Primary angle closure glaucoma (PACG) is a major cause of blindness worldwide. We conducted a genome-wide association study (GWAS) followed by replication in a combined total of 10,503 PACG cases and 29,567 controls drawn from 24 countries across Asia, Australia, Europe, North America, and South America. We observed significant evidence of disease association at five new genetic loci upon meta-analysis of all patient collections. These loci are at EPDR1 rs3816415 (odds ratio (OR) = 1.24, P = 5.94 × 10(-15)), CHAT rs1258267 (OR = 1.22, P = 2.85 × 10(-16)), GLIS3 rs736893 (OR = 1.18, P = 1.43 × 10(-14)), FERMT2 rs7494379 (OR = 1.14, P = 3.43 × 10(-11)), and DPM2-FAM102A rs3739821 (OR = 1.15, P = 8.32 × 10(-12)). We also confirmed significant association at three previously described loci (P < 5 × 10(-8) for each sentinel SNP at PLEKHA7, COL11A1, and PCMTD1-ST18), providing new insights into the biology of PACG.

Purpose : To assess perceptions and implications of COVID-19 across the spectrum of visual impairment (VI) and normally-sighted individuals Design : Prospective cross-sectional comparative study. Method : XXXXXX Setting : Institutional. Patients : 232 patients and their caregivers. Four groups were created based on better eye characteristics: blind (best-corrected distance visual acuity (BCDVA) < 3/60 or visual field < 10 central degrees), severe VI (3/60 ≤ BCDVA < 6/60, vertical cup-to-disc ratio ≥ 0.85 or neuroretinal rim width ≤ 0.1), moderate VI (6/60 ≤ BCDVA < 6/18), or no/mild VI (controls, BCDVA ≥ 6/18) based on International Classification of Diseases-10 criteria and Foster and Quigley's consensus definition of glaucoma. Procedure : Telephone questionnaires. Main Outcomes and Measures : Differences in perceptions and implications of COVID-19 across various levels of VI. Caregiver perceptions were a secondary outcome measure. Results : Survey was completed by 232 participants, with 58 participants in each VI group. Mean age was 58.9 years ± 13.2. Greater degrees of VI were associated with older age (P=0.008) and lower education level (P=0.046). Blind participants more commonly perceived vision as a risk factor for contracting COVID-19 (P=0.045), were concerned about access to healthcare (P<0.001), obtained news through word of mouth (P<0.001), and less commonly wore masks (P=0.003). Controls more commonly performed frequent handwashing (P=0.001), were aware of telemedicine (P=0.029), and had fewer concerns about social interactions (P=0.020) compared to groups with substantial VI. All caregivers reported more frequent patient care since COVID-19 began. Conclusions : The pandemic may have a disproportionate impact on the visually-impaired, and evidence-based assessments of COVID-19 health outcomes in this population are warranted.

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These results suggest that the aqueous cytokine levels of chronic PACG eyes differ significantly from nonglaucomatous eyes. This is the first study reporting significantly increased levels of eotaxin, MIP-1β, and IP-10 and lower levels of TNF-α, IL-5, IL-9, IL-17, and GM-CSF in chronic PACG patients, suggesting a plausible role of these inflammatory cytokines in its pathogenesis.