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Abstract
Central corneal thickness (CCT) is a highly heritable trait associated with complex eye diseases such as keratoconus and glaucoma. We perform a genome-wide association meta-analysis of CCT and identify 19 novel regions. In addition to adding support for known connective tissue-related pathways, pathway analyses uncover previously unreported gene sets. Remarkably, >20% of the CCT-loci are near or within Mendelian disorder genes. These included FBN1, ADAMTS2 and TGFB2 which associate with connective tissue disorders (Marfan, Ehlers-Danlos and Loeys-Dietz syndromes), and the LUM-DCN-KERA gene complex involved in myopia, corneal dystrophies and cornea plana. Using index CCT-increasing variants, we find a significant inverse correlation in effect sizes between CCT and keratoconus (r = −0.62, P = 5.30 × 10−5) but not between CCT and primary open-angle glaucoma (r = −0.17, P = 0.2). Our findings provide evidence for shared genetic influences between CCT and keratoconus, and implicate candidate genes acting in collagen and extracellular matrix regulation.
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1 Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
2 University of Bordeaux, Bordeaux Population Health Research Center, Bordeaux, France
3 Institute of Genetics and Molecular Medicine, Medical Research Council Human Genetics Unit, University of Edinburgh, Edinburgh, UK
4 Regenerative Medicine Institute and Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Cornea Genetic Eye Institute, Los Angeles, CA, USA
5 Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany; Department of Ophthalmology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
6 Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
7 Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
8 Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA; Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, USA
9 Biomedical Sciences Research Institute, Ulster University, Belfast, Northern Ireland, UK; Royal Victoria Hospital, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
10 Institute for Translational Genomics and Population Sciences and Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA; Division of Genomic Outcomes, Departments of Pediatrics and Medicine, Harbor-UCLA Medical Center, Torrance, CA, USA
11 Institute of Genetics and Molecular Medicine, Medical Research Council Human Genetics Unit, University of Edinburgh, Edinburgh, UK; Centre for Ophthalmology and Visual Science, University of Western Australia, Lions Eye Institute, Perth, WA, Australia
12 Department of Twin Research and Genetic Epidemiology, King’s College London, London, UK
13 Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK; NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
14 Faculty of Medicine, University of Split, Split, Croatia
15 Departments of Medicine and Epidemiology and Cardiovascular Health Research Unit, University of Washington, Washington, USA; The New York Academy of Medicine, New York, NY, USA
16 Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
17 Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
18 Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
19 University of Newcastle, Newcastle, NSW 2308, Australia
20 Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
21 NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
22 Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
23 Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Australia
24 Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
25 Department of Ophthalmology, Flinders University, Adelaide, Australia
26 Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, Mannheim, Germany
27 Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Mainz, Germany
28 Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA, USA
29 Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
30 Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
31 Institute of Genetics and Molecular Medicine, Medical Research Council Human Genetics Unit, University of Edinburgh, Edinburgh, UK; Centre for Global Health Research, Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
32 Department of Ophthalmology, Duke University Medical Center, Durham, NC, 27705 NC, USA
33 Center for Human Genetics, Marshfield Clinic Research Foundation, Marshfield, WI, USA
34 Department of Ophthalmology, University of North Carolina, Chapel Hill, NC, 27517 NC, USA
35 Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
36 Department of Ophthalmology, College of Medicine, University of Iowa, Iowa City, IA, 52242 IA, USA; Department of Anatomy/Cell Biology, College of Medicine, University of Iowa, Iowa City, IA, 52242 IA, USA
37 Wilmer Eye Institute, John Hopkins University, Baltimore, MD, 21287 MD, USA
38 Eye Doctors of Washington, Chevy Chase, MD, 20815 MD, USA
39 Scripps Genome Center, University of California at San Diego, San Diego, CA, 92037 CA, USA
40 Department of Ophthalmology, Duke University Medical Center, Durham, NC, 27705 NC, USA; Department of Medicine, Duke University Medical Center, Durham, NC, 27710 NC, USA
41 Department of Biostatistics, Harvard School of Public Health, Boston, MA, 02115 MA, USA
42 Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, 33136 FL, USA
43 Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, 48105 MI, USA
44 Department of Ophthalmology, Harvard Medical School and Massachusetts Eye and Ear Infirmary, Boston, MA, USA
45 Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, 33136 FL, USA
46 Department of Ophthalmology, WVU Eye Institute, Morgantown, WV, 26506 WV, USA
47 Department of Ophthalmology, UPMC Eye Center, University of Pittsburgh, Pittsburgh, PA, 15213 PA, USA
48 Department of Ophthalmology, Stanford University, Palo Alto, CA, 94303 CA, USA
49 Department of Ophthalmology, Mayo Clinic, Rochester, MN, 55905 MN, USA
50 Department of Genetics, Stanford University, Palo Alto, CA, 94305 CA, USA
51 Department of Ophthalmology, Hamilton Eye Center, University of California, San Diego, CA, 92093 CA, USA
52 Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK; Dept Statistics, University of Oxford, Oxford, UK
53 Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
54 Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Subiaco, WA, Australia; Cambridge Institute for Medical Research, University of Cambridge School of Clinical Medicine, Cambridge, UK
55 Department of Psychosis Studies, NIHR Biomedical Research Centre for Mental Health at the Institute of Psychiatry, King’s College London and The South London and Maudsley NHS Foundation Trust, London, UK
56 University of Queensland Diamantina Institute, Brisbane, QLD 4102, QLD, Australia
57 Dept Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK; Dept Epidemiology and Public Health, University College London, London, UK
58 Neuropsychiatric Genetics Research Group, Institute of Molecular Medicine, Trinity College Dublin, Dublin, Eire, Ireland
59 Molecular and Physiological Sciences, The Wellcome Trust, London, UK
60 Department of Oncology, Old Road Campus, University of Oxford, Oxford, UK; Digestive Diseases Centre, Leicester Royal Infirmary, Leicester, UK; Centre for Digestive Diseases, Queen Mary University of London, London, UK
61 Clinical Neurosciences, St George’s University of London, London, UK
62 King’s College London Dept Medical and Molecular Genetics, King’s Health Partners, Guy’s Hospital, London, UK
63 Biomedical Research Centre, Ninewells Hospital and Medical School, Dundee, UK
64 King’s College London Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, London, UK
65 Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
66 University of Cambridge Dept Clinical Neurosciences, Addenbrooke’s Hospital, Cambridge, UK
67 Dept Molecular Neuroscience, Institute of Neurology, London, UK
68 Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands; Netherlands Consortium for Healthy Ageing, Netherlands Genomics Initiative, The Hague, The Netherlands
69 Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia; School of Medicine, Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
70 Genome Institute of Singapore, Singapore, Singapore
71 Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA, USA; Department of Ophthalmology, Harvard Medical School and Massachusetts Eye and Ear Infirmary, Boston, MA, USA
72 Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Australia; Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia
73 Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands
74 Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
75 Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
76 Centre for Ophthalmology and Visual Science, University of Western Australia, Lions Eye Institute, Perth, WA, Australia
77 Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands