Cited by 67Retinal Diseases and TreatmentsRetinal Development and DisordersGenetic Associations and Epidemiology

Genetics and genetic testing for age-related macular degeneration

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Warwick, A., Lotery, A.·2018·Eye

Abstract

Considerable advances have been made in our understanding of age-related macular degeneration (AMD) genetics over the past decade. The genetic associations discovered to date are estimated to account for approximately half of AMD heritability, and functional studies of these variants have revealed new insights into disease pathogenesis, leading to the development of potential novel therapies. There is furthermore growing interest in genetic testing for predicting an individual's risk of AMD and offering personalised preventive or therapeutic treatments. We review the progress made so far in AMD genetics and discuss the possible applications for genetic testing.

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  • The ability to better risk-stratify patients can improve outcomes by better allocating scarce resources to patients most in need or by selecting the most effective treatment from alternatives.

    “The ability to better riskstratify patients can improve outcomes by better allocating scarce resources to the patients most in need or by selecting the most effective treatment from alternatives [1,26].”

    From Genetics and Age-Related Macular Degeneration: A Practical Review for Clinicians. (2024) · cites this paper as [26]

    The Pharmacogenetics and AMD section discusses whether genetic variants predict response to anti-VEGF treatment, which relates to selecting treatment based on patient characteristics. But it says the findings need validation and does not establish improved outcomes from treatment selection or discuss allocating scarce resources. No page number is available in our copy. (LLM, conf=0.76)

