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Barbara E K Klein - One of the best experts on this subject based on the ideXlab platform.
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refraction and change in refraction over a 20 year period in the beaver dam eye study
Investigative Ophthalmology & Visual Science, 2018Co-Authors: Samantha M Bomotti, Barbara E K Klein, Priya Duggal, Ronald Klein, Kristine E Lee, Bryan Lau, Alison P. KleinAbstract:Purpose Hyperopic shifts in refraction have been consistently reported in adults over 40, followed by myopic shifts after age 70. Although potential factors underlying these changes in refraction in older adults have been investigated previously, the studies were restricted by the limited longitudinal data available. The authors of this study sought to better characterize the long-term trajectory of refraction in older adults using 20 years of prospective data. Methods The impact of cohort effects on refraction over 20 years was examined. Generalized estimating equations were used to evaluate the etiologic factors underlying refraction and changes in refraction measured over a 20-year period (1988-2010) among adults over age 40 from the Beaver Dam Eye Study. Results Only individuals with Nuclear cataract experienced a myopic shift in refraction, showing a 0.25 diopter (D) decrease (95% confidence interval [CI]: -0.44 D to -0.07 D) over a five-year period. Individuals with mild and moderate Nuclear Sclerosis showed varying degrees of hyperopic shifts over five years (0.22 D: 95% CI: 0.20 D-0.25 D; 0.23 D: 95% CI: 0.20 D-0.27 D, respectively). Conclusions Nuclear cataract is the primary contributor to the myopic shift among older individuals. Birth cohort effects on baseline refraction but not change in refraction were observed.
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heritability analysis of spherical equivalent axial length corneal curvature and anterior chamber depth in the beaver dam eye study
Archives of Ophthalmology, 2009Co-Authors: Alison P. Klein, Joan E Baileywilson, Priya Duggal, Ronald Klein, Bhoom Suktitipat, Barbara E K KleinAbstract:Objective To examine genetic influences for quantitative refraction. Spherical equivalent and its related binary traits of myopia and hyperopia are highly correlated within families. Many linkage regions have been reported for myopia, high myopia, and quantitative refraction. However, the measured phenotype of spherical equivalent is in large part dictated by the relationship between the underlying optical components of axial length, corneal curvature, and anterior chamber depth. Methods Using data from the fourth visit of the Beaver Dam Eye Study, we conducted familial correlation and heritability analysis of quantitative spherical equivalent, axial length, anterior chamber depth, and corneal curvature using data from 715 individuals in 189 pedigrees. Results Overall, every trait was highly heritable. Heritability estimates were 0.58 (SE 0.13) for spherical equivalent after adjustment for age, education, and Nuclear Sclerosis; 0.95 (SE 0.11) for corneal curvature after adjustment for height; 0.67 (SE 0.14) for axial length after adjustment for height and education; and 0.78 (SE 0.14) for anterior chamber depth after adjustment for age, education, height, and Nuclear Sclerosis. Conclusion Refraction and the underlying traits of axial length, corneal curvature, and anterior chamber depth are highly heritable. Genetic analysis of these traits may provide greater insight into the development of refractive errors.
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confirmation of linkage to ocular refraction on chromosome 22q and identification of a novel linkage region on 1q
Archives of Ophthalmology, 2007Co-Authors: Alison P. Klein, Priya Duggal, Joan E Baileywilson, Ronald Klein, Barbara E K KleinAbstract:Objective To localize genes influencing ocular refraction in subjects in the Beaver Dam Eye Study. Previous studies establish that myopia clusters within families and linkage to myopia has been demonstrated on 2q, 4q, 12q, 17q, 18q, 22q, and Xq. Few studies have examined genetic effects across the entire range of refraction, though linkages to 1p, 3q, 4q, 8p, and 11p have been reported, and our previous analysis of the Beaver Dam Eye Study demonstrated substantial heritability for refraction (68%). Methods We conducted nonparametric sibling-pair and genome-wide linkage analyses on spherical equivalent adjusting for age, education, and Nuclear Sclerosis, in 834 sibling pairs in 486 extended pedigrees. Results We identified a novel region of suggestive linkage on 1q (multipoint, P P = .0033) previously linked to myopia. Additionally, there was some evidence of linkage to 7p (multipoint, P = .0023). Conclusion Refraction is a complex trait influenced by both genes and environment. Our work confirms a previously reported linkage region on 22q and identifies 2 novel regions of linkage on 1q and 7p. Clinical Relevance Further, genetic research is needed to finemap this trait to identify the causative gene. Modifying the actions of such a gene might lead to a reduction in the risk of refractive error.
