Abstract
Purpose :
To investigate whether the aqueous angiopoietin-like 4 (ANGPTL4) level correlates with clinical features in neovascular age-related macular degeneration (AMD).
Methods :
The control and study groups consisted of all consecutive patients who received senile cataract surgery or intravitreal ranibizumab injection for treatment-naïve neovascular AMD, respectively. The AMD group received three monthly ranibizumab injections followed by monthly pro re nata for at least 12 months. Aqueous ANGPTL4 and VEGF were measured at baseline and 4 weeks after the first injection. In the AMD group, best-corrected visual acuity (BCVA), and central subfield thickness (CST) were measured at baseline and at 12 months. The lesion area by fluorescein angiography were also measured and it included CNV leakage and one or more of the following in or adjacent to the location of CNV: serous pigment epithelial detachment, hemorrhage, and blocked fluorescence.
Results :
The AMD group (30 eyes) had higher baseline aqueous ANGPTL4 (4366 ± 3279 pg/ml) and VEGF levels (63.1 ± 31.6 pg/ml) than that of the controls (32 eyes) (1693 ± 750 pg/ml and 34.1 ± 13.7 pg/ml, respectively) (both P<0.001). Four weeks after the first intravitreal ranibizumab injection, just before the second injection, the aqueous levels of VEGF in the neovascular AMD group were below the limit of detection. This change relative to the baseline aqueous VEGF levels was statistically significant (P < 0.001). However, a similar change in aqueous ANGPTL4 levels at 4 weeks (3947 ± 2931 pg/ml) was not observed (P = 0.167). Even after multiple comparisons, baseline ANGPTL4 correlated with the lesion area at baseline and at 12 months (β = 0.503, R2 = 0.490, P = 0.040 and β = 0.410, R2 = 0.508, P = 0.026, respectively), and also correlated with the frequency of anti-VEGF injections during 12 months (r = 0.476, P=0.008).
Conclusions :
Aqueous ANGPTL4 levels correlated with the lesion area at baseline and at 12 months, and anti-VEGF treatment frequency. ANGPTL4 may be a potential diagnostic and/or therapeutic biomarker in the neovascular AMD.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.