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Zaman A, Caywood L, Prough M, Clouse J, Harrington S, Adams L, Fuzzell D, Fuzzell S, Laux R, Hochstetler SD, Ogrocki P, Lerner A, Vance JM, Haines JL, Scott WK, Pericak-Vance MA, Cuccaro ML. Psychometric Approaches to Defining Cognitive Phenotypes in the Old Order Amish. Int J Geriatr Psychiatry 2023; 38:e5903. [PMID: 36929524 DOI: 10.1002/gps.5903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 03/11/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVE Memory and cognitive problems are central to the diagnosis of Alzheimer's disease (AD). Psychometric approaches to defining phenotypes can aid in identify genetic variants associated with AD. However, these approaches have mostly been limited to affected individuals. Defining phenotypes of both affected and unaffected individuals may help identify genetic variants associated with both AD and healthy aging. This study compares psychometric methods for developing cognitive phenotypes that are more granular than clinical classifications. METHODS 682 older Old Order Amish individuals were included in the analysis. Adjusted Z-scores of cognitive tests were used to create four models including 1) global threshold scores or 2) memory threshold scores, and 3) global clusters and 4) memory clusters. An ordinal regression examined the coherence of the models with clinical classifications [cognitively impaired (CI), mildly impaired (MI), cognitively unimpaired (CU)], APOE-e4, sex, and age. An ANOVA examined the best model phenotypes for differences in clinical classification, APOE-e4, domain Z-scores (memory, language, executive function, and processing speed), sex, and age. RESULTS The memory cluster identified four phenotypes and had the best fit (χ2 = 491.66). Individuals in the worse performing phenotypes were more likely to be classified as CI or MI and to have APOE-e4. Additionally, all four phenotypes performed significantly differently from one another on the domains of memory, language, and executive functioning. CONCLUSIONS Memory cluster stratification identified the cognitive phenotypes that best aligned with clinical classifications, APOE-e4, and cognitive performance We predict these phenotypes will prove useful in searching for protective genetic variants. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Andrew Zaman
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Laura Caywood
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Michael Prough
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jason Clouse
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sharlene Harrington
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Larry Adams
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Denise Fuzzell
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Sarada Fuzzell
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Renee Laux
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Sherri D Hochstetler
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Paula Ogrocki
- Department of Neurology, Case Western Reserve University, Cleveland, OH, USA
| | - Alan Lerner
- Department of Neurology, Case Western Reserve University, Cleveland, OH, USA
| | - Jeffery M Vance
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA.,Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jonathan L Haines
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA.,Cleveland Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, USA
| | - William K Scott
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA.,Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Margaret A Pericak-Vance
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA.,Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Michael L Cuccaro
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA.,Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
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Waksmunski AR, Miskimen K, Song YE, Grunin M, Laux R, Fuzzell D, Fuzzell S, Adams LD, Caywood L, Prough M, Stambolian D, Scott WK, Pericak-Vance MA, Haines JL. Consequences of a Rare Complement Factor H Variant for Age-Related Macular Degeneration in the Amish. Invest Ophthalmol Vis Sci 2022; 63:8. [PMID: 35930268 PMCID: PMC9363678 DOI: 10.1167/iovs.63.9.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Genetic variants in the complement factor H gene (CFH) have been consistently implicated in age-related macular degeneration (AMD) risk. However, their functional effects are not fully characterized. We previously identified a rare, AMD-associated variant in CFH (P503A, rs570523689) in 19 Amish individuals, but its functional consequences were not investigated. Methods We performed genotyping for CFH P503A in 1326 Amish individuals to identify additional risk allele carriers. We examined differences for age at AMD diagnosis between carriers and noncarriers. In blood samples from risk allele carriers and noncarriers, we quantified (i) CFH RNA expression, (ii) CFH protein expression, and (iii) C-reactive protein (CRP) expression. Potential changes to the CFH protein structure were interrogated computationally with Phyre2 and Chimera software programs. Results We identified 39 additional carriers from Amish communities in Ohio and Indiana. On average, carriers were younger than noncarriers at AMD diagnosis, but this difference was not significant. CFH transcript and protein levels in blood samples from Amish carriers and noncarriers were also not significantly different. CRP levels were also comparable in plasma samples from carriers and noncarriers. Computational protein modeling showed slight changes in the CFH protein conformation that were predicted to alter interactions between the CFH 503 residue and other neighboring residues. Conclusions In total, we have identified 58 risk allele carriers for CFH P503A in the Ohio and Indiana Amish. Although we did not detect significant differences in age at AMD diagnosis or expression levels of CFH in blood samples from carriers and noncarriers, we observed modest structural changes to the CFH protein through in silico modeling. Based on our functional and computational observations, we hypothesize that CFH P503A may affect CFH binding or function rather than expression, which would require additional research to confirm.
