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Saks DG, Schulz A, Qassim A, Marshall H, Hewitt AW, MacGregor S, Craig JE, Graham SL. Genetic risk of glaucoma is associated with vascular and retinal nerve fibre wedge defects. Acta Ophthalmol 2024; 102:e185-e194. [PMID: 37800621 DOI: 10.1111/aos.15775] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 08/31/2023] [Accepted: 09/18/2023] [Indexed: 10/07/2023]
Abstract
PURPOSE To evaluate the association between localised vascular and retinal nerve fibre layer (RNFL) loss and genetic risk for glaucoma and cardiovascular disease using polygenic risk scores (PRS). METHODS 858 eyes were included from 455 individuals with suspect and early manifest primary open angle glaucoma. Eyes were characterised as having localised vascular and/or RNFL wedge-shaped defects by scrutiny of optical coherence tomography angiography (OCTA) and OCT images, respectively. Investigations included associations with pre-established scores for genetic risk of glaucoma and cardiovascular disease in the context of glaucoma risk factors and systemic vascular disease outcomes. RESULTS Higher genetic risk for glaucoma was associated with both vascular wedge defects and RNFL defects (p < 0.001 and p = 0.020, respectively). A greater genetic risk of glaucoma was associated with the presence of multiple vascular wedges per eye (p = 0.005). Glaucoma progression based on global RNFL loss was associated with vascular and RNFL wedge defects (p ≤ 0.001 and p = 0.008, respectively). The glaucoma PRS was significantly associated with vascular, but not RNFL, wedge defects after controlling for disc haemorrhage (p = 0.007 and p = 0.070, respectively). Vascular wedge defects were not related to the cardiovascular PRS. CONCLUSION Individuals with a higher genetic risk of glaucoma based on the PRS were more likely to have retinal vascular defects, as well as structural glaucomatous loss, but this did not relate to systemic cardiovascular risk. This possibly implies a local pathophysiology for the vascular defects in some cases, which may have clinical relevance in the early stages of glaucoma and in individuals at high genetic risk.
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Affiliation(s)
- Danit G Saks
- Macquarie Medical School, Macquarie University, Sydney, New South Wale, Australia
| | - Angela Schulz
- Macquarie Medical School, Macquarie University, Sydney, New South Wale, Australia
| | - Ayub Qassim
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
| | - Henry Marshall
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Stuart MacGregor
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Jamie E Craig
- Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia
| | - Stuart L Graham
- Macquarie Medical School, Macquarie University, Sydney, New South Wale, Australia
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Hollitt GL, Qassim A, Thomson D, Schmidt JM, Nguyen TT, Landers J, MacGregor S, Siggs OM, Souzeau E, Craig JE. Genetic Risk Assessment of Degenerative Eye Disease (GRADE): study protocol of a prospective assessment of polygenic risk scores to predict diagnosis of glaucoma and age-related macular degeneration. BMC Ophthalmol 2023; 23:431. [PMID: 37875865 PMCID: PMC10594830 DOI: 10.1186/s12886-023-03143-5] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 09/14/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Glaucoma and age-related macular degeneration (AMD) account for a substantial portion of global blindness. Both conditions are highly heritable, with recognised monogenic and polygenic inheritance patterns. Current screening guidelines lack decisive recommendations. Polygenic risk scores (PRS) allow for cost-effective broad population risk stratification for these conditions. The predictive potential of PRS could facilitate earlier diagnosis and treatment, and prevent unnecessary vision loss. METHODS The Genetic Risk Assessment of Degenerative Eye disease (GRADE) study is a prospective study designed to generate high-quality evidence about the feasibility of PRS to stratify individuals from the general population, enabling identification of those at highest risk of developing glaucoma or AMD. The targeted recruitment is 1000 individuals aged over 50 years, from which blood or saliva samples will be used for genotyping and an individual PRS for glaucoma and AMD will be derived. Individuals with PRS values in the bottom decile (n = 100), top decile (n = 100) and middle 80% (n = 100) for both glaucoma and AMD will undergo a detailed eye examination for glaucoma and/or AMD. DISCUSSION The primary objective will be to compare the prevalence of glaucoma and AMD cases between low, intermediate, and high PRS risk groups. We expect to find a higher prevalence of both diseases in the high PRS risk group, as compared to the middle and low risk groups. This prospective study will assess the clinical validity of a PRS for glaucoma and AMD in the general Australian population. Positive findings will support the implementation of PRS into clinical practice.
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Affiliation(s)
- Georgina L Hollitt
- Department of Ophthalmology, Flinders University, 1 Flinders Drive, 5042, Bedford Park, SA, Australia.
| | - Ayub Qassim
- Department of Ophthalmology, Flinders University, 1 Flinders Drive, 5042, Bedford Park, SA, Australia
| | - Daniel Thomson
- Department of Ophthalmology, Flinders University, 1 Flinders Drive, 5042, Bedford Park, SA, Australia
| | - Joshua M Schmidt
- Department of Ophthalmology, Flinders University, 1 Flinders Drive, 5042, Bedford Park, SA, Australia
| | - Thi Thi Nguyen
- Department of Ophthalmology, Flinders University, 1 Flinders Drive, 5042, Bedford Park, SA, Australia
| | - John Landers
- Department of Ophthalmology, Flinders University, 1 Flinders Drive, 5042, Bedford Park, SA, Australia
| | - Stuart MacGregor
- QIMR Berghofer Medical Research Institute, 4006, Herston, QLD, Australia
| | - Owen M Siggs
- Department of Ophthalmology, Flinders University, 1 Flinders Drive, 5042, Bedford Park, SA, Australia
- Garvan Institute of Medical Research, 2010, Darlinghurst, NSW, Australia
| | - Emmanuelle Souzeau
- Department of Ophthalmology, Flinders University, 1 Flinders Drive, 5042, Bedford Park, SA, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders University, 1 Flinders Drive, 5042, Bedford Park, SA, Australia
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Hassall MM, Javadiyan S, Klebe S, Awadalla MS, Sharma S, Qassim A, White M, Thomas PQ, Craig JE, Siggs OM. Phenotypic consequences of a nanophthalmos-associated TMEM98 variant in human and mouse. Sci Rep 2023; 13:11017. [PMID: 37419942 PMCID: PMC10328987 DOI: 10.1038/s41598-023-37855-x] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/28/2023] [Indexed: 07/09/2023] Open
Abstract
Nanophthalmos is characterised by shorter posterior and anterior segments of the eye, with a predisposition towards high hyperopia and primary angle-closure glaucoma. Variants in TMEM98 have been associated with autosomal dominant nanophthalmos in multiple kindreds, but definitive evidence for causation has been limited. Here we used CRISPR/Cas9 mutagenesis to recreate the human nanophthalmos-associated TMEM98 p.(Ala193Pro) variant in mice. The p.(Ala193Pro) variant was associated with ocular phenotypes in both mice and humans, with dominant inheritance in humans and recessive inheritance in mice. Unlike their human counterparts, p.(Ala193Pro) homozygous mutant mice had normal axial length, normal intraocular pressure, and structurally normal scleral collagen. However, in both homozygous mice and heterozygous humans, the p.(Ala193Pro) variant was associated with discrete white spots throughout the retinal fundus, with corresponding retinal folds on histology. This direct comparison of a TMEM98 variant in mouse and human suggests that certain nanophthalmos-associated phenotypes are not only a consequence of a smaller eye, but that TMEM98 may itself play a primary role in retinal and scleral structure and integrity.
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Affiliation(s)
- Mark M Hassall
- Department of Ophthalmology, Flinders University, Bedford Park, SA, Australia.
| | - Shari Javadiyan
- Department of Ophthalmology, Flinders University, Bedford Park, SA, Australia
| | - Sonja Klebe
- Department of Anatomical Pathology, Flinders University, Bedford Park, SA, Australia
| | - Mona S Awadalla
- Department of Ophthalmology, Flinders University, Bedford Park, SA, Australia
| | - Shiwani Sharma
- Department of Ophthalmology, Flinders University, Bedford Park, SA, Australia
| | - Ayub Qassim
- Department of Ophthalmology, Flinders University, Bedford Park, SA, Australia
| | - Melissa White
- Department of Molecular and Cellular Biology and Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Paul Q Thomas
- Department of Molecular and Cellular Biology and Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders University, Bedford Park, SA, Australia
| | - Owen M Siggs
- Department of Ophthalmology, Flinders University, Bedford Park, SA, Australia.
- Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.
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Marshall HN, Mullany S, Han X, Qassim A, He W, Hassall MM, Schmidt J, Thomson D, Nguyen TT, Berry EC, Knight LS, Hollitt GL, Ridge B, Schulz A, Mills RA, Healey PR, Agar A, Galanopoulos A, Landers J, Graham SL, Hewitt AW, Casson RJ, MacGregor S, Siggs OM, Craig JE. High Polygenic Risk is Associated with Earlier Initiation and Escalation of Treatment in Early Primary Open Angle Glaucoma. Ophthalmology 2023:S0161-6420(23)00229-4. [PMID: 37044160 DOI: 10.1016/j.ophtha.2023.03.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/07/2023] [Accepted: 03/31/2023] [Indexed: 04/14/2023] Open
Abstract
PURPOSE To assess whether a glaucoma polygenic risk score (PRS) was associated with treatment commencement or escalation in early primary open angle glaucoma. DESIGN Prospective longitudinal observational cohort study. PARTICIPANTS Participants from the PROGRESSA study (Progression Risk of Glaucoma: RElevant SNPs with Significant Association) were divided into a cohort of glaucoma suspects who were treatment naive at enrolment, and early manifest and suspect glaucoma cases on treatment at enrolment. METHODS A per-allele weighted glaucoma PRS was calculated for 1,107 participants. Multivariable mixed effects Cox proportional regression analysis assessed the association between PRS and time to commencement of intraocular pressure (IOP) lowering therapy in 416 glaucoma suspects who were treatment naive at study enrolment. Secondary analysis evaluated the association between PRS and escalation of IOP lowering therapy amongst 691 suspect and early manifest glaucoma cases who were on IOP lowering therapy at enrolment. MAIN OUTCOME MEASURES Commencement or escalation of IOP lowering therapy. RESULTS A higher glaucoma PRS was associated with a greater risk of commencing IOP-lowering therapy within 5 years (HR: 1.45/Standard Deviation (SD) 95% Confidence Interval (CI) [1.27, 1.62] P<0.001). This finding persisted after adjustment for relevant demographic and clinical parameters (adjusted HR: 1.23/SD 95%CI [1.07, 1.43] P=0.005). Participants in the upper population-based quintile had a 3.3 times greater risk of commencing therapy by 5 years than the lowest quintile (HR: 3.30 95%CI [1.63, 6,70] P<0.001), and a 5.4 greater risk of commencing IOP lowering therapy by 2 years than the lowest quintile (HR: 5.45 95%CI [2.08, 14.25] P<0.001). A higher glaucoma PRS was associated with a greater risk of treatment escalation amongst cases on treatment at enrolment (HR: 1.19/SD 95%CI [1.09, 1.31] P<0.001). In combined analysis of treatment naive suspects and treated cases, participants in the top population-based quintile were at 2.3 times greater risk of requiring initiation or escalation of IOP lowering therapy than the lowest quintile (HR: 2.33 95%CI [1.75, 3.01] P<0.001). CONCLUSIONS This study demonstrates novel associations between glaucoma polygenic risk and risk of commencement or escalation of IOP lowering therapy, building upon previous work highlighting the potential clinical utility of genetic risk stratification in glaucoma.
