title: Predictors of Response to Intravitreal Anti-Vascular Endothelial Growth Factor Treatment of Age-Related Macular Degeneration.
abstract: OBJECTIVE
  To identify factors that influence visual and anatomic response to treatment with intravitreal anti-vascular endothelial growth factor (VEGF) for neovascular age-related macular degeneration (AMD).
  
  
  METHODS
  Observational cohort study.
  
  
  METHODS
  Seventy-two patients were included in this study. Best-corrected Snellen visual acuity (VA) and central foveal thickness measured on optical coherence tomography (OCT) at time of treatment and post-treatment follow-up visits were recorded. Associations between demographic, behavioral, and genetic risk factors and the 2 outcomes were analyzed using mixed-effects linear regression models. Two loci in complement factor H (CFH) were included in a risk score to determine the association between CFH risk and improvement in VA and central foveal thickness.
  
  
  RESULTS
  There was a small improvement in VA following anti-VEGF treatment (mean: 3.7 ± 3.0 letters), which was not statistically significant. Significant improvement in VA was observed for the nonrisk CFH Y402H genotype (P < .001) and for a low CFH risk score (P = .019). Regarding the outcome of change in central foveal thickness, improvement was noted in all genotype groups, but reduction after treatment was significantly higher in the low CFH risk score group (P = .033). A significant improvement in mean VA was seen among smokers (P < .001), but this relationship was not observed for central foveal thickness.
  
  
  CONCLUSIONS
  After anti-VEGF therapy, significant improvement in VA was observed for low-risk CFH genotypes and subjects with a low risk score. There was a statistically significant reduction in central foveal thickness overall, and subjects with a low CFH risk score improved more than the high-risk group.
authors.affiliation: Kellogg Eye Center, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Anjali R
authors.initials: AR
authors.lastname: Shah
authors.affiliation: California Pacific Medical Center, Department of Ophthalmology, San Francisco, California.
authors.forename: Steven
authors.initials: S
authors.lastname: Williams
authors.affiliation: New England Eye Center, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Caroline R
authors.initials: CR
authors.lastname: Baumal
authors.affiliation: Channing Division of Network Medicine, Harvard University, Boston, Massachusetts.
authors.forename: Bernard
authors.initials: B
authors.lastname: Rosner
authors.affiliation: New England Eye Center, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Jay S
authors.initials: JS
authors.lastname: Duker
authors.affiliation: New England Eye Center, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts. Electronic address: jseddon@tuftsmedicalcenter.org.
authors.forename: Johanna M
authors.initials: JM
authors.lastname: Seddon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000627:therapeutic use; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000235:genetics / Q000503:physiopathology; D015331:Cohort Studies; D017242:Complement Factor H / Q000235:genetics; D005260:Female; D005838:Genotype; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D000069579:Ranibizumab / Q000627:therapeutic use; D012160:Retina / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity / Q000502:physiology*; D057135:Wet Macular Degeneration / Q000188:drug therapy* / Q000235:genetics / Q000503:physiopathology
chemical_list: D020533:Angiogenesis Inhibitors; C493495:CFH protein, human; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D017242:Complement Factor H; D000069579:Ranibizumab