title: Genetic variants in pigment epithelium-derived factor influence response of polypoidal choroidal vasculopathy to photodynamic therapy.
abstract: OBJECTIVE
  To investigate whether photodynamic therapy (PDT) outcomes of polypoidal choroidal vasculopathy (PCV) are related to baseline clinical characteristics, smoking history, or genetic factors by analyzing the retreatment-free period after the first PDT.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  The study consisted of 167 patients with PCV who underwent PDT as their first treatment.
  
  
  METHODS
  We targeted 638 single nucleotide polymorphisms (SNPs) in 42 possible susceptible genes for age-related macular degeneration to evaluate their relation to the effectiveness of PDT for PCV. For this evaluation, we used 2 methods: (1) survival analysis, with the retreatment-free period as the target; and (2) logistic regression test between the need for additional therapy within 3 months after the first PDT and the genotypes, with age, gender, smoking status, and greatest linear dimension (GLD) at baseline as covariates. The contributions of smoking status and GLD at baseline for the retreatment-free period also were evaluated. Contributions of these factors to visual prognosis were evaluated for 1 year after PDT.
  
  
  METHODS
  Retreatment-free period after the first PDT for PCV. Secondary outcome measures included correlation of the susceptible factor to the retreatment requirement within the 3-month follow-up and the mean visual acuity change.
  
  
  RESULTS
  In survival analyses, SERPINF1 rs12603825 showed a significant association with the retreatment-free period after the first PDT; those patients homozygous for the minor allele A of rs12603825 received additional treatment after PDT within significantly shorter times than those with other genotypes (P = 0.0038). There was no significant difference in the retreatment-free period between baseline GLD and smoking status. Retreatment within 3 months was required significantly more in patients with the AA genotype, even after taking into consideration the effect of clinical characteristics (age, gender), baseline PCV lesion size, and smoking status (P = 0.0027). Furthermore, patients with the AA genotype showed significantly worse visual prognosis after PDT (P = 0.013).
  
  
  CONCLUSIONS
  Pigment epithelium-derived factor (SERPINF1 or PEDF) polymorphisms may influence the initial response to and visual prognosis after PDT for PCV. Our findings may lead to understanding the pathogenesis of PCV and modification of the effects of PDT.
authors: Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Isao
authors: I
authors: Nakata
authors: Kenji
authors: K
authors: Yamashiro
authors: Ryo
authors: R
authors: Yamada
authors: Norimoto
authors: N
authors: Gotoh
authors: Hideo
authors: H
authors: Nakanishi
authors: Hisako
authors: H
authors: Hayashi
authors: Akitaka
authors: A
authors: Tsujikawa
authors: Atsushi
authors: A
authors: Otani
authors: Sotaro
authors: S
authors: Ooto
authors: Hiroshi
authors: H
authors: Tamura
authors: Masaaki
authors: M
authors: Saito
authors: Kuniharu
authors: K
authors: Saito
authors: Tomohiro
authors: T
authors: Iida
authors: Akio
authors: A
authors: Oishi
authors: Yasuo
authors: Y
authors: Kurimoto
authors: Fumihiko
authors: F
authors: Matsuda
authors: Nagahisa
authors: N
authors: Yoshimura
mesh_terms: D000368:Aged; D002829:Choroid / Q000098:blood supply; D015862:Choroid Diseases / Q000188:drug therapy / Q000235:genetics*; D015331:Cohort Studies; D005136:Eye Proteins / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D014644:Genetic Variation; D006801:Humans; D008297:Male; D009414:Nerve Growth Factors / Q000235:genetics*; D010778:Photochemotherapy; D020641:Polymorphism, Single Nucleotide; D011127:Polyps / Q000188:drug therapy / Q000235:genetics*; D011379:Prognosis; D019233:Retreatment; D012189:Retrospective Studies; D015843:Serpins / Q000235:genetics*; D012907:Smoking; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000188:drug therapy / Q000235:genetics*; D000099174:Pigment Epithelium-Derived Factor
chemical_list: D005136:Eye Proteins; D009414:Nerve Growth Factors; D015843:Serpins; D000099174:Pigment Epithelium-Derived Factor