title: VEGF-A polymorphisms predict short-term functional response to intravitreal ranibizumab in exudative age-related macular degeneration.
abstract: OBJECTIVE
  To investigate the association between VEGF gene SNPs and early response to intravitreal ranibizumab for exudative age-related macular degeneration.
  
  
  METHODS
  Sixty-four patients (64 eyes) were prospectively enrolled and treated for neovascular age-related macular degeneration with ranibizumab monotherapy. Visual acuity was measured using the ETDRS chart. A loading phase of 3 monthly intravitreal injections of ranibizumab 0.5 mg/0.05 ml was performed. The analyzed VEGF-A gene SNPs were rs699947 (-2578A/C) and rs1570360 (-1154G/A); the allelic discrimination was performed in real-time PCR platform. The difference of best corrected visual acuity (ETDRS letters) read before and after treatment was considered as functional outcome.
  
  
  RESULTS
  Ranibizumab was significantly more effective as measured by best corrected visual acuity in patients harboring the VEGF-A -2578C allele (from +6.26 to +7.44 ETDRS letters), whereas patients carrying the VEGF-A -2578AA genotype revealed an absence of early functional response to ranibizumab (-1.78 ETDRS letters; p = 0.0192).
  
  
  CONCLUSIONS
  This study suggests that the VEGF-A -2578A/C SNP may represent an important molecular determinant of the early functional outcome of ranibizumab. Original submitted 3 December 2012; Revision submitted 18 February 2013.
authors.affiliation: Ophthalmology Unit, University of Pisa, Pisa, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Lazzeri
authors.forename: Michele
authors.initials: M
authors.lastname: Figus
authors.forename: Paola
authors.initials: P
authors.lastname: Orlandi
authors.forename: Anna
authors.initials: A
authors.lastname: Fioravanti
authors.forename: Teresa
authors.initials: T
authors.lastname: Di Desidero
authors.forename: Elisa
authors.initials: E
authors.lastname: Agosta
authors.forename: Maria Sole
authors.initials: MS
authors.lastname: Sartini
authors.forename: Chiara
authors.initials: C
authors.lastname: Posarelli
authors.forename: Marco
authors.initials: M
authors.lastname: Nardi
authors.forename: Romano
authors.initials: R
authors.lastname: Danesi
authors.forename: Guido
authors.initials: G
authors.lastname: Bocci
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D005260:Female; D005838:Genotype; D006801:Humans; D058449:Intravitreal Injections / Q000379:methods; D008268:Macular Degeneration / Q000188:drug therapy* / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D011446:Prospective Studies; D000069579:Ranibizumab; D042461:Vascular Endothelial Growth Factor A / Q000235:genetics*
chemical_list: D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab