Background: Age-related macular degeneration (AMD) affects the central part of the retina and causes blindness. In developed countries, AMD occurs in people over 50 years old. Important factors for AMD pathogenesis are an immune response, inflammation, and genetic factors. This study aimed to determine the impact of IL1RL1 rs1041973 and IL1RAP rs4624606 single nucleotide polymorphisms (SNPs) on the occurrence of AMD and the outcome of treatment with aflibercept and bevacizumab. Patients and Methods: 563 patients with AMD and 281 healthy candidates were evaluated. Patients with exudative AMD were treated with intravitreal bevacizumab and aflibercept and, after 6 months based on the changes in bestcorrected visual acuity and central macular thickness, were classified as 'responders' or 'poor-responders'. Genotyping of IL1RL1 rs1041973 and IL1RAP rs4624606 was accomplished using real-time PCR. Age was compared using the Mann-Whitney U-test. Categorical data (gender, genotype, and allele distributions) compared between groups using the χ 2 test or the Fisher's exact test. Associations of gene polymorphisms were calculated using logistic regression analysis with adjustment for age in exudative and atrophic AMD analysis. An adjusted significance threshold for multiple comparisons α=0.025 was applied. Results: Statistically significant differences in the distribution of IL1RAP rs4624606 genotypes (TT, TA and AA) were found between males with atrophic AMD and controls: 50%, 42.9% and 7.1% vs. 69.7%, 30.3% and 0%, respectively, p=0.015. Moreover, we found that 'responders' had a significantly better best-corrected visual acuity than 'poor-responders' before treatment (p=0.032). The central macular thickness was significantly lower in exudative AMD patients with IL1RL1 rs1041973 AA genotype than in wild type and heterozygous (CC+CA) genotype carriers before treatment (p=0.017). Conclusion: IL1RAP rs4624606 may be associated with atrophic AMD in males while IL1RL1 rs1041973 may play a protective role against macular thickening in exudative AMD patients. Age-related macular degeneration (AMD), the leading cause of blindness in developed countries, is a complex disease caused entirely by environmental, demographic, and genetic factors (1, 2). AMD is classified into early or intermediate stages with the formation of drusen, an amorphous extracellular deposit in the retina, and characteristic pigmentary changes, and late stages, which may either be atrophic (geographic atrophy) or wet (neovascular type) (3). Early stages of the disease are often clinically asymptomatic. It progresses slowly and evolves into late AMD only in 10-20% of patients, of which two-thirds have neovascular and one-third atrophic AMD type (4). Late forms are characterized by the irreversible loss of central vision. Treatment in clinical practice is currently available only for the neovascular type: intraocular injections with VEGF inhibitors; there are no clinically approved treatment options for atrophic AMD and/or the possibility to stop early AMD forms...
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