title: Impact of loading phase, initial response and CFH genotype on the long-term outcome of treatment for neovascular age-related macular degeneration.
abstract: OBJECTIVE
  Factors influencing the outcome of anti-VEGF treatment in neovascular AMD are still investigated. We analyzed the impact of a loading phase, the significance of an initial response for the long-term and the effect of the CFH polymorphism (p.His402Tyr) on treatment outcome.
  
  
  METHODS
  Patients treated with ranibizumab for neovascular AMD were analyzed over a period of 24 months by assessing effects of loading phase, initial response and genotype of CFH rs1061170 (c.1204C>T, p.His402Tyr).
  
  
  RESULTS
  204 eyes were included. A change of +5.0 [-1;+11] letters and +1.5 [-5.5;+9.5] was observed with a median of 4 [3]; [7] and 10 [7]; [14] ranibizumab injections during 12 and 24 months, respectively. Loading phase was no significant predictor for treatment as VA outcome in eyes with and without loading phase was similar (p = 0.846 and p = 0.729) at 12 and 24 months. In contrast, initial response was a significant predictor for improving vision of 5 or more letters at 12 (p = 0.001; OR = 6.75) and 24 months (p = 0.01; OR = 4.66). Furthermore, the CT genotype at CFH rs1061170 was identified as a significant predictor for a favorable VA outcome at 12 and 24 months (OR = 6.75, p = 0.001 and OR = 4.66, p = 0.01).
  
  
  CONCLUSIONS
  Our data suggest that clinical decisions regarding treatment may be guided by observing patients' initial response as well as their genotype of SNP rs1061170, while the criterion of loading phase may not bear the customary value.
authors: Department of Ophthalmology, University Hospital of Zurich, Zurich, Switzerland. moreno@menghini.biz
authors: Moreno
authors: M
authors: Menghini
authors: Barbara
authors: B
authors: Kloeckener-Gruissem
authors: Johannes
authors: J
authors: Fleischhauer
authors: Malaika M
authors: MM
authors: Kurz-Levin
authors: Florian K P
authors: FK
authors: Sutter
authors: Wolfgang
authors: W
authors: Berger
authors: Daniel
authors: D
authors: Barthelmes
mesh_terms: D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use*; D020256:Choroidal Neovascularization / Q000150:complications*; D017242:Complement Factor H / Q000235:genetics*; D005260:Female; D005838:Genotype; D006801:Humans; D008268:Macular Degeneration / Q000150:complications* / Q000188:drug therapy* / Q000235:genetics / Q000503:physiopathology; D008297:Male; D000069579:Ranibizumab; D020127:Recovery of Function / Q000187:drug effects / Q000235:genetics; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D017242:Complement Factor H; D000069579:Ranibizumab