Myopia (nearsightedness) is a highly common eye condition that is predominantly caused by an axial elongation of the eye. Myopia can usually be corrected with negative glasses, contact lenses, and/or laser refractive surgery. Unfortunately, however, high myopia (-6 diopters or more) can lead to structural changes in the retina and optic disc, resulting in sight-threat ening complications. Myopia results from an interplay between genetic and environmental risk factors (eg. nearwork, . higher educational level, playing outdoors). In this thesis, we studied 130.000 patients from myopia studies from all over the world. We discovered that one third of the European population is myopic. 1 in 3 persons with high myopia becomes blind or visually impaired over time. Furthermore, we identified 26 genetic factors for myopia and 9 for axial length. These genetic factors play a role in neurotransmission, ion transport, retinoic acid metabolism, extracellular matrix remodeling, and eye development. Additionally, we described the role of education (an environmental risk factor) in the development of myopia, and we provide compelling evidence of a gene-by-environment interaction; persons with a high genetic susceptibility and a high educational level are more likely to develop myopia than persons with only one of these two factors. The studies described in this thesis have provided considerable insight into the complex genetic and environmental factors that give rise to myopia and refractive error, and they have given us new directions for treating and/or preventing this rising health issue.

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C.C.W. Klaver (Caroline) , J.R. Vingerling (Hans)
Erasmus University Rotterdam
Financial support The studies described in this thesis were supported by the Netherlands Organization of Scientific Research (NWO) (Vidi 91796357 to C.C.W. Klaver), NWO Investments (175.010.2005.011, 911-03-012 to the Rotterdam Study), the Netherlands Genomics Initiative (NGI)/NWO (050-060-810 to the Rotterdam Study), Erasmus Medical Center and Erasmus University, Netherlands Organization for Health Research and Development (ZonMw), the Research Institute for Diseases in the Elderly (014-93-015, RIDE2), the Ministry of Education, Culture and Science, the Ministry for Health, Welfare and Sports, the European Commission (DG XII), the Municipality of Rotterdam, Center for Medical Systems Biology of NGI, UitZicht (2009-22, 2011-25, 2014-38), Stichting Combined Ophthalmic Research Rotterdam (1.3.0), CORRBI Biobank, Bayer Ophthalmology Research Award, Lijf en Leven, Stichting MD Fonds, Prof. Dr. Henkes Stichting, Stichting Nederlands Oogheelkundig Onderzoek, Swart van Essen, Bevordering van Volkskracht, Blindenhulp, Landelijke Stichting voor Blinden en Slechtzienden, Rotterdamse Vereniging voor Blindenbelangen, Stichting Blinden Penning, OOG, Algemene Nederlandse Vereniging ter Voorkoming van Blindheid, the Rotterdam Eye Hospital Research Foundation, Stichting Winckel-Sweep, Erasmus Trustfonds, Stichting Simonsfonds, Ter Meulen Fonds, Stichting Dondersfonds, Landelijke Stichting Blinden en Slechtzienden, Stichting Glaucoomfonds, Stichting tot Verbetering van het Lot der Blinden, Stichting Nelly Reef Fund, ANVVB, Blindenfonds, Medical Workshop, Zeiss, Laméris Ootech, Hoya, Thea Pharma, Allergan, Ophtec, Essilor, Bayer, Optical Low Vision Services, Topcon Europe, Alcon, and Novartis. Printing of this thesis was supported by Stichting Glaucoomfonds, Rotterdamse Vereniging voor Blindenbelangen, Erasmus MC, Landelijke Stichting voor Blinden en Slechtzienden, Prof. Dr. Henkes Stichting, Stichting Dondersfonds, J.E. Jurriaanse Stichting, Bayer, Thea Pharma, ChipSoft, and ABN Amro.
Erasmus MC: University Medical Center Rotterdam

Verhoeven, V.J.M. (2015, June 16). What causes myopia?. Erasmus University Rotterdam. Retrieved from http://hdl.handle.net/1765/78245