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Affiliation(s)
- Andrea R Waksmunski
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, Ohio, United States.,Cleveland Institute for Computational Biology, Case Western Reserve University, Cleveland, Ohio, United States.,Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, United States
| | - Kristy Miskimen
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, United States
| | - Yeunjoo E Song
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, United States
| | - Michelle Grunin
- Cleveland Institute for Computational Biology, Case Western Reserve University, Cleveland, Ohio, United States.,Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, United States
| | - Renee Laux
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, United States
| | - Denise Fuzzell
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, United States
| | - Sarada Fuzzell
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, United States
| | - Larry D Adams
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Laura Caywood
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Michael Prough
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Dwight Stambolian
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - William K Scott
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Margaret A Pericak-Vance
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Jonathan L Haines
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, Ohio, United States.,Cleveland Institute for Computational Biology, Case Western Reserve University, Cleveland, Ohio, United States.,Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, United States
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Ramos J, Chowdhury AR, Caywood LJ, Prough M, Denise Fuzzell M, Fuzzell S, Miskimen K, Whitehead PL, Adams LD, Laux R, Song Y, Ogrocki P, Lerner AJ, Vance JM, Haines JL, Scott WK, Pericak-Vance MA, Cuccaro ML. Lower Levels of Education Are Associated with Cognitive Impairment in the Old Order Amish. J Alzheimers Dis 2020; 79:451-458. [PMID: 33285633 DOI: 10.3233/jad-200909] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Lower education has been reported to be associated with dementia. However, many studies have been done in settings where 12 years of formal education is the standard. Formal schooling in the Old Order Amish communities (OOA) ends at 8th grade which, along with their genetic homogeneity, makes it an interesting population to study the effect of education on cognitive impairment. OBJECTIVE The objective of this study was to examine the association of education with cognitive function in individuals from the OOA. We hypothesized that small differences in educational attainment at lower levels of formal education were associated with risk for cognitive impairment. METHODS Data of 2,426 individuals from the OOA aged 54-99 were analyzed. The Modified Mini-Mental State Examination (3MS-R) was used to classify participants as CI or normal. Individuals were classified into three education categories: <8, 8, and >8 years of education. To measure the association of education with cognitive status, a logistic regression model was performed adding age and sex as covariates. RESULTS Our results showed that individuals who attained lowest levels of education (<8 and 8) had a higher probability of becoming cognitvely impaired compared with people attending >8 years (OR = 2.96 and 1.85). CONCLUSION Even within a setting of low levels of formal education, small differences in educational attainment can still be associated with the risk of cognitive impairment. Given the homogeneity of the OOA, these results are less likely to be biased by differences in socioeconomic backgrounds.
