Predictors of response to intravitreal anti–vascular endothelial growth factor treatment of age-related macular degeneration

AR Shah, S Williams, CR Baumal, B Rosner… - American journal of …, 2016 - Elsevier
AR Shah, S Williams, CR Baumal, B Rosner, JS Duker, JM Seddon
American journal of ophthalmology, 2016Elsevier
Purpose To identify factors that influence visual and anatomic response to treatment with
intravitreal anti–vascular endothelial growth factor (VEGF) for neovascular age-related
macular degeneration (AMD). Design Observational cohort study. Methods Seventy-two
patients were included in this study. Best-corrected Snellen visual acuity (VA) and central
foveal thickness measured on optical coherence tomography (OCT) at time of treatment and
post-treatment follow-up visits were recorded. Associations between demographic …
Purpose
To identify factors that influence visual and anatomic response to treatment with intravitreal anti–vascular endothelial growth factor (VEGF) for neovascular age-related macular degeneration (AMD).
Design
Observational cohort study.
Methods
Seventy-two patients were included in this study. Best-corrected Snellen visual acuity (VA) and central foveal thickness measured on optical coherence tomography (OCT) at time of treatment and post-treatment follow-up visits were recorded. Associations between demographic, behavioral, and genetic risk factors and the 2 outcomes were analyzed using mixed-effects linear regression models. Two loci in complement factor H (CFH) were included in a risk score to determine the association between CFH risk and improvement in VA and central foveal thickness.
Results
There was a small improvement in VA following anti-VEGF treatment (mean: 3.7 ± 3.0 letters), which was not statistically significant. Significant improvement in VA was observed for the nonrisk CFH Y402H genotype (P < .001) and for a low CFH risk score (P = .019). Regarding the outcome of change in central foveal thickness, improvement was noted in all genotype groups, but reduction after treatment was significantly higher in the low CFH risk score group (P = .033). A significant improvement in mean VA was seen among smokers (P < .001), but this relationship was not observed for central foveal thickness.
Conclusion
After anti-VEGF therapy, significant improvement in VA was observed for low-risk CFH genotypes and subjects with a low risk score. There was a statistically significant reduction in central foveal thickness overall, and subjects with a low CFH risk score improved more than the high-risk group.
Elsevier