Yaş Tip Yaşa Bağlı Makula Dejenerasyonunda Kompleman Faktör H Cc ve Tt Polimorfizminin Intravitreal Anti-Vegf Tedavisi

Abstract

The purpose of this study is to evaluate the effect of the komplement factor H (CFH) Y402H CC and TT polymorphisms on treatment response to intravitreal ranibizumab injection in patients with wet type Age Related Macular Degeneration (ARMD). 193 patients with CNV secondary to ARMD followed up for at least 6 months of follow up, and with at least 3 ranibizumab injections were included in the study. At the last examination increase in visual acuity (VA) of 5 letters or more compared to the initial VA was regarded as good response, and decrase in VA of 5 letters or more compared to the initial visual acuity was evaluated as poor response. Genetic analysis was done by PCR melting curve analysis. In the statistical evaluation, SPSS version 18 software was employed. The mean age of the patients was 71.01 (55-86), the mean follow-up was 13.34 (6-36) months and the mean number of injections was 4.02 (3-15). There were 96 patients in the good response group (Group 1), and 97 patients in the poor response group (Group 2). The initial VA in group 1 was found to be 41.34 (10-64) letters, the initial central macular thickness (CMT) was 213.40 (126-494) µm, and the initial lesion width was 3760 (1430-6430) µm. The initial VA in group 2 was 52.89 (26-82) letters, the initial CMT was 257.60 (115-882) µm, the initial lesion width was 4460 (1000-7650) µm. There was no statistically significant difference between the two groups in terms of the initial VA and CMT (p= 0.094, p= 0.083). However, there was a statistically significant difference between the groups in terms of the width of the initial lesion (p= 0.003). In group 1, 15 CC, 30 TT, 51 TC, in group 2 49 CC, 2 TT, 46 TC allelles were found and the distribution was significantly different between the two groups (p= 0.012). Change in the distribution of genotypes was not associated with either the lesion size or VA (p= 0.841). Fibrosis developed in 12 patients who were all poor responders. It is observed that CFH Y402H CC accompanied poor response and TT accompanied good response in this series of ARMD patients undergoing ranibizumab therapy.