A new polygenic score for refractive error improves detection of children at risk of high myopia but not the prediction of those at risk of myopic macular degeneration
Rosie Clark, Samantha Sze‐Yee Lee, Ran Du, Yining Wang, Sander C. M. Kneepkens, Jason Charng, Yu Huang, Michael Hunter, Chen Jiang, J. Willem L. Tideman, Ronald B. Melles, Caroline C. W. Klaver, David A. Mackey, Cathy Williams, Hélène Choquet, Kyoko Ohno‐Matsui, Jeremy A. Guggenheim, Joan E. Bailey‐Wilson, Paul N. Baird, Veluchamy A. Barathi, Ginevra Biino, Kathryn P. Burdon, Harry Campbell, Li Jia Chen, Ching‐Yu Cheng, Emily Y. Chew, Jamie E. Craig, Margaret M. DeAngelis, Cécile Delcourt, Xiaohu Ding, Qiao Fan, Maurizio Fossarello, Paul J. Foster, Puya Gharahkhani, Jeremy A. Guggenheim, Xiaobo Guo, Annechien E. G. Haarman, Toomas Haller, Christopher J. Hammond, Xikun Han, Caroline Hayward, Mingguang He, Alex W. Hewitt, Quan V. Hoang, Pirro G. Hysi, Adriana I. Iglesias, Robert P. Igo, Sudha K. Iyengar, Jost B. Jonas, Mika Kähönen, Jaakko Kaprio, Anthony P. Khawaja, Barbara E.K. Klein, Jonathan H. Lass, K. Lee, Terho Lehtimäki, Deyana Lewis, Qing Li, Shi‐Ming Li, Leo‐Pekka Lyytikäinen, Stuart MacGregor, David A. Mackey, Nicholas G. Martin, Akira Meguro, Andres Metspalu, Candace D. Middlebrooks, Masahiro Miyake, Nobuhisa Mizuki, Anthony M. Musolf, Stefan Nickels, Konrad Oexle, Chi Pui Pang, Olavi Pärssinen, Andrew D. Paterson, Norbert Pfeiffer, Ozren Polašek, Jugnoo S. Rahi, Olli T. Raitakari, Igor Rudan, Srujana Sahebjada, Seang‐Mei Saw, Claire L. Simpson, Dwight Stambolian, E Shyong Tai, Milly S. Tedja, J. Willem L. Tideman, Akitaka Tsujikawa, Cornelia M. van Duijn, Virginie J. M. Verhoeven, Véronique Vitart, Ningli Wang, Ya Xing Wang, Juho Wedenoja, Wen Bin Wei, Cathy Williams, Katie Williams, James F. Wilson, Robert Wojciechowski, Jason C. Yam, Kenji Yamashiro
Abstract
BACKGROUND: High myopia (HM), defined as a spherical equivalent refractive error (SER) ≤ -6.00 diopters (D), is a leading cause of sight impairment, through myopic macular degeneration (MMD). We aimed to derive an improved polygenic score (PGS) for predicting children at risk of HM and to test if a PGS is predictive of MMD after accounting for SER. METHODS: The PGS was derived from genome-wide association studies in participants of UK Biobank, CREAM Consortium, and Genetic Epidemiology Research on Adult Health and Aging. MMD severity was quantified by a deep learning algorithm. Prediction of HM was quantified as the area under the receiver operating curve (AUROC). Prediction of severe MMD was assessed by logistic regression. FINDINGS: In independent samples of European, African, South Asian and East Asian ancestry, the PGS explained 19% (95% confidence interval 17-21%), 2% (1-3%), 8% (7-10%) and 6% (3-9%) of the variation in SER, respectively. The AUROC for HM in these samples was 0.78 (0.75-0.81), 0.58 (0.53-0.64), 0.71 (0.69-0.74) and 0.67 (0.62-0.72), respectively. The PGS was not associated with the risk of MMD after accounting for SER: OR = 1.07 (0.92-1.24). INTERPRETATION: Performance of the PGS approached the level required for clinical utility in Europeans but not in other ancestries. A PGS for refractive error was not predictive of MMD risk once SER was accounted for. FUNDING: Supported by the Welsh Government and Fight for Sight (24WG201).