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Physician: Strong association between mt-1 variant, glaucoma progression

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LAS VEGAS — The mt-1 variant of the myocilin gene is present in about 15% of individuals with progressing primary open-angle glaucoma, according to Jon R. Polansky, MD.

Using a Cox proportional hazard model, results from retrospective studies have shown that “the greatest risk factor for [glaucoma progression] was having this particular variant,” Dr. Polansky said here at the First Annual Ocular Surgery News Symposium — Glaucoma: Improving Your Odds. “We found a clear and statistically strong association for the mti-1 genotype and glaucoma progression using optic disc and visual field measurements of severity, controlling for glaucoma risk factors.”

According to Dr. Polansky the practical aspect of this discovery is that an mt-1 test could be offered to a patient and they could decide for themselves to get this test done.

A positive for the mt-1 variant, also known as TIGR/MYOC, could alter patient management. That is, “closer monitoring of disc, field and IOP and more aggressive treatment to lower IOP would become a factor in considering selecting a lower target pressure and would justify expense and effort involved,” Dr. Polansky said.

The results and conclusions of the work of Dr. Polansky and co-authors R.P. Juster, PhD, and George L. Spaeth, MD, will be published next month in the Journal of Clinical Genetics.