title: Influence of seasonal sunlight intensity and iris color on the anti-VEGF therapy for neovascular age-related macular degeneration.
abstract: OBJECTIVE
  To investigate the influence of seasonal light intensity and patients' iris color on the visual recovery after anti-vascular endothelial growth factor (VEGF) therapy with ranibizumab or bevacizumab for neovascular age-related macular degeneration (AMD).
  
  
  METHODS
  The visual acuity of 555 eyes (529 patients) with neovascular AMD was evaluated after intravitreal injections of either ranibizumab or bevacizumab in respect to global radiation intensity and iris color.
  
  
  RESULTS
  The functional results during anti-VEGF therapy revealed a seasonal oscillation with a negative correlation between visual recovery and global radiation intensity (R(2)=-0.756, P=0.004). Although the influence of the sunlight intensity on the visual recovery was significant after the first injection, this effect vanished within the continuous course of treatment. Regarding the improvement of functional recovery depending on iris color, dark-colored eyes (16.0%) gained 8.5 ± 10.0 letters after the first injection and 9.9 ± 12.8 letters after the second injection, compared with 3.4 ± 8.6 letters and 4.4 ± 11.0 letters in light-colored eyes (84.0%), respectively (P=0.005 and P=0.019).
  
  
  CONCLUSIONS
  Our results indicate that seasonal sunlight intensity and iris color might influence the visual recovery of neovascular AMD patients undergoing anti-VEGF therapy. Our findings may be used as suggestions to refine individual anti-VEGF therapy regimens, especially in patients with light-colored eyes.
authors.affiliation: Department of Ophthalmology, Charité - University Medicine Berlin, Berlin, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Brockmann
authors.forename: T
authors.initials: T
authors.lastname: Brockmann
authors.forename: J
authors.initials: J
authors.lastname: Dawczynski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D005127:Eye Color / Q000502:physiology*; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D020127:Recovery of Function / Q000502:physiology; D012621:Seasons; D013472:Sunlight; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab
references.citation: N Engl J Med. 2006 Oct 5;355(14):1419-31
references.pmid: 17021318
references.citation: Ophthalmologica. 2012;227 Suppl 1:2-10
references.pmid: 22517120
references.citation: Invest Ophthalmol Vis Sci. 1990 Aug;31(8):1592-8
references.pmid: 2201662
references.citation: Stroke. 1996 Oct;27(10):1774-9
references.pmid: 8841328
references.citation: Invest Ophthalmol Vis Sci. 2011 Jul 01;52(7):4694-702
references.pmid: 21282580
references.citation: Eye (Lond). 2012 Jul;26(7):950-7
references.pmid: 22562185
references.citation: Ophthalmology. 2012 Dec;119(12):2537-48
references.pmid: 23084240
references.citation: N Engl J Med. 2006 Oct 5;355(14):1432-44
references.pmid: 17021319
references.citation: Ophthalmology. 2013 Jan;120(1):115-21
references.pmid: 23149126
references.citation: Exp Eye Res. 1996 Mar;62(3):293-7
references.pmid: 8690039
references.citation: Prog Retin Eye Res. 2004 Sep;23(5):523-31
references.pmid: 15302349
references.citation: Arch Ophthalmol. 1997 May;115(5):659-63
references.pmid: 9152135
references.citation: Forensic Sci Int Genet. 2013 Jan;7(1):28-40
references.pmid: 22709892
references.citation: Arch Ophthalmol. 2001 Feb;119(2):246-50
references.pmid: 11176987
references.citation: Ophthalmology. 2009 Oct;116(10):1913-9
references.pmid: 19592102
references.citation: Br J Ophthalmol. 2013 Apr;97(4):389-94
references.pmid: 23143904
references.citation: Mol Vis. 2010 Dec 07;16:2598-604
references.pmid: 21151600
references.citation: Ophthalmology. 2007 Dec;114(12):2168-73
references.pmid: 18054635
references.citation: Am J Ophthalmol. 1994 Jan 15;117(1):19-23
references.pmid: 8291588
references.citation: Trans Am Ophthalmol Soc. 2011 Dec;109:115-56
references.pmid: 22253485
references.citation: Br J Ophthalmol. 2012 Feb;96(2):208-12
references.pmid: 21558292
references.citation: Arch Intern Med. 2009 Jan 12;169(1):75-80
references.pmid: 19139327
references.citation: Klin Monbl Augenheilkd. 2010 Apr;227(4):244-8
references.pmid: 20408066
references.citation: Invest Ophthalmol Vis Sci. 1994 May;35(6):2734-40
references.pmid: 7514581
references.citation: Ophthalmologica. 2012;228(2):93-101
references.pmid: 22571933
references.citation: Ophthalmologica. 2012;227 Suppl 1:11-20
references.pmid: 22517121
references.citation: Br J Ophthalmol. 2007 Oct;91(10):1318-22
references.pmid: 17537784
references.citation: Acta Ophthalmol. 2011 Jun;89(4):e344-9
references.pmid: 21232084
references.citation: Am J Ophthalmol. 2012 Aug;154(2):222-6
references.pmid: 22813448
references.citation: N Engl J Med. 2011 May 19;364(20):1897-908
references.pmid: 21526923
references.citation: Ophthalmology. 2012 Jul;119(7):1399-411
references.pmid: 22578446
references.citation: Am J Ophthalmol. 2007 Dec;144(6):850-857
references.pmid: 17949673
references.citation: Arch Ophthalmol. 2004 May;122(5):750-7
references.pmid: 15136324
references.citation: Am J Ophthalmol. 2008 Feb;145(2):239-248
references.pmid: 18222192
references.citation: Invest Ophthalmol Vis Sci. 2005 Aug;46(8):2671-82
references.pmid: 16043837
references.citation: Br J Ophthalmol. 2006 Jan;90(1):29-32
references.pmid: 16361662
references.citation: Ophthalmologe. 2010 Dec;107(12):1123-32
references.pmid: 21153577
references.citation: Clin Exp Ophthalmol. 2003 Aug;31(4):317-21
references.pmid: 12880456
references.citation: Am J Ophthalmol. 2010 May;149(5):735-40
references.pmid: 20138605
references.citation: Ophthalmology. 1998 Aug;105(8):1359-63
references.pmid: 9709743
references.citation: Ophthalmology. 2007 Feb;114(2):246-52
references.pmid: 17270674
references.citation: Ophthalmologica. 2011;225(2):112-9
references.pmid: 20938212