Genetic Factors Associated With Early Response To Intravitreal Ranibizumab Treatment In Korean Neovascular Age-related Macular Degeneration Patients

Abstract

 

Purpose:

 

To investigate the association between genetic risk variants for age-related macular degeneration (AMD) and early response to intravitreal ranibizumab treatment in Korean neovascular AMD patients.

 

Methods:

 

Genotype analysis for 23 single-nucleotide polymorphisms within 14 genes was performed in patients with subfoveal choroidal neovascularization secondary to AMD. The patients underwent three monthly injections (month 0, 1, 2) of intravitreal ranibizumab and were prospectively followed up to 3 months after the third injection (month 5) with monthly ETDRS vision, optical coherence tomography, angiography and additional injections when retreatment criteria were met. Visual acuity (VA) improvement of ≥2 lines from baseline and angiographic improvement were considered as good responses to treatment. For each polymorphism, risk allele frequency was compared according to the visual and angiographic responses at month 5. In addition, rates of good responses were compared between genotypes, and logistic regression analysis with adjustment for age, sex, baseline VA and central retinal thickness (CRT), smoking history and additional injection after treatment was performed.

 

Results:

 

A total of 280 Korean patients (280 eyes) were enrolled. After ranibizumab treatment, VA improved by 9.5 ± 18.9 letters and CRT decreased by 65.9 ± 113.5 µm (P < 0.001 for both). No polymorphism revealed significant differences in the risk allele frequencies between the response groups. However, logistic regression showed that patients with the homozygous risk genotype for VEGFA rs699947 had an increased chance of good response at month 5 compared with other genotypes (Odds ratio, 2.85; 95% confidence interval, 1.17-6.95; P = 0.022, unadjusted for multiple tests).

 

Conclusions:

 

In this Korean neovascular AMD cohort, we observed some evidence of association between VEGFA genetic variants and early visual outcome following ranibizumab treatment.

 

Keywords: age-related macular degeneration • choroid: neovascularization