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      A Genome-Wide Association Study for Susceptibility to Visual Experience-Induced Myopia

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          Abstract

          Purpose

          The rapid rise in prevalence over recent decades and high heritability of myopia suggest a role for gene–environment (G × E) interactions in myopia susceptibility. Few such G × E interactions have been discovered to date. We aimed to test the hypothesis that genetic analysis of susceptibility to visual experience-induced myopia in an animal model would identify novel G × E interaction loci.

          Methods

          Chicks aged 7 days ( n = 987) were monocularly deprived of form vision for 4 days. A genome-wide association study (GWAS) was carried out in the 20% of chicks most susceptible and least susceptible to form deprivation ( n = 380). There were 304,963 genetic markers tested for association with the degree of induced axial elongation in treated versus control eyes (A-scan ultrasonography). A GWAS candidate region was examined in the following three human cohorts: CREAM consortium ( n = 44,192), UK Biobank ( n = 95,505), and Avon Longitudinal Study of Parents and Children (ALSPAC; n = 4989).

          Results

          A locus encompassing the genes PIK3CG and PRKAR2B was genome-wide significantly associated with myopia susceptibility in chicks (lead variant rs317386235, P = 9.54e−08). In CREAM and UK Biobank GWAS datasets, PIK3CG and PRKAR2B were enriched for strongly-associated markers (meta-analysis lead variant rs117909394, P = 1.7e−07). In ALSPAC participants, rs117909394 had an age-dependent association with refractive error (−0.22 diopters [D] change over 8 years, P = 5.2e−04) and nearby variant rs17153745 showed evidence of a G × E interaction with time spent reading (effect size −0.23 D, P = 0.022).

          Conclusions

          This work identified the PIK3CG- PRKAR2B locus as a mediator of susceptibility to visually induced myopia in chicks and suggests a role for this locus in conferring susceptibility to myopia in human cohorts.

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          Most cited references36

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          The epidemics of myopia: Aetiology and prevention.

          There is an epidemic of myopia in East and Southeast Asia, with the prevalence of myopia in young adults around 80-90%, and an accompanying high prevalence of high myopia in young adults (10-20%). This may foreshadow an increase in low vision and blindness due to pathological myopia. These two epidemics are linked, since the increasingly early onset of myopia, combined with high progression rates, naturally generates an epidemic of high myopia, with high prevalences of "acquired" high myopia appearing around the age of 11-13. The major risk factors identified are intensive education, and limited time outdoors. The localization of the epidemic appears to be due to the high educational pressures and limited time outdoors in the region, rather than to genetically elevated sensitivity to these factors. Causality has been demonstrated in the case of time outdoors through randomized clinical trials in which increased time outdoors in schools has prevented the onset of myopia. In the case of educational pressures, evidence of causality comes from the high prevalence of myopia and high myopia in Jewish boys attending Orthodox schools in Israel compared to their sisters attending religious schools, and boys and girls attending secular schools. Combining increased time outdoors in schools, to slow the onset of myopia, with clinical methods for slowing myopic progression, should lead to the control of this epidemic, which would otherwise pose a major health challenge. Reforms to the organization of school systems to reduce intense early competition for accelerated learning pathways may also be important.
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            Effect of Time Spent Outdoors at School on the Development of Myopia Among Children in China: A Randomized Clinical Trial.

            Myopia has reached epidemic levels in parts of East and Southeast Asia. However, there is no effective intervention to prevent the development of myopia.
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              Increased prevalence of myopia in the United States between 1971-1972 and 1999-2004.

              To compare US population prevalence estimates for myopia in 1971-1972 and 1999-2004. The 1971-1972 National Health and Nutrition Examination Survey provided the earliest nationally representative estimates for US myopia prevalence; myopia was diagnosed by an algorithm using either lensometry, pinhole visual acuity, and presenting visual acuity (for presenting visual acuity > or =20/40) or retinoscopy (for presenting visual acuity -2.0 diopters [D]: 17.5% vs 13.4%, respectively [P -7.9 D: 22.4% vs 11.4%, respectively [P < .001]; < or =-7.9 D: 1.6% vs 0.2%, respectively [P < .001]). When using similar methods for each period, the prevalence of myopia in the United States appears to be substantially higher in 1999-2004 than 30 years earlier. Identifying modifiable risk factors for myopia could lead to the development of cost-effective interventional strategies.
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                Author and article information

                Journal
                Invest Ophthalmol Vis Sci
                Invest. Ophthalmol. Vis. Sci
                iovs
                Invest Ophthalmol Vis Sci
                IOVS
                Investigative Ophthalmology & Visual Science
                The Association for Research in Vision and Ophthalmology
                0146-0404
                1552-5783
                February 2019
                : 60
                : 2
                : 559-569
                Affiliations
                [1 ]School of Optometry & Vision Sciences, Cardiff University, Cardiff, United Kingdom
                [2 ]School of Optometry, Hong Kong Polytechnic University, Kowloon, Hong Kong, China
                [3 ]Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, Scotland, United Kingdom
                [4 ]The Roslin Institute and R(D)SVS, University of Edinburgh, Easter Bush, Midlothian, United Kingdom
                [5 ]Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
                [6 ]Department of Health Technology & Informatics, Hong Kong Polytechnic University, Kowloon, Hong Kong, China
                Author notes
                Correspondence: Jeremy A. Guggenheim, School of Optometry & Vision Sciences, Cardiff University, Maindy Road, Cardiff CF24 4HQ, UK; GuggenheimJ1@ 123456cardiff.ac.uk .
                Shea Ping Yip, Department of Health Technology & Informatics, Hong Kong Polytechnic University, Kowloon, Hong Kong, China; shea.ping.yip@ 123456polyu.edu.hk .

                CW, SPY, and JAG are members of the CREAM Consortium. CW and JAG are members of the UK Biobank Eye and Vision Consortium.

                Article
                iovs-60-01-25 IOVS-18-25597R1
                10.1167/iovs.18-25597
                6363377
                30721303
                aa168335-5051-427c-aead-7ee0adf5728c
                Copyright 2019 The Authors

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 25 August 2018
                : 18 October 2018
                Categories
                Anatomy and Pathology/Oncology

                refractive error,myopia,genome-wide association study,uk biobank,alspac

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