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  1. Smith W, Assink J, Klein R, Mitchell P, Klaver CC, Klein BE et al. Risk factors for age-related macular degeneration: Pooled findings from three continents. Ophthalmology 2001; 108: 697-704.
  2. Wong WL, Su X, Li X, Cheung CM, Klein R, Cheng CY et al. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta- analysis. Lancet Glob. Health. 2014; 2: e106-16.
  3. Fritsche LG, Fariss RN, Stambolian D, Abecasis GR, Curcio CA, Swaroop A. Age-related macular degeneration: genetics and biology coming together. Annu. Rev. Genomics Hum. Genet. 2014; 15: 151-171.
  4. Sobrin L, Seddon JM. Nature and nurture-genes and environment-predict onset and progression of macular degeneration. Prog. Retin. Eye Res. 2014; 40: 1-15.
  5. Seddon JM, Cote J, Page WF, Aggen SH, Neale MC. The US twin study of age-related macular degeneration: relative roles of genetic and environmental influences. Arch. Ophthalmol. 2005; 123: 321-327.
  6. Seddon JM, Afshari MA, Sharma S, Bernstein PS, Chong S, Hutchinson A et al. Assessment of mutations in the Best macular dystrophy (VMD2) gene in patients with adult-onset foveomacular vitelliform dystrophy, age-related maculopathy, and bull's-eye maculopathy. Ophthalmology 2001; 108: 2060-2067.
  7. Ayyagari R, Zhang K, Hutchinson A, Yu Z, Swaroop A, Kakuk LE et al. Evaluation of the ELOVL4 gene in patients with age-related macular degeneration. Ophthalmic Genet. 2001; 22: 233-239.
  8. Haddad S, Chen CA, Santangelo SL, Seddon JM. The genetics of age-related macular degeneration: a review of progress to date. Surv. Ophthalmol. 2006; 51: 316-363.
  9. De La Paz MA, Pericak-Vance MA, Lennon F, Haines JL, Seddon JM. Exclusion of TIMP3 as a candidate locus in age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 1997; 38: 1060- 1065.
  10. Fisher SA, Abecasis GR, Yashar BM, Zareparsi S, Swaroop A, Iyengar SK et al. Meta-analysis of genome scans of age-related macular degeneration. Hum. Mol. Genet. 2005; 14: 2257-2264.
  11. Haines JL, Hauser MA, Schmidt S, Scott WK, Olson LM, Gallins P et al. Complement factor H variant increases the risk of age-related macular degeneration. Science 2005; 308: 419-421.
  12. Hageman GS, Anderson DH, Johnson LV, Hancox LS, Taiber AJ, Hardisty LI et al. A common haplotype in the complement regulatory gene factor H (HF1/CFH) predisposes individuals to age- related macular degeneration. Proc. Natl. Acad. Sci. U. S. A. 2005; 102: 7227-7232.
  13. Edwards AO, Ritter R,3rd, Abel KJ, Manning A, Panhuysen C, Farrer LA. Complement factor H polymorphism and age-related macular degeneration. Science 2005; 308: 421-424.
  14. Klein RJ, Zeiss C, Chew EY, Tsai JY, Sackler RS, Haynes C et al. Complement factor H polymorphism in age-related macular degeneration. Science 2005; 308: 385-389.
  15. Gold B, Merriam JE, Zernant J, Hancox LS, Taiber AJ, Gehrs K et al. Variation in factor B (BF) and complement component 2 (C2) genes is associated with age-related macular degeneration. Nat. Genet. 2006; 38: 458-462.
  16. Yates JR, Sepp T, Matharu BK, Khan JC, Thurlby DA, Shahid H et al. Complement C3 variant and the risk of age-related macular degeneration. N. Engl. J. Med. 2007; 357: 553-561.
  17. Dinu V, Miller PL, Zhao H. Evidence for association between multiple complement pathway genes and AMD. Genet. Epidemiol. 2007; 31: 224-237.
  18. Fagerness JA, Maller JB, Neale BM, Reynolds RC, Daly MJ, Seddon JM. Variation near complement factor I is associated with risk of advanced AMD. Eur. J. Hum. Genet. 2009; 17: 100-104.
  19. Ennis S, Jomary C, Mullins R, Cree A, Chen X, Macleod A et al. Association between the SERPING1 gene and age-related macular degeneration: a two-stage case-control study. Lancet 2008; 372: 1828-1834.
