Predictors of Response to Intravitreal Anti–Vascular Endothelial Growth Factor Treatment of Age-Related Macular Degeneration

Purpose 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). Design 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. Conclusion 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.