Predictive Factors For Short-term Visual Acuity Outcome After Intravitreal Injection Of Bevacizumab Treatment For Wet Age-related Macular Degeneration

Objective: To identify the predictive factors for short-term visual outcome afterintravitreal bevacizumab therapy to patients with wet age-related macular degenerationby evaluating the clinical features and single nucleotide polymorphisms of hightemperature requirement A1genotype.Methods:35patients with wet age-related macular degeneration were reviewedafter intravitreal bevacizumab therapy, they were all diagnosed in the First AffiliatedHospital of Dalian Medical University. The clinical features like age, gender, height,weight, systemic disease, fundus fluorescein angiography and optical coherencetomography characteristics, best corrected visual acuity, the area of choroidalneovascularization and central macular thickness were evaluated and followed up for3months; Peripheral venous blood from all patients for extraction of genomic DNA wascollected and single nucleotide polymorphisms of HTRA1(rs11200638) genes wassequenced. Patients were divided into two groups according to the final visual gain(LogMAR): Group B(Better-visual gain group)and Group W(Worse-visual gaingroup)．Comparative age, duration, baseline best corrected visual acuity, body massindex, SNP of HTRA1, OCT and FFA characteristics between the two groups wereanalyzed.Result: Of the35patients, the BCVA (Log MAR), the average area of choroidalneovascularization and the central macular thickness changed significantly. The age waspositively correlated with the FVG(r=0.380, P=0.024), the baseline BCVA (Log MAR)was negatively correlated with the FVG(r=-0.742, P<0.001), the baseline area ofchoroidal neovascularization was positively correlated with the FVG(r=0.458, P=0.006).The patients in group B were younger than group W, group B:(68.3±1.1) years, groupW:(74.1±5.4) years, P=0.014and had smaller baseline area of choroidal neovascularization, group B:(2.7±1.0) disc area, group W:(3.5±0.5) disc area, P=0.022,worse baseline BCVA (Log MAR), group B:0.92±0.26, group W:0.55±0.19, P=0.001.There was no significant difference between two groups in duration, central macularthickness and HTRA1genotype.Conclusion: Intravitreal bevacizumab therapy had obvious short-term effect, butwith individual differences, younger patients with smaller baseline area of choroidalneovascularization and lower baseline BCVA are most likely to benefit frombevacizumab treatment. Age, baseline BCVA and baseline area of choroidalneovascularization are the most important predictive factors of the final visual gain afterintravitreal bevacizumab therapy in patients with wet age-related macular degeneration.