Proliferative diabetic retinopathy

disease
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Summary

Proliferative diabetic retinopathy (MONDO:0001660) is a disease with 4 cohort genes (44 GWAS associations across 4 studies) and 110 clinical trials. Top therapeutic interventions include bevacizumab, triamcinolone acetonide, and faricimab.

At a glance

  • Cohort genes: 4
  • GWAS associations: 44
  • Clinical trials: 110

Clinical features

No curated clinical features (Orphanet) for this disease.

Identifiers

Disease identifiers

FieldValue
Canonical nameproliferative diabetic retinopathy
Mondo IDMONDO:0001660
EFOEFO:0009322
DOIDDOID:13207
ICD-11348602398
NCITC84457
SNOMED CT59276001
UMLSC0154830
MedGen56347
Is cancer (heuristic)no

Data availability: 44 GWAS associations (4 studies).

Disease family

Classification path: disease › human disease › disease by body system or component › nervous system disorderretinal disorderretinal vascular disorderdiabetic retinopathyproliferative diabetic retinopathy

Related subtypes (2): background diabetic retinopathy, diabetic macular edema

Genetics & variants

GWAS landscape

44 GWAS associations across 4 studies. Top hits map to 22 distinct genes (as reported by GWAS).

Top associations by p-value

rsIDp-valueGeneRisk alleleOdds ratio
rs30812191e-09WDR72C1.29
rs1155238829e-09GOLIM4 - EGFEM1P?3.1
rs727404082e-08LINC01720 - HNRNPA1P46A1.52
rs1843407844e-08LINC01777 - LINC01646?
rs47260665e-08PRKAG2?
rs10653865e-08HLA-BC1.17
rs1379498236e-08NNT - RNU6-381P?2.33
rs2002956207e-08GOLIM4 - EGFEM1P?1.39
rs14144741e-07C1orf94?1.6
rs75331413e-07GPATCH2?1.47
rs783404933e-07RN7SL691P - RN7SL193P?1.66
rs784645343e-07DPP10?
rs11449644e-07CPM?1.49
rs713541955e-07ZFP82?1.5
rs730501715e-07NAALADL2?1.5
rs1149212305e-07STUM?1.9
rs10007087e-07SLC16A7?
rs741611907e-07Y_RNA - MIR378C?3.12
rs112013358e-07RPS3AP5 - LINC01519?1.3
rs1492018699e-07FN1-DT - LINC00607?5.57
rs732281991e-06CD96?2.78
rs114887111e-06LINC02814?1.43
rs1386836631e-06SEC11C - GRP?4.9
rs753481861e-06Y_RNA - MKNK2P1?1.9
rs76040161e-06COMMD1?2.5
rs20641961e-06TPT1P4 - UTRN?1.82
rs618118671e-06KCNN3?
rs1163960651e-06SNTB1-AS1 - RPL35AP19?
rs2015849911e-06ZNF572 - SQLE-DT?1.63
rs747056721e-06OC90?1.45

Top studies (by case count)

StudyLead authorYearCasesControlsTitle
GCST007289Pollack S20183982,848Multiethnic Genome-wide Association Study of Diabetic Retinopathy using Liability Threshold Modeling of Duration of Diabetes and Glycemic Control.
GCST007291Pollack S20183981,970Multiethnic Genome-wide Association Study of Diabetic Retinopathy using Liability Threshold Modeling of Duration of Diabetes and Glycemic Control.
GCST006283Graham PS20181760Genome-wide association studies for diabetic macular edema and proliferative diabetic retinopathy.
GCST008668Liu C2019640Genome-wide association study for proliferative diabetic retinopathy in Africans.