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age related eye disease visual impairment and survival the beaver dam eye study
Archives of Ophthalmology, 2006Co-Authors: Michael D Knudtson, Barbara E K Klein, Ronald KleinAbstract:Objective To investigate the relationship of age-related maculopathy, cataract, glaucoma, visual impairment, and diabetic retinopathy to survival during a 14-year period. Methods Persons ranging in age from 43 to 84 years in the period from September 15, 1987, to May 4, 1988, participated in the baseline examination of the population-based Beaver Dam Eye Study (n = 4926). Standardized protocols, including photography, were used to determine the presence of ocular disease. Survival was followed using standardized protocols. Results As of December 31, 2002, 32% of the baseline population had died (median follow-up, 13.2 years). After adjusting for age, sex, and systemic and lifestyle factors, poorer survival was associated with cortical cataract (hazard ratio [HR], 1.21; 95% confidence interval [CI], 1.06-1.37), any cataract (HR, 1.16; 95% CI, 1.03-1.32), diabetic retinopathy (HR per 1-step increase in 4-level severity, 1.36; 95% CI, 1.14-1.63), and visual impairment (HR, 1.24; 95% CI, 1.04-1.48) and marginally associated with increasing severity of Nuclear Sclerosis (HR, 1.07; 95% CI, 0.99-1.16). Age-related maculopathy and glaucoma were not associated with poorer survival. Associations tended to be slightly stronger in men than women. Conclusions Cataract, diabetic retinopathy, and visual impairment were associated with poorer survival and not explained by traditional risk factors for mortality. These ocular conditions may serve as markers for mortality in the general population.
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an automatic system for classification of Nuclear Sclerosis from slit lamp photographs
Medical Image Computing and Computer-Assisted Intervention, 2003Co-Authors: Shaohua Fan, Charles R Dyer, Larry D Hubbard, Barbara E K KleinAbstract:A robust and automatic system has been developed to detect the visual axis and extract important feature landmarks from slit-lamp photographs, and objectively grade the severity of Nuclear Sclerosis based on the intensities of those landmarks. Using linear regression, we first select the features that play important roles in classification, and then fit a linear grading function. We evaluated the grading function using human grades as error bounds for “ground truth” grades, and compared the machine grades with the human grades. As expected, the automatic system significantly speeds up the process of grading, and grades computed are consistent and reproducible. Machine grading time for one image is less than 2 seconds on a Pentium III 996MHz machine while human grading takes about 2 minutes. Statistical results show that the predicted grades by the system are very reliable. For the testing set of 141 images, with correct grading defined by a tolerance of one grade level difference from the human grade, the automated system has a grading accuracy of 95.8% based on the AREDS grading scale.
Ronald Klein - One of the best experts on this subject based on the ideXlab platform.
