Association of Apolipoprotein E Polymorphism with Intravitreal Ranibizumab Treatment Outcomes in Age-Related Macular Degeneration

Curr Eye Res. 2016 Jun;41(6):862-6. doi: 10.3109/02713683.2015.1067325. Epub 2015 Sep 23.

Abstract

Purpose: Genetic factors are known to influence the response to anti-vascular endothelial growth factor (VEGF) treatment in exudative age-related macular degeneration (AMD). The current study was conducted to investigate the association of Apolipoprotein E (ApoE) polymorphism with the treatment response to ranibizumab for exudative AMD.

Methods: One hundred nine eyes (109 patients, 59.6% male, mean age 63.84 ± 7.22 years) treated with intravitreal ranibizumab injections were included in the analysis. Smoking status and lesion type were recorded. Patients were categorized into three groups according to visual acuity (VA) change at 6 months after the first injection: VA loss >5 Early Treatment Diabetic Retinopathy Study (ETDRS) letters (Group 1); VA change between five ETDRS letters gain and loss (Group 2); VA improvement >5 ETDRS letters (Group 3). The association of ApoE gene polymorphisms with the three groups was evaluated.

Results: Both smoking status and lesion type showed no significant association with VA change (p = 0.12 and p = 0.64, respectively). A lower frequency of ɛ2 and a higher frequency of ɛ4 were observed in Group 3 (2.9 and 25.7%, respectively). VA improvement with more than five ETDRS letters was significantly associated with the presence of the ɛ4 genotype (p = 0.01).

Conclusions: This study demonstrated that carriers of the ApoE ɛ4 polymorphism genotype show demonstrable improvement in VA after treatment with ranibizumab in exudative AMD. ApoE polymorphism identification may be used as a genetic screening to tailor individualized therapeutic approach for optimal treatment in neovascular AMD.

Keywords: Age-related macular degeneration; ApoE; Apolipoprotein E; ranibizumab.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angiogenesis Inhibitors / administration & dosage
  • Apolipoproteins E / drug effects
  • Apolipoproteins E / genetics*
  • Apolipoproteins E / metabolism
  • DNA / genetics*
  • Female
  • Follow-Up Studies
  • Genotype
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Polymorphism, Genetic*
  • Prospective Studies
  • Ranibizumab / administration & dosage*
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Wet Macular Degeneration / drug therapy
  • Wet Macular Degeneration / genetics*
  • Wet Macular Degeneration / metabolism

Substances

  • Angiogenesis Inhibitors
  • Apolipoproteins E
  • Vascular Endothelial Growth Factor A
  • DNA
  • Ranibizumab