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Affiliation(s)
- Henry N Marshall
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Sean Mullany
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Xikun Han
- QIMR Berghofer Medical Research Institute, Herston, Queensland
| | - Ayub Qassim
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Weixiong He
- QIMR Berghofer Medical Research Institute, Herston, Queensland
| | - Mark M Hassall
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Joshua Schmidt
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Daniel Thomson
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Thi Thi Nguyen
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Ella C Berry
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Lachlan Sw Knight
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Georgina L Hollitt
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Bronwyn Ridge
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Angela Schulz
- Faculty of Health and Medical Sciences, Macquarie University, Sydney, Australia
| | - Richard A Mills
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Paul R Healey
- Centre for Vision Research, University of Sydney, Sydney, Australia
| | - Ashish Agar
- Department of Ophthalmology, University of New South Wales, Sydney, Australia
| | - Anna Galanopoulos
- Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, South Australia
| | - John Landers
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Stuart L Graham
- Faculty of Health and Medical Sciences, Macquarie University, Sydney, Australia
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Robert J Casson
- Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, South Australia
| | | | - Owen M Siggs
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia; Garvan Institute of Medical Research, Sydney, New South Wales
| | - Jamie E Craig
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
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Berry EC, Marshall HN, Mullany S, Torres SD, Schmidt J, Thomson D, Knight LSW, Hollitt GL, Qassim A, Ridge B, Schulz A, Hassall MM, Nguyen TT, Lake S, Mills RA, Agar A, Galanopoulos A, Landers J, Healey PR, Graham SL, Hewitt AW, MacGregor S, Casson RJ, Siggs OM, Craig JE. Physical Activity Is Associated With Macular Thickness: A Multi-Cohort Observational Study. Invest Ophthalmol Vis Sci 2023; 64:11. [PMID: 36867133 PMCID: PMC9988706 DOI: 10.1167/iovs.64.3.11] [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] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Purpose To assess the association between physical activity and spectral-domain optical coherence tomography (SD-OCT)-measured rates of macular thinning in an adult population with primary open-angle glaucoma. Methods The correlation between accelerometer-measured physical activity and rates of macular ganglion cell-inner plexiform layer (GCIPL) thinning was measured in 735 eyes from 388 participants of the Progression Risk of Glaucoma: RElevant SNPs with Significant Association (PROGRESSA) study. The association between accelerometer-measured physical activity and cross-sectional SD-OCT macular thickness was then assessed in 8862 eyes from 6152 participants available for analysis in the UK Biobank who had SD-OCT, ophthalmic, comorbidity, and demographic data. Results Greater physical activity was associated with slower rates of macular GCIPL thinning in the PROGRESSA study (beta = 0.07 µm/y/SD; 95% confidence interval [CI], 0.03-0.13; P = 0.003) after adjustment for ophthalmic, demographic and systemic predictors of macular thinning. This association persisted in subanalyses of participants characterized as glaucoma suspects (beta = 0.09 µm/y/SD; 95% CI, 0.03-0.15; P = 0.005). Participants in the upper tertile (greater than 10,524 steps/d) exhibited a 0.22-µm/y slower rate of macular GCIPL thinning than participants in the lower tertile (fewer than 6925 steps/d): -0.40 ± 0.46 µm/y versus -0.62 ± 0.55 µm/y (P = 0.003). Both time spent doing moderate/vigorous activity and mean daily active calories were positively correlated with rate of macular GCIPL thinning (moderate/vigorous activity: beta = 0.06 µm/y/SD; 95% CI, 0.01-0.105; P = 0.018; active calories: beta = 0.06 µm/y/SD; 95% CI, 0.006-0.114; P = 0.032). Analysis among 8862 eyes from the UK Biobank revealed a positive association between physical activity and cross-sectional total macular thickness (beta = 0.8 µm/SD; 95% CI, 0.47-1.14; P < 0.001). Conclusions These results highlight the potential neuroprotective benefits of exercise on the human retina.
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Affiliation(s)
- Ella C Berry
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Henry N Marshall
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Sean Mullany
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | | | - Joshua Schmidt
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Daniel Thomson
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Lachlan S W Knight
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Georgina L Hollitt
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Ayub Qassim
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Bronwyn Ridge
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Angela Schulz
- Faculty of Health and Medical Sciences, Macquarie University, Sydney, Australia
| | - Mark M Hassall
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Thi Thi Nguyen
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Stewart Lake
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Richard A Mills
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Ashish Agar
- Department of Ophthalmology, University of New South Wales, Sydney, New South Wales, Australia
| | - Anna Galanopoulos
- Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - John Landers
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Paul R Healey
- Centre for Vision Research, University of Sydney, Sydney, New South Wales, Australia
| | - Stuart L Graham
- Faculty of Health and Medical Sciences, Macquarie University, Sydney, Australia
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Stuart MacGregor
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Robert J Casson
- Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Owen M Siggs
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia.,Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
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Aboobakar IF, Kinzy TG, Zhao Y, Fan B, Pasquale LR, Qassim A, Kolovos A, Schmidt JM, Craig JE, Cooke Bailey JN, Wiggs JL. Mitochondrial TXNRD2 and ME3 genetic risk scores are associated with specific primary open-angle glaucoma phenotypes. Ophthalmology 2023:S0161-6420(23)00129-X. [PMID: 36813040 DOI: 10.1016/j.ophtha.2023.02.018] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 12/23/2022] [Accepted: 02/06/2023] [Indexed: 02/22/2023] Open
Abstract
PURPOSE Genetic variants in regions that include the mitochondrial genes TXNRD2 and ME3 are associated with primary open-angle glaucoma (POAG) in genome-wide association studies (GWAS). To assess their clinical impact, we investigated whether TXNRD2 and ME3 genetic risk scores (GRSs) are associated with specific glaucoma phenotypes. DESIGN Cross-sectional study PARTICIPANTS: 2617 POAG cases and 2634 controls from the NEIGHBORHOOD consortium. METHODS All POAG-associated single nucleotide polymorphisms (SNPs) in the TXNRD2 and ME3 loci were identified using GWAS data (p<0.05). Of these, 20 TXNRD2 and 24 ME3 SNPs were selected after adjusting for linkage disequilibrium. The correlation between SNP effect size and gene expression levels was investigated using the Gene-Tissue Expression (GTEx) database. GRSs were constructed for each individual using the unweighted sum of TXNRD2, ME3, and TXNRD2+ME3 combined risk alleles. Age and gender-adjusted odds ratios (ORs) for POAG diagnosis were calculated per decile for each GRS. Additionally, the clinical features of POAG cases in the top 1, 5, and 10% of each GRS were compared to the bottom 1, 5, and 10%, respectively. MAIN OUTCOME MEASURES POAG OR per GRS decile; maximal treated intraocular pressure (IOP) and prevalence of paracentral visual field loss among POAG cases with high vs. low GRSs. RESULTS Increased SNP effect size strongly correlated with higher TXNRD2 and lower ME3 expression levels (r=0.95 and -0.97, respectively, p<0.05 for both). Individuals in decile 10 of TXNRD2+ME3 GRS had the highest odds of POAG diagnosis (OR=1.79 compared to decile 1, p<0.001). POAG cases in the top 1% of TXNRD2 GRS had higher mean maximal treated IOP compared to the bottom 1% (19.9 mmHg vs 15.6 mmHg, adjusted p=0.03). POAG cases in the top 1% of ME3 and TXNRD2+ME3 GRS had a higher prevalence of paracentral field loss compared to the bottom 1% (72.7-88.9% vs 14.3-33.3%; adjusted p=0.03 for both). CONCLUSIONS POAG patients with higher TXNRD2 and ME3 GRSs had higher treated IOP and a greater prevalence of paracentral field loss. Functional studies exploring how these variants impact mitochondrial function in glaucoma patients are warranted.
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Affiliation(s)
- Inas F Aboobakar
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Tyler G Kinzy
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Yan Zhao
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Baojian Fan
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ayub Qassim
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Antonia Kolovos
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Joshua M Schmidt
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Jessica N Cooke Bailey
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Janey L Wiggs
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts.
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7
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Mullany S, Diaz-Torres S, Schmidt JM, Thomson D, Qassim A, Marshall HN, Knight LS, Berry EC, Kolovos A, Dimasi D, Lake S, Mills RA, Landers J, Mitchell P, Healey PR, Commerford T, Klebe S, Souzeau E, Hassall MM, MacGregor S, Gharahkhani P, Siggs OM, Craig JE. No Strong Association Between the Apolipoprotein E E4 Allele and Glaucoma: a Multicohort Study. Ophthalmology Science 2023; 3:100287. [PMID: 37007646 PMCID: PMC10064233 DOI: 10.1016/j.xops.2023.100287] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/22/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023]
Abstract
Purpose To elucidate a potential association between the apolipoprotein E (APOE) E4 allele and glaucoma prevalence in large cohorts. Design A cross-sectional analysis of baseline and prospectively collected cohort data. Participants UK Biobank (UKBB) participants of genetically determined European ancestry (n = 438 711). Replication analyses were performed using clinical and genotyping data collected from European participants recruited to the Canadian Longitudinal Study of Aging (CLSA; n = 18 199), the Australian and New Zealand Registry of Advanced Glaucoma (ANZRAG; n = 1970), and the Blue Mountains Eye Study (BMES; n = 2440). Methods Apolipoprotein E alleles and genotypes were determined, and their distributions were compared on the basis of glaucoma status. Similar analyses were performed using positive control outcomes associated with the APOE E4 allele (death, dementia, age-related macular degeneration) and negative control outcomes not associated with the APOE E4 allele (cataract, diabetic eye disease). Outcome phenotypes were also correlated with Alzheimer's dementia (AD), a clinical outcome highly associated with the APOE E4 allele. Main Outcome Measures Results of APOE E4 genotype-phenotype comparisons were reported as odds ratios (ORs) with 95% confidence intervals (CIs). Replication analyses investigated APOE E4 associations in 2 replication cohorts (CLSA and ANZRAG/BMES). Results The APOE E4 allele was inversely associated with glaucoma (OR, 0.96; 95% CI, 0.93-0.99; P = 0.016) and both negative controls (cataract: OR, 0.98; 95% CI, 0.96-0.99; P = 0.015; diabetic eye disease: OR, 0.92; 95% CI, 0.87-0.97; P = 0.003) in the UKBB cohort. A paradoxical positive association was observed between AD and both glaucoma (OR, 1.30; 95% CI, 1.08-1.54; P < 0.01) and cataract (OR, 1.15; 1.04-1.28; P = 0.018). No association between the APOE E4 allele and glaucoma was observed in either replication cohort (CLSA: OR, 1.03; 95% CI, 0.89-1.19; P = 0.66; ANZRAG/BMES: OR, 0.97; 95% CI, 0.84-1.12; P = 0.65). Conclusions A small negative association observed between APOE E4 and glaucoma within the UKBB was not evident in either replication cohort and may represent an artifact of glaucoma underdiagnosis in APOE E4 carriers. Financial Disclosures The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Sean Mullany
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
- Correspondence: Sean Mullany, Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Flinders Drive, Bedford Park, Adelaide, SA 5042.
| | - Santiago Diaz-Torres
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Joshua M. Schmidt
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Daniel Thomson
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Ayub Qassim
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Henry N. Marshall
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Lachlan S.W. Knight
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Ella C. Berry
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Antonia Kolovos
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - David Dimasi
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Stewart Lake
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Richard A. Mills
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - John Landers
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Paul Mitchell
- Centre for Vision Research, University of Sydney, Sydney, Australia
| | - Paul R. Healey
- Centre for Vision Research, University of Sydney, Sydney, Australia
| | - Toby Commerford
- Department of Geriatric Medicine, Royal Adelaide Hospital, Adelaide, South Australia
| | - Sonja Klebe
- Department of Pathology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Emmanuelle Souzeau
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Mark M. Hassall
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
| | - Stuart MacGregor
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Puya Gharahkhani
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Owen M. Siggs
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
- Garvan Institute of Medical Research, Darlinghurst, New South Wales
| | - Jamie E. Craig
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia
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8
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Marshall H, Berry EC, Torres SD, Mullany S, Schmidt J, Thomson D, Nguyen TT, Knight LS, Hollitt G, Qassim A, Kolovos A, Ridge B, Schulz A, Lake S, Mills RA, Agar A, Galanopoulos A, Landers J, Healey PR, Graham SL, Hewitt AW, Casson RJ, MacGregor S, Siggs OM, Craig JE. Association Between Body Mass Index and Primary Open Angle Glaucoma in Three Cohorts. Am J Ophthalmol 2023; 245:126-133. [PMID: 35970205 DOI: 10.1016/j.ajo.2022.08.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/04/2022] [Accepted: 08/04/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE To evaluate the relationship between body mass index (BMI) and glaucoma progression. DESIGN Multicohort observational study. METHODS This study combined a retrospective longitudinal analysis of suspect and early manifest primary open angle glaucoma cases from the Progression Risk of Glaucoma: RElevant SNPs with Significant Association (PROGRESSA) study with 2 replication cohorts from the UK Biobank and the Canadian Longitudinal Study of Ageing (CLSA). In the PROGRESSA study, multivariate analysis correlated BMI with longitudinal visual field progression in 471 participants. The BMI was then associated with glaucoma diagnosis and cross-sectional vertical cup-disc ratio (VCDR) measurements in the UK Biobank, and finally prospectively associated with longitudinal change in VCDR in the CLSA study. RESULTS In the PROGRESSA study, a lower BMI conferred a faster rate of visual field progression (mean duration of monitoring (5.28 ± 1.80 years (10.6 ± 3.59 visits) (β 0.04 dB/year/SD95% CI [0.005, 0.069]; P = .013). In the UK Biobank, a 1 standard deviation lower BMI was associated with a worse cross-sectional VCDR (β -0.048/SD 95% CI [-0.056, 0.96]; P < .001) and a 10% greater likelihood of glaucoma diagnosis, as per specialist grading of retinal fundus imaging (OR 0.90 95% CI [0.84, 0.98]; P = .011). Similarly, a lower BMI was associated with a greater risk of glaucoma diagnosis as per International Classification of Disease data (OR 0.94/SD; 95% CI [0.91, 0.98]; P = .002). Body mass index was also positively correlated with intraocular pressure (β 0.11/SD; 95% CI [0.06, 0.15]; P < .001). Finally, a lower BMI was then associated with greater VCDR change in the CLSA (β -0.007/SD; 95% CI [-0.01, -0.001]; P = .023). CONCLUSIONS Body mass index correlated with longitudinal and cross-sectional glaucomatous outcomes. This supports previous work illustrating a correlation between BMI and glaucoma.