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refraction and change in refraction over a 20 year period in the beaver dam eye study
Investigative Ophthalmology & Visual Science, 2018Co-Authors: Samantha M Bomotti, Barbara E K Klein, Priya Duggal, Ronald Klein, Kristine E Lee, Bryan Lau, Alison P. KleinAbstract:Purpose Hyperopic shifts in refraction have been consistently reported in adults over 40, followed by myopic shifts after age 70. Although potential factors underlying these changes in refraction in older adults have been investigated previously, the studies were restricted by the limited longitudinal data available. The authors of this study sought to better characterize the long-term trajectory of refraction in older adults using 20 years of prospective data. Methods The impact of cohort effects on refraction over 20 years was examined. Generalized estimating equations were used to evaluate the etiologic factors underlying refraction and changes in refraction measured over a 20-year period (1988-2010) among adults over age 40 from the Beaver Dam Eye Study. Results Only individuals with Nuclear cataract experienced a myopic shift in refraction, showing a 0.25 diopter (D) decrease (95% confidence interval [CI]: -0.44 D to -0.07 D) over a five-year period. Individuals with mild and moderate Nuclear Sclerosis showed varying degrees of hyperopic shifts over five years (0.22 D: 95% CI: 0.20 D-0.25 D; 0.23 D: 95% CI: 0.20 D-0.27 D, respectively). Conclusions Nuclear cataract is the primary contributor to the myopic shift among older individuals. Birth cohort effects on baseline refraction but not change in refraction were observed.
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heritability analysis of spherical equivalent axial length corneal curvature and anterior chamber depth in the beaver dam eye study
Archives of Ophthalmology, 2009Co-Authors: Alison P. Klein, Joan E Baileywilson, Priya Duggal, Ronald Klein, Bhoom Suktitipat, Barbara E K KleinAbstract:Objective To examine genetic influences for quantitative refraction. Spherical equivalent and its related binary traits of myopia and hyperopia are highly correlated within families. Many linkage regions have been reported for myopia, high myopia, and quantitative refraction. However, the measured phenotype of spherical equivalent is in large part dictated by the relationship between the underlying optical components of axial length, corneal curvature, and anterior chamber depth. Methods Using data from the fourth visit of the Beaver Dam Eye Study, we conducted familial correlation and heritability analysis of quantitative spherical equivalent, axial length, anterior chamber depth, and corneal curvature using data from 715 individuals in 189 pedigrees. Results Overall, every trait was highly heritable. Heritability estimates were 0.58 (SE 0.13) for spherical equivalent after adjustment for age, education, and Nuclear Sclerosis; 0.95 (SE 0.11) for corneal curvature after adjustment for height; 0.67 (SE 0.14) for axial length after adjustment for height and education; and 0.78 (SE 0.14) for anterior chamber depth after adjustment for age, education, height, and Nuclear Sclerosis. Conclusion Refraction and the underlying traits of axial length, corneal curvature, and anterior chamber depth are highly heritable. Genetic analysis of these traits may provide greater insight into the development of refractive errors.
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confirmation of linkage to ocular refraction on chromosome 22q and identification of a novel linkage region on 1q
Archives of Ophthalmology, 2007Co-Authors: Alison P. Klein, Priya Duggal, Joan E Baileywilson, Ronald Klein, Barbara E K KleinAbstract:Objective To localize genes influencing ocular refraction in subjects in the Beaver Dam Eye Study. Previous studies establish that myopia clusters within families and linkage to myopia has been demonstrated on 2q, 4q, 12q, 17q, 18q, 22q, and Xq. Few studies have examined genetic effects across the entire range of refraction, though linkages to 1p, 3q, 4q, 8p, and 11p have been reported, and our previous analysis of the Beaver Dam Eye Study demonstrated substantial heritability for refraction (68%). Methods We conducted nonparametric sibling-pair and genome-wide linkage analyses on spherical equivalent adjusting for age, education, and Nuclear Sclerosis, in 834 sibling pairs in 486 extended pedigrees. Results We identified a novel region of suggestive linkage on 1q (multipoint, P P = .0033) previously linked to myopia. Additionally, there was some evidence of linkage to 7p (multipoint, P = .0023). Conclusion Refraction is a complex trait influenced by both genes and environment. Our work confirms a previously reported linkage region on 22q and identifies 2 novel regions of linkage on 1q and 7p. Clinical Relevance Further, genetic research is needed to finemap this trait to identify the causative gene. Modifying the actions of such a gene might lead to a reduction in the risk of refractive error.
