7 research outputs found

    A large genome-wide association study of age-related macular degeneration highlights contributions of rare and common variants.

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    This is the author accepted manuscript. The final version is available from Nature Publishing Group via http://dx.doi.org/10.1038/ng.3448Advanced age-related macular degeneration (AMD) is the leading cause of blindness in the elderly, with limited therapeutic options. Here we report on a study of >12 million variants, including 163,714 directly genotyped, mostly rare, protein-altering variants. Analyzing 16,144 patients and 17,832 controls, we identify 52 independently associated common and rare variants (P < 5 × 10(-8)) distributed across 34 loci. Although wet and dry AMD subtypes exhibit predominantly shared genetics, we identify the first genetic association signal specific to wet AMD, near MMP9 (difference P value = 4.1 × 10(-10)). Very rare coding variants (frequency <0.1%) in CFH, CFI and TIMP3 suggest causal roles for these genes, as does a splice variant in SLC16A8. Our results support the hypothesis that rare coding variants can pinpoint causal genes within known genetic loci and illustrate that applying the approach systematically to detect new loci requires extremely large sample sizes.We thank all participants of all the studies included for enabling this research by their participation in these studies. Computer resources for this project have been provided by the high-performance computing centers of the University of Michigan and the University of Regensburg. Group-specific acknowledgments can be found in the Supplementary Note. The Center for Inherited Diseases Research (CIDR) Program contract number is HHSN268201200008I. This and the main consortium work were predominantly funded by 1X01HG006934-01 to G.R.A. and R01 EY022310 to J.L.H

    Purified triamcinolone acetonide as antifibrotic adjunct in glaucoma filtering surgery

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    Item does not contain fulltextBACKGROUND: The purpose of this study is to compare the effects of mitomycin C (MMC) and triamcinolone acetonide (TAC) during and after glaucoma filtering surgery. METHODS: Retrospective interventional consecutive case series. All eyes underwent primary guarded trabeculectomy with either MMC or sub-Tenon TAC injection. Intraoperative and postoperative complications up to 5 years after the filtering surgery were evaluated. Differences between the two regimens were tested for statistical significance. RESULTS: A total of 64 trabeculectomies, of which 39 with MMC and 25 with TAC, were compared. At the 5-year follow-up examination three of the eyes treated with MMC (7.7 %) and none of the eyes treated with TAC had an intraocular pressure of more than 18 mmHg (p = 0.08). In the MMC group, three eyes required repeated glaucoma surgery (7.7 %; one trabeculectomy, one Baerveldt drainage implant, one cyclodiode laser treatment), while this was two eyes in the TAC group (8.0 %; one Baerveldt drainage implant, one cyclodiode laser treatment) (p = 0.97). CONCLUSION: The present study demonstrates that in primary trabeculectomy, the 5-year risk profiles of MMC and purified TAC are comparable, suggesting that as an antifibrotic agent TAC is at least as effective as MMC. Prospective randomized trials will need to confirm the agents' relative long-term benefits

    Development and validation of novel clinical endpoints in intermediate age-related macular degeneration in MACUSTAR

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    Background. Currently, no validated clinical endpoints for treatment studies exist for intermediate age-related macular degeneration (iAMD). Objective. The European MACUSTAR study aims to develop and clinically validate adequate clinical endpoints for future treatment studies in iAMD and to identify early determinants of disease progression to late stage AMD. Material and methods. The MACUSTAR study protocol was developed by an international consortium of researchers from academia, the pharmaceutical industry and medical device companies. The MACUSTAR project is funded by the Innovative Medicines Initiative 2 (IMI2) of the European Union. Results. The MACUSTAR study consists of a cross-sectional and a longitudinal investigation. A total of 750 subjects with early, intermediate and late AMD as well as control subjects with no signs of AMD will be included with a follow-up period of 3 years. Overall, 20 European study centers are involved. Conclusion. The MACUSTAR project will generate large high-quality datasets, which will allow clinical validation of novel endpoints for future interventional trials in iAMD. The aim is that these endpoints will be accepted as suitable for medication approval studies by the regulatory authorities and that understanding of the disease process will be improved

    Autonomic Nervous System: Adrenergic Agonists

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    Dynamo models of the solar cycle

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