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Affiliation(s)
- Henry Marshall
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C).
| | - Ella C Berry
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | | | - Sean Mullany
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C); QIMR Berghofer Medical Research Institute, Herston, Australia (S.D.T, S.M)
| | - Joshua Schmidt
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Daniel Thomson
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Thi Thi Nguyen
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Lachlan Sw Knight
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Georgina Hollitt
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Ayub Qassim
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Antonia Kolovos
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Bronwyn Ridge
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Angela Schulz
- Faculty of Health and Medical Sciences, Macquarie University, Sydney, Australia (A.S, S.L.G)
| | - Stewart Lake
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Richard A Mills
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Ashish Agar
- Department of Ophthalmology, University of New South Wales, Sydney, Australia (A.A)
| | - Anna Galanopoulos
- Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, Australia (A.G, R.J.C)
| | - John Landers
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
| | - Paul R Healey
- Centre for Vision Research, University of Sydney, Sydney, Australia (P.R.H)
| | - Stuart L Graham
- Faculty of Health and Medical Sciences, Macquarie University, Sydney, Australia (A.S, S.L.G)
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia (A.W.H)
| | - Robert J Casson
- Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, Australia (A.G, R.J.C)
| | - Stuart MacGregor
- QIMR Berghofer Medical Research Institute, Herston, Australia (S.D.T, S.M)
| | - Owen M Siggs
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C); Garvan Institute of Medical Research, Sydney, Australia (O.M.S)
| | - Jamie E Craig
- From Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia (H.M, E.C.B, S.M, J.S, D.T, T.T.N, L.S.W.K, G.H, A.Q, A.K, B.R, S.L, R.A.M, J.L, O.M.S, J.E.C)
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9
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Siggs OM, Qassim A, Han X, Marshall HN, Mullany S, He W, Souzeau E, Galanopoulos A, Agar A, Landers J, Casson RJ, Hewitt AW, Healey PR, Graham SL, MacGregor S, Craig JE. Association of High Polygenic Risk With Visual Field Worsening Despite Treatment in Early Primary Open-Angle Glaucoma. JAMA Ophthalmol 2022; 141:2798369. [PMID: 36355370 PMCID: PMC9650622 DOI: 10.1001/jamaophthalmol.2022.4688] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 09/21/2022] [Indexed: 08/31/2023]
Abstract
Importance Irreversible vision loss from primary open-angle glaucoma (POAG) can be prevented through timely diagnosis and treatment, although definitive diagnosis can be difficult in early-stage disease. As a consequence, large numbers of individuals with suspected glaucoma require regular monitoring, even though many of these may never develop disease and other high-risk individuals with suspected glaucoma may have delayed or inadequate treatment. POAG is one of the most heritable common diseases, and this provides an opportunity to use genetic instruments in risk-stratified screening, diagnosis, and treatment of early glaucoma. Objective To assess the association of glaucoma polygenic risk with glaucoma progression in early-stage disease. Design, Setting, and Participants This cohort study used clinical and genetic data obtained from a longitudinal cohort study, Progression Risk of Glaucoma: Relevant SNPs With Significant Association (PROGRESSA). Participants of European ancestry with characteristic optic nerve head changes suggestive of glaucoma were included. Data were collected between February 2012 and June 2020. Analysis took place between July 2020 and April 2022. Main Outcomes and Measures The association of a glaucoma polygenic risk score (PRS) (2673 uncorrelated variants) with rate of peripapillary retinal nerve fiber layer thinning on optical coherence tomography and progression of visual field loss on 24-2 Humphrey visual fields. Results A total of 1777 eyes from 896 individuals had sufficient data for structural progression analyses and 1563 eyes from 808 individuals for functional progression analyses. The mean (SD) age was 62.1 (9.9) years, 488 (44%) were male, and 1087 of 1103 individuals (98.5%) had European ancestry. An ancestrally matched normative population cohort (n = 17 642) was used for PRS reference. Individuals in the top 5% PRS risk group were at a higher risk of visual field progression compared with the remaining 95% after 5 years (hazard ratio, 1.5; 95% CI, 1.13-1.97; P = .005). Conversely, those in the bottom 20% PRS risk group were at a lower risk of visual field progression compared with an intermediate risk group over 3 years (hazard ratio, 0.52; 95% CI, 0.28-0.96; P = .04). Conclusions and Relevance In this study, high polygenic risk was associated with more rapid structural and functional progression in early POAG, despite more intensive treatment. A PRS may serve as a valuable adjunct to identify individuals who stand to benefit the most from more frequent surveillance and earlier or more intensive treatment.
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Affiliation(s)
- Owen M. Siggs
- Department of Ophthalmology, Flinders University, Bedford Park, Australia
- Garvan Institute of Medical Research, Darlinghurst, Australia
| | - Ayub Qassim
- Department of Ophthalmology, Flinders University, Bedford Park, Australia
| | - Xikun Han
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Henry N. Marshall
- Department of Ophthalmology, Flinders University, Bedford Park, Australia
| | - Sean Mullany
- Department of Ophthalmology, Flinders University, Bedford Park, Australia
| | - Weixiong He
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Emmanuelle Souzeau
- Department of Ophthalmology, Flinders University, Bedford Park, Australia
| | - Anna Galanopoulos
- South Australian Institute of Ophthalmology, University of Adelaide, Adelaide, Australia
| | - Ashish Agar
- Department of Ophthalmology, Prince of Wales Hospital, Randwick, Australia
| | - John Landers
- Department of Ophthalmology, Flinders University, Bedford Park, Australia
| | - Robert J. Casson
- South Australian Institute of Ophthalmology, University of Adelaide, Adelaide, Australia
| | - Alex W. Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Paul R. Healey
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Australia
| | - Stuart L. Graham
- Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, Australia
| | | | - Jamie E. Craig
- Department of Ophthalmology, Flinders University, Bedford Park, Australia
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10
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Mullany S, Marshall H, Diaz-Torres S, Berry EC, Schmidt JM, Thomson D, Qassim A, To MS, Dimasi D, Kuot A, Knight LS, Hollitt G, Kolovos A, Schulz A, Lake S, Mills RA, Agar A, Galanopoulos A, Landers J, Mitchell P, Healey PR, Graham SL, Hewitt AW, Souzeau E, Hassall MM, Klebe S, MacGregor S, Gharahkhani P, Casson RJ, Siggs OM, Craig JE. The APOE E4 Allele Is Associated with Faster Rates of Neuroretinal Thinning in a Prospective Cohort Study of Suspect and Early Glaucoma. Ophthalmology Science 2022; 2:100159. [PMID: 36249683 PMCID: PMC9560531 DOI: 10.1016/j.xops.2022.100159] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/08/2022] [Accepted: 04/08/2022] [Indexed: 11/24/2022]
Abstract
Purpose Design Participants Methods Main Outcome Measures Results Conclusions
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11
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Mullany S, Marshall H, Zhou T, Thomson D, Schmidt JM, Qassim A, Knight LSW, Hollitt G, Berry EC, Nguyen T, To MS, Dimasi D, Kuot A, Dubowsky J, Fogarty R, Sun M, Chehade L, Kuruvilla S, Supramaniam D, Breen J, Sharma S, Landers J, Lake S, Mills RA, Hassall MM, Chan WO, Klebe S, Souzeau E, Siggs OM, Craig JE. RNA Sequencing of Lens Capsular Epithelium Implicates Novel Pathways in Pseudoexfoliation Syndrome. Invest Ophthalmol Vis Sci 2022; 63:26. [PMID: 35348588 PMCID: PMC8982629 DOI: 10.1167/iovs.63.3.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/11/2022] Open
Abstract
Purpose Pseudoexfoliation syndrome (PEX) is a common systemic disease that results in severe and often irreversible vision loss. Despite considerable research effort, PEX remains incompletely understood. This study sought to perform the first RNAseq study in elucidate the pathophysiology of PEX, and contribute a publicly available transcriptomic data resource for future research. Methods Human ocular lens capsular epithelium samples were collected from 25 patients with PEX and 39 non-PEX controls undergoing cataract surgery. RNA extracted from these specimens was subjected to polyadenylated (mRNA) selection and deep bulk RNA sequencing. Differential expression analysis investigated protein-coding gene transcripts. Exploratory analyses used pathway analysis tools, and curated class- and disease-specific gene sets. Results Differential expression analysis demonstrated that 2882 genes were differentially expressed according to PEX status. Genes associated with viral gene expression pathways were among the most upregulated, alongside genes encoding ribosomal and mitochondrial respiratory transport chain proteins. Cell adhesion protein transcripts including type 4 collagen subunits were downregulated. Conclusions This comparative transcriptomic dataset highlights novel and previously recognized pathogenic pathways in PEX and provides the first comprehensive transcriptomic resource, adding an additional layer to build further understanding of PEX pathophysiology.
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Affiliation(s)
- Sean Mullany
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Henry Marshall
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Tiger Zhou
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Daniel Thomson
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Joshua M Schmidt
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Ayub Qassim
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Lachlan S W Knight
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Georgina Hollitt
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Ella C Berry
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Thi Nguyen
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Minh-Son To
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - David Dimasi
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Abraham Kuot
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Joshua Dubowsky
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Rhys Fogarty
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Michelle Sun
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Luke Chehade
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Shilpa Kuruvilla
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Devaraj Supramaniam
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - James Breen
- SAHMRI Bioinformatics Core, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Shiwani Sharma
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - John Landers
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Stewart Lake
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Richard A Mills
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Mark M Hassall
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Weng O Chan
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Sonja Klebe
- Flinders Department of Pathology, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Emmanuelle Souzeau
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
| | - Owen M Siggs
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia.,Garvan Institute of Medical Research Institute, Darlinghurst, Sydney, Australia
| | - Jamie E Craig
- Flinders Centre for Ophthalmology, Eye and Vision Research, Flinders Health and Medical Research Institute (FHMRI), Flinders University, Adelaide, Australia
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12
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Marshall H, Mullany S, Han X, Berry EC, Hassall MM, Qassim A, Nguyen T, Hollitt GL, Knight LS, Ridge B, Schmidt J, Crowley C, Schulz A, Mills RA, Agar A, Galanopoulos A, Landers J, Healey PR, Graham SL, Hewitt AW, Casson RJ, MacGregor S, Siggs OM, Craig JE. Genetic Risk of Cardiovascular Disease Is Associated with Macular Ganglion Cell-Inner Plexiform Layer Thinning in an Early Glaucoma Cohort. Ophthalmol Sci 2022; 2:100108. [PMID: 36246177 PMCID: PMC9559075 DOI: 10.1016/j.xops.2021.100108] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/05/2021] [Accepted: 12/16/2021] [Indexed: 06/16/2023]
Abstract
PURPOSE To evaluate the association between genetic risk for cardiovascular disease and retinal thinning in early glaucoma. DESIGN Prospective, observational genetic association study. PARTICIPANTS Multicohort study combining a cohort of patients with suspect and early manifest primary open-angle glaucoma (POAG), a cohort of patients with perimetric POAG, and an external normative control cohort. METHODS A cardiovascular disease genetic risk score was calculated for 828 participants from the Progression Risk of Glaucoma: Relevant SNPs [single nucleotide polymorphisms] with Significant Association (PROGRESSA) study. Participants were characterized as showing either predominantly macular ganglion cell-inner plexiform layer (GCIPL), predominantly peripapillary retinal nerve fiber layer (pRNFL) or equivalent macular GCIPL and pRNFL spectral-domain OCT thinning. The cardiovascular disease genetic risk scores for these groups were compared to an internal reference group of stable suspected glaucoma and of an external normative population. Replication was undertaken by comparing the phenotypes of participants from the Australia New Zealand Registry of Advanced Glaucoma (ANZRAG) with the normative control group. MAIN OUTCOME MEASURES Spectral-domain OCT and Humphrey Visual Field (HVF) change. RESULTS After accounting for age, sex, and intraocular pressure (IOP), participants with predominantly macular GCIPL thinning showed a higher cardiovascular disease genetic risk score than reference participants (odds ratio [OR], 1.76/standard deviation [SD]; 95% confidence interval [CI], 1.18-2.62; P = 0.005) and than normative participants (OR, 1.32/SD; 95% CI, 1.12-1.54; P = 0.002). This finding was replicated by comparing ANZRAG participants with predominantly macular GCIPL change with the normative population (OR, 1.39/SD; 95% CI, 1.05-1.83; P = 0.022). Review of HVF data identified that participants with paracentral visual field defects also demonstrated a higher cardiovascular disease genetic risk score than reference participants (OR, 1.85/SD; 95% CI, 1.16-2.97; P = 0.010). Participants with predominantly macular GCIPL thinning exhibited a higher vertical cup-to-disc ratio genetic risk score (OR, 1.48/SD; 95% CI, 1.24-1.76; P < 0.001), but an IOP genetic risk score (OR, 1.12/SD; 95% CI, 0.95-1.33; P = 0.179) comparable with that of the normative population. CONCLUSIONS This study highlighted the relationship between cardiovascular disease and retinal thinning in suspect and manifest glaucoma cases.
