A new polygenic score for refractive error improves detection of children at risk of high myopia but not the prediction of those at risk of myopic macular degeneration

February 12, 2026
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AUTHORS

Rosie Clark, Samantha Sze-Yee Lee, Ran Du, Yining Wang, Sander C M Kneepkens, Jason Charng, Yu Huang, Michael L Hunter, Chen Jiang, J Willem L Tideman, Ronald B Melles, Caroline C W Klaver, David A Mackey, Cathy Williams, Hélène Choquet, Kyoko Ohno-Matsui, Jeremy A Guggenheim, CREAM Consortium, UK Biobank Eye and Vision Consortium

EBioMedicine. 2023 May;91:104551. doi: 10.1016/j.ebiom.2023.104551. Epub 2023 Apr 11.

ABSTRACT

BACKGROUND: High myopia (HM), defined as a spherical equivalent refractive error (SER) ≤ -6.00 diopters (D), is a leading cause of sight impairment, through myopic macular degeneration (MMD). We aimed to derive an improved polygenic score (PGS) for predicting children at risk of HM and to test if a PGS is predictive of MMD after accounting for SER.

METHODS: The PGS was derived from genome-wide association studies in participants of UK Biobank, CREAM Consortium, and Genetic Epidemiology Research on Adult Health and Aging. MMD severity was quantified by a deep learning algorithm. Prediction of HM was quantified as the area under the receiver operating curve (AUROC). Prediction of severe MMD was assessed by logistic regression.

FINDINGS: In independent samples of European, African, South Asian and East Asian ancestry, the PGS explained 19% (95% confidence interval 17-21%), 2% (1-3%), 8% (7-10%) and 6% (3-9%) of the variation in SER, respectively. The AUROC for HM in these samples was 0.78 (0.75-0.81), 0.58 (0.53-0.64), 0.71 (0.69-0.74) and 0.67 (0.62-0.72), respectively. The PGS was not associated with the risk of MMD after accounting for SER: OR = 1.07 (0.92-1.24).

INTERPRETATION: Performance of the PGS approached the level required for clinical utility in Europeans but not in other ancestries. A PGS for refractive error was not predictive of MMD risk once SER was accounted for.

FUNDING: Supported by the Welsh Government and Fight for Sight (24WG201).

PMID:37055258 | PMC:PMC10203044 | DOI:10.1016/j.ebiom.2023.104551

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