Endophenotypes for Age-Related Macular Degeneration: Extending Our Reach into the Preclinical Stages of Disease

Journal of Clinical Medicine

Michael B. Gorin³  Daniel E. Weeks⁴  Robert V. Baron²  Yvette P. Conley¹  Maria C. Ortube³  Steven Nusinowitz³ 

[1]Department of Health Promotion, School of Nursing, University of Pittsburgh, Pittsburgh, PA 15213, USA

[2] E-Mail:

[3]Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA

[4] E-Mail:

[5]Department of Ophthalmology, David Geffen School of Medicine—UCLA, Stein Eye Institute, Los Angeles, CA 90095, USA

[6] E-Mails:

[7]Departments of Human Genetics and Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA

[8] E-Mail:

关键词: age-related macular degeneration;    endophenotype;    genetic risk;    preclinical diagnostics;    retinal function;    predictive modeling;   

DOI  :  10.3390/jcm3041335

来源: mdpi

【 摘 要 】

The key to reducing the individual and societal burden of age-related macular degeneration (AMD)-related vision loss, is to be able to initiate therapies that slow or halt the progression at a point that will yield the maximum benefit while minimizing personal risk and cost. There is a critical need to find clinical markers that, when combined with the specificity of genetic testing, will identify individuals at the earliest stages of AMD who would benefit from preventive therapies. These clinical markers are endophenotypes for AMD, present in those who are likely to develop AMD, as well as in those who have clinical evidence of AMD. Clinical characteristics associated with AMD may also be possible endophenotypes if they can be detected before or at the earliest stages of the condition, but we and others have shown that this may not always be valid. Several studies have suggested that dynamic changes in rhodopsin regeneration (dark adaptation kinetics and/or critical flicker fusion frequencies) may be more subtle indicators of AMD-associated early retinal dysfunction. One can test for the relevance of these measures using genetic risk profiles based on known genetic risk variants. These functional measures may improve the sensitivity and specificity of predictive models for AMD and may also serve to delineate clinical subtypes of AMD that may differ with respect to prognosis and treatment.

【 授权许可】

CC BY   
© 2014 by the authors; licensee MDPI, Basel, Switzerland.