Variant details and genetic-evidence tiers

Tier distribution (top 50 variants)

TierVariants
Tier 1: coding2
Tier 2: splice/UTR0
Tier 3: regulatory0
Tier 4: intronic/intergenic40

MAF distribution

BucketVariants
common (>=0.05)29
low_freq (0.01-0.05)2
rare (<0.01)0
unknown11

Functional consequences

ConsequenceCount
intron_variant22
intergenic_variant18
missense_variant2

Top variants

rsIDChrPosAllelesMAFConsequenceGenep-valueTier
rs30812191553583969CAGAG>C,CAG0.13intron_variantWDR721e-09Tier 4: intronic/intergenic
rs1155238823168158417A>Gintergenic_variantGOLIM4 - EGFEM1P9e-09Tier 4: intronic/intergenic
rs727404081191136701G>A0.03intron_variantLINC01720 - HNRNPA1P462e-08Tier 4: intronic/intergenic
rs18434078414529823C>Tintergenic_variantLINC01777 - LINC016464e-08Tier 4: intronic/intergenic
rs47260667151625186G>A,Cintron_variantPRKAG25e-08Tier 4: intronic/intergenic
rs1065386631356770G>A,C,T0.43missense_variantHLA-B5e-08Tier 1: coding
rs137949823543743007G>A,C,T0.05intergenic_variantNNT - RNU6-381P6e-08Tier 4: intronic/intergenic
rs2002956203168172398AT>A,ATTintergenic_variantGOLIM4 - EGFEM1P7e-08Tier 4: intronic/intergenic
rs1414474134197810C>A,G0.05missense_variantC1orf941e-07Tier 1: coding
rs75331411217543535T>C,G0.05intron_variantGPATCH23e-07Tier 4: intronic/intergenic
rs78340493443636179C>A0.05intergenic_variantRN7SL691P - RN7SL193P3e-07Tier 4: intronic/intergenic
rs784645342115234275C>A,Gintron_variantDPP103e-07Tier 4: intronic/intergenic
rs11449641268944857G>A,C,T0.05intergenic_variantCPM4e-07Tier 4: intronic/intergenic
rs713541951936385416G>C0.05intergenic_variantZFP825e-07Tier 4: intronic/intergenic
rs730501713174801688G>A,C0.05intergenic_variantNAALADL25e-07Tier 4: intronic/intergenic
rs1149212301226595161G>A0.05intron_variantSTUM5e-07Tier 4: intronic/intergenic
rs10007081259689707C>A,T0.05intron_variantSLC16A77e-07Tier 4: intronic/intergenic
rs7416119010130737530A>G0.05intron_variantY_RNA - MIR378C7e-07Tier 4: intronic/intergenic
rs112013351085018443C>G,T0.05intergenic_variantRPS3AP5 - LINC015198e-07Tier 4: intronic/intergenic
rs1492018692215487796T>A,Cintergenic_variantFN1-DT - LINC006079e-07Tier 4: intronic/intergenic
rs732281993111597517G>A0.05intron_variantCD961e-06Tier 4: intronic/intergenic
rs114887111229105486C>T0.05intron_variantLINC028141e-06Tier 4: intronic/intergenic
rs1386836631859195550C>Tintergenic_variantSEC11C - GRP1e-06Tier 4: intronic/intergenic
rs753481861036782685T>C,Gintergenic_variantY_RNA - MKNK2P11e-06Tier 4: intronic/intergenic
rs7604016261965000T>A,C0.05intron_variantCOMMD11e-06Tier 4: intronic/intergenic
rs20641966144266047C>G,T0.05intron_variantTPT1P4 - UTRN1e-06Tier 4: intronic/intergenic
rs618118671154802768C>T0.05intron_variantKCNN31e-06Tier 4: intronic/intergenic
rs1163960658121117030T>A0.05intron_variantSNTB1-AS1 - RPL35AP191e-06Tier 4: intronic/intergenic
rs2015849918124979483CATT>Cintergenic_variantZNF572 - SQLE-DT1e-06Tier 4: intronic/intergenic
rs747056728132042380A>T0.05intron_variantOC901e-06Tier 4: intronic/intergenic

Genes & proteins

Mendelian disease overlap and somatic drivers

GenCC: 0 · Orphanet: 8 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0

Orphanet rare-disease linkage (cohort genes)

GeneOrphanet IDRare disease
WDR72Orphanet:100033Hypomaturation amelogenesis imperfecta
WDR72Orphanet:402041Autosomal recessive distal renal tubular acidosis
HLA-BOrphanet:117Behçet disease
HLA-BOrphanet:275798Pulmonary arterial hypertension associated with connective tissue disease
HLA-BOrphanet:29207Reactive arthritis
HLA-BOrphanet:3287Takayasu arteritis
HLA-BOrphanet:36426Stevens-Johnson syndrome
HLA-BOrphanet:397Giant cell arteritis

Cohort genes → proteins

4 cohort genes, 4 distinct canonical proteins.