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Key Words
- ANOVA, analysis of variance
- ANZRAG, Australia New Zealand Registry of Advanced Glaucoma
- CI, confidence interval
- Cardiovascular disease
- DDLS, Disc Damage Likelihood Scale
- GCIPL, ganglion cell–inner plexiform layer
- Glaucoma
- HVF, Humphrey Visual Field
- IOP, intraocular pressure
- Macular GCIPL
- OR, odds ratio
- POAG, primary open-angle glaucoma
- PROGRESSA, Progression Risk of Glaucoma: Relevant SNPs with Significant Association
- Paracentral visual field
- Retinal thinning
- SNP, single nucleotide polymorphism
- VCDR, vertical cup-to-disc ratio
- pRNFL, peripapillary retinal nerve fiber layer
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Affiliation(s)
- Henry Marshall
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Sean Mullany
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Xikun Han
- Statistical Genetics Laboratory, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Australia
| | - Ella C. Berry
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Mark M. Hassall
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Ayub Qassim
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Thi Nguyen
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Georgina L. Hollitt
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Lachlan S.W. Knight
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Bronwyn Ridge
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Joshua Schmidt
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Caroline Crowley
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Angela Schulz
- Faculty of Health and Medical Sciences, Macquarie University, Sydney, Australia
| | - Richard A. Mills
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Ashish Agar
- Department of Ophthalmology, University of New South Wales, Sydney, Australia
| | - Anna Galanopoulos
- Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, Australia
| | - John Landers
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Paul R. Healey
- Centre for Vision Research, University of Sydney, Sydney, Australia
| | - Stuart L. Graham
- Department of Ophthalmology, University of New South Wales, Sydney, Australia
| | - Alex W. Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Robert J. Casson
- Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, Australia
| | - Stuart MacGregor
- Statistical Genetics Laboratory, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Australia
| | - Owen M. Siggs
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
- Garvan Institute of Medical Research, Sydney, Australia
| | - Jamie E. Craig
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
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13
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Saks D, Schulz A, Sheriff S, Shen T, Gupta V, Qassim A, Ridge B, Pham R, Craig J, Graham S. Quantification of localised vascular wedge-shaped defects in glaucoma. Clin Exp Ophthalmol 2022; 50:724-735. [PMID: 35796092 PMCID: PMC9796144 DOI: 10.1111/ceo.14134] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 06/15/2022] [Accepted: 07/03/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Vascular dysfunction plays a considerable role in glaucoma pathogenesis. Previous glaucoma case studies described localised wedge-shaped vascular defects, similar to retinal nerve fibre layer (RNFL) wedge defects. This study investigates the prevalence and quantification of this vessel loss, in relation to primary open angle glaucoma (POAG) parameters. METHODS This study included 608 eyes (351 participants): 192 PROGRESSA study participants (342 eyes) with suspect, preperimetric or early manifest POAG, observed for vascular wedge defect presence (cohort one); an additional 114 individuals (cohort two-208 eyes) with POAG at various stages of progression for wedge characterisation; and 38 controls (56 eyes). Vascular wedge defects were observed using optical coherence tomography angiography (OCTA). Wedge parameters and vessel densities were quantified using ImageJ software. RNFL and ganglion cell layer inner plexiform layer (GCLIPL) from OCT scans, and mean deviation (Humphrey visual field 24-2) were also assessed. RESULTS Vascular wedge defects were found in 45/342 eyes (13.2%) in cohort one, in 41/208 eyes (19.7%) in cohort two and were not found in controls. Wedge defects were mostly inferotemporal (80%), and present at all disease stages. They were associated with visual field loss in the opposite hemisphere, thinner RNFL (p < 0.001), thinner GCLIPL (p = 0.003), and focal RNFL loss corresponding with the vascular defect region. CONCLUSION Vascular wedge defects are present at all POAG stages even before functional change and are strongly concordant with focal RNFL loss. Further research is needed to explore these defects in particular their temporal relationship with clinical measures of POAG.
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Affiliation(s)
- Danit Saks
- Department of Clinical MedicineMacquarie UniversitySydneyNew South WalesAustralia
| | - Angela Schulz
- Department of Clinical MedicineMacquarie UniversitySydneyNew South WalesAustralia
| | - Samran Sheriff
- Department of Clinical MedicineMacquarie UniversitySydneyNew South WalesAustralia
| | - Ting Shen
- Department of Clinical MedicineMacquarie UniversitySydneyNew South WalesAustralia
| | - Vivek Gupta
- Department of Clinical MedicineMacquarie UniversitySydneyNew South WalesAustralia
| | - Ayub Qassim
- Department of Ophthalmology, Flinders Health and Medical Research InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Bronwyn Ridge
- Department of Ophthalmology, Flinders Health and Medical Research InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Ryan Pham
- Department of Ophthalmology, Flinders Health and Medical Research InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Jamie Craig
- Department of Ophthalmology, Flinders Health and Medical Research InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Stuart Graham
- Department of Clinical MedicineMacquarie UniversitySydneyNew South WalesAustralia
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14
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Siggs OM, Han X, Qassim A, Souzeau E, Kuruvilla S, Marshall HN, Mullany S, Mackey DA, Hewitt AW, Gharahkhani P, MacGregor S, Craig JE. Association of Monogenic and Polygenic Risk With the Prevalence of Open-Angle Glaucoma. JAMA Ophthalmol 2021; 139:1023-1028. [PMID: 34264281 DOI: 10.1001/jamaophthalmol.2021.2440] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Importance Early diagnosis of open-angle glaucoma can lead to vision-saving treatment, and genetic variation is an increasingly powerful indicator in disease risk stratification. Objective To compare polygenic and monogenic variants in risk of glaucoma. Design, Setting, and Participants Clinical and genetic data were obtained for 2507 individuals from the Australian and New Zealand Registry of Advanced Glaucoma (ANZRAG) and 411 337 individuals in cross-sectional cohort studies including individuals of European ancestry in the UK Biobank. Recruitment to the UK Biobank occurred between 2006 and 2010, and data analysis occurred between September 2019 and August 2020. Main Outcomes and Measures Association of monogenic and polygenic variants with glaucoma risk. Results Individuals at high polygenic risk, defined as those in the top 5% of an unselected population, had a glaucoma risk (odds ratio [OR], 2.77; 95% CI, 2.58-2.98) comparable with the risk among individuals heterozygous for the MYOC p.Gln368Ter variant (OR 4.19; 95% CI, 3.25-5.31), which is the most common single-gene variant known to cause primary open-angle glaucoma. High polygenic risk was more than 6 times more common than MYOC p.Gln368Ter heterozygosity in ANZRAG (15.7% vs 2.6%) and more than 15 times more common in the general population (5.0% vs 0.32%). Within ANZRAG, high polygenic risk was associated with a mean (SD) age at glaucoma diagnosis that did not differ from the age at glaucoma diagnosis among individuals heterozygous for MYOC p.Gln368Ter (57.2 [14.2] vs 54.8 [13.6] years; P > .99). Conclusions and Relevance Monogenic and high polygenic risk were each associated with a more than 2.5-fold increased odds of developing glaucoma and an equivalent mean age at glaucoma diagnosis, with high polygenic risk more than 15 times more common in the general population.
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Affiliation(s)
- Owen M Siggs
- Department of Ophthalmology, Flinders University, Bedford Park, Australia.,Garvan Institute of Medical Research, Darlinghurst, Australia
| | - Xikun Han
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Ayub Qassim
- Department of Ophthalmology, Flinders University, Bedford Park, Australia
| | - Emmanuelle Souzeau
- Department of Ophthalmology, Flinders University, Bedford Park, Australia
| | - Shilpa Kuruvilla
- Department of Ophthalmology, Flinders University, Bedford Park, Australia
| | - Henry N Marshall
- Department of Ophthalmology, Flinders University, Bedford Park, Australia
| | - Sean Mullany
- Department of Ophthalmology, Flinders University, Bedford Park, Australia
| | - David A Mackey
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.,Lions Eye Institute, Centre for Ophthalmology and Vision Sciences, University of Western Australia, Perth, Australia
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.,Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | | | | | - Jamie E Craig
- Department of Ophthalmology, Flinders University, Bedford Park, Australia
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15
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Han X, Steven K, Qassim A, Marshall HN, Bean C, Tremeer M, An J, Siggs OM, Gharahkhani P, Craig JE, Hewitt AW, Trzaskowski M, MacGregor S. Automated AI labeling of optic nerve head enables insights into cross-ancestry glaucoma risk and genetic discovery in >280,000 images from UKB and CLSA. Am J Hum Genet 2021; 108:1204-1216. [PMID: 34077762 DOI: 10.1016/j.ajhg.2021.05.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 05/10/2021] [Indexed: 02/06/2023] Open
Abstract
Cupping of the optic nerve head, a highly heritable trait, is a hallmark of glaucomatous optic neuropathy. Two key parameters are vertical cup-to-disc ratio (VCDR) and vertical disc diameter (VDD). However, manual assessment often suffers from poor accuracy and is time intensive. Here, we show convolutional neural network models can accurately estimate VCDR and VDD for 282,100 images from both UK Biobank and an independent study (Canadian Longitudinal Study on Aging), enabling cross-ancestry epidemiological studies and new genetic discovery for these optic nerve head parameters. Using the AI approach, we perform a systematic comparison of the distribution of VCDR and VDD and compare these with intraocular pressure and glaucoma diagnoses across various genetically determined ancestries, which provides an explanation for the high rates of normal tension glaucoma in East Asia. We then used the large number of AI gradings to conduct a more powerful genome-wide association study (GWAS) of optic nerve head parameters. Using the AI-based gradings increased estimates of heritability by ∼50% for VCDR and VDD. Our GWAS identified more than 200 loci associated with both VCDR and VDD (double the number of loci from previous studies) and uncovered dozens of biological pathways; many of the loci we discovered also confer risk for glaucoma.
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16
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Mullany S, Souzeau E, Klebe S, Zhou T, Knight LSW, Qassim A, Berry EC, Marshall H, Hussey M, Dubowsky A, Breen J, Hassall MM, Mills RA, Craig JE, Siggs OM. A novel GSN variant outside the G2 calcium-binding domain associated with Amyloidosis of the Finnish type. Hum Mutat 2021; 42:818-826. [PMID: 33973672 DOI: 10.1002/humu.24214] [Citation(s) in RCA: 3] [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] [Received: 01/20/2021] [Revised: 04/15/2021] [Accepted: 04/26/2021] [Indexed: 12/21/2022]
Abstract
Gelsolin (GSN) variants have been implicated in amyloidosis of the Finnish type. This case series reports a novel GSN:c.1477T>C,p.(Trp493Arg) variant in a family with ocular and systemic features consistent with Finnish Amyloidosis. Exome sequencing performed on affected individuals from two families manifesting cutis laxa and polymorphic corneal stromal opacities demonstrated the classic GSN:c.654G>A,p.Asp214Asn variant in single affected individual from one family, and a previously undocumented GSN:c.1477T>C variant in three affected first-degree relatives from a separate family. Immunohistochemical studies on corneal tissue from a proband with the c.1477T>C variant identified gelsolin protein within histologically defined corneal amyloid deposits. This study reports a novel association between the predicted pathogenic GSN:c.1477T>C variant and amyloidosis of the Finnish type, and is the first to provide functional evidence of a pathological GSN variant at a locus distant to the critical G2 calcium-binding region, resulting in the phenotype of amyloidosis of the Finnish type.
