Objective To compare CYP1B1 and MYOC variants in a cohort of neonatal-onset (NO) and infantile-onset (IO) primary congenital glaucoma (PCG).
Methods This prospective observational study included 43 infants with PCG (14 NO and 29 IO) presenting between January 2017 and January 2019 with a minimum 1-year follow-up. CYP1B1 and MYOC genes were screened using Sanger sequencing with in-silico analysis of the variants using Polymorphism Phenotyping v.2 and Protein Variation Effect Analyser platforms. Allelic frequency was estimated using Genome Aggregation Database (gnomAd). Disease presentation and outcome were correlated to the genetic variants in both groups.
Results Babies with CYP1B1 mutations had more severe disease at presentation and worse outcomes. Six of 14 (42.8%) NO glaucoma and 5 of 29 (17.2%) IO harboured CYP1B1 mutations. Five of six babies in the NO group and three of five in the IO group harboured the variant c.1169G>A, [p.R390H]. They required more surgeries and had a poorer outcome. On in-silico analysis c.1169G>A, [p.R390H] scored very likely pathogenic. Two patients in the IO group who had the c.1294C>G, [p.L432V] variant had a good outcome. Five of 14 NO-PCG and 8 of 29 IO-PCG harboured the variant c.227G>A, [p.R76K] in the MYOC gene, which was scored benign by in-silico analysis, and was also found in 2 of 15 normal controls.
Conclusions Patients with CYP1B1 pathogenic variants had a poorer outcome than those without. We found more NO PCG babies with CYP1B1 mutations compared with IO PCG. This may be one of the reasons for NO PCG having a poorer prognosis compared with IO PCG.
- intraocular pressure
Data availability statement
Data are available upon reasonable request. All data relevant to the study are available on reasonable request.
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Contributors SK: concept, design of work, manuscript writing, critical revision of content and final approval of version to be published. Also, SK is accountable for all aspects of work in ensuring questions related to accuracy or integrity of any part of work are appropriately investigated and resolved. MLG and NS: genetic analysis, concept and design. DP, SPS, HK and AK: lab work of genetic component. DD, SS and FT: data collection, analysis and manuscript preparation. SSP: overall coordination and supervision.
Funding The parent institute supported this project, 'Postgraduate Institute of Medical Education and Research, Chandigarh, India' as an Intramural project. The grant received was only for the genetic testing involved.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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