Evidence partition

SubsetGenes
gwas_only4

Cohort genes (full)

SymbolHGNCEnsemblUniProtNameEvidence
WDR72HGNC:26790ENSG00000166415Q3MJ13WD repeat-containing protein 72gwas
GAP43HGNC:4140ENSG00000172020P17677Neuromodulingwas
HLA-BHGNC:4932ENSG00000234745P01889HLA class I histocompatibility antigen, B alpha chaingwas
NRXN3HGNC:8010ENSG00000021645Q9HDB5Neurexin-3-betagwas

Cohort function summary

Lead sentence per gene, UniProt-curated.

SymbolProtein nameFunction (lead sentence)
WDR72WD repeat-containing protein 72Plays a major role in formation of tooth enamel.
GAP43NeuromodulinThis protein is associated with nerve growth.
HLA-BHLA class I histocompatibility antigen, B alpha chainAntigen-presenting major histocompatibility complex class I (MHCI) molecule.
NRXN3Neurexin-3-betaNeuronal cell surface protein that may be involved in cell recognition and cell adhesion.

Protein-family classification

Druggable: 1 · Difficult: 1 · Unknown: 2 · Druggable fraction: 0.25

Family distribution

Cohort families vs a genome-wide background (hypergeometric, BH-FDR; fold = observed/expected). Counts kept; sorted by enrichment, so the catch-all Other/Unknown bucket no longer leads.

FamilyGenesFoldFDR
Antibody/Immunoglobulin17.3×0.318
Scaffold/PPI14.3×0.318
Other/Unknown20.9×0.769

Per-gene assignment

SymbolFamilyDruggable?ECInterPro (top 3)
WDR72Scaffold/PPInoWD40_rpt, WD40/YVTN_repeat-like_dom_sf, WD40_repeat_CS
GAP43Other/UnknownnoIQ_motif_EF-hand-BS, Neuromodulin, Neuromodulin_C
HLA-BAntibody/ImmunoglobulinyesMHC_I_a_a1/a2, Ig/MHC_CS, Ig_C1-set
NRXN3Other/UnknownnoLaminin_G, Neurexin-like, ConA-like_dom_sf

Expression context

Cohort genes with no expression data: 0.

4 cohort genes are a single-cell marker in ≥1 SCXA experiment.

Breadth distribution (Bgee present_calls)

BucketGenes
narrow (1-5 tissues)0
moderate (6-20)0
broad (>20)4
unknown0

Top tissues across cohort

TissueCohort genes
kidney epithelium1
pancreatic ductal cell1
renal medulla1
Brodmann (1909) area 101
cortical plate1
frontal pole1
blood1
granulocyte1
spleen1
cerebellar vermis1
substantia nigra pars compacta1
substantia nigra pars reticulata1

Per-gene tissue summary (top 30)

SymbolBgee breadthFANTOM5 breadthSCXATop tissues
WDR72139tissue_specificmarkerkidney epithelium, pancreatic ductal cell, renal medulla
GAP43209broadmarkerfrontal pole, Brodmann (1909) area 10, cortical plate
HLA-B134ubiquitousmarkerblood, spleen, granulocyte
NRXN3231ubiquitousmarkercerebellar vermis, substantia nigra pars compacta, substantia nigra pars reticulata

Protein interactions among cohort

Intra-cohort edges: 0.

Hub genes (top 10 by interactor count)

SymbolInteractor count
HLA-B3,209
GAP433,008
WDR721,126
NRXN3165

Structural data

PDB: 1 · AlphaFold-only: 3 · No structure: 0

Cohort genes with PDB structures (top 30)

SymbolUniProtPDB entries
HLA-BP01889237

AlphaFold-only cohort genes (top 30 by pLDDT)

SymbolUniProtpLDDT
WDR72Q3MJ1367.22
NRXN3Q9HDB559.75
GAP43P1767756.00

Function

Pathway analysis

Distinct Reactome pathways touched by cohort: 14. Enrichment computed across 4 evidence-associated genes (3 with Reactome annotation).