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Affiliation(s)
- Sean Mullany
- Flinders Department of Ophthalmology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Emmanuelle Souzeau
- Flinders Department of Ophthalmology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Sonja Klebe
- Department of Pathology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.,Department of Anatomical Pathology, SA Pathology, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Tiger Zhou
- Flinders Department of Ophthalmology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Lachlan S W Knight
- Flinders Department of Ophthalmology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Ayub Qassim
- Flinders Department of Ophthalmology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Ella C Berry
- Flinders Department of Ophthalmology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Henry Marshall
- Flinders Department of Ophthalmology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Matthew Hussey
- Department of Anatomical Pathology, SA Pathology, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Andrew Dubowsky
- Department of Anatomical Pathology, SA Pathology, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - James Breen
- SAHMRI Bioinformatics Core, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Mark M Hassall
- Flinders Department of Ophthalmology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Richard A Mills
- Flinders Department of Ophthalmology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Jamie E Craig
- Flinders Department of Ophthalmology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Owen M Siggs
- Flinders Department of Ophthalmology, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
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17
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Qassim A, Souzeau E, Hollitt G, Hassall MM, Siggs OM, Craig JE. Risk Stratification and Clinical Utility of Polygenic Risk Scores in Ophthalmology. Transl Vis Sci Technol 2021; 10:14. [PMID: 34111261 PMCID: PMC8114010 DOI: 10.1167/tvst.10.6.14] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 02/19/2021] [Indexed: 11/24/2022] Open
Abstract
Translational Relevance Common genetic variants can be used to effectively stratify the risk of disease development and progression and may be used to guide screening, triaging, monitoring, or treatment thresholds.
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Affiliation(s)
- Ayub Qassim
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Emmanuelle Souzeau
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Georgie Hollitt
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Mark M. Hassall
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Owen M. Siggs
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Jamie E. Craig
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
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18
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Knight LSW, Ruddle JB, Taranath DA, Goldberg I, Smith JEH, Gole G, Chiang MY, Willett F, D'Mellow G, Breen J, Qassim A, Mullany S, Elder JE, Vincent AL, Staffieri SE, Kearns LS, Mackey DA, Luu S, Siggs OM, Souzeau E, Craig JE. Childhood and Early Onset Glaucoma Classification and Genetic Profile in a Large Australasian Disease Registry. Ophthalmology 2021; 128:1549-1560. [PMID: 33892047 DOI: 10.1016/j.ophtha.2021.04.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/12/2021] [Accepted: 04/12/2021] [Indexed: 12/22/2022] Open
Abstract
PURPOSE To report the relative frequencies of childhood and early onset glaucoma subtypes and their genetic findings in a large single cohort. DESIGN Retrospective clinical and molecular study. PARTICIPANTS All individuals with childhood glaucoma (diagnosed 0 to <18 years) and early onset glaucoma (diagnosed 18 to <40 years) referred to a national disease registry. METHODS We retrospectively reviewed the referrals of all individuals with glaucoma diagnosed at <40 years of age recruited to the Australian and New Zealand Registry of Advanced Glaucoma (ANZRAG). Subtypes of glaucoma were determined using the Childhood Glaucoma Research Network (CGRN) classification system. DNA extracted from blood or saliva samples underwent sequencing of genes associated with glaucoma. MAIN OUTCOME MEASURES The phenotype and genotype distribution of glaucoma diagnosed at <40 years of age. RESULTS A total of 290 individuals (533 eyes) with childhood glaucoma and 370 individuals (686 eyes) with early onset glaucoma were referred to the ANZRAG. Primary glaucoma was the most prevalent condition in both cohorts. In the childhood cohort, 57.6% of individuals (167/290, 303 eyes) had primary congenital glaucoma (PCG), and 19.3% (56/290, 109 eyes) had juvenile open-angle glaucoma. Juvenile open-angle glaucoma constituted 73.2% of the early onset glaucoma cohort (271/370, 513 eyes). Genetic testing in probands resulted in a diagnostic yield of 24.7% (125/506) and a reclassification of glaucoma subtype in 10.4% of probands (13/125). The highest molecular diagnostic rate was achieved in probands with glaucoma associated with nonacquired ocular anomalies (56.5%). Biallelic variants in CYP1B1 (n = 29, 23.2%) and heterozygous variants in MYOC (n = 24, 19.2%) and FOXC1 (n = 21, 16.8%) were most commonly reported among probands with a molecular diagnosis. Biallelic CYP1B1 variants were reported in twice as many female individuals as male individuals with PCG (66.7% vs. 33.3%, P = 0.02). CONCLUSIONS We report on the largest cohort of individuals with childhood and early onset glaucoma from Australasia using the CGRN classification. Primary glaucoma was most prevalent. Genetic diagnoses ascertained in 24.7% of probands supported clinical diagnoses and genetic counseling. International collaborative efforts are required to identify further genes because the majority of individuals still lack a clear molecular diagnosis.
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Affiliation(s)
- Lachlan S W Knight
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Adelaide, Australia.
| | - Jonathan B Ruddle
- Department of Ophthalmology, Royal Children's Hospital, Melbourne, Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Deepa A Taranath
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Adelaide, Australia
| | - Ivan Goldberg
- Discipline of Ophthalmology, Save Sight Institute, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - James E H Smith
- Discipline of Ophthalmology, Save Sight Institute, Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Department of Ophthalmology, The Children's Hospital at Westmead, Sydney, Australia; Department of Ophthalmology, Macquarie University Hospital, Sydney, Australia
| | - Glen Gole
- University of Queensland Children's Health Queensland Clinical Unit, Queensland Children's Hospital, Brisbane, Australia
| | - Mark Y Chiang
- Department of Ophthalmology, Queensland Children's Hospital, Brisbane, Australia
| | - Faren Willett
- Department of Ophthalmology, Queensland Children's Hospital, Brisbane, Australia
| | | | - James Breen
- South Australian Genomics Centre, South Australian Health & Medical Research Institute, Adelaide, Australia; Robinson Research Institute, University of Adelaide, Adelaide, Australia; Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Ayub Qassim
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Adelaide, Australia
| | - Sean Mullany
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Adelaide, Australia
| | - James E Elder
- Department of Ophthalmology, Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Andrea L Vincent
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand; Eye Department, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand
| | - Sandra E Staffieri
- Department of Ophthalmology, Royal Children's Hospital, Melbourne, Australia; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Lisa S Kearns
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - David A Mackey
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia; Lions Eye Institute, Centre for Vision Sciences, University of Western Australia, Perth, Australia; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Susie Luu
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Adelaide, Australia
| | - Owen M Siggs
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Adelaide, Australia
| | - Emmanuelle Souzeau
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Adelaide, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Adelaide, Australia
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19
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Qassim A, Mullany S, Knight LSW, Siggs OM, Craig JE. Reply. Ophthalmology 2021; 128:e31-e32. [PMID: 33832780 DOI: 10.1016/j.ophtha.2021.01.029] [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] [Received: 01/19/2021] [Revised: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 10/21/2022] Open
Affiliation(s)
- Ayub Qassim
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia.
| | - Sean Mullany
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Lachlan S W Knight
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Owen M Siggs
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
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20
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Mullany S, Xiao L, Qassim A, Marshall H, Gharahkhani P, MacGregor S, Hassall MM, Siggs OM, Souzeau E, Craig JE. Normal-tension glaucoma is associated with cognitive impairment. Br J Ophthalmol 2021; 106:952-956. [PMID: 33781990 PMCID: PMC9234418 DOI: 10.1136/bjophthalmol-2020-317461] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 01/21/2021] [Accepted: 02/05/2021] [Indexed: 02/01/2023]
Abstract
Background/aims Recent research suggests an association between normal-tension glaucoma (NTG) and dementia. This study investigated whether cognitive impairment is more strongly associated with NTG than high tension glaucoma (HTG) using cognitive screening within an Australiasian Glaucoma Disease Registry. Methods The authors completed a case–control cross-sectional cognitive screening involving 290 age-matched and sex-matched NTG participants and HTG controls aged ≥65 randomly sampled from the Australian and New Zealand Registry of Advanced Glaucoma. Cognitive screening was performed using the Telephone Version of the Montreal Cognitive Assessment (T-MoCA). The T-MoCA omits points requiring visual interpretation, accounting for confounding factors related to vision loss in visually impaired participants. Cognitive impairment was defined by a T-MoCA score of <11/22. Cognition was compared between NTG and HTG participants using predetermined thresholds and absolute screening scores. Results A total of 290 participants completed cognitive assessment. There were no differences in NTG (n=144) and HTG (n=146) cohort demographics or ocular parameters at baseline. Cognitive impairment was more prevalent in the NTG cohort than the HTG cohort (OR=2.2; 95% CI 1.1 to 6.7, p=0.030). Though a linear trend was also observed between lower absolute T-MoCA scores in the NTG cohort when compared with the HTG cohort, this association was not statistically significant (p=0.108). Conclusion This study demonstrated an association between NTG status and poor cognition, supporting the hypothesis that there exists a disease association and shared pathoaetiological features between NTG and dementia.
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Affiliation(s)
- Sean Mullany
- Ophthalmology, Flinders University, Adelaide, South Australia, Australia
| | - Lewis Xiao
- Ophthalmology, Flinders University, Adelaide, South Australia, Australia
| | - Ayub Qassim
- Ophthalmology, Flinders University, Adelaide, South Australia, Australia
| | - Henry Marshall
- Ophthalmology, Flinders University, Adelaide, South Australia, Australia
| | - Puya Gharahkhani
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Stuart MacGregor
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Mark M Hassall
- Ophthalmology, Flinders University, Adelaide, South Australia, Australia
| | - Owen M Siggs
- Ophthalmology, Flinders University, Adelaide, South Australia, Australia
| | - Emmanuelle Souzeau
- Ophthalmology, Flinders University, Adelaide, South Australia, Australia
| | - Jamie E Craig
- Ophthalmology, Flinders University, Adelaide, South Australia, Australia
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Gharahkhani P, Jorgenson E, Hysi P, Khawaja AP, Pendergrass S, Han X, Ong JS, Hewitt AW, Segrè AV, Rouhana JM, Hamel AR, Igo RP, Choquet H, Qassim A, Josyula NS, Cooke Bailey JN, Bonnemaijer PWM, Iglesias A, Siggs OM, Young TL, Vitart V, Thiadens AAHJ, Karjalainen J, Uebe S, Melles RB, Nair KS, Luben R, Simcoe M, Amersinghe N, Cree AJ, Hohn R, Poplawski A, Chen LJ, Rong SS, Aung T, Vithana EN, Tamiya G, Shiga Y, Yamamoto M, Nakazawa T, Currant H, Birney E, Wang X, Auton A, Lupton MK, Martin NG, Ashaye A, Olawoye O, Williams SE, Akafo S, Ramsay M, Hashimoto K, Kamatani Y, Akiyama M, Momozawa Y, Foster PJ, Khaw PT, Morgan JE, Strouthidis NG, Kraft P, Kang JH, Pang CP, Pasutto F, Mitchell P, Lotery AJ, Palotie A, van Duijn C, Haines JL, Hammond C, Pasquale LR, Klaver CCW, Hauser M, Khor CC, Mackey DA, Kubo M, Cheng CY, Craig JE, MacGregor S, Wiggs JL. Genome-wide meta-analysis identifies 127 open-angle glaucoma loci with consistent effect across ancestries. Nat Commun 2021; 12:1258. [PMID: 33627673 PMCID: PMC7904932 DOI: 10.1038/s41467-020-20851-4] [Citation(s) in RCA: 158] [Impact Index Per Article: 52.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 12/08/2020] [Indexed: 12/20/2022] Open
Abstract
Primary open-angle glaucoma (POAG), is a heritable common cause of blindness world-wide. To identify risk loci, we conduct a large multi-ethnic meta-analysis of genome-wide association studies on a total of 34,179 cases and 349,321 controls, identifying 44 previously unreported risk loci and confirming 83 loci that were previously known. The majority of loci have broadly consistent effects across European, Asian and African ancestries. Cross-ancestry data improve fine-mapping of causal variants for several loci. Integration of multiple lines of genetic evidence support the functional relevance of the identified POAG risk loci and highlight potential contributions of several genes to POAG pathogenesis, including SVEP1, RERE, VCAM1, ZNF638, CLIC5, SLC2A12, YAP1, MXRA5, and SMAD6. Several drug compounds targeting POAG risk genes may be potential glaucoma therapeutic candidates.