  20. Anderson DH, Radeke MJ, Gallo NB, Chapin EA, Johnson PT, Curletti CR et al. The pivotal role of the complement system in aging and age-related macular degeneration: hypothesis re-visited. Prog. Retin. Eye Res. 2010; 29: 95-112.
  21. Johnson LV, Leitner WP, Staples MK, Anderson DH. Complement activation and inflammatory processes in Drusen formation and age related macular degeneration. Exp. Eye Res. 2001; 73: 887- 896.
  22. Crabb JW, Miyagi M, Gu X, Shadrach K, West KA, Sakaguchi H et al. Drusen proteome analysis: an approach to the etiology of age-related macular degeneration. Proc. Natl. Acad. Sci. U. S. A. 2002; 99: 14682-14687.
  23. Mullins RF, Russell SR, Anderson DH, Hageman GS. Drusen associated with aging and age-related macular degeneration contain proteins common to extracellular deposits associated with atherosclerosis, elastosis, amyloidosis, and dense deposit disease. FASEB J. 2000; 14: 835-846.
  24. Warwick A, Khandhadia S, Ennis S, Lotery A. Age-Related Macular Degeneration: A Disease of Systemic or Local Complement Dysregulation? J. Clin. Med. 2014; 3: 1234-1257.
  25. Bomback AS, Smith RJ, Barile GR, Zhang Y, Heher EC, Herlitz L et al. Eculizumab for dense deposit disease and C3 glomerulonephritis. Clin. J. Am. Soc. Nephrol. 2012; 7: 748-756.
  26. McAvoy CE, Silvestri G. Retinal changes associated with type 2 glomerulonephritis. Eye (Lond) 2005; 19: 985-989.
  27. Khandhadia S, Hakobyan S, Heng LZ, Gibson J, Adams DH, Alexander GJ et al. Age-related macular degeneration and modification of systemic complement factor H production through liver transplantation. Ophthalmology 2013; 120: 1612-1618.
  28. Heurich M, Martinez-Barricarte R, Francis NJ, Roberts DL, Rodriguez de Cordoba S, Morgan BP et al. Common polymorphisms in C3, factor B, and factor H collaborate to determine systemic complement activity and disease risk. Proc. Natl. Acad. Sci. U. S. A. 2011; 108: 8761-8766.
  29. Johnson PT, Betts KE, Radeke MJ, Hageman GS, Anderson DH, Johnson LV. Individuals homozygous for the age-related macular degeneration risk-conferring variant of complement factor H have elevated levels of CRP in the choroid. Proc. Natl. Acad. Sci. U. S. A. 2006; 103: 17456-17461.
  30. Clark SJ, Perveen R, Hakobyan S, Morgan BP, Sim RB, Bishop PN et al. Impaired binding of the age-related macular degeneration-associated complement factor H 402H allotype to Bruch's membrane in human retina. J. Biol. Chem. 2010; 285: 30192-30202.
  31. Kelly U, Yu L, Kumar P, Ding JD, Jiang H, Hageman GS et al. Heparan sulfate, including that in Bruch's membrane, inhibits the complement alternative pathway: implications for age-related macular degeneration. J. Immunol. 2010; 185: 5486-5494.
  32. Weismann D, Hartvigsen K, Lauer N, Bennett KL, Scholl HP, Charbel Issa P et al. Complement factor H binds malondialdehyde epitopes and protects from oxidative stress. Nature 2011; 478: 76- 81.
  33. Nan R, Farabella I, Schumacher FF, Miller A, Gor J, Martin AC et al. Zinc binding to the Tyr402 and His402 allotypes of complement factor H: possible implications for age-related macular degeneration. J. Mol. Biol. 2011; 408: 714-735.
  34. Mullins RF, Schoo DP, Sohn EH, Flamme-Wiese MJ, Workamelahu G, Johnston RM et al. The membrane attack complex in aging human choriocapillaris: relationship to macular degeneration and choroidal thinning. Am. J. Pathol. 2014; 184: 3142-3153.
  35. Mullins RF, Dewald AD, Streb LM, Wang K, Kuehn MH, Stone EM. Elevated membrane attack complex in human choroid with high risk complement factor H genotypes. Exp. Eye Res. 2011; 93: 565-567.
  36. Yang Z, Camp NJ, Sun H, Tong Z, Gibbs D, Cameron DJ et al. A variant of the HTRA1 gene increases susceptibility to age-related macular degeneration. Science 2006; 314: 992-993.