Pathways by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 3 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

PathwayCohort genesFoldFDRSample cohort genes
Endosomal/Vacuolar pathway1346.1×0.035HLA-B
DAP12 interactions1158.6×0.035HLA-B
Antigen Presentation: Folding, assembly and peptide loading of class I MHC1131.3×0.035HLA-B
Neurexins and neuroligins165.6×0.043NRXN3
Interferon alpha/beta signaling150.8×0.043HLA-B
ER-Phagosome pathway143.3×0.043HLA-B
Interferon gamma signaling141.8×0.043HLA-B
L1CAM interactions140.1×0.043GAP43
SARS-CoV-2 activates/modulates innate and adaptive immune responses129.7×0.048HLA-B
Immunoregulatory interactions between a Lymphoid and a non-Lymphoid cell129.1×0.048HLA-B
Axon guidance115.1×0.080GAP43
Nervous system development114.3×0.080GAP43
Neutrophil degranulation17.7×0.134HLA-B
Developmental Biology14.8×0.194GAP43

GO biological processes by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 4 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

GO termCohort genesFoldFDRSample cohort genes
axon choice point recognition12106.5×0.007GAP43
regulation of dendritic cell differentiation11404.3×0.007HLA-B
regulation of T cell anergy11053.2×0.007HLA-B
regulation of interleukin-12 production11053.2×0.007HLA-B
regulation of postsynaptic specialization assembly11053.2×0.007GAP43
protection from natural killer cell mediated cytotoxicity1702.2×0.008HLA-B
regulation of interleukin-6 production1421.3×0.010HLA-B
radial glial cell differentiation1383.0×0.010GAP43
detection of bacterium1351.1×0.010HLA-B
antigen processing and presentation of endogenous peptide antigen via MHC class Ib1324.1×0.010HLA-B
antigen processing and presentation of endogenous peptide antigen via MHC class I via ER pathway, TAP-independent1324.1×0.010HLA-B
axon regeneration1280.9×0.010GAP43
regulation of filopodium assembly1263.3×0.010GAP43
neuron cell-cell adhesion1247.8×0.010NRXN3
regulation of growth1234.1×0.010GAP43
vocalization behavior1221.7×0.010NRXN3
tissue regeneration1191.5×0.010GAP43
astrocyte differentiation1191.5×0.010GAP43
response to auditory stimulus1183.2×0.010GAP43
biomineral tissue development1162.0×0.011WDR72
positive regulation of T cell mediated cytotoxicity1127.7×0.013HLA-B
adult behavior1117.0×0.014NRXN3
cell fate commitment173.9×0.020GAP43
learning170.2×0.020NRXN3
social behavior168.0×0.020NRXN3
response to wounding155.4×0.024GAP43
defense response154.0×0.024HLA-B
phospholipase C-activating G protein-coupled receptor signaling pathway132.9×0.038GAP43
protein localization to plasma membrane127.2×0.044WDR72
axon guidance122.6×0.051NRXN3

Therapeutics

Drug target analysis

Approved (phase 4): 0 · Phase ≥3: 0 · Phased (≥1): 0 · Undrugged: 4

Druggability breadth: 2 of 4 evidence-associated genes (50%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).

Top cohort targets by molecule count

SymbolMoleculesMax phase
WDR7200
GAP4300
HLA-B00
NRXN300

Bioactivity and enzyme data

Enzyme cohort genes (≥1 EC): 0.

Cohort genes with ChEMBL bioactivity (full, sorted by assay count)

SymbolAssaysType breakdown
GAP431Binding:1
HLA-B1Binding:1

Pharmacogenomics

Cohort genes with a PharmGKB record: 4; with CPIC/DPWG dosing guidelines: 1.