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Affiliation(s)
- Puya Gharahkhani
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
| | - Eric Jorgenson
- Division of Research, Kaiser Permanente Northern California (KPNC), Oakland, CA, USA
| | - Pirro Hysi
- Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Sarah Pendergrass
- Geisinger Research, Biomedical and Translational Informatics Institute, Danville, PA, USA
| | - Xikun Han
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Jue Sheng Ong
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
- Centre for Eye Research Australia, University of Melbourne, Melbourne, VIC, Australia
| | - Ayellet V Segrè
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - John M Rouhana
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Andrew R Hamel
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Robert P Igo
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Helene Choquet
- Division of Research, Kaiser Permanente Northern California (KPNC), Oakland, CA, USA
| | - Ayub Qassim
- Department of Ophthalmology, Flinders University, Bedford Park, SA, Australia
| | - Navya S Josyula
- Geisinger Research, Biomedical and Translational Informatics Institute, Rockville, MD, USA
| | - Jessica N Cooke Bailey
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
- Cleveland Institute for Computational Biology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Pieter W M Bonnemaijer
- Depatment of Ophthalmology, Erasmus MC, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Adriana Iglesias
- Depatment of Ophthalmology, Erasmus MC, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
| | - Owen M Siggs
- Department of Ophthalmology, Flinders University, Bedford Park, SA, Australia
| | - Terri L Young
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Veronique Vitart
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Alberta A H J Thiadens
- Depatment of Ophthalmology, Erasmus MC, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Juha Karjalainen
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland
- Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Steffen Uebe
- Institute of Human Genetics, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität, Erlangen-Nürnberg, Erlangen, Germany
| | | | - K Saidas Nair
- Department of Ophthalmology, School of Medicine, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Robert Luben
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Mark Simcoe
- Twin Research and Genetic Epidemiology, King's College London, London, UK
- Department of Ophthalmology, Kings College London, London, United Kingdom
- Institute of Ophthalmology, University College London, London, UK
| | | | - Angela J Cree
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Rene Hohn
- Department of Ophthalmology, Inselspital, University Hospital Bern, University of Bern, Bern, Germany
- Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | - Alicia Poplawski
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Mainz, Germany
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Shi-Song Rong
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Certre, Singapore, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Eranga Nishanthie Vithana
- Singapore Eye Research Institute, Singapore National Eye Certre, Singapore, Singapore
- Duke-National University of Singapore Medical School, Singapore, Republic of Singapore
| | - Gen Tamiya
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
- RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo, Japan
| | - Yukihiro Shiga
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
| | - Masayuki Yamamoto
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
| | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
- Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
- Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
- Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
| | - Hannah Currant
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - Ewan Birney
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - Xin Wang
- 23 and Me Inc., San Francisco, CA, USA
| | | | | | | | - Adeyinka Ashaye
- Department of Ophthalmology, University of Ibadan, Ibadan, Nigeria
| | - Olusola Olawoye
- Department of Ophthalmology, University of Ibadan, Ibadan, Nigeria
| | - Susan E Williams
- Division of Ophthalmology, Department of Neurosciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Stephen Akafo
- Unit of Ophthalmology, Department of Surgery, University of Ghana Medical School, Accra, Ghana
| | - Michele Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Kazuki Hashimoto
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
| | - Yoichiro Kamatani
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Laboratory of Complex Trait Genomics, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
| | - Masato Akiyama
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yukihide Momozawa
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Paul J Foster
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital National Health Service Foundation Trust & UCL Institute of Ophthalmology, London, UK
- UCL Institute of Ophthalmology, University College London, London, UK
| | - Peng T Khaw
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital National Health Service Foundation Trust & UCL Institute of Ophthalmology, London, UK
- UCL Institute of Ophthalmology, University College London, London, UK
| | - James E Morgan
- Cardiff Centre for Vision Sciences, College of Biomedical and Life Sciences, Maindy Road, Cardiff University, Cardiff, UK
| | - Nicholas G Strouthidis
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital National Health Service Foundation Trust & UCL Institute of Ophthalmology, London, UK
- UCL Institute of Ophthalmology, University College London, London, UK
| | - Peter Kraft
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jae H Kang
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Francesca Pasutto
- Institute of Human Genetics, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität, Erlangen-Nürnberg, Erlangen, Germany
| | - Paul Mitchell
- Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
| | - Andrew J Lotery
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Psychiatric & Neurodevelopmental Genetics Unit, Departments of Psychiatry and Neurology, Massachusetts General Hospital, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Cornelia van Duijn
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jonathan L Haines
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
- Cleveland Institute for Computational Biology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Chris Hammond
- Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Caroline C W Klaver
- Depatment of Ophthalmology, Erasmus MC, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands
- Institute for Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Michael Hauser
- Department of Medicine, Duke University, Durham, NC, USA
- Department of Ophthalmology, Duke University, Durham, NC, USA
- Singapore Eye Research Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Chiea Chuen Khor
- Division of Human Genetics, Genome Institute of Singapore, Singapore, Singapore
| | - David A Mackey
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
- Centre for Eye Research Australia, University of Melbourne, Melbourne, VIC, Australia
- Centre for Ophthalmology and Visual Science, University of Western Australia, Lions Eye Institute, Nedlands, WA, Australia
| | - Michiaki Kubo
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Certre, Singapore, Singapore
- Ophthalmology & Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jamie E Craig
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Stuart MacGregor
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Janey L Wiggs
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
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22
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Qassim A, Mullany S, Awadalla MS, Hassall MM, Nguyen T, Marshall H, Kolovos A, Schulz AM, Han X, Gharahkhani P, Galanopoulos A, Agar A, Healey PR, Hewitt AW, Landers J, Casson RJ, Graham SL, MacGregor S, Souzeau E, Siggs OM, Craig JE. A Polygenic Risk Score Predicts Intraocular Pressure Readings Outside Office Hours and Early Morning Spikes as Measured by Home Tonometry. Ophthalmol Glaucoma 2020; 4:411-420. [PMID: 33316431 DOI: 10.1016/j.ogla.2020.12.002] [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] [Received: 09/23/2020] [Revised: 12/02/2020] [Accepted: 12/04/2020] [Indexed: 01/29/2023]
Abstract
PURPOSE Intraocular pressure (IOP) elevations may occur in early morning or outside office hours and can be missed during routine in-clinic IOP measurements. Such fluctuations or peaks likely contribute to glaucoma progression. We sought to investigate the relationship between an IOP polygenic risk score (PRS) and short-term IOP profile. DESIGN Cross-sectional study. PARTICIPANTS Four hundred seventy-three eyes from 239 participants with suspected or established primary open-angle glaucoma sampled from 4 outpatient clinics in Australia between August 2016 and December 2019. METHODS Participants underwent Icare HOME (Icare Oy, Vanda, Finland) tonometer measurements to record IOP 4 times daily for 5 days. Unreliable measurements were excluded. A minimum of 2 days with at least 3 reliable measurements were required. We used a validated IOP PRS derived from 146 IOP-associated variants in a linear regression model adjusted for central corneal thickness and age. MAIN OUTCOME MEASURES Highest recorded early morning IOP and mean IOP within and outside office hours. Early morning IOP spikes were defined by a higher early morning IOP than the maximum in-office hours IOP. RESULTS Reliable measurements were obtained from 334 eyes of 176 participants (mean age, 64 ± 9 years). Eyes in the highest IOP PRS quintile showed an early morning IOP increase of 4.3 mmHg (95% confidence interval [CI], 1.4-7.3; P = 0.005) and mean increase in IOP outside office hours of 2.7 mmHg (95% CI, 0.61-4.7; P = 0.013) than the lowest quintile, which were significant independently after accounting for a recent in-clinic IOP measured by Goldmann applanation tonometry. Eyes in the highest PRS quintile were 5.4-fold more likely to show early morning IOP spikes than the lowest quintile (odds ratio 95% CI, 1.3-23.6; P = 0.023). CONCLUSIONS A validated IOP PRS was associated with higher early morning IOP and mean IOP outside office hours. These findings support a role for genetic risk prediction of susceptibility to elevated IOP that may not be apparent during in-clinic hours, requiring more detailed clinical phenotyping using home tonometry, the results of which may guide additional interventions to improve IOP control.
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Affiliation(s)
- Ayub Qassim
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia.
| | - Sean Mullany
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Mona S Awadalla
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Mark M Hassall
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Thi Nguyen
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Henry Marshall
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Antonia Kolovos
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Angela M Schulz
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
| | - Xikun Han
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | - Anna Galanopoulos
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
| | - Ashish Agar
- Department of Ophthalmology, Prince of Wales Hospital, Randwick, Australia
| | - Paul R Healey
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Australia
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Australia
| | - John Landers
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Robert J Casson
- South Australian Institute of Ophthalmology, University of Adelaide, Adelaide, Australia
| | - Stuart L Graham
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
| | | | - Emmanuelle Souzeau
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Owen M Siggs
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
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23
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Qassim A, Mullany S, Abedi F, Marshall H, Hassall MM, Kolovos A, Knight LSW, Nguyen T, Awadalla MS, Chappell A, Schulz AM, Galanopoulos A, Agar A, Healey PR, Hewitt AW, Graham SL, Landers J, Casson RJ, Siggs OM, Craig JE. Corneal Stiffness Parameters Are Predictive of Structural and Functional Progression in Glaucoma Suspect Eyes. Ophthalmology 2020; 128:993-1004. [PMID: 33245936 DOI: 10.1016/j.ophtha.2020.11.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/28/2020] [Accepted: 11/18/2020] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To investigate corneal stiffness parameters (SPs) as predictors of future progression risk in glaucoma suspect eyes. DESIGN Prospective, longitudinal study. PARTICIPANTS Three hundred seventy-one eyes from 228 primary open-angle glaucoma suspects, based on optic disc appearance, with normal baseline Humphrey Visual Field (HVF; Carl Zeiss Meditec) results. METHODS Baseline corneal SPs were measured using Corvis ST (Oculus Optikgeräte GmbH). Participants were followed up every 6 months with clinical examination, HVF testing, and OCT. The baseline SP at first applanation (SP-A1) and highest concavity predicted the prospective outcome measures. MAIN OUTCOME MEASURES Structural progression was measured by the OCT rate of thinning of the retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL). Functional progression was assessed by permutation analysis of pointwise linear regression criteria on HVF testing. RESULTS Stiffness parameters correlated positively with central corneal thickness (CCT), which was adjusted for in all analyses. A higher SP-A1, suggestive of a stiffer cornea, was associated with a faster rate of RNFL thinning (P < 0.001), synergistic with thinner CCT (P = 0.004) over a mean follow-up of 4.2 years. Eyes with higher SP-A1 and thinner CCT (thin and stiff corneas) showed accelerated RNFL thinning by 0.72 μm/year relative to eyes with lower SP-A1 and thicker CCT (95% confidence interval [CI], 0.17-1.28; P = 0.011) and were at 2.9-fold higher likelihood of fast RNFL progression of more than 1 μm/year (95% CI, 1.4-6.1; P = 0.006). Consistent results also were observed with GCIPL thinning. Furthermore, a higher SP-A1 was associated with a greater risk of visual field progression (P = 0.002), synergistic with thinner CCT (P = 0.010). Eyes with higher SP-A1 and thinner CCT were at 3.7-fold greater risk of visual field progression relative to eyes with thicker CCT and lower SP-A1 (95% CI, 1.3-10.5; P = 0.014). CONCLUSIONS Glaucoma suspect eyes with higher corneal SPs and lower CCT, suggestive of thin and stiff corneas, are at greater risk of progression. Corneal SPs seem to act synergistically with CCT as risk factors for glaucoma progression.
