Risk of Posterior Staphyloma in Highly Myopic Europeans : From Epidemiology to Anatomy. (MYOFORTE)

In this cross-sectionnal study the aim is to increase the understanding of posterior staphyloma through a unique European consortium. Therefore, all eligible patients that either visit the outpatient clinic at Radboud in Nimegen, the Netherlands, or visit University Hopital Puerta de HierroMajadahonda in Madrid, Spain, or visit University Hospital Cochin in Paris, France, and after consenting, will be included.

600 high myopic European cases are expecting. A standardized protocol in all centers in order to create a uniform dataset.

Besides the standard of care, blood samples will be collected.

All data collected will be stored in an onlie Castor database

Study Overview

• Status: Recruiting
• Conditions: High Myopia
• Intervention / Treatment: Biological: blood sampling for DNA

Detailed Description

Main objective: To characterize the phenotype, genetics and biology of myopic staphyloma in a European population (three countries involved).

Primary Outcome Measure:

The primary objective of this study is to identify genetic variants (SNPs) significantly associated with the presence of posterior staphyloma in individuals of European ancestry with high myopia.

A genome-wide association study (GWAS) will be conducted in 600 highly myopic Caucasian participants, divided into two well-phenotyped groups:

• 300 patients with posterior staphyloma (case group)
• 300 patients without posterior staphyloma (control group) SNP allele frequencies will be compared between the two groups using logistic regression models adjusted for relevant covariates (age, sex, axial length, and genetic ancestry via principal components).

The primary endpoint is the identification of SNPs s reaching genome wide significance (p < 5×10-⁸)after correction for multiple testing.

Secondary Outcome Measures:

1. Functional annotation and biological pathway enrichment of associated loci Genome-wide significant SNPs will undergo functional annotation to identify nearby genes, regulatory regions, or non-coding variants with putative biological function.

   Pathway and gene ontology enrichment analyses (e.g., KEGG, Reactome, GO) will be performed to highlight potential biological mechanisms contributing to posterior staphyloma pathogenesis.

2. Association with retinal imaging phenotypes Exploratory analyses will assess the relationship between genome wide significant variants and quantitative retinal imaging traits, including: subfoveal choroidal thickness,axial length,staphyloma depth, stpahyloma location, scleral curvature… These associations will be evaluated using multivariable linear regression models, adjusted for potential confounders.

3. Association with structural complications of posterior staphyloma Further exploratory analyses will investigate whether genome wide significant

   SNPs are associated with major strutural complications of posterier staphyloma, such as :

   macular atrophy,Bruch's membrane ruptures,choroidal neovascularization,foveoschisis, retinal detachment, visual fonction These analyses aim to uncover genetic markers linked to disease severity or progression

4. Differential expression of disease-relevant plasma/ serum protein biomarkers between groups, quantified by mass spectrometry, and correlated with clinical phenotype severity or progression (e.g., visual acuity loss, anatomical changes on OCT)
5. Efficiency and quality of iPSC reprogramming from peripheral blood mononuclear cells (PBMCs) in each study group, 4 individuals (1 male and 1 female myopic patient with staphyloma and 1 male and 1 female myopic patient without staphyloma, aged 30 to 35) assessed by reprogramming success rate, pluripotency marker expression, and genomic integrity. Derived iPSCs will be used differentiate retinal pigment epithelial cells in order to compare disease-relevant cellular phenotypes and functional responses in vitro.

• Study Type: Interventional
• Enrollment (Estimated): 200
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Valérie PLENCE, Msc; Phone Number: +33 01 58 41 11 78; Email: valerie.plence-fauroux@aphp.fr
• Study Contact Backup: Name: Francine Behar-Cohen, MD, PhD; Phone Number: +33 06 60 97 44 19; Email: francine.cohen@aphp.fr

Study Locations

• France
  • Paris, France, 75014
    • Recruiting
    • Cochin Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Adults with high myopia (axial length ≥ 26.00 mm or degree of myopia of at least -6 diopters), with and without posterior staphyloma

  • Adults aged 18 years or over
  • Patient with high myopia (axial length ≥ 26.00 mm or degree of myopia of at least -6 diopters), with good quality retinal imaging
  • Patient who has signed a consent form to participate in the study
  • Patient who is a beneficiary of a social security scheme or who is entitled to it

Exclusion Criteria:

• Any systemic or ocular pathologies with an impact on the posterior segment of the eye

  • Patient with a systemic pathology likely to affect the posterior segment of the eye:
  • Diabetes
  • Systemic inflammatory disease: sarcoidosis, rheumatoid arthritis, systemic lupus erythematosus, Horton's disease
  • Patients with retinitis pigmentosa
  • Patients with syndromic myopia
  • Patients with myopia associated with a genetic disease such as hereditary vitreoretinopathy
  • Patients under guardianship, curatorship or legal protection, as well as pregnant or breastfeeding women (article L1121-5 of the CSP).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: AM A : High Myopia without myopic staphyloma	Biological: blood sampling for DNA; Blood sampling for DNA and serum and plasma colection and PBMC
Active Comparator: ARM B : High myopia with myopic staphyloma	Biological: blood sampling for DNA; Blood sampling for DNA and serum and plasma colection and PBMC

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Differential gene expression between myopic patients with and without staphyloma	Genetic analysis	Through study completion, an average of 1 year.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Establish correlations between the phenotype and systemic molecular markers	Proteomic analysis in blood	Through study completion, an average of 1 year.
Compare phenotype of staphyloma between France and 2 other European countries: Netherlands and Spain	Retinal imaging	25 months

Collaborators and Investigators

• Sponsor: Assistance Publique - Hôpitaux de Paris
• Collaborators: URC-CIC Paris Descartes Necker Cochin
• Investigators: Principal Investigator: Francine BEHAR-COHEN, MD,PhD, Assistance Publique Hopitaux de Paris

Study record dates

Study Major Dates

• Study Start (Actual): February 2, 2026
• Primary Completion (Estimated): December 1, 2027
• Study Completion (Estimated): December 1, 2027

Study Registration Dates

• First Submitted: March 24, 2025
• First Submitted That Met QC Criteria: April 25, 2025
• First Posted (Actual): April 29, 2025

Study Record Updates

• Last Update Posted (Actual): March 31, 2026
• Last Update Submitted That Met QC Criteria: March 30, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: High myopia; Myopic staphyloma
• Additional Relevant MeSH Terms: Eye Diseases; Refractive Errors; Myopia; Investigative Techniques; Specimen Handling; Clinical Laboratory Techniques; Diagnostic Techniques and Procedures; Diagnosis; Punctures; Surgical Procedures, Operative; Nucleic Acids; Nucleic Acids, Nucleotides, and Nucleosides; Blood Specimen Collection; DNA
• Other Study ID Numbers: APHP240842

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No