title: Association of Apolipoprotein E Polymorphism with Intravitreal Ranibizumab Treatment Outcomes in Age-Related Macular Degeneration.
abstract: Genetic factors are known to influence the response to anti-vascular endothelial growth factor (VEGF) treatment in exudative age-related macular degeneration (AMD). The current study was conducted to investigate the association of Apolipoprotein E (ApoE) polymorphism with the treatment response to ranibizumab for exudative AMD.
  
  
  
  One hundred nine eyes (109 patients, 59.6% male, mean age 63.84 ± 7.22 years) treated with intravitreal ranibizumab injections were included in the analysis. Smoking status and lesion type were recorded. Patients were categorized into three groups according to visual acuity (VA) change at 6 months after the first injection: VA loss >5 Early Treatment Diabetic Retinopathy Study (ETDRS) letters (Group 1); VA change between five ETDRS letters gain and loss (Group 2); VA improvement >5 ETDRS letters (Group 3). The association of ApoE gene polymorphisms with the three groups was evaluated.
  
  
  
  Both smoking status and lesion type showed no significant association with VA change (p = 0.12 and p = 0.64, respectively). A lower frequency of ɛ2 and a higher frequency of ɛ4 were observed in Group 3 (2.9 and 25.7%, respectively). VA improvement with more than five ETDRS letters was significantly associated with the presence of the ɛ4 genotype (p = 0.01).
  
  
  
  This study demonstrated that carriers of the ApoE ɛ4 polymorphism genotype show demonstrable improvement in VA after treatment with ranibizumab in exudative AMD. ApoE polymorphism identification may be used as a genetic screening to tailor individualized therapeutic approach for optimal treatment in neovascular AMD.
authors.affiliation: a Department of Ophthalmology, Faculty of Medicine , Selcuk University , Konya , Turkey .
authors.forename: Berker
authors.initials: B
authors.lastname: Bakbak
authors.affiliation: a Department of Ophthalmology, Faculty of Medicine , Selcuk University , Konya , Turkey .
authors.forename: Banu Turgut
authors.initials: BT
authors.lastname: Ozturk
authors.affiliation: b Department of Medical Genetics, Faculty of Medicine , Meram Necmettin Erbakan University , Konya , Turkey and.
authors.forename: Ayşe Gul
authors.initials: AG
authors.lastname: Zamani
authors.affiliation: a Department of Ophthalmology, Faculty of Medicine , Selcuk University , Konya , Turkey .
authors.forename: Saban
authors.initials: S
authors.lastname: Gonul
authors.affiliation: c Department of Statistics, Faculty of Science Faculty , Selcuk University , Konya , Turkey.
authors.forename: Neslihan
authors.initials: N
authors.lastname: Iyit
authors.affiliation: a Department of Ophthalmology, Faculty of Medicine , Selcuk University , Konya , Turkey .
authors.forename: Sansal
authors.initials: S
authors.lastname: Gedik
authors.affiliation: b Department of Medical Genetics, Faculty of Medicine , Meram Necmettin Erbakan University , Konya , Turkey and.
authors.forename: M Selman
authors.initials: MS
authors.lastname: Yıldırım
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D001057:Apolipoproteins E / Q000187:drug effects / Q000235:genetics* / Q000378:metabolism; D004247:DNA / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D011446:Prospective Studies; D000069579:Ranibizumab / Q000008:administration & dosage*; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D057135:Wet Macular Degeneration / Q000188:drug therapy / Q000235:genetics* / Q000378:metabolism
chemical_list: D020533:Angiogenesis Inhibitors; D001057:Apolipoproteins E; D042461:Vascular Endothelial Growth Factor A; D004247:DNA; D000069579:Ranibizumab
keywords: Age-related macular degeneration; ApoE; Apolipoprotein E; ranibizumab