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 ≥15 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 ± 2.3 SD letters with a total of 46 participants (31.9%) gaining ≥15 letters. Change in median CRT was ？81.5？μm. 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 ≥15 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%–90% 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) [4–7]. 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 [8–10]. 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
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