%0 Journal Article
%T Predictors of Visual Response to Intravitreal Bevacizumab for Treatment of Neovascular Age-Related Macular Degeneration
%A Kai Fang
%A Jun Tian
%A Xueying Qing
%A Shuai Li
%A Jing Hou
%A Juan Li
%A Wenzhen Yu
%A Dafang Chen
%A Yonghua Hu
%A Xiaoxin Li
%J Journal of Ophthalmology
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/676049
%X Purpose. To identify the predictors of visual response to the bevacizumab treatment of neovascular age-related macular degeneration (AMD). Design. A cohort study within the Neovascular AMD Treatment Trial Using Bevacizumab (NATTB). Methods. This was a multicenter trial including 144 participants from the NATTB study. Visual outcomes measured by change in visual acuity (VA) score, proportion gaining ¡Ý15 letters, and change in central retinal thickness (CRT) were compared among groups according to the baseline, demographic, and ocular characteristics and genotypes. Results. Mean change in the VA score was 9.2 ¡À 2.3 SD letters with a total of 46 participants (31.9%) gaining ¡Ý15 letters. Change in median CRT was £¿81.5£¿¦Ìm. Younger age, lower baseline VA score, shorter duration of neovascular AMD, and TT genotype in rs10490924 were significantly associated with greater VA score improvement ( , , , and , resp.). Lower baseline VA score and TT genotype in rs10490924 were significantly associated with a higher likelihood of gaining ¡Ý15 letters ( , and , resp.). Conclusions. Baseline VA and genotype of rs10490924 were both important predictors for visual response to bevacizumab at 6 months. This trial is registered with the Registration no. NCT01306591. 1. Introduction Age-related macular degeneration (AMD) is the leading cause of blindness in people of 50 years of age or older in the developed countries [1, 2] and 80%¨C90% of severe vision loss and/or legal blindness can be attributed to neovascular AMD [3]. Vascular endothelial growth factor (VEGF) has been proven to play a major role in the pathogenesis of choroidal neovascularization (CNV) [4¨C7]. Bevacizumab (Avastin, Genentech), a monoclonal antibody to VEGF used intravenously as an anticancer agent, has been increasingly used ¡°off-label¡± as an intravitreal therapy for neovascular AMD. Bevacizumab is derived from the same antibody as ranibizumab (Lucentis, Genentech) which is a smaller antigen-binding fragment and a frequently used anti-VEGF drug in the treatment of AMD [8¨C10]. Several studies show that bevacizumab has longer half-life in the vitreous fluid than ranibizumab because it is a full-length monoclonal antibody [11, 12], so the use of bevacizumab may reduce the frequency of visit and treatment for patients. Besides, a single dose of ranibizumab costs 40 times more than the cost of a single dose of bevacizumab [13]; this cost difference would undoubtedly have a notable influence on the patients who are treated for neovascular AMD in China. Since 2005, there have been short- and long-term
%U http://www.hindawi.com/journals/joph/2013/676049/