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Affiliation(s)
- Ayub Qassim
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia.
| | - Sean Mullany
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Farshad Abedi
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Henry Marshall
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Mark M Hassall
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Antonia Kolovos
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Lachlan S W Knight
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Thi Nguyen
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Mona S Awadalla
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Angela Chappell
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Angela M Schulz
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Anna Galanopoulos
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
| | - Ashish Agar
- Department of Ophthalmology, Prince of Wales Hospital, Randwick, Australia
| | - Paul R Healey
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Stuart L Graham
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - John Landers
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Robert J Casson
- South Australian Institute of Ophthalmology, University of Adelaide, Adelaide, Australia
| | - Owen M Siggs
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
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24
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Marshall H, Mullany S, Qassim A, Siggs O, Hassall M, Ridge B, Nguyen T, Awadalla M, Andrew NH, Healey PR, Agar A, Galanopoulos A, Hewitt AW, MacGregor S, Graham SL, Mills R, Shulz A, Landers J, Casson RJ, Craig JE. Cardiovascular Disease Predicts Structural and Functional Progression in Early Glaucoma. Ophthalmology 2020; 128:58-69. [PMID: 32730956 DOI: 10.1016/j.ophtha.2020.06.067] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/24/2020] [Accepted: 06/30/2020] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To investigate the association between cardiovascular disease and baseline structural defects and disease progression in glaucoma. DESIGN Prospective, longitudinal study of preperimetric and perimetric glaucoma. PARTICIPANTS Two thousand six hundred twenty-eight eyes from 1314 participants recruited to the Progression Risk of Glaucoma: Relevant SNPs with Significant Association (PROGRESSA) study were evaluated for baseline and longitudinal structural thinning using spectral-domain OCT and for visual field progression on Humphrey visual field (HVF) assessment. METHODS Patients were classified as either predominantly macula ganglion cell-inner plexiform layer (mGCIPL), predominantly peripapillary retinal nerve fiber layer (pRNFL), or both mGCIPL and pRNFL structural change at enrollment, and then evaluated for longitudinal OCT or HVF progression. Cardiovascular disease and medication characteristics of the participants were compared with a reference group of stable patients. MAIN OUTCOME MEASURES OCT and HVF baseline status and longitudinal progression. RESULTS After accounting for age and cardiovascular characteristics, patients with predominantly mGCIPL thinning at baseline showed a higher prevalence of hypertension (odds ratio [OR], 2.70; 95% confidence interval [CI], 1.66-4.41; P < 0.001), antihypertensive use (OR, 2.03; 95% CI, 1.20-3.46; P = 0.008), and statin use (OR, 1.98; 95% CI, 1.07-3.66; P = 0.029) than reference patients. Patients with predominantly pRNFL thinning exhibited a comparable prevalence of cardiovascular disease or medication with reference patients. Review of longitudinal OCT and HVF data (mean follow-up, 5.34 ± 1.29 years) showed that hypertension was associated with an increased risk of both OCT (OR, 1.79; 95% CI, 1.17-2.75; P = 0.006) and HVF progression (OR, 1.92; 95% CI, 1.18-3.15; P = 0.013). A 1-standard deviation (approximately 21 mmHg) increase in systolic blood pressure at baseline was associated with a greater risk of OCT progression (OR, 1.27; 95% CI, 1.01-1.63; P = 0.041) and HVF progression (OR, 1.32; 95% CI, 1.01-1.73; P = 0.043). The association between systolic blood pressure and structural progression was comparable to that observed between intraocular pressure and structural progression (OR, 1.30; 95% CI, 1.01-1.67; P = 0.039). CONCLUSIONS Cardiovascular disease is an important risk factor for glaucoma progression.
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Affiliation(s)
- Henry Marshall
- Department of Ophthalmology, Flinders University, Adelaide, Australia.
| | - Sean Mullany
- Department of Ophthalmology, Flinders University, Adelaide, Australia
| | - Ayub Qassim
- Department of Ophthalmology, Flinders University, Adelaide, Australia
| | - Owen Siggs
- Department of Ophthalmology, Flinders University, Adelaide, Australia
| | - Mark Hassall
- Department of Ophthalmology, Flinders University, Adelaide, Australia
| | - Bronwyn Ridge
- Department of Ophthalmology, Flinders University, Adelaide, Australia
| | - Thi Nguyen
- Department of Ophthalmology, Flinders University, Adelaide, Australia
| | - Mona Awadalla
- Department of Ophthalmology, Flinders University, Adelaide, Australia
| | - Nicholas H Andrew
- Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, South Australia
| | - Paul R Healey
- Centre for Vision Research, University of Sydney, Sydney, Australia
| | - Ashish Agar
- Department of Ophthalmology, University of New South Wales, Sydney, Australia
| | - Anna Galanopoulos
- Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, South Australia
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | | | - Stuart L Graham
- Faculty of Health and Medical Sciences, Macquarie University, Sydney, Australia
| | - Richard Mills
- Department of Ophthalmology, Flinders University, Adelaide, Australia
| | - Angela Shulz
- Faculty of Health and Medical Sciences, Macquarie University, Sydney, Australia
| | - John Landers
- Department of Ophthalmology, Flinders University, Adelaide, Australia
| | - Robert J Casson
- Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, South Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders University, Adelaide, Australia
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Awadalla MS, Qassim A, Hassall M, Nguyen TT, Landers J, Craig JE. Using Icare HOME tonometry for follow‐up of patients with open‐angle glaucoma before and after selective laser trabeculoplasty. Clin Exp Ophthalmol 2020; 48:328-333. [DOI: 10.1111/ceo.13686] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 10/29/2019] [Accepted: 11/15/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Mona S. Awadalla
- Department of OphthalmologyFlinders University Adelaide South Australia Australia
| | - Ayub Qassim
- Department of OphthalmologyFlinders University Adelaide South Australia Australia
| | - Mark Hassall
- Department of OphthalmologyFlinders University Adelaide South Australia Australia
| | - Thi T. Nguyen
- Department of OphthalmologyFlinders University Adelaide South Australia Australia
| | - John Landers
- Department of OphthalmologyFlinders University Adelaide South Australia Australia
| | - Jamie E. Craig
- Department of OphthalmologyFlinders University Adelaide South Australia Australia
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26
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Siggs OM, Awadalla MS, Souzeau E, Staffieri SE, Kearns LS, Laurie K, Kuot A, Qassim A, Edwards TL, Coote MA, Mancel E, Walland MJ, Dondey J, Galanopoulous A, Casson RJ, Mills RA, MacArthur DG, Ruddle JB, Burdon KP, Craig JE. The genetic and clinical landscape of nanophthalmos and posterior microphthalmos in an Australian cohort. Clin Genet 2020; 97:764-769. [PMID: 32052405 DOI: 10.1111/cge.13722] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/04/2020] [Accepted: 02/06/2020] [Indexed: 11/30/2022]
Abstract
Nanophthalmos and posterior microphthalmos are ocular abnormalities in which both eyes are abnormally small, and typically associated with extreme hyperopia. We recruited 40 individuals from 13 kindreds with nanophthalmos or posterior microphthalmos, with 12 probands subjected to exome sequencing. Nine probands (69.2%) were assigned a genetic diagnosis, with variants in MYRF, TMEM98, MFRP, and PRSS56. Two of four PRSS56 families harbored the previously described c.1066dupC variant implicated in over half of all reported PRSS56 kindreds, with different surrounding haplotypes in each family suggesting a mutational hotspot. Individuals with a genetic diagnosis had shorter mean axial lengths and higher hyperopia than those without, with recessive forms associated with the most extreme phenotypes. These findings detail the genetic architecture of nanophthalmos and posterior microphthalmos in a cohort of predominantly European ancestry, their relative clinical phenotypes, and highlight the shared genetic architecture of rare and common disorders of refractive error.
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Affiliation(s)
- Owen M Siggs
- Department of Ophthalmology, Flinders University, Adelaide, Australia
| | - Mona S Awadalla
- Department of Ophthalmology, Flinders University, Adelaide, Australia
| | | | - Sandra E Staffieri
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.,Department of Ophthalmology, University of Melbourne, Melbourne, Australia.,Department of Ophthalmology, Royal Children's Hospital, Melbourne, Australia
| | - Lisa S Kearns
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Kate Laurie
- Department of Ophthalmology, Flinders University, Adelaide, Australia
| | - Abraham Kuot
- Department of Ophthalmology, Flinders University, Adelaide, Australia
| | - Ayub Qassim
- Department of Ophthalmology, Flinders University, Adelaide, Australia
| | - Thomas L Edwards
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Michael A Coote
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Erica Mancel
- Centre Hospitalier Territorial de Nouvelle-Calédonie, Noumea, New Caledonia
| | - Mark J Walland
- Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Joanne Dondey
- Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Anna Galanopoulous
- Discipline of Ophthalmology & Visual Sciences, University of Adelaide, Adelaide, Australia
| | - Robert J Casson
- Discipline of Ophthalmology & Visual Sciences, University of Adelaide, Adelaide, Australia
| | - Richard A Mills
- Department of Ophthalmology, Flinders University, Adelaide, Australia
| | - Daniel G MacArthur
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Boston, Massachusetts.,Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Jonathan B Ruddle
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.,Department of Ophthalmology, University of Melbourne, Melbourne, Australia.,Department of Ophthalmology, Royal Children's Hospital, Melbourne, Australia
| | - Kathryn P Burdon
- Department of Ophthalmology, Flinders University, Adelaide, Australia.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders University, Adelaide, Australia
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27
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Qassim A, Walland MJ, Landers J, Awadalla M, Nguyen T, Loh J, Schulz AM, Ridge B, Galanopoulos A, Agar A, Hewitt AW, Graham SL, Healey PR, Casson RJ, Craig JE. Effect of phacoemulsification cataract surgery on intraocular pressure in early glaucoma: A prospective multi‐site study. Clin Exp Ophthalmol 2020; 48:442-449. [DOI: 10.1111/ceo.13724] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/19/2020] [Accepted: 01/26/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Ayub Qassim
- Department of OphthalmologyFlinders University, Flinders Medical Centre Adelaide South Australia Australia
| | - Mark J. Walland
- Glaucoma Investigation and Research UnitRoyal Victorian Eye and Ear Hospital Melbourne Victoria Australia
| | - John Landers
- Department of OphthalmologyFlinders University, Flinders Medical Centre Adelaide South Australia Australia
| | - Mona Awadalla
- Department of OphthalmologyFlinders University, Flinders Medical Centre Adelaide South Australia Australia
| | - Thi Nguyen
- Department of OphthalmologyFlinders University, Flinders Medical Centre Adelaide South Australia Australia
| | - Jason Loh
- Department of OphthalmologyFlinders University, Flinders Medical Centre Adelaide South Australia Australia
| | - Angela M. Schulz
- Faculty of Medicine and Health SciencesMacquarie University Sydney New South Wales Australia
| | - Bronwyn Ridge
- Department of OphthalmologyFlinders University, Flinders Medical Centre Adelaide South Australia Australia
| | - Anna Galanopoulos
- South Australian Institute of OphthalmologyRoyal Adelaide Hospital Adelaide New South Wales Australia
| | - Ashish Agar
- Department of OphthalmologyPrince of Wales Hospital Sydney New South Wales Australia
| | - Alex W. Hewitt
- Menzies Institute for Medical ResearchUniversity of Tasmania Hobart Tasmania Australia
| | - Stuart L. Graham
- Faculty of Medicine and Health SciencesMacquarie University Sydney New South Wales Australia
| | - Paul R. Healey
- Centre for Vision ResearchWestmead Institute for Medical Research, University of Sydney Sydney New South Wales Australia
| | - Robert J. Casson
- South Australian Institute of OphthalmologyUniversity of Adelaide Adelaide South Australia Australia
| | - Jamie E. Craig
- Department of OphthalmologyFlinders University, Flinders Medical Centre Adelaide South Australia Australia
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28
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Qassim A, Souzeau E, Siggs OM, Hassall MM, Han X, Griffiths HL, Frost NA, Vallabh NA, Kirwan JF, Menon G, Cree AJ, Galanopoulos A, Agar A, Healey PR, Graham SL, Landers J, Casson RJ, Gharahkhani P, Willoughby CE, Hewitt AW, Lotery AJ, MacGregor S, Craig JE. An Intraocular Pressure Polygenic Risk Score Stratifies Multiple Primary Open-Angle Glaucoma Parameters Including Treatment Intensity. Ophthalmology 2020; 127:901-907. [PMID: 32081492 DOI: 10.1016/j.ophtha.2019.12.025] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To examine the combined effects of common genetic variants associated with intraocular pressure (IOP) on primary open-angle glaucoma (POAG) phenotype using a polygenic risk score (PRS) stratification. DESIGN Cross-sectional study. PARTICIPANTS For the primary analysis, we examined the glaucoma phenotype of 2154 POAG patients enrolled in the Australian and New Zealand Registry of Advanced Glaucoma, including patients recruited from the United Kingdom. For replication, we examined an independent cohort of 624 early POAG patients. METHODS Using IOP genome-wide association study summary statistics, we developed a PRS derived solely from IOP-associated variants and stratified POAG patients into 3 risk tiers. The lowest and highest quintiles of the score were set as the low- and high-risk groups, respectively, and the other quintiles were set as the intermediate risk group. MAIN OUTCOME MEASURES Clinical glaucoma phenotype including maximum recorded IOP, age at diagnosis, number of family members affected by glaucoma, cup-to-disc ratio, visual field mean deviation, and treatment intensity. RESULTS A dose-response relationship was found between the IOP PRS and the maximum recorded IOP, with the high genetic risk group having a higher maximum IOP by 1.7 mmHg (standard deviation [SD], 0.62 mmHg) than the low genetic risk group (P = 0.006). Compared with the low genetic risk group, the high genetic risk group had a younger age of diagnosis by 3.7 years (SD, 1.0 years; P < 0.001), more family members affected by 0.46 members (SD, 0.11 members; P < 0.001), and higher rates of incisional surgery (odds ratio, 1.5; 95% confidence interval, 1.1-2.0; P = 0.007). No statistically significant difference was found in mean deviation. We further replicated the maximum IOP, number of family members affected by glaucoma, and treatment intensity (number of medications) results in the early POAG cohort (P ≤ 0.01). CONCLUSIONS The IOP PRS was correlated positively with maximum IOP, disease severity, need for surgery, and number of affected family members. Genes acting via IOP-mediated pathways, when considered in aggregate, have clinically important and reproducible implications for glaucoma patients and their close family members.
