Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.
Retina. 2012 Sep;32(8):1486-91. doi: 10.1097/IAE.0b013e318240a540.
To identify genetic associations between specific risk genes and bilateral advanced age-related macular degeneration (AMD) in a retrospective, observational case series of 1,003 patients: 173 patients with geographic atrophy in at least 1 eye and 830 patients with choroidal neovascularization in at least 1 eye.
Patients underwent clinical examination and fundus photography. The images were subsequently graded using a modified grading system adapted from the Age-Related Eye Disease Study. Genetic analysis was performed to identify genotypes at 4 AMD-associated variants (ARMS2 A69S, CFH Y402H, C3 R102G, and CFB R32Q) in these patients.
There were no statistically significant relationships between clinical findings and genotypes at CFH, C3, and CFB. The genotype at ARMS2 correlated with bilateral advanced AMD using a variety of comparisons: unilateral geographic atrophy versus bilateral geographic atrophy (P = 0.08), unilateral choroidal neovascularization versus bilateral choroidal neovascularization (P = 9.0 × 10(-8)), and unilateral late AMD versus bilateral late AMD (P = 5.9 × 10(-8)).
In this series, in patients with geographic atrophy or choroidal neovascularization in at least 1 eye, the ARMS2 A69S substitution strongly associated with geographic atrophy or choroidal neovascularization in the fellow eye. The ARMS2 A69S substitution may serve as a marker for bilateral advanced AMD.
在一项对 1003 名患者的回顾性、观察性病例系列研究中,确定特定风险基因与双侧晚期年龄相关性黄斑变性(AMD)之间的遗传关联:173 名患者至少有 1 只眼存在地图状萎缩,830 名患者至少有 1 只眼存在脉络膜新生血管。
患者接受临床检查和眼底照相。随后使用改良的分级系统对图像进行分级,该分级系统改编自年龄相关性眼病研究。对这些患者的 4 个 AMD 相关变体(ARMS2 A69S、CFH Y402H、C3 R102G 和 CFB R32Q)进行基因分析以确定基因型。
CFH、C3 和 CFB 的基因型与临床发现之间无统计学显著关系。ARMS2 的基因型与双侧晚期 AMD 存在多种比较相关:单侧地图状萎缩与双侧地图状萎缩(P=0.08)、单侧脉络膜新生血管与双侧脉络膜新生血管(P=9.0×10(-8))、单侧晚期 AMD 与双侧晚期 AMD(P=5.9×10(-8))。
在本系列中,在至少 1 只眼存在地图状萎缩或脉络膜新生血管的患者中,ARMS2 A69S 取代与对侧眼的地图状萎缩或脉络膜新生血管强烈相关。ARMS2 A69S 取代可能是双侧晚期 AMD 的标志物。