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age related eye disease visual impairment and survival the beaver dam eye study
Archives of Ophthalmology, 2006Co-Authors: Michael D Knudtson, Barbara E K Klein, Ronald KleinAbstract:Objective To investigate the relationship of age-related maculopathy, cataract, glaucoma, visual impairment, and diabetic retinopathy to survival during a 14-year period. Methods Persons ranging in age from 43 to 84 years in the period from September 15, 1987, to May 4, 1988, participated in the baseline examination of the population-based Beaver Dam Eye Study (n = 4926). Standardized protocols, including photography, were used to determine the presence of ocular disease. Survival was followed using standardized protocols. Results As of December 31, 2002, 32% of the baseline population had died (median follow-up, 13.2 years). After adjusting for age, sex, and systemic and lifestyle factors, poorer survival was associated with cortical cataract (hazard ratio [HR], 1.21; 95% confidence interval [CI], 1.06-1.37), any cataract (HR, 1.16; 95% CI, 1.03-1.32), diabetic retinopathy (HR per 1-step increase in 4-level severity, 1.36; 95% CI, 1.14-1.63), and visual impairment (HR, 1.24; 95% CI, 1.04-1.48) and marginally associated with increasing severity of Nuclear Sclerosis (HR, 1.07; 95% CI, 0.99-1.16). Age-related maculopathy and glaucoma were not associated with poorer survival. Associations tended to be slightly stronger in men than women. Conclusions Cataract, diabetic retinopathy, and visual impairment were associated with poorer survival and not explained by traditional risk factors for mortality. These ocular conditions may serve as markers for mortality in the general population.
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changes in refraction over 10 years in an adult population the beaver dam eye study
Investigative Ophthalmology & Visual Science, 2002Co-Authors: Kristine E Lee, Barbara E K Klein, Ronald Klein, Tien Yin WongAbstract:Purpose To quantify the 10-year change in refraction in persons more than 40 years of age. Methods All people 43 to 84 years of age and living in Beaver Dam, Wisconsin, in 1988 were invited for a baseline examination (1988-1990), a 5-year follow-up examination (1993-1995), and a 10-year follow-up examination (1998-2000). Refractions were determined according to the same protocol at all examinations. Aphakic and pseudophakic eyes and eyes with best corrected visual acuity of 20/200 or worse were excluded. After exclusions, refraction data were available on 2362 right eyes of the 2937 people examined at baseline and 10-year follow-up. Results Age was related to the direction and amount of change in refraction. Spherical equivalent became more positive in the youngest subjects and more negative in the oldest. After adjustment for the severity of Nuclear Sclerosis and other factors, the 10-year change in refraction was +0.48, +0.03, and -0.19 D for persons 43 to 59, 60 to 69 and 70+ years of age at the baseline examination, respectively. Severity of Nuclear Sclerosis was also strongly related to amount of change. Those with mild Nuclear Sclerosis at baseline had a change of +0.35 D, whereas those with severe Nuclear Sclerosis had a change of -0.53 D. The amount of change was also related to diabetes and weakly related to baseline refractive error, but was unrelated to gender and education. In addition to the longitudinal changes observed, there was a birth cohort effect. In comparing people of the same age across examinations, those born in more recent years had more myopia than those born in earlier years. Conclusions Significant changes in spherical equivalent in adults occur over a 10-year period. Younger people became more hyperopic, whereas older people became more myopic. These data provide evidence of a longitudinal change in refraction in adults, which may explain the refractive patterns observed in cross-sectional studies.
Kristine E Lee - One of the best experts on this subject based on the ideXlab platform.
