The role of systemic infection and response to Ranibizumab therapy for Age Related Macular Degeneration (AMD)

Abstract

 

Purpose

 

In the chronic neurodegenerative disease, Alzheimer’s disease, systemic inflammation has been associated with progression and relapse of the disease. Chronic and acute inflammation has also been implicated in choroidal angiogenesis and subsequent AMD development. We hypothesised that system inflammation may also alter the response of AMD to the anti-vascular endothelial growth factor (VEGF) agent Ranibizumab.

 

Methods

 

Patients attending the Southampton Eye Unit (SEU) for treatment of AMD with Ranibizumab were enrolled at their third loading intravitreal injection. Patients were seen monthly at their clinical review. Systemic illness, further anti-VEGF injections or changes to medication were noted. Each patient was enrolled for 6 months. Demographic information was obtained from casenotes and patient questionnaires. Recorded optical coherence tomography (OCT) scans provided objective evidence of CNV activity.

 

Results

 

Our initial demographic analysis did not show a relationship between administered Ranibizumab intravitreal injections and recorded systemic infections (p= 0.863). There was also no relationship between central macular thickness (CMT) change from baseline and patient reported systemic infection (p=0.270).

 

Conclusions

 

This analysis of demographic data showed no relationship between patient reported systemic infections and CMT. Further study of inflammatory cytokines may provide more direct / alternative evidence of the effect of systemic inflammation on CNV activation.

 

 

Mean change in CMT from baseline

 

 

Keywords: 412 age-related macular degeneration • 557 inflammation • 464 clinical (human) or epidemiologic studies: risk factor assessment