Association of complement factor H polymorphism with response of exudative age-related macular degeneration to intravitreal anti-vascular endothelial growth factor theraphies

Purpose: To investigate whether there is an association between complement factor H (CFH) polymorphisms with response to treatment with intravitreal antivascular endothelial growth factor agents (anti VEGF) for choroidal neovascularization (CNV) due to exudative age-related macular degeneration (AMD).Material and Method: A retrospective study of 120 patients with CNV due to AMD treated with intravitreal anti VEGF therapy was conducted. Mean age of patients was 66.51±10.34. Sixty one patients were treated with intravitreal bevacizumab (IVB, 50.8 %) and fifty nine patients were treated with intravitreal ranibizumab (IVR, 49.2 %). Sixty five patients (54.2 %) had occult CNV, 47 patients (39.2 %) had predominantly classic CNV and 8 patients (6.7 %) had minimal classic CNV. All patients underwent visual acuity measurement, fundus fluorescein angiography (FFA) and optic coherence tomography (OCT). Each patient was genotyped for the single nucleotide polymorphism (Y402H) in the CFH gene.Results: For the CFH Y402H polymorphism, 26 patients (21.7 %) were TT, 57 (47.5 %) were TC, and 37 (30.8 %) were CC. Patients with the CFH CC genotype fared significantly worse with IVB than did those with the CFH TC and TT genotypes (TT 0.38±0.42; TC 0.18±0.46 ve CC -0.15±0.21; p:0.001; p:0.006). Patients with the CFH CC genotype fared significantly worse with IVR than did those with the CFH TC and TT genotypes (TT 0.46±0.47, TC 0.36±0.50 ve CC -0.15±0.21; p:0.001; p:0.001). Visual acuity increased in CFH TT and CFH TC group and decreased in the CC group with both drugs. Response to IVB was worse for the CFH TC and TT genotype compared with the response to IVR for the TC and CC genotypes. This difference in response to treatment, however, did not reach statistical significance. Mean treatment per month was 0.47±0.18 in IVB group and 0.41±0.14 in IVR group.Conclusions: Response to intravitreal anti VEGF therapy was significantly worse for the CFH Y402H CC genotype compared with the TC and CC genotypes. In the light of our findings, it is possible to think that, CFH polymorphism detection may be crucial for making intravitreal treatment decision in near future.