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Ophthalmic Molecular Genetics
May 2000

Myocilin Gln368stop Mutation and Advanced Age as Risk Factors for Late-Onset Primary Open-Angle Glaucoma

Author Affiliations

EDWIN M.STONEMD, PHDFrom the Istituto di Genetica Molecolare CNR, Alghero (Ms Casu and Drs Angius and Pirastu), Clinica Oculistica Università degli Studi di Verona, Verona (Drs Spinelli, Ghilotti, and Bonomi), Istituto di Ricerca sulle Talassemie ed Anemie Mediterranee CNR, Cagliari (Ms Loi and Dr Sole), IRCSS–Ospedale CSS–Servizio di Genetica Medica, S. Giovanni Rotondo, Foggia (Mr Totaro and Drs Zelante and Gasparini), and Clinica Oculistica Università degli Studi di Milano, Ospedale San Paolo (Dr Orzalesi), Italy.

Arch Ophthalmol. 2000;118(5):674-679. doi:10.1001/archopht.118.5.674

Background  Juvenile open-angle glaucoma has been found to be associated with molecular defects in the myocilin (MYOC) gene. Most of the defects are missense mutations located in the third exon. The Gln368stop mutation has recently been found in several cases of late-onset primary open-angle glaucoma (POAG).

Objective  To study the effect of glaucoma risk in a relatively homogeneous genetic population.

Methods  A clinical study was performed in all living members of a 5-generation family. DNA analysis was performed for studying association with genetic markers and identifying the mutation.

Results  We identified the Gln368stop molecular defect in 19 patients with POAG, 5 patients with ocular hypertension, and 22 healthy carriers. We compared affected and unaffected carriers based on age at onset and last examination, respectively. Besides the presence of 3 young patients with POAG (<40 years old), the number of glaucomatous patients in the advanced age group increased.

Conclusions  The penetrance of glaucoma increases with age in Gln368stop carriers, but some remain unaffected at advanced age and others are affected at an early age. This suggests that additional risk factors are operating within this family, which may be identified by a genome-wide linkage search in this large pedigree.

Clinical Relevance  The myocilin Gln368stop mutation shows a good genotype-phenotype correlation and should be investigated in all familiar cases of chronic POAG. This may be important for early diagnosis and periodical checkups of presymptomatic individuals belonging to these families.