  37. Jakobsdottir J, Conley YP, Weeks DE, Mah TS, Ferrell RE, Gorin MB. Susceptibility genes for age- related maculopathy on chromosome 10q26. Am. J. Hum. Genet. 2005; 77: 389-407.
  38. Stanton CM, Chalmers KJ, Wright AF. The chromosome 10q26 susceptibility locus in age-related macular degeneration. Adv. Exp. Med. Biol. 2012; 723: 365-370.
  39. Grassmann F, Heid IM, Weber BH, International AMD Genomics Consortium (IAMDGC). Recombinant Haplotypes Narrow the ARMS2/HTRA1 Association Signal for Age-Related Macular Degeneration. Genetics 2017; 205: 919-924.
  40. Fritsche LG, Chen W, Schu M, Yaspan BL, Yu Y, Thorleifsson G et al. Seven new loci associated with age-related macular degeneration. Nat. Genet. 2013; 45: 433-9, 439e1-2.
  41. Yu Y, Bhangale TR, Fagerness J, Ripke S, Thorleifsson G, Tan PL et al. Common variants near FRK/COL10A1 and VEGFA are associated with advanced age-related macular degeneration. Hum. Mol. Genet. 2011; 20: 3699-3709.
  42. Fritsche LG, Igl W, Bailey JN, Grassmann F, Sengupta S, Bragg-Gresham JL et al. A large genome- wide association study of age-related macular degeneration highlights contributions of rare and common variants. Nat. Genet. 2016; 48: 134-143.
  43. Eichler EE, Flint J, Gibson G, Kong A, Leal SM, Moore JH et al. Missing heritability and strategies for finding the underlying causes of complex disease. Nat. Rev. Genet. 2010; 11: 446-450.
  44. Gibson G. Rare and common variants: twenty arguments. Nat. Rev. Genet. 2012; 13: 135-145.
  45. Sobrin L, Maller JB, Neale BM, Reynolds RC, Fagerness JA, Daly MJ et al. Genetic profile for five common variants associated with age-related macular degeneration in densely affected families: a novel analytic approach. Eur. J. Hum. Genet. 2010; 18: 496-501.
  46. Raychaudhuri S, Iartchouk O, Chin K, Tan PL, Tai AK, Ripke S et al. A rare penetrant mutation in CFH confers high risk of age-related macular degeneration. Nat. Genet. 2011; 43: 1232-1236.
  47. Seddon JM, Yu Y, Miller EC, Reynolds R, Tan PL, Gowrisankar S et al. Rare variants in CFI, C3 and C9 are associated with high risk of advanced age-related macular degeneration. Nat. Genet. 2013; 45: 1366-1370.
  48. van de Ven JP, Nilsson SC, Tan PL, Buitendijk GH, Ristau T, Mohlin FC et al. A functional variant in the CFI gene confers a high risk of age-related macular degeneration. Nat. Genet. 2013; 45: 813-817.
  49. Zhan X, Larson DE, Wang C, Koboldt DC, Sergeev YV, Fulton RS et al. Identification of a rare coding variant in complement 3 associated with age-related macular degeneration. Nat. Genet. 2013; 45: 1375-1379.
  50. Helgason H, Sulem P, Duvvari MR, Luo H, Thorleifsson G, Stefansson H et al. A rare nonsynonymous sequence variant in C3 is associated with high risk of age-related macular degeneration. Nat. Genet. 2013; 45: 1371-1374.
  51. Duvvari MR, van de Ven JP, Geerlings MJ, Saksens NT, Bakker B, Henkes A et al. Whole Exome Sequencing in Patients with the Cuticular Drusen Subtype of Age-Related Macular Degeneration. PLoS One 2016; 11: e0152047.
  52. Geerlings MJ, Kremlitzka M, Bakker B, Nilsson SC, Saksens NT, Lechanteur YT et al. The Functional Effect of Rare Variants in Complement Genes on C3b Degradation in Patients With Age-Related Macular Degeneration. JAMA Ophthalmol. 2017; 135: 39-46.
  53. Hoffman JD, Cooke Bailey JN, D'Aoust L, Cade W, Ayala-Haedo J, Fuzzell D et al. Rare complement factor H variant associated with age-related macular degeneration in the Amish. Invest. Ophthalmol. Vis. Sci. 2014; 55: 4455-4460.
  54. Pras E, Kristal D, Shoshany N, Volodarsky D, Vulih I, Celniker G et al. Rare genetic variants in Tunisian Jewish patients suffering from age-related macular degeneration. J. Med. Genet. 2015; 52: 484-492.
