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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Invest+Ophthalmol+Vis+Sci
2015 ; 56
(4
): 2192-202
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
Risk Prediction for Progression of Macular Degeneration: 10 Common and Rare
Genetic Variants, Demographic, Environmental, and Macular Covariates
#MMPMID25655794
Seddon JM
; Silver RE
; Kwong M
; Rosner B
Invest Ophthalmol Vis Sci
2015[Apr]; 56
(4
): 2192-202
PMID25655794
show ga
PURPOSE: To determine the association between genetic variants and transition to
advanced age-related macular degeneration (AMD), and to develop a predictive
model and online application to assist in clinical decision making. METHODS:
Among 2951 subjects in the Age-Related Eye Disease Study, 834 progressed from no
AMD, early AMD, or intermediate AMD to advanced disease. Survival analysis was
used to assess which genetic, demographic, environmental, and macular covariates
were independently associated with progression. Attributable risk, area under the
curve statistics (AUCs), and reclassification odds ratios (ORs) were calculated.
Split-sample validation was performed. An online risk calculator was developed
and is available in the public domain at www.seddonamdriskscore.org. RESULTS: Ten
genetic loci were independently associated with progression, including newly
identified rare variant C3 K155Q (hazard ratio: 1.7, 95% confidence interval:
1.2-2.5, P = 0.002), three variants in CFH, and six variants in ARMS2/HTRA1, CFB,
C3, C2, COL8A1, and RAD51B. Attributable risk calculations revealed that 80% of
incident AMD is attributable to genetic factors, adjusting for demographic
covariates and baseline macular phenotypes. In a model including 10 genetic loci,
age, sex, education, body mass index, smoking, and baseline AMD status, the AUC
for progression to advanced AMD over 10 years was 0.911. Split-sample validation
showed a similar AUC (0.907). Reclassification analyses indicated that subjects
were categorized into a more accurate risk category if genetic information was
included (OR 3.2, P < 0.0001). CONCLUSIONS: Rare variant C3 K155Q was
independently associated with AMD progression. The comprehensive model may be
useful for identifying and monitoring high-risk patients, selecting appropriate
therapies, and designing clinical trials.