To study the effects of IL-8, VEGF, CFH, complement component C3 and LOC387715 single nucleotide polymorphisms and neovascular lesion characteristics on the response to intravitreal bevacizumab treatment in exudative age-related macular degeneration (AMD).Methods
Fifty patients with treatment naïve exudative AMD were recruited to this two-year prospective follow-up study, and treated with bevacizumab on their once-a-month visits when sub- or intraretinal fluid in OCTs, or a new hemorrhage was detected. Visual acuities (VA) and contrast sensitivities (CS) were assessed on every visit, and fluorescein (FA) and indocyanine green (ICGA) angiographies recorded at baseline, and after one and two years of follow-up. Blood samples were collected for genotyping.Results
VEGF -2578A/C and CFH Y402H polymorphisms and baseline lesion size in ICGA associated with the number of needed reinjections during the follow-up, and IL-8 -251A/T associated with the disappearance of fluid in OCTs. The alleles A in IL-8 -251A/T, A in VEGF -2578A/C, and C in CFH Y402H had a cumulative effect on the presence of fluid in OCTs. A marked difference existed between patients having 0 - 2 risk alleles compared to those having 3 - 6 risk alleles (P=0.00002). An association was also detected between the VEGF -2578A/C polymorphism and CS gain (P=0.014). During the first year VA change correlated negatively with the number of visits when cystic changes were detected in the OCTs (r=-0.366, P=0.009), but the association did not persist during the second year.Conclusion
VEGF -2578A/C, IL-8 -251A/T, and CFH Y402H seem to to affect the persistence of fluid in the macular area during bevacizumab therapy of exudative AMD.