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Mendelian Randomization Implicates Bidirectional Association between Myopia and Primary Open-Angle Glaucoma or
Rachel S Chong1, Hengtong Li2, Alex J Y Cheong3
1Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Republic of Singapore; Ophthalmology & Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Republic of Singapore.
Ophthalmology
|December 9, 2022
Summary
Myopia and primary open-angle glaucoma (POAG) share a bidirectional genetic link, primarily mediated by intraocular pressure (IOP). This suggests IOP-lowering treatments could benefit myopic glaucoma patients.
Area of Science:
- Ophthalmology
- Genetics
- Epidemiology
Background:
- Observational studies suggest a link between myopia and primary open-angle glaucoma (POAG), but findings are inconsistent.
- Confounding factors in myopia can complicate clinical glaucoma testing.
Purpose of the Study:
- To investigate genetic causal associations between myopia and POAG using Mendelian randomization (MR).
- To identify mediators in the relationship between myopia and POAG.
Main Methods:
- Utilized Mendelian randomization (MR) analysis on large genetic datasets (n=216,257-542,934).
- Employed multiple MR models and multivariate genomic structural modeling.
Main Results:
- Confirmed consistent bidirectional genetic associations between myopia and POAG.
- Found significant bidirectional genetic links between myopia and intraocular pressure (IOP).
- Intraocular pressure demonstrated a significant mediation effect on refractive spherical equivalent (RSE) and POAG.
Conclusions:
- A strong bidirectional genetic causal link exists between myopia and POAG, mediated by IOP.
- IOP-lowering treatments may be beneficial for myopic eyes with glaucoma.
- Genetic analysis overcomes confounding factors present in observational studies.