Genetics in neovascular age-related macular degeneration susceptibility and treatment response to anti-VEGF intravitreal injection: A case series study

Clin Exp Ophthalmol. 2024 Aug;52(6):655-664. doi: 10.1111/ceo.14388. Epub 2024 May 16.

Abstract

Background: To identify genotypes associated with neovascular age-related macular degeneration (nAMD) and investigate the associations between genotype variations and anti-vascular endothelial growth factor (VEGF) treatment response.

Methods: This observational, retrospective, case series study enrolled patients diagnosed with nAMD who received anti-VEGF treatment in National Taiwan University Hospital with at least one-year follow-up between 2012 and 2020. A genome-wide association study (GWAS) was conducted on enrolled patients and controls. Correlations between the genotypes identified from GWAS and the treatment response of functional/anatomical biomarkers, including visual acuity (VA), presence of intraretinal or subretinal fluid (SRF), serous or fibrovascular pigmented epithelium detachment (PED), and disruption of the ellipsoid zone (EZ), were analysed.

Results: In total, 182 patients with nAMD and 1748 controls were enrolled. GWAS revealed 16 single nucleotide polymorphisms (SNPs) as risk loci for nAMD, including seven loci in CFH and ARMS2/HTRA1 and nine novel loci, including rs117517872 and rs79835234(COPB2-DT), rs7525578(RAP1A), rs2123738(LOC105376755), rs1374879(CNTN3), rs3812692(SAR1A), rs117501587(PRKCA), rs9965945(CNDP1), and rs189769231(MATK). Our study revealed rs800292(CFH), rs11200638(HTRA1), and rs2123738(LOC105376755) correlated with poor treatment response in VA (P = 0.005), SRF (P = 0.044), and fibrovascular PED (P = 0.007), respectively. Rs9965945(CNDP1) was correlated with poor response in disruption of EZ (P = 0.046) and serous PED (P = 0.049).

Conclusions: Among the 16 SNPs found in the GWAS, four loci-CFH, ARMS2/HTRA1, and two novel loci-were correlated with the susceptibility of nAMD and anatomical/functional responses after anti-VEGF treatment.

Keywords: genome‐wide association study; macular degeneration; single nucleotide polymorphism; vascular endothelial growth factor.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors* / administration & dosage
  • Angiogenesis Inhibitors* / therapeutic use
  • Bevacizumab / administration & dosage
  • Bevacizumab / therapeutic use
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Genetic Predisposition to Disease
  • Genome-Wide Association Study*
  • Genotype
  • High-Temperature Requirement A Serine Peptidase 1
  • Humans
  • Intravitreal Injections*
  • Male
  • Middle Aged
  • Polymorphism, Single Nucleotide*
  • Ranibizumab / administration & dosage
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A* / antagonists & inhibitors
  • Vascular Endothelial Growth Factor A* / genetics
  • Visual Acuity* / physiology
  • Wet Macular Degeneration* / diagnosis
  • Wet Macular Degeneration* / drug therapy
  • Wet Macular Degeneration* / genetics
  • Wet Macular Degeneration* / physiopathology

Substances

  • Vascular Endothelial Growth Factor A
  • Angiogenesis Inhibitors
  • Ranibizumab
  • VEGFA protein, human
  • Bevacizumab
  • HTRA1 protein, human
  • High-Temperature Requirement A Serine Peptidase 1