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refraction and change in refraction over a 20 year period in the beaver dam eye study
Investigative Ophthalmology & Visual Science, 2018Co-Authors: Samantha M Bomotti, Barbara E K Klein, Priya Duggal, Ronald Klein, Kristine E Lee, Bryan Lau, Alison P. KleinAbstract:Purpose Hyperopic shifts in refraction have been consistently reported in adults over 40, followed by myopic shifts after age 70. Although potential factors underlying these changes in refraction in older adults have been investigated previously, the studies were restricted by the limited longitudinal data available. The authors of this study sought to better characterize the long-term trajectory of refraction in older adults using 20 years of prospective data. Methods The impact of cohort effects on refraction over 20 years was examined. Generalized estimating equations were used to evaluate the etiologic factors underlying refraction and changes in refraction measured over a 20-year period (1988-2010) among adults over age 40 from the Beaver Dam Eye Study. Results Only individuals with Nuclear cataract experienced a myopic shift in refraction, showing a 0.25 diopter (D) decrease (95% confidence interval [CI]: -0.44 D to -0.07 D) over a five-year period. Individuals with mild and moderate Nuclear Sclerosis showed varying degrees of hyperopic shifts over five years (0.22 D: 95% CI: 0.20 D-0.25 D; 0.23 D: 95% CI: 0.20 D-0.27 D, respectively). Conclusions Nuclear cataract is the primary contributor to the myopic shift among older individuals. Birth cohort effects on baseline refraction but not change in refraction were observed.
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changes in refraction over 10 years in an adult population the beaver dam eye study
Investigative Ophthalmology & Visual Science, 2002Co-Authors: Kristine E Lee, Barbara E K Klein, Ronald Klein, Tien Yin WongAbstract:Purpose To quantify the 10-year change in refraction in persons more than 40 years of age. Methods All people 43 to 84 years of age and living in Beaver Dam, Wisconsin, in 1988 were invited for a baseline examination (1988-1990), a 5-year follow-up examination (1993-1995), and a 10-year follow-up examination (1998-2000). Refractions were determined according to the same protocol at all examinations. Aphakic and pseudophakic eyes and eyes with best corrected visual acuity of 20/200 or worse were excluded. After exclusions, refraction data were available on 2362 right eyes of the 2937 people examined at baseline and 10-year follow-up. Results Age was related to the direction and amount of change in refraction. Spherical equivalent became more positive in the youngest subjects and more negative in the oldest. After adjustment for the severity of Nuclear Sclerosis and other factors, the 10-year change in refraction was +0.48, +0.03, and -0.19 D for persons 43 to 59, 60 to 69 and 70+ years of age at the baseline examination, respectively. Severity of Nuclear Sclerosis was also strongly related to amount of change. Those with mild Nuclear Sclerosis at baseline had a change of +0.35 D, whereas those with severe Nuclear Sclerosis had a change of -0.53 D. The amount of change was also related to diabetes and weakly related to baseline refractive error, but was unrelated to gender and education. In addition to the longitudinal changes observed, there was a birth cohort effect. In comparing people of the same age across examinations, those born in more recent years had more myopia than those born in earlier years. Conclusions Significant changes in spherical equivalent in adults occur over a 10-year period. Younger people became more hyperopic, whereas older people became more myopic. These data provide evidence of a longitudinal change in refraction in adults, which may explain the refractive patterns observed in cross-sectional studies.