  55. Ratnapriya R, Zhan X, Fariss RN, Branham KE, Zipprer D, Chakarova CF et al. Rare and common variants in extracellular matrix gene Fibrillin 2 (FBN2) are associated with macular degeneration. Hum. Mol. Genet. 2014; 23: 5827-5837.
  56. Saksens NT, Geerlings MJ, Bakker B, Schick T, Daha MR, Fauser S et al. Rare Genetic Variants Associated With Development of Age-Related Macular Degeneration. JAMA Ophthalmol. 2016; 134: 287-293.
  57. Yu Y, Triebwasser MP, Wong EK, Schramm EC, Thomas B, Reynolds R et al. Whole-exome sequencing identifies rare, functional CFH variants in families with macular degeneration. Hum. Mol. Genet. 2014; 23: 5283-5293.
  58. Geerlings MJ, de Jong EK, den Hollander AI. The complement system in age-related macular degeneration: A review of rare genetic variants and implications for personalized treatment. Mol. Immunol. 2017; 84: 65-76.
  59. Triebwasser MP, Roberson ED, Yu Y, Schramm EC, Wagner EK, Raychaudhuri S et al. Rare Variants in the Functional Domains of Complement Factor H Are Associated With Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2015; 56: 6873-6878.
  60. Wagner EK, Raychaudhuri S, Villalonga MB, Java A, Triebwasser MP, Daly MJ et al. Mapping rare, deleterious mutations in Factor H: Association with early onset, drusen burden, and lower antigenic levels in familial AMD. Sci. Rep. 2016; 6: 31531.
  61. Ferrara D, Seddon JM. Phenotypic Characterization of Complement Factor H R1210C Rare Genetic Variant in Age-Related Macular Degeneration. JAMA Ophthalmol. 2015; 133: 785-791.
  62. Warwick A, Gibson J, Sood R, Lotery A. A rare penetrant TIMP3 mutation confers relatively late onset choroidal neovascularisation which can mimic age-related macular degeneration. Eye (Lond) 2016; 30: 488-491.
  63. Cooke Bailey JN, Hoffman JD, Sardell RJ, Scott WK, Pericak-Vance MA, Haines JL. The Application of Genetic Risk Scores in Age-Related Macular Degeneration: A Review. J. Clin. Med. 2016; 5: 10.3390/jcm5030031. · DOI
  64. Grassmann F, Fritsche LG, Keilhauer CN, Heid IM, Weber BH. Modelling the genetic risk in age- related macular degeneration. PLoS One 2012; 7: e37979.
  65. Hageman GS, Gehrs K, Lejnine S, Bansal AT, Deangelis MM, Guymer RH et al. Clinical validation of a genetic model to estimate the risk of developing choroidal neovascular age-related macular degeneration. Hum. Genomics 2011; 5: 420-440.
  66. Perlee LT, Bansal AT, Gehrs K, Heier JS, Csaky K, Allikmets R et al. Inclusion of genotype with fundus phenotype improves accuracy of predicting choroidal neovascularization and geographic atrophy. Ophthalmology 2013; 120: 1880-1892.
  67. Seddon JM, Silver RE, Kwong M, Rosner B. Risk Prediction for Progression of Macular Degeneration: 10 Common and Rare Genetic Variants, Demographic, Environmental, and Macular Covariates. Invest. Ophthalmol. Vis. Sci. 2015; 56: 2192-2202.
  68. Seddon JM, Reynolds R, Yu Y, Daly MJ, Rosner B. Risk models for progression to advanced age- related macular degeneration using demographic, environmental, genetic, and ocular factors. Ophthalmology 2011; 118: 2203-2211.
  69. Chiu CJ, Mitchell P, Klein R, Klein BE, Chang ML, Gensler G et al. A risk score for the prediction of advanced age-related macular degeneration: development and validation in 2 prospective cohorts. Ophthalmology 2014; 121: 1421-1427.
  70. Schwartz SG, Hampton BM, Kovach JL, Brantley MA,Jr. Genetics and age-related macular degeneration: a practical review for the clinician. Clin. Ophthalmol. 2016; 10: 1229-1235.
  71. Ding Y, Liu Y, Yan Q, Fritsche LG, Cook RJ, Clemons T et al. Bivariate Analysis of Age-Related Macular Degeneration Progression Using Genetic Risk Scores. Genetics 2017; 206: 119-133.
