PURPOSE. The S1 RNA binding domain 1 (SRBD1) and elongation of long-chain fatty acids family member 5 (ELOVL5) have been reported to be susceptibility genes for early-onset normaltension glaucoma (NTG). The present study we conducted to assess whether these genes were associated with primary open-angle glaucoma (POAG), including late-onset NTG and high-tension glaucoma (HTG). METHODS. Three hundred seventy Japanese patients with POAG, including 158 NTG and 212 HTG patients and 191 control subjects were analyzed for SRBD1 (rs3213787) and ELOVL5 (rs735860) gene polymorphisms. RESULTS. The A allele frequencies of rs3213787 were significantly higher in NTG (98.4%, P ϭ 0.0003) and HTG (97.6%, P ϭ 0.0013) patients than in the control subjects (92.7%). The A allele frequency was significantly higher (P ϭ 0.014), even though the NTG patients were limited to those diagnosed at ages older than 60 years. The POAG patients with the CC or CT risk genotypes of rs735860 were significantly older (P ϭ 0.032, analysis of variance, P ϭ 0.043 and P ϭ 0.015, respectively) than were the POAG patients with the TT genotype, and the frequency of a family history of glaucoma in POAG patients with the CC risk genotype was significantly higher (P ϭ 0.015) than that in POAG patients with the TT genotype. CONCLUSIONS. SRBD1 gene polymorphism is associated with the development of HTG as well as NTG, including late-onset NTG. Typical POAG associated with ELOVL5 gene polymorphism may have a late rather than an early onset. (Invest Ophthalmol Vis Sci. 2011;52:4626 -4629) G laucoma includes a group of eye disorders characterized by visual field defects, apoptosis of the retinal ganglion cells, and progressive degeneration of the optic nerve. Primary open-angle glaucoma (POAG) represents the most prevalent form of glaucoma and is clinically classified as high-tension glaucoma (HTG), in which elevated intraocular pressure (IOP) is a major feature, and normal-tension glaucoma (NTG), in which IOP is consistently within the statistically normal population range. It is recognized that POAG is a multifactorial disorder involving the role of multiple genes. 1 To date, mutations in three genes (myocilin, 2 optineurin, 3 and WD repeat domain 36 4 ) and several susceptibility gene polymorphisms, such as optic atrophy 1 5 and estrogen receptor beta, 6 have been reported to contribute to the development of POAG. However, these mutations and polymorphisms do not account for all POAG cases, and other unknown genetic factors are considered to contribute to the development of POAG. In the Japanese population, the prevalence of NTG is higher than in other ethnic populations (92% of Japanese patients with POAG have NTG), 7 and it is important to elucidate the genetic factors that are responsible for the development of NTG.To identify susceptibility genes for early-onset NTG, we previously performed a genome-wide association study with more than 500,000 single-nucleotide polymorphisms (SNPs; GeneChip Human Mapping 500K Array Set; Affymetrix Inc., Santa Clara, CA), ...