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diabetes cardiovascular disease selected cardiovascular disease risk factors and the 5 year incidence of age related cataract and progression of lens opacities the beaver dam eye study
American Journal of Ophthalmology, 1998Co-Authors: Barbara E K Klein, Ronald Klein, Kristine E LeeAbstract:PURPOSE: To describe the relationships of diabetes mellitus, cardiovascular disease, and selected cardiovascular disease risk factors to cumulative incidence of age-related cataract and to progression of lens opacities over a 5-year interval. METHODS: A follow-up examination of the Beaver Dam Eye Study cohort was performed 5 years after the baseline evaluation. Ages at the census prior to baseline ranged from 43 to 84 years of age. Protocols for examination, lens photography, and grading were the same for both examinations. RESULTS: Age at baseline was the most significant characteristic associated with incidence of Nuclear, cortical, and posterior subcapsular cataract in those without diabetes (P < .001) for all cataracts. The positive association of age with cataract was found for Nuclear and cortical cataract in the worse eye (P ≤ .04) but not posterior subcapsular cataract in those with diabetes. Progression of Nuclear Sclerosis was common, occurring in about 70% of subjects when considering either eye. Incident cortical and posterior subcapsular cataracts (P ≤ .001 for worse eye for each lesion) and progression of cortical and posterior subcapsular opacities were more common in those with diabetes (P ≤ .001 for either eye for each lesion). Increased glycated hemoglobin level was associated with increased risk of Nuclear and cortical cataracts in those with diabetes. Relationships of risk factors to posterior subcapsular cataracts, especially among those with diabetes, were often in the expected direction but lacked significance possibly due to small samples. CONCLUSIONS: Diabetes mellitus is associated with incidence over 5 years of cortical and posterior subcapsular cataract and with progression of more minor cortical and posterior subcapsular lens opacities. These changes may be related to level of glycemia. Cardiovascular disease and its risk factors have little effect on incidence of any age-related cataract.
Alison P. Klein - One of the best experts on this subject based on the ideXlab platform.
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refraction and change in refraction over a 20 year period in the beaver dam eye study
Investigative Ophthalmology & Visual Science, 2018Co-Authors: Samantha M Bomotti, Barbara E K Klein, Priya Duggal, Ronald Klein, Kristine E Lee, Bryan Lau, Alison P. KleinAbstract:Purpose Hyperopic shifts in refraction have been consistently reported in adults over 40, followed by myopic shifts after age 70. Although potential factors underlying these changes in refraction in older adults have been investigated previously, the studies were restricted by the limited longitudinal data available. The authors of this study sought to better characterize the long-term trajectory of refraction in older adults using 20 years of prospective data. Methods The impact of cohort effects on refraction over 20 years was examined. Generalized estimating equations were used to evaluate the etiologic factors underlying refraction and changes in refraction measured over a 20-year period (1988-2010) among adults over age 40 from the Beaver Dam Eye Study. Results Only individuals with Nuclear cataract experienced a myopic shift in refraction, showing a 0.25 diopter (D) decrease (95% confidence interval [CI]: -0.44 D to -0.07 D) over a five-year period. Individuals with mild and moderate Nuclear Sclerosis showed varying degrees of hyperopic shifts over five years (0.22 D: 95% CI: 0.20 D-0.25 D; 0.23 D: 95% CI: 0.20 D-0.27 D, respectively). Conclusions Nuclear cataract is the primary contributor to the myopic shift among older individuals. Birth cohort effects on baseline refraction but not change in refraction were observed.
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heritability analysis of spherical equivalent axial length corneal curvature and anterior chamber depth in the beaver dam eye study
Archives of Ophthalmology, 2009Co-Authors: Alison P. Klein, Joan E Baileywilson, Priya Duggal, Ronald Klein, Bhoom Suktitipat, Barbara E K KleinAbstract:Objective To examine genetic influences for quantitative refraction. Spherical equivalent and its related binary traits of myopia and hyperopia are highly correlated within families. Many linkage regions have been reported for myopia, high myopia, and quantitative refraction. However, the measured phenotype of spherical equivalent is in large part dictated by the relationship between the underlying optical components of axial length, corneal curvature, and anterior chamber depth. Methods Using data from the fourth visit of the Beaver Dam Eye Study, we conducted familial correlation and heritability analysis of quantitative spherical equivalent, axial length, anterior chamber depth, and corneal curvature using data from 715 individuals in 189 pedigrees. Results Overall, every trait was highly heritable. Heritability estimates were 0.58 (SE 0.13) for spherical equivalent after adjustment for age, education, and Nuclear Sclerosis; 0.95 (SE 0.11) for corneal curvature after adjustment for height; 0.67 (SE 0.14) for axial length after adjustment for height and education; and 0.78 (SE 0.14) for anterior chamber depth after adjustment for age, education, height, and Nuclear Sclerosis. Conclusion Refraction and the underlying traits of axial length, corneal curvature, and anterior chamber depth are highly heritable. Genetic analysis of these traits may provide greater insight into the development of refractive errors.
