Sub-cellular level resolution of common genetic variation in the photoreceptor layer identifies continuum between rare disease and common variation

Photoreceptor cells (PRCs) are the light-detecting cells of the retina. Such cells can be non-invasively imaged using optical coherence tomography (OCT) which is used in clinical settings to diagnose and monitor ocular diseases. Here we present the largest genome-wide association study of PRC morphology to date utilising quantitative phenotypes extracted from OCT images within the UK Biobank. We discovered 111 loci associated with the thickness of one or more of the PRC layers, many of which had prior associations to ocular phenotypes and pathologies, and 27 with no prior associations. We further identified 10 genes associated with PRC thickness through gene burden testing using exome data. In both cases there was a significant enrichment for genes involved in rare eye pathologies, in particular retinitis pigmentosa. There was evidence for an interaction effect between common genetic variants, VSX2 involved in eye development and PRPH2 known to be involved in retinal dystrophies. We further identified a number of genetic variants with a differential effect across the macular spatial field. Our results suggest a continuum between common and rare variation which impacts retinal structure, sometimes leading to disease. Author summaryThe photoreceptor cells (PRCs) are found at the back of the retina and are responsible for detecting light and converting this to an electrical signal. Examination of these cells using optical coherence tomography (OCT) is often used to aid diagnosis and monitor several eye diseases including age-related macular degeneration and retinal dystrophies. Here we harnessed the large scale of the UK Biobank to study genetic effects on the thickness of the PRC layers, a measure extracted from the OCT images. We found a large number of common genetic variants associated with these measures, many of which are in or near genes known to be involved in eye biology or eye diseases. In particular we found many genetic variants associated with PRC thickness that are in or near genes known to be involved in a set of rare diseases called retinal dystrophies. We also found that the interaction of two of these genetic variants has an effect on the PRC layer thickness. Overall, we provided evidence for a relationship between common genetic variation, and both common and rare variation in retinal biology.

Automated summary

We conducted the largest genome-wide association study of photoreceptor cell (PRC) morphology to date using optical coherence tomography (OCT). We identified 111 loci associated with PRC thickness, many of which had prior associations to ocular phenotypes and pathologies. We also discovered 10 genes associated with PRC thickness through gene burden testing using exome data. These findings provide evidence for a relationship between common and rare genetic variation in retinal biology.