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A multitrait polygenic risk score for open-angle glaucoma stratifies risk of pigmentary glaucoma in pigment dispersion syndrome
Journal article   Open access   Peer reviewed

A multitrait polygenic risk score for open-angle glaucoma stratifies risk of pigmentary glaucoma in pigment dispersion syndrome

Antonia Kolovos, Ayub Qassim, Henry Marshall, Thi Thi Nguyen, Joshua Schmidt, Mark M Hassall, Victoria Tang, Giorgina Maxwell, John Landers, Richard Mills, …
Ophthalmology. Glaucoma, Vol.9(2), pp.193-201
03/2026
DOI: 10.1016/j.ogla.2025.10.005
PMCID: PMC12797852
PMID: 41130539
url
https://pmc.ncbi.nlm.nih.gov/articles/PMC12797852/View
Open Access

Abstract

Pigment dispersion syndrome (PDS) is a known risk factor for glaucoma, with at least 1 in 10 PDS patients developing glaucoma. There are no standardized clinical tools to stratify risk of glaucoma onset or progression in the context of PDS. This study investigated whether multitrait polygenic risk scores (PRS) built from variants collectively associated with open-angle glaucoma, intraocular pressure (IOP), and vertical cup:disc ratio (VCDR) could stratify individuals with PDS for their risk of glaucoma development. Cross-sectional study of two independent PDS cohorts: the Australian and New Zealand Registry of Advanced Glaucoma (ANZRAG, n=264), and the Glaucoma Services at the University of Iowa Carver College of Medicine (n=203). Participants of European ancestry with PDS were classified as PDS-Glaucoma (n=288), PDS-Glaucoma Suspect (n=110), or PDS-No Glaucoma (n=69). Previously published and validated PRS for open-angle glaucoma, IOP, and VCDR were expressed as a percentile or quintile of an ancestrally-matched normal population. Multivariable logistic and linear regressions, and survival analyses were performed. Odds of pigmentary glaucoma, and odds of clinically-relevant outcomes. Participants from ANZRAG with PDS in the top quintile of an open-angle Glaucoma-PRS had greater odds of glaucoma diagnosis compared to the bottom quintile (adjusted OR 5.29, 95% CI 1.57-21.28, p=0.011). This observation was replicated amongst participants with PDS from the University of Iowa (adjusted OR 4.07, 95% CI 1.24-13.85, p=0.021). Amongst those with PDS-Glaucoma across both cohorts combined, participants in the top quintile of Glaucoma-PRS compared to the bottom quintile were diagnosed 8 years earlier (95% CI 5.17-10.41, p<0.001), recorded a maximum IOP 8mmHg higher (95% CI 2.89-11.95, p=0.001), were at greater risk of escalation to incisional surgery (adjusted OR 1.37, 95% CI 1.03-1.87, p=0.038), and were at greater risk of additional incisional surgeries to the same eye (adjusted OR 1.27, 95% CI 1.08-1.52, p=0.006). A PRS for IOP also differentiated pigmentary glaucoma status; a PRS for VCDR did not. A multitrait PRS for open-angle glaucoma stratifies risk of glaucoma onset and disease severity amongst individuals with PDS.
Genetics Glaucoma Polygenic risk score Pigmentary glaucoma Pigment dispersion syndrome

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