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Affiliation(s)
- Jairo Ramos
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Aneesa R Chowdhury
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Laura J Caywood
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Michael Prough
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - M Denise Fuzzell
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Sarada Fuzzell
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Kristy Miskimen
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Patrice L Whitehead
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Larry D Adams
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Renee Laux
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Yeunjoo Song
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Paula Ogrocki
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Alan J Lerner
- University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Jeffery M Vance
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA.,The Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jonathan L Haines
- Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Cleveland Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, USA
| | - William K Scott
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA.,The Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Margaret A Pericak-Vance
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA.,The Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Michael L Cuccaro
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA.,The Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
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Ramos J, Caywood LJ, Prough M, Fuzzell MD, Fuzzell S, Miskimen K, Whitehead PL, Adams LD, Laux R, Song Y, Ogrocki P, Lerner AJ, Vance JM, Scott WK, Pericak-Vance MA, Cuccaro ML. P3-140: PROTECTIVE EFFECT OF EDUCATION ON COGNITIVE FUNCTION IN THE OLD ORDER AMISH. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jairo Ramos
- John P. Hussman Institute for Human Genomics; University of Miami Miller School of Medicine; Miami FL USA
| | | | - Michael Prough
- John P. Hussman Institute for Human Genomics; University of Miami Miller School of Medicine; Miami FL USA
| | - M. Denise Fuzzell
- Case Western Reserve University School of Medicine; Cleveland OH USA
| | - Sarada Fuzzell
- Case Western Reserve University School of Medicine; Cleveland OH USA
| | - Kristy Miskimen
- Case Western Reserve University School of Medicine; Cleveland OH USA
| | | | - Larry D. Adams
- John P. Hussman Institute for Human Genomics; University of Miami Miller School of Medicine; Miami FL USA
| | - Renee Laux
- Case Western Reserve University School of Medicine; Cleveland OH USA
| | - Yeunjoo Song
- Case Western Reserve University School of Medicine; Cleveland OH USA
| | - Paula Ogrocki
- University Hospitals Cleveland Medical Center; Cleveland OH USA
| | - Alan J. Lerner
- Case Western Reserve University School of Medicine; Cleveland OH USA
| | - Jeffery M. Vance
- John P. Hussman Institute for Human Genomics; University of Miami Miller School of Medicine; Miami FL USA
| | - William K. Scott
- John P. Hussman Institute for Human Genomics; University of Miami Miller School of Medicine; Miami FL USA
| | - Margaret A. Pericak-Vance
- John P. Hussman Institute for Human Genomics; University of Miami Miller School of Medicine; Miami FL USA
- The Dr. John T. Macdonald Foundation Department of Human Genetics; University of Miami Miller School of Medicine; Miami FL USA
| | - Michael L. Cuccaro
- John P. Hussman Institute for Human Genomics; University of Miami Miller School of Medicine; Miami FL USA
- The Dr. John T. Macdonald Foundation Department of Human Genetics; University of Miami Miller School of Medicine; Miami FL USA
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Main LR, Disher MC, Song Y, Laux R, Miskimen K, Cuccaro ML, Ogrocki P, Lerner AJ, Vance JM, Fuzzell MD, Fuzzell S, Sewell J, Caywood LJ, Prough M, Scott B, Pericak-Vance MA, Haines JL. P3-135: PROTECTIVE GENETIC VARIANTS IN THE MIDWESTERN AMISH. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Leighanne R. Main
- Case Western Reserve University School of Medicine; Cleveland OH USA
| | | | - Yeunjoo Song
- Case Western Reserve University School of Medicine; Cleveland OH USA
| | - Renee Laux
- Case Western Reserve University School of Medicine; Cleveland OH USA
| | - Kristy Miskimen
- Case Western Reserve University School of Medicine; Cleveland OH USA
| | - Michael L. Cuccaro
- University of Miami; Miami FL USA
- John P. Hussman Institute for Human Genomics; University of Miami Miller School of Medicine; Miami FL USA
| | - Paula Ogrocki
- University Hospitals Cleveland Medical Center; Cleveland OH USA
| | - Alan J. Lerner
- Case Western Reserve University School of Medicine; Cleveland OH USA
- University Hospitals Cleveland Medical Center; Cleveland OH USA
| | - Jeffery M. Vance
- University of Miami; Miami FL USA
- John P. Hussman Institute for Human Genomics; University of Miami Miller School of Medicine; Miami FL USA
| | - M Denise Fuzzell
- Case Western Reserve University School of Medicine; Cleveland OH USA
| | - Sarada Fuzzell
- Case Western Reserve University School of Medicine; Cleveland OH USA
