Abstract
PURPOSE: To investigate the genetic relationships between primary open-angle glaucoma (POAG) and major visual pathways in the brain to better understand the neurological biology of glaucoma, which may facilitate the discovery of neuroprotective drug targets. METHODS: We assessed the relationship between POAG and the volumes of five visual pathway regions using genetic correlation and polygenic risk score (PRS). We further used Mendelian randomization (MR) to investigate the causal relationships. In addition, we used genome-wide association study (GWAS)-pairwise analysis to identify genomic segments with shared causal variants and summary data-based MR (SMR) to uncover potential causal genes shared between POAG and the visual brain regions. RESULTS: We found a weak but significant genetic correlation only between POAG and optic chiasm (OC) volume (rg = -0.094, P = 0.009). Similarly, PRS for none of the volumes of visual pathway regions showed a significant association with POAG, except for the OC volume (odds ratio = 0.96, P = 0.0003). In addition, no causal relationships were found between POAG and visual brain regions. The GWAS-pairwise analyses revealed several genomic segments with shared causal variants between POAG and the five brain regions; genetic loci implicated for OC included the CDKN2 gene family region. In addition, the SMR analyses identified five shared potential causal genes, including PHETA1, MAPKAPK5-AS1, and EEF1AKMT2. CONCLUSIONS: Our findings suggest a genetic overlap between POAG and the volumes of visual pathway regions, including shared candidate causal genes. Further investigations are required to elucidate the specific role of the shared genes in the etiology of POAG and to assess their potential as neuroprotective drug targets.