Genetic variations in autoimmune genes and VKH disease

Genetic evidence supports the causal effects of exposure to ambient air pollution on autoimmune eye diseases

Previous observational studies have reported inconsistent associations between air pollution and autoimmune eye diseases (AEDs). The primary objective of this Mendelian randomization (MR) study was to investigate the causal link of air pollution with AEDs risk. The instrumental variables were selected based on genome-wide association study data. Univariable and multivariable MR analyses were conducted to disentangle the causality of air pollutants with AEDs. The estimates of univariable MR analysis revealed a suggestively causal link between NO2 or NOx exposure and diabetic retinopathy (OR=1.29, 95% CI=1.05-1.58, P=0.015; OR=1.33, 95% CI=1.05-1.69, P=0.019, respectively). A suggestive association was observed between PM2.5 exposure and age-related macular degeneration (OR=1.46, 95% CI=1.09-1.97, P=0.013). In addition, multivariable MR indicated that the observed association was remained consistent and robust. Rigorous sensitivity analyses confirmed the robustness and consistency of these findings. Our study firstly provided the genetic evidence linking air pollution, specially NO2, NOx and PM2.5, to AEDs susceptibility.

High prevalence of angle-closure glaucoma in Vogt-Koyanagi-Harada disease

PURPOSE

To determine the prevalence, clinical characteristics, and mechanisms of secondary glaucoma in Vogt-Koyanagi-Harada (VKH) disease.

METHODS

This retrospective, longitudinal observational study analyzed the demographic data, disease stage, glaucoma development, intraocular pressure, best-corrected visual acuity, lens status, optic nerve, gonioscopy, management, and visual outcomes of VKH disease. Clinical features were used to categorize the stage of VKH disease. VKH eyes were divided into two groups, with or without glaucoma, undergoing further analysis, including statistical analysis.

RESULTS

305 eyes of 155 patients with VKH disease with a median follow-up of 22 months were included. Secondary glaucoma developed in 67 (22%) eyes, most of which (64.2%) had chronic recurrent VKH at presentation. Angle-closure was present in 55 (82.1%) of glaucoma eyes. Peripheral anterior and posterior synechiae were present in 58 (86.6%) and 51 (76.1%) eyes, respectively. Pupillary block and posterior synechiae resulted in iris bombé in 17 (25.4%) eyes with glaucoma. At the last visit, visual acuity was worse in eyes with glaucoma (p < 0.001).

CONCLUSION

We found that angle-closure disease is a significant cause of secondary glaucoma in VKH. Eyes with glaucoma were more likely to present in the chronic recurrent stage of the disease.