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Acta Ophthalmol. 2015 Nov;93(7):e541-9. doi: 10.1111/aos.12718. Epub 2015 May 19.

BAX and BCL-2 polymorphisms, as predictors of proliferative vitreoretinopathy development in patients suffering retinal detachment: the Retina 4 project.

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Instituto de Oftalmobiología Aplicada (IOBA-Retina Group), University of Valladolid, Valladolid, Spain.
Unidad de Medicina Molecular, Departamento de Medicina, University of Salamanca, Salamanca, Spain.
Instituto de Biología Molecular y Celular del Cáncer (IBMCC), Consejo Superior de Investigaciones Científicas (CSIC), Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, Salamanca, Spain.
University of Castilla La Mancha, Albacete, Spain.
Department of Sense Organs, Medical School, Hospital SanJoão, University of Porto, Porto, Portugal.
Moorfields Eye Hospital, National Institute of Health Research (NIHR), Biomedical Research Centre, London, UK.
Royal Hallamshire Hospital, University of Sheffield, Sheffield, UK.
Nuffield Laboratory of Ophthalmology, John Radcliffe Hospital, University of Oxford, Oxford, UK.
Rotterdam Eye Hospital, Erasmus Medical Center, University of Rotterdam, Rotterdam, The Netherlands.



To compare the distribution of BCL-2 -938C>A (rs2279115) and BAX -248G>A (rs4645878) genotypes among European subjects undergoing rhegmatogenous retinal detachment (RRD) surgery in relation to the further development of proliferative vitreoretinopathy (PVR).


A case-control gene association study, as a part of Retina 4 project, was designed. rs2279115 and rs4645878 polymorphisms were analysed in 555 samples from patients with RRD (134 with PVR secondary to surgery). Proportions of genotypes and AA homozygous groups of BCL-2 and BAX polymorphisms between subsamples were analysed in two phases. Genotypic and allelic frequencies were compared in global sample and in subsamples.


BAX: Differences were observed in the genotype frequencies and in AA carriers between controls and cases in the global series. The odds ratio (OR) of A carriers in the global sample was 1.7 (95% CI: 1.23-2.51). Proportions of genotypes in Spain + Portugal were significant different. The OR of A carriers from Spain and Portugal was 1.8 (95% CI: 1.11-2.95). BCL-2: No significant differences were observed in genotype frequencies. However, proportions of genotypes in Spain + Portugal were significant. A protective effect (OR: 0.6 95% CI: 0.43-0.96) was found in A carriers from Spain and Portugal.


Results suggest that A allele of rs4645878 could be a biomarker of high risk of developing PVR in patients undergoing RD surgery. The possible role of BCL-2 (inhibitor of necroptosis pathway) as a possible new target in PVR prophylaxis should be investigated.


Bcl-2; apoptosis; bax; necroptosis; proliferative vitreoretinopathy; retinal detachment

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