Cohort genes with a CPIC/DPWG dosing guideline

SymbolCPIC guidelines
HLA-B1

Chemical tractability of cohort targets

0 approved/phased compounds have measured bioactivity against a cohort gene (and aren’t yet in disease-level trials). This is a research / tractability signal, NOT a therapeutic recommendation — a bioactivity row often reflects off-target or screening binding (e.g. promiscuous kinase inhibitors against a cohort kinase), implying no disease mechanism.

Druggability pyramid

Cohort genes binned by druggability tier (high → low):

TierDefinitionGenesSymbols
AApproved (phase 4 drug)0
BPhased (≥1) drug, not yet approved0
CDruggable family + PDB, no drug1HLA-B
DDruggable family + AlphaFold only, no drug0
EDifficult family or no structure, no drug3WDR72, GAP43, NRXN3

Undrugged target profiles

4 cohort genes are undrugged. Ranked by ‘starting-point quality’ (assay depth + drugged-partner adjacency).

SymbolChEMBL assaysDrugged partners (top 3)
WDR720
GAP431
HLA-B1
NRXN30

Clinical trials & evidence

Clinical trials

Clinical trials: 110.

Phase distribution (across all retrieved trials)

PhaseTrials
Not specified50
PHASE417
PHASE215
PHASE313
PHASE2/PHASE36
PHASE1/PHASE24
PHASE14
EARLY_PHASE11