  72. Jakobsdottir J, Gorin MB, Conley YP, Ferrell RE, Weeks DE. Interpretation of genetic association studies: markers with replicated highly significant odds ratios may be poor classifiers. PLoS Genet. 2009; 5: e1000337.
  73. Kondo N, Bessho H, Honda S, Negi A. Complement factor H Y402H variant and risk of age-related macular degeneration in Asians: a systematic review and meta-analysis. Ophthalmology 2011; 118: 339-344.
  74. Restrepo NA, Spencer KL, Goodloe R, Garrett TA, Heiss G, Buzkova P et al. Genetic determinants of age-related macular degeneration in diverse populations from the PAGE study. Invest. Ophthalmol. Vis. Sci. 2014; 55: 6839-6850.
  75. Spencer KL, Glenn K, Brown-Gentry K, Haines JL, Crawford DC. Population Differences in Genetic Risk for Age-related Macular Degeneration and Implications for Genetic Testing. Arch. Ophthalmol. 2012; 130: 116-117.
  76. Age-Related Eye Disease Study 2 Research Group. Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial. JAMA 2013; 309: 2005-2015.
  77. Awh CC, Lane AM, Hawken S, Zanke B, Kim IK. CFH and ARMS2 genetic polymorphisms predict response to antioxidants and zinc in patients with age-related macular degeneration. Ophthalmology 2013; 120: 2317-2323.
  78. Awh CC, Hawken S, Zanke BW. Treatment response to antioxidants and zinc based on CFH and ARMS2 genetic risk allele number in the Age-Related Eye Disease Study. Ophthalmology 2015; 122: 162-169.
  79. Chew EY, Klein ML, Clemons TE, Agron E, Abecasis GR. Genetic testing in persons with age- related macular degeneration and the use of the AREDS supplements: to test or not to test? Ophthalmology 2015; 122: 212-215.
  80. Chew EY, Klein ML, Clemons TE, Agron E, Ratnapriya R, Edwards AO et al. No clinically significant association between CFH and ARMS2 genotypes and response to nutritional supplements: AREDS report number 38. Ophthalmology 2014; 121: 2173-2180.
  81. Klein ML, Francis PJ, Rosner B, Reynolds R, Hamon SC, Schultz DW et al. CFH and LOC387715/ARMS2 genotypes and treatment with antioxidants and zinc for age-related macular degeneration. Ophthalmology 2008; 115: 1019-1025.
  82. Seddon JM, Silver RE, Rosner B. Response to AREDS supplements according to genetic factors: survival analysis approach using the eye as the unit of analysis. Br. J. Ophthalmol. 2016; 100: 1731- 1737.
  83. Csaky KG, Schachat AP, Kaiser PK, Small KW, Heier JS. The Use of Genetic Testing in the Management of Patients With Age-Related Macular Degeneration. Journal of VitreoRetinal Diseases 2017; 1: 75-78.

Cited by

Sorted by citations

Authors
Warwick, A., & Lotery, A.
Affiliations
  • Moorfields Eye Hospital (GB)
  • University of Southampton (GB)
Corresponding author
Lotery, A.
Venue
Eye
Published
2017-11-10
Volume
32
Issue
5
Pages
849-857
ISSN
  • 0078-5334 (ISSN-L)
  • 0950-222X
  • 1476-5454
OpenAlex
W2768026721
Cited by
67
References
103
Citations by year
2026: 3 · 2025: 8 · 2024: 5 · 2023: 12 · 2022: 9 · 2021: 6 · 2020: 11 · 2019: 9 · 2018: 4
FWCI
1.21
Type
journal article
Language
en
Open access
Locations
  • Eye (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • ePrints Soton (University of Southampton) (submittedVersion)
Funders
National Institute for Health and Care Research (NF-SI-0515-10020)
Topics
  • Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Retinal Development and Disorders
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic Associations and Epidemiology
Keywords
age-related macular degeneration, genetic association, heritability, genetic variants, pathogenesis, genetic testing, risk prediction, personalized medicine, new drugs
MeSH terms
Genetic Testing, Humans, Macular Degeneration, Risk Factors, Genetic Predisposition to Disease

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