| | - Jane Sewell
- Case Western Reserve University School of Medicine; Cleveland OH USA
| | | | - Michael Prough
- John P. Hussman Institute for Human Genomics; University of Miami Miller School of Medicine; Miami FL USA
| | | | - Margaret A. Pericak-Vance
- John P. Hussman Institute for Human Genomics; University of Miami Miller School of Medicine; Miami FL USA
- The Dr. John T. Macdonald Foundation Department of Human Genetics; University of Miami Miller School of Medicine; Miami FL USA
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Sardell RJ, Nittala MG, Adams LD, Laux RA, Cooke Bailey JN, Fuzzell D, Fuzzell S, Reinhart-Mercer L, Caywood LJ, Horst V, Mackay T, Dana D, Sadda SR, Scott WK, Stambolian D, Haines JL, Pericak-Vance MA. Heritability of Choroidal Thickness in the Amish. Ophthalmology 2016; 123:2537-2544. [PMID: 27771146 DOI: 10.1016/j.ophtha.2016.09.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 08/22/2016] [Accepted: 09/01/2016] [Indexed: 01/31/2023] Open
Abstract
PURPOSE To evaluate the heritability of choroidal thickness and its relationship to age-related macular degeneration (AMD). DESIGN Cohort study. PARTICIPANTS Six hundred eighty-nine individuals from Amish families with early or intermediate AMD. METHODS Ocular coherence tomography was used to quantify choroidal thickness, and fundus photography was used to classify eyes into categories using a modified Clinical Age-Related Maculopathy Staging (CARMS) system. Repeatability and heritability of choroidal thickness and its phenotypic and genetic correlations with the AMD phenotype (CARMS category) were estimated using a generalized linear mixed model (GLMM) approach that accounted for relatedness, repeated measures (left and right eyes), and the effects of age, gender, and refraction. MAIN OUTCOME MEASURES Heritability of choroidal thickness and its phenotypic and genetic correlation with the AMD phenotype (CARMS category). RESULTS Phenotypic correlation between choroidal thickness and CARMS category was moderate (Spearman's rank correlation, rs = -0.24; n = 1313 eyes) and significant (GLMM posterior mean, -4.27; 95% credible interval [CI], -7.88 to -0.79; P = 0.02) after controlling for relatedness, age, gender, and refraction. Eyes with advanced AMD had thinner choroids than eyes without AMD (posterior mean, -73.8; 95% CI, -94.7 to -54.6; P < 0.001; n = 1178 eyes). Choroidal thickness was highly repeatable within individuals (repeatability, 0.78; 95% CI, 0.68 to 0.89) and moderately heritable (heritability, 0.40; 95% CI, 0.14 to 0.51), but did not show significant genetic correlation with CARMS category, although the effect size was moderate (genetic correlation, -0.18; 95% CI, -0.49 to 0.16). Choroidal thickness also varied with age, gender, and refraction. The CARMS category showed moderate heritability (heritability, 0.49; 95% CI, 0.26 to 0.72). CONCLUSIONS We quantify the heritability of choroidal thickness for the first time, highlighting a heritable, quantitative trait that is measurable in all individuals regardless of AMD affection status, and moderately phenotypically correlated with AMD severity. Choroidal thickness therefore may capture variation not captured by the CARMS system. However, because the genetic correlation between choroidal thickness and AMD severity was not significant in our data set, genes associated with the 2 traits may not overlap substantially. Future studies should therefore test for genetic variation associated with choroidal thickness to determine the overlap in genetic basis with AMD.
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Affiliation(s)
- Rebecca J Sardell
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida
| | - Muneeswar G Nittala
- Department of Ophthalmology, Doheny Eye Institute, University of California, Los Angeles, Los Angeles, California
| | - Larry D Adams
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida
| | - Reneé A Laux
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio
| | - Jessica N Cooke Bailey
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio
| | - Denise Fuzzell
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio
| | - Sarada Fuzzell
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio
| | - Lori Reinhart-Mercer
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida
| | - Laura J Caywood
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida
| | - Violet Horst
- Departments of Ophthalmology and Genetics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Tine Mackay
- Departments of Ophthalmology and Genetics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Debbie Dana
- Departments of Ophthalmology and Genetics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - SriniVas R Sadda
- Department of Ophthalmology, Doheny Eye Institute, University of California, Los Angeles, Los Angeles, California
| | - William K Scott
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida
| | - Dwight Stambolian
- Departments of Ophthalmology and Genetics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jonathan L Haines
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio
| | - Margaret A Pericak-Vance
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida.
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