Top trials by phase / activity

NCTPhaseStatusTitle
NCT07118670PHASE4ACTIVE_NOT_RECRUITINGHigh Dose Eylea for Proliferative Diabetic Retinopathy Outcomes
NCT00563043PHASE4TERMINATEDChanges in Electroretinogram and Contrast Sensitivity After PASCAL Treatment
NCT00563628PHASE4TERMINATEDChanges in Macular Thickness After Patterns Scan Laser
NCT00682240PHASE4COMPLETEDMorphological and Functional Retinal Changes Following Retinal Photocoagulation
NCT00802269PHASE4TERMINATEDPain Using Reduced Fluence Parameters in Photocoagulation for Diabetic Retinopathy.
NCT01025934PHASE4COMPLETEDIntravitreal Bevacizumab for Surgical Treatment of Severe Proliferative Diabetic Retinopathy
NCT01486771PHASE4UNKNOWNMacugen for Proliferative Diabetic Retinopathy Study With Extended Dosing (M-PDRS ED)
NCT01724385PHASE4COMPLETEDIntravitreal Bevacizumab for Proliferative Diabetic Retinopathy
NCT01854593PHASE4COMPLETEDProspective Randomized Controlled Study of Intravitreal Injection of Bevacizumab for Proliferative Diabetic Retinopathy
NCT01921192PHASE4UNKNOWNEffect of Folic Acid, Vitamin B6 and Vitamin B12 in Diabetic Retinopathy
NCT02005432PHASE4UNKNOWNPASCAL Laser Versus ETDRS Laser Associated With Intravitreal Ranibizumab (IVR) Versus Only IVR for Proliferative Diabetic Retinopathy
NCT02096874PHASE4COMPLETEDBevacizumab and Peripheral Retinal Changes on Wide Field Angiography in Diabetic Macular Edema
NCT02816710PHASE4COMPLETEDConbercept Injection in Treatment of Severe Proliferative Diabetic Retinopathy
NCT03506750PHASE4UNKNOWNDay Regimes of CONbercept on CytokinEs of PDR Patients Undergoing Vitrectomy - Trial (CONCEPT)
NCT04464694PHASE4UNKNOWNPre-vitrectomy Intravitreal Ranibizumab for Patients With Proliferative Diabetic Retinopathy Combined With Diabetic Macular Edema
NCT04674254PHASE4COMPLETEDMacular Perfusion Changes After Anti-VEGF Versus Targeted Retinal Photocoagulation in Proliferative Diabetic Retinopathy
NCT05514925PHASE4UNKNOWNCryoapplication Versus Anti-VEGF Before Diabetic Vitrectomy
NCT06790784PHASE3RECRUITINGFaricimab + PRP vs. Vitrectomy + Endolaser for Treatment of PDR
NCT00170742PHASE3TERMINATEDStudy to Assess the Efficacy and Safety of Monthly Octreotide Intramuscular Injections in Patients With Proliferative Diabetic Retinopathy After Lasercoagulation This Study is Not Being Conducted in the United States.
NCT00445003PHASE3COMPLETEDLaser-Ranibizumab-Triamcinolone for Proliferative Diabetic Retinopathy
NCT00516464PHASE3UNKNOWNEvaluation of Ranibizumab in Proliferative Diabetic Retinopathy (PDR) Requiring Vitrectomy
NCT00545870PHASE3COMPLETEDBevacizumab Versus Ranibizumab for Diabetic Retinopathy
NCT00600236PHASE3WITHDRAWNHLA and it Relation With the Development of Proliferative Diabetic Retinopathy in Mexican Population
NCT00600262PHASE2/PHASE3TERMINATEDIntravitreal Bevacizumab for Diabetic Retinopathy
NCT00656435PHASE3COMPLETEDBevacizumab and Long Acting Gas in Diabetic Vitrectomy
NCT00996437PHASE2/PHASE3COMPLETEDIntravitreal Ranibizumab for Vitreous Hemorrhage Due to Proliferative Diabetic Retinopathy (N)
NCT01489189PHASE3COMPLETEDPrompt Panretinal Photocoagulation Versus Ranibizumab+Deferred Panretinal Photocoagulation for Proliferative Diabetic Retinopathy
NCT01589718PHASE3WITHDRAWNA Study of the Safety, Tolerability, and Efficacy of IVT Pre-op 0.3mg Pegaptanib Sodium Versus Sham, for Management of Tractional Retinal Detachment and Vitreous Hemorrhage With Proliferative Diabetic Retinopathy
NCT01627977PHASE3COMPLETEDAssociation of Lutein, Zeaxanthin and Brilliant Blue in Chromovitrectomy
NCT01813773PHASE2/PHASE3COMPLETEDTreatment With Intravitreal Aflibercept Injection For Proliferative Diabetic Retinopathy, The A.C.T Study
NCT02157350PHASE3COMPLETEDThe Individually Marked Panretinal lasEr phoTokoagUlation for Proliferative Diabetic Retinopathy Study - DETECT
NCT02328118PHASE2/PHASE3UNKNOWN25-Gauge Vitrectomy With Ranibizumab or Triamcinolone Acetonide on Proliferative Diabetic Retinopathy in China
NCT02447185PHASE3UNKNOWN25-G Vitrectomy With Ranibizumab or Triamcinolone Acetonide on PDR in China-Randomized Clinical Trial
NCT02705274PHASE2/PHASE3COMPLETEDPRP vs Bevacizumab for PDR Treatment
NCT02858076PHASE2/PHASE3COMPLETEDAnti-VEGF vs. Prompt Vitrectomy for VH From PDR
NCT04278417PHASE3COMPLETEDStudy of Efficacy and Safety of Brolucizumab Versus Panretinal Photocoagulation Laser in Patients With Proliferative Diabetic Retinopathy
NCT05393284PHASE2ACTIVE_NOT_RECRUITINGPhase 2 Spectra Study to Evaluate the Safety and Efficacy of OPL-0401 in Patients With Diabetic Retinopathy
NCT00606138PHASE1/PHASE2COMPLETEDRanibizumab for Treatment of Persistent Diabetic Neovascularization Assessed by Wide-Field Imaging
NCT00668785PHASE2TERMINATEDIntravitreal Ranibizumab to Treat Macular Edema After Panretinal Photocoagulation (Phase II)
NCT00776763PHASE2COMPLETEDOcular Growth Factors Profile in Proliferative Retinopathies Before and After Intravitreal Bevacizumab

Drugs tested across these trials (top 30)

MoleculeMax phaseTrials referencing
BEVACIZUMAB412
TRIAMCINOLONE ACETONIDE43
FARICIMAB42
PEGAPTANIB SODIUM42
AFLIBERCEPT41
ALCOHOL41
BROLUCIZUMAB41
CANAKINUMAB41
RANIBIZUMAB41
CONBERCEPT33
MAXACALCITOL31
EMIXUSTAT HYDROCHLORIDE21
S-ROLIPRAM04
E13301