PACG (primary angle-closure glaucoma (EPDR1, CHAT, GLIS3, FERMT2, DPM2-FAM102); and exfoliation syndrome (XFS) glaucoma (CACNA1A). In total sixteen genomic regions have been associated with POAG (including the normal tension glaucoma (NTG) subgroup), 8 with PACG and 2 with XFS. These studies are defining important biological pathways and processes that contribute to disease pathogenesis.
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Affiliation(s)
- Janey L Wiggs
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear, Boston, MA 02114, USA
| | - Louis R Pasquale
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear, Boston, MA 02114, USA.,Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02114, USA
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Nathan N, Kuchtey RW. Genetics, Diagnosis, and Monitoring of Pseudoexfoliation Glaucoma. CURRENT OPHTHALMOLOGY REPORTS 2017; 4:206-212. [PMID: 28503365 DOI: 10.1007/s40135-016-0113-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Recent studies have shed new light on the genetic factors underlying pseudoexfoliation syndrome, growing our understanding of the role of the lysyl oxidase-like 1 (LOXL1) gene and its various polymorphisms as well as identifying new genetic associations. Recent years have brought new insight on how these genetic factors interact with other factors, including environmental, to confer risk to individuals and populations worldwide. All of these findings may hold importance to the screening, diagnosis, and monitoring of pseudoexfoliation and may also help lead to the identification of novel therapeutic targets. This review serves as an update on the recent trends and findings in pseudoexfoliation syndrome.
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Affiliation(s)
- Niraj Nathan
- 2311 Pierce Ave, Nashville, TN 37232-8808, 615-936-2020, 615-936-1540 (Fax),
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MTHFR and MTHFD1 gene polymorphisms are not associated with pseudoexfoliation syndrome in South Indian population. Int Ophthalmol 2017; 38:599-606. [DOI: 10.1007/s10792-017-0498-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 03/08/2017] [Indexed: 12/29/2022]
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Aboobakar IF, Johnson WM, Stamer WD, Hauser MA, Allingham RR. Major review: Exfoliation syndrome; advances in disease genetics, molecular biology, and epidemiology. Exp Eye Res 2016; 154:88-103. [PMID: 27845061 DOI: 10.1016/j.exer.2016.11.011] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 10/06/2016] [Accepted: 11/10/2016] [Indexed: 12/20/2022]
Abstract
Exfoliation syndrome (XFS) is a common age-related disorder that leads to deposition of extracellular fibrillar material throughout the body. The most recognized disease manifestation is exfoliation glaucoma (XFG), which is a common cause of blindness worldwide. Recent developments in XFS genetics, cell biology and epidemiology have greatly improved our understanding of the etiology of this complex inherited disease. This review summarizes current knowledge of XFS pathogenesis, identifies gaps in knowledge, and discusses areas for future research.
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Affiliation(s)
- Inas F Aboobakar
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA
| | - William M Johnson
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA
| | - W Daniel Stamer
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA
| | - Michael A Hauser
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA
| | - R Rand Allingham
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA.
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Pasquale LR, Borrás T, Fingert JH, Wiggs JL, Ritch R. Exfoliation syndrome: assembling the puzzle pieces. Acta Ophthalmol 2016; 94:e505-12. [PMID: 26648185 DOI: 10.1111/aos.12918] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 09/25/2015] [Indexed: 12/15/2022]
Abstract
PURPOSE To summarize various topics and the cutting edge approaches to refine XFS pathogenesis that were discussed at the 21st annual Glaucoma Foundation Think Tank meeting in New York City, Sept. 19-20, 2014. METHODS The highlights of three categories of talks on cutting edge research in the field were summarized. RESULTS Exfoliation syndrome (XFS) is a systemic disorder with a substantial ocular burden, including high rates of cataract, cataract surgery complications, glaucoma and retinal vein occlusion. New information about XFS is akin to puzzle pieces that do not quite join together to reveal a clear picture regarding how exfoliation material (XFM) forms. CONCLUSION Meeting participants concluded that it is unclear how the mild homocysteinemia seen in XFS might contribute to the disarrayed extracellular aggregates characteristic of this syndrome. Lysyl oxidase-like 1 (LOXL1) variants are unequivocally genetic risk factors for XFS but exactly how these variants contribute to the assembly of exfoliation material (XFM) remains unclear. Variants in a new genomic region, CACNA1A associated with XFS, may alter calcium concentrations at the cell surface and facilitate XFM formation but much more work is needed before we can place this new finding in proper context. It is hoped that various animal model and ex vivo systems will emerge that will allow for proper assembly of the puzzle pieces into a coherent picture of XFS pathogenesis. A clear understanding of XFS pathogenesis may lead to 'upstream solutions' to reduce the ocular morbidity produced by XFS.
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Affiliation(s)
- Louis R. Pasquale
- Department of Ophthalmology; Mass Eye & Ear Infirmary; Harvard Medical School; Boston Massachusetts USA
- Department of Medicine; Harvard Medical School; Brigham and Women's Hospital; Boston Massachusetts USA
| | - Terete Borrás
- Department of Ophthalmology; University of North Carolina; Chapel Hill North Carolina USA
| | - John H. Fingert
- Department of Ophthalmology and Visual Sciences; University of Iowa; Iowa City Iowa USA
| | - Janey L. Wiggs
- Department of Ophthalmology; Mass Eye & Ear Infirmary; Harvard Medical School; Boston Massachusetts USA
| | - Robert Ritch
- Einhorn Clinical Research Center; New York Eye and Ear Infirmary of Mount Sinai; New York City New York USA
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Exfoliation Syndrome and Solar Exposure: New Epidemiological Insights Into the Pathophysiology of the Disease. Int Ophthalmol Clin 2016; 55:13-22. [PMID: 26322422 DOI: 10.1097/iio.0000000000000092] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Worldwide, the prevalence of moderate to severe visual impairment and blindness is 285 millions, with 65% of visually impaired and 82% of all blind people being 50 years and older. Meta-analyses have shown that two out of three blind people are women, a gender discrepancy that holds true for both developed and developing countries. Cataract accounts for more than half of all blindness globally and gender inequity in access to cataract surgery is the major cause of the higher prevalence of blindness in women. In addition to gender differences in cataract surgical coverage, population-based studies on the prevalence of lens opacities indicate that women have a higher risk of developing cataract. Laboratory as well as epidemiologic studies suggest that estrogen may confer antioxidative protection against cataractogenesis, but the withdrawal effect of estrogen in menopause leads to increased risk of cataract in women. For the other major age-related eye diseases; glaucoma, age-related macular degeneration (AMD) and diabetic retinopathy, data are inconclusive. Due to anatomic factors, angle closure glaucoma is more common in women, whereas the dominating glaucoma type; primary open-angle glaucoma (POAG), is more prevalent in men. Diabetic retinopathy also has a male predominance and vascular/circulatory factors have been implied both in diabetic retinopathy and in POAG. For AMD, data on gender differences are conflicting although some studies indicate increased prevalence of drusen and neovascular AMD in women. To conclude, both biologic and socioeconomic factors must be considered when investigating causes of gender differences in the prevalence of age-related eye disease.
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