Gotoh Norimoto, Yamada Ryo, Nakanishi Hideo, Saito Masaaki, Iida Tomohiro, Matsuda Fumihiko, Yoshimura Nagahisa
Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan.
Clin Exp Ophthalmol. 2008 Jul;36(5):437-42.
Typical exudative age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV) are two of the major macular diseases found in Asians. Although genomic studies have shown a contribution by CFH and LOC387715/HTRA1 polymorphisms to the development of these two diseases, the correlation of the clinical phenotypes to these genotypes has not been determined in Asian patients.
The prevalence of the CFH Y402H and HTRA1 rs11200638 genotypes was determined in 116 patients with typical exudative AMD and in 204 patients with PCV. Potential correlations of these polymorphisms were tested retrospectively and cross-sectionally for bilaterality of the disease, final visual acuity and the greatest linear dimension of the choroidal neovascular (CNV) lesion.
There was no significant difference in the incidence of CFH Y402H (P = 0.598) and HTRA1 rs11200638 (P = 0.290) between eyes with typical exudative AMD and with PCV. There was a significant association between the lesion size and HTRA1 rs11200638. For eyes with typical AMD, the size of the lesion (6363 +/- 2837 microm) was significantly larger in the high-risk homozygous group (AA), than in the low-risk homozygous group (GG) (3866 +/- 1947 microm; P = 0.0003). The same tendency was observed for the size of the lesion in PCV cases (homozygous group: 6347 +/- 2673 microm, non-risk homozygous group: 4405 +/- 2066 microm, P = 1.3 x 10(-5).
A common genetic background may exist between typical exudative AMD and PCV patients. Among the patients with these two clinical entities, those with a homozygous HTRA1 rs11200638 risk allele had larger CNV lesions.
典型渗出性年龄相关性黄斑变性(AMD)和息肉状脉络膜血管病变(PCV)是亚洲人群中发现的两种主要黄斑疾病。尽管基因组研究表明CFH和LOC387715/HTRA1基因多态性与这两种疾病的发生有关,但在亚洲患者中,临床表型与这些基因型之间的相关性尚未确定。
测定了116例典型渗出性AMD患者和204例PCV患者中CFH Y402H和HTRA1 rs11200638基因型的患病率。回顾性和横断面地测试了这些多态性与疾病双侧性、最终视力和脉络膜新生血管(CNV)病变最大线性尺寸之间的潜在相关性。
典型渗出性AMD眼和PCV眼中CFH Y402H(P = 0.598)和HTRA1 rs11200638(P = 0.290)的发生率无显著差异。病变大小与HTRA1 rs11200638之间存在显著关联。对于典型AMD眼,高危纯合子组(AA)的病变大小(6363±2837微米)显著大于低危纯合子组(GG)(3866±1947微米;P = 0.0003)。PCV病例的病变大小也观察到相同趋势(纯合子组:6347±2673微米,非风险纯合子组:4405±2066微米,P = 1.3×10⁻⁵)。
典型渗出性AMD患者和PCV患者可能存在共同的遗传背景。在这两种临床类型的患者中,携带HTRA1 rs11200638风险等位基因纯合子的患者CNV病变更大。