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

Clark, R; Lee, SS-Y; Du, R; Wang, Y; Kneepkens, SCM; Charng, J; Huang, Y; Hunter, ML; Jiang, C; Tideman, JWL; Melles, RB; Klaver, CCW; Mackey, DA; Williams, C; Choquet, H; Ohno-Matsui, K; Guggenheim, JA

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Journal article

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

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).

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

Clark, R., Lee, S. S.-Y., Du, R., Wang, Y., Kneepkens, S. C. M., Charng, J., Huang, Y., Hunter, M. L., Jiang, C., Tideman, J. W. L., Melles, R. B., Klaver, C. C. W., Mackey, D. A., Williams, C., Choquet, H., Ohno-Matsui, K., & Guggenheim, J. A. (2023). 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. EBioMedicine, 91.

MLA Style

Clark, R, et al. “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.” EBioMedicine, vol. 91, 2023.

Chicago Style

Clark, R, SS-Y Lee, R Du, et al. 2023. “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.” EBioMedicine 91.
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