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confirmation of linkage to ocular refraction on chromosome 22q and identification of a novel linkage region on 1q
Archives of Ophthalmology, 2007Co-Authors: Alison P. Klein, Priya Duggal, Joan E Baileywilson, Ronald Klein, Barbara E K KleinAbstract:Objective To localize genes influencing ocular refraction in subjects in the Beaver Dam Eye Study. Previous studies establish that myopia clusters within families and linkage to myopia has been demonstrated on 2q, 4q, 12q, 17q, 18q, 22q, and Xq. Few studies have examined genetic effects across the entire range of refraction, though linkages to 1p, 3q, 4q, 8p, and 11p have been reported, and our previous analysis of the Beaver Dam Eye Study demonstrated substantial heritability for refraction (68%). Methods We conducted nonparametric sibling-pair and genome-wide linkage analyses on spherical equivalent adjusting for age, education, and Nuclear Sclerosis, in 834 sibling pairs in 486 extended pedigrees. Results We identified a novel region of suggestive linkage on 1q (multipoint, P P = .0033) previously linked to myopia. Additionally, there was some evidence of linkage to 7p (multipoint, P = .0023). Conclusion Refraction is a complex trait influenced by both genes and environment. Our work confirms a previously reported linkage region on 22q and identifies 2 novel regions of linkage on 1q and 7p. Clinical Relevance Further, genetic research is needed to finemap this trait to identify the causative gene. Modifying the actions of such a gene might lead to a reduction in the risk of refractive error.
Tien Yin Wong - One of the best experts on this subject based on the ideXlab platform.
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changes in refraction over 10 years in an adult population the beaver dam eye study
Investigative Ophthalmology & Visual Science, 2002Co-Authors: Kristine E Lee, Barbara E K Klein, Ronald Klein, Tien Yin WongAbstract:Purpose To quantify the 10-year change in refraction in persons more than 40 years of age. Methods All people 43 to 84 years of age and living in Beaver Dam, Wisconsin, in 1988 were invited for a baseline examination (1988-1990), a 5-year follow-up examination (1993-1995), and a 10-year follow-up examination (1998-2000). Refractions were determined according to the same protocol at all examinations. Aphakic and pseudophakic eyes and eyes with best corrected visual acuity of 20/200 or worse were excluded. After exclusions, refraction data were available on 2362 right eyes of the 2937 people examined at baseline and 10-year follow-up. Results Age was related to the direction and amount of change in refraction. Spherical equivalent became more positive in the youngest subjects and more negative in the oldest. After adjustment for the severity of Nuclear Sclerosis and other factors, the 10-year change in refraction was +0.48, +0.03, and -0.19 D for persons 43 to 59, 60 to 69 and 70+ years of age at the baseline examination, respectively. Severity of Nuclear Sclerosis was also strongly related to amount of change. Those with mild Nuclear Sclerosis at baseline had a change of +0.35 D, whereas those with severe Nuclear Sclerosis had a change of -0.53 D. The amount of change was also related to diabetes and weakly related to baseline refractive error, but was unrelated to gender and education. In addition to the longitudinal changes observed, there was a birth cohort effect. In comparing people of the same age across examinations, those born in more recent years had more myopia than those born in earlier years. Conclusions Significant changes in spherical equivalent in adults occur over a 10-year period. Younger people became more hyperopic, whereas older people became more myopic. These data provide evidence of a longitudinal change in refraction in adults, which may explain the refractive patterns observed in cross-sectional studies.