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Affiliation(s)
- Ayub Qassim
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia.
| | - Emmanuelle Souzeau
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Owen M Siggs
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Mark M Hassall
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Xikun Han
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Helen L Griffiths
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - N Andrew Frost
- Department of Ophthalmology, Torbay Hospital, Torquay, Devon, United Kingdom
| | - Neeru A Vallabh
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
| | - James F Kirwan
- Department of Ophthalmology, Portsmouth Hospitals, Portsmouth, United Kingdom
| | - Geeta Menon
- Department of Ophthalmology, Frimley Park Hospital NHS Foundation Trust, Frimley, United Kingdom
| | - Angela J Cree
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Anna Galanopoulos
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia
| | - Ashish Agar
- Department of Ophthalmology, Prince of Wales Hospital, Randwick, Australia
| | - Paul R Healey
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
| | - Stuart L Graham
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - John Landers
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Robert J Casson
- South Australian Institute of Ophthalmology, University of Adelaide, Adelaide, Australia
| | | | - Colin E Willoughby
- Biomedical Sciences Research Institute, Ulster University, Coleraine, United Kingdom; Royal Victoria Hospital, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Andrew J Lotery
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | | | - Jamie E Craig
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
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29
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Siggs OM, Souzeau E, Breen J, Qassim A, Zhou T, Dubowsky A, Ruddle JB, Craig JE. Autosomal dominant nanophthalmos and high hyperopia associated with a C-terminal frameshift variant in MYRF. Mol Vis 2019; 25:527-534. [PMID: 31700225 PMCID: PMC6817736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 09/19/2019] [Indexed: 10/27/2022] Open
Abstract
Purpose Nanophthalmos is a rare subtype of microphthalmia associated with high hyperopia and an increased risk of angle-closure glaucoma. We investigated the genetic cause of nanophthalmos and high hyperopia in an autosomal dominant kindred. Methods A proband with short axial length, high hyperopia, and dextrocardia was subjected to exome sequencing. Human and rodent gene expression data sets were used to investigate the expression of relevant genes. Results We identified a segregating heterozygous frameshift variant at the 3' end of the penultimate exon of MYRF. Using Myc-MYRF chromatin immunoprecipitation data from rat oligodendrocytes, MYRF was found to bind immediately upstream of the transcriptional start site of Tmem98, a gene that itself has been implicated in autosomal dominant nanophthalmos. MYRF and TMEM98 were found to be expressed in the human retina, with a similar pattern of expression across several dissected human eye tissues. Conclusions C-terminal variants in MYRF, which are expected to escape nonsense-mediated decay, represent a rare cause of autosomal dominant nanophthalmos with or without dextrocardia or congenital diaphragmatic hernia.
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Affiliation(s)
- Owen M. Siggs
- Department of Ophthalmology, Flinders University, Bedford Park, South Australia, Australia
| | - Emmanuelle Souzeau
- Department of Ophthalmology, Flinders University, Bedford Park, South Australia, Australia
| | - James Breen
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Ayub Qassim
- Department of Ophthalmology, Flinders University, Bedford Park, South Australia, Australia
| | - Tiger Zhou
- Department of Ophthalmology, Flinders University, Bedford Park, South Australia, Australia
| | | | - Jonathan B. Ruddle
- Department of Ophthalmology, University of Melbourne, Melbourne, Victoria, Australia
| | - Jamie E. Craig
- Department of Ophthalmology, Flinders University, Bedford Park, South Australia, Australia
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30
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Han X, Qassim A, An J, Marshall H, Zhou T, Ong JS, Hassall MM, Hysi PG, Foster PJ, Khaw PT, Mackey DA, Gharahkhani P, Khawaja AP, Hewitt AW, Craig JE, MacGregor S. Genome-wide association analysis of 95 549 individuals identifies novel loci and genes influencing optic disc morphology. Hum Mol Genet 2019; 28:3680-3690. [DOI: 10.1093/hmg/ddz193] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/30/2019] [Accepted: 08/04/2019] [Indexed: 12/13/2022] Open
Abstract
Abstract
Optic nerve head morphology is affected by several retinal diseases. We measured the vertical optic disc diameter (DD) of the UK Biobank (UKBB) cohort (N = 67 040) and performed the largest genome-wide association study (GWAS) of DD to date. We identified 81 loci (66 novel) for vertical DD. We then replicated the novel loci in International Glaucoma Genetic Consortium (IGGC, N = 22 504) and European Prospective Investigation into Cancer–Norfolk (N = 6005); in general the concordance in effect sizes was very high (correlation in effect size estimates 0.90): 44 of the 66 novel loci were significant at P < 0.05, with 19 remaining significant after Bonferroni correction. We identified another 26 novel loci in the meta-analysis of UKBB and IGGC data. Gene-based analyses identified an additional 57 genes. Human ocular tissue gene expression analysis showed that most of the identified genes are enriched in optic nerve head tissue. Some of the identified loci exhibited pleiotropic effects with vertical cup-to-disc ratio, intraocular pressure, glaucoma and myopia. These results can enhance our understanding of the genetics of optic disc morphology and shed light on the genetic findings for other ophthalmic disorders such as glaucoma and other optic nerve diseases.
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Affiliation(s)
- Xikun Han
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- School of Medicine, University of Queensland, St Lucia, Brisbane, Australia
| | - Ayub Qassim
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Jiyuan An
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Henry Marshall
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Tiger Zhou
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Jue-Sheng Ong
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Mark M Hassall
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Pirro G Hysi
- Department of Ophthalmology, King’s College London, St. Thomas’ Hospital, London, UK
| | - Paul J Foster
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Peng T Khaw
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - David A Mackey
- Menzies Institute for Medical Research, University of Tasmania, Australia
- Lions Eye Institute, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia
| | - Puya Gharahkhani
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Australia
- Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Stuart MacGregor
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
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Awadalla MS, Fitzgerald J, Andrew NH, Zhou T, Marshall H, Qassim A, Hassall M, Casson RJ, Graham SL, Healey PR, Agar A, Galanopoulos A, Phipps S, Chappell A, Landers J, Craig JE. Prevalence and type of artefact with spectral domain optical coherence tomography macular ganglion cell imaging in glaucoma surveillance. PLoS One 2018; 13:e0206684. [PMID: 30517101 PMCID: PMC6281246 DOI: 10.1371/journal.pone.0206684] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 10/17/2018] [Indexed: 11/18/2022] Open
Abstract
Purpose The ganglion cell analysis (GCA) of the CIRRUSTM HD-OCT (Carl Zeiss, Meditec; Dublin, CA) provides measurement of the macular ganglion cell-inner plexiform layer (GCIPL) thickness. This study determined the frequency of scan artefacts and errors in GCIPL imaging in individuals undergoing HD-OCT surveillance for glaucoma. Method A total of 1439 eyes from 721 subjects enrolled in a prospective study assessing predictors of glaucoma progression underwent macular GCIPL imaging with the CIRRUS HD-OCT at recruitment. The prevalence of acquisition errors, segmentation errors, and co-morbid macular pathology was determined. Results A total of 87 (6.0%) of the 1439 scans had either acquisition errors, segmentation artefacts, or other macular pathology. The most common co-morbid macular pathology was epiretinal membrane in 2.2% of eyes. Conclusion The macular GCIPL scan was artefact free in 94% of eyes. However, epiretinal membrane and high myopia can cause scan artefact and should be considered when interpreting the results.
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Affiliation(s)
- Mona S. Awadalla
- Flinders University, Department of Ophthalmology, South Australia, Australia
- * E-mail:
| | - Jude Fitzgerald
- Flinders University, Department of Ophthalmology, South Australia, Australia
| | - Nicholas H. Andrew
- Flinders University, Department of Ophthalmology, South Australia, Australia
| | - Tiger Zhou
- Flinders University, Department of Ophthalmology, South Australia, Australia
| | - Henry Marshall
- Flinders University, Department of Ophthalmology, South Australia, Australia
| | - Ayub Qassim
- Flinders University, Department of Ophthalmology, South Australia, Australia
| | - Mark Hassall
- Flinders University, Department of Ophthalmology, South Australia, Australia
| | - Robert J. Casson
- University of Adelaide, Discipline of Ophthalmology & Visual Sciences, Adelaide, Australia
| | - Stuart L. Graham
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Paul R. Healey
- University of Sydney Discipline of Ophthalmology, Sydney, Australia
- Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
| | - Ashish Agar
- Marsden Eye Specialists, Sydney, Australia
- Department of Ophthalmology, Prince of Wales Hospital, University of New South Wales, Sydney, Australia
| | - Anna Galanopoulos
- University of Adelaide, Discipline of Ophthalmology & Visual Sciences, Adelaide, Australia
| | | | - Angela Chappell
- Flinders University, Department of Ophthalmology, South Australia, Australia
| | - John Landers
- Flinders University, Department of Ophthalmology, South Australia, Australia
| | - Jamie E. Craig
- Flinders University, Department of Ophthalmology, South Australia, Australia
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Qassim A, Viki M, Ng SK, Jersmann H, Casson RJ. Climate and season: the effects on ophthalmic diseases. Clin Exp Ophthalmol 2017; 45:385-392. [PMID: 27894161 DOI: 10.1111/ceo.12883] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 11/22/2016] [Accepted: 11/23/2016] [Indexed: 12/11/2022]
Abstract
Seasonal changes and climate have a significant impact on human health. Diseases influenced by temperature and climate conditions are likely to undergo dynamic pattern shifts with consequent impact on human health. A number of infectious and non-infectious ophthalmic diseases are influenced by temperature and seasonality. Awareness of this is important from public and global health perspective in addition to resource allocation strategies. We examine the evidence for a seasonal pattern to ophthalmic diseases and assess the possible impact of climate change.
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Affiliation(s)
- Ayub Qassim
- University of Adelaide, Adelaide, South Australia, Australia
| | - Mthulisi Viki
- University of Adelaide, Adelaide, South Australia, Australia
| | - Soo Khai Ng
- University of Adelaide, Adelaide, South Australia, Australia.,South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Hubertus Jersmann
- Lung Research, Hanson Institute and Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Robert J Casson
- University of Adelaide, Adelaide, South Australia, Australia.,South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
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Eyre HA, Lavretsky H, Kartika J, Qassim A, Baune BT. Modulatory Effects of Antidepressant Classes on the Innate and Adaptive Immune System in Depression. Pharmacopsychiatry 2016; 49:85-96. [PMID: 26951496 DOI: 10.1055/s-0042-103159] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Current reviews exploring for unique immune-modulatory profiles of antidepressant classes are limited by focusing mainly on cytokine modulation only and neglecting other aspects of the innate and adaptive immune system. These reviews also do not include recent comparative clinical trials, immune-genetic studies and therapeutics with unique neurotransmitter profiles (e. g., agomelatine). This systematic review extends the established literature by comprehensively reviewing the effects of antidepressants classes on both the innate and adaptive immune system. Antidepressants appear, in general, to reduce pro-inflammatory factor levels, particularly C-reactive protein (CRP), tumour necrosis factor (TNF)-α, interleukin (IL)-1β and IL-6. We caution against conclusions as to which antidepressant possesses the greater anti-inflammatory effect, given the methodological heterogeneity among studies and the small number of comparative studies. The effects of antidepressant classes on adaptive immune factors are complex and poorly understood, and few studies have been conducted. Methodological heterogeneity is high among these studies (e. g., length of study, cohort characteristics, dosage used and immune marker analysis). We recommend larger, comparative studies - in clinical and pre-clinical populations.
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Affiliation(s)
- H A Eyre
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - H Lavretsky
- Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, USA
| | - J Kartika
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - A Qassim
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - B T Baune
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
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