Pharmacogenetics of Complement Factor H (Y402H), ARMS2(Loc387715) and Htra1 ; Treatment Response of Exudative Age-Related Macular Degeneration With Bevacizumab in Korean Population

초록

Purpose: To determine whether there is a pharmacogenetic effect of complement factor H(CFH), LOC387715 and HTRA1 genotypes on the treatment of exudative age-related macular degeneration(AMD) with bevacizumab in Korean. Methods: A retrospective cohort study of 75 patients diagnosed exudative AMD being treated with intravitreal bevacizumab(2.5mg) was conducted. 75 patients were followed up for more than 6 months and 54 patients were followed up for more than 1 year. All patients received three initial injection every 4weeks and were treated "as needed" based on clinical findings, optical coherence tomography and fluorescein angiography after third injection. Population who received PDT within 6month before bevacizumab injection was excluded. 39 patients who received PDT more than 6months before injection were included in the study. Genotypes were determined by allele-specific digestion of polymerase chain reaction for the CFH Y402H(rs1061170), LOC387715(rs10490924) and HTRA1(rs11200638). Treatment response was evaluated by comparing visual acuity(V/A) and Central macular thickness(CMT) of before and after initial 3time injection(immediate, 6month and 1year). Results: Gender, age, DM and baseline lesion size(greatest linear dimension) differences were not statistically significant in the baseline study of the each genotypes. Hypertension was statistically significant in all genotypes (CFH;P=0.036, HTRA1;P=0.028, LOC387715;P=0.016). V/A and CMT change between two groups, which received PDT and didn't, were similar and showed no significant difference statistically. V/A and CMT change of each subgroup CFH Y402H and HTRA1 gene were not statistically significant. However, 6 months visual improvement of LOC387715 was statistically significant (LogMAR, TT:from 0.959 to 0.743, GT:from 0.864 to 0.6, GG:from 1.175 to 0.988, P=0.0368). Conclusions: There were no positive association of the response to treatment of AMD with bevacizumab according to each genotypes of CFH, HTRA1