Emerging roles for antiangiogenesis factors in management of ocular disease

ABSTRACT.To explore whether the complement factor H (CFH) polymorphism rs1061170/ Y402H is associated with responsiveness to antivascular endothelial growth factor (VEGF) agents in age-related macular degeneration (AMD). We reviewed the English literature to examine the association between the polymorphism rs1061170/Y402H of the CFH gene and responsiveness to treatment with anti-VEGF drugs in AMD patients. A meta-analysis of eligible studies was also performed. Pooled odds ratios (ORs) and 95% CIs were estimated using Stata V.12.0. Statistical heterogeneity was measured using Q-statistic testing. Fourteen relevant studies including a total of 2963 AMD patients were eligible. In AMD patients without a treatment history, individuals carrying the rs1061170/Y402H TT genotype were more likely to achieve a better outcome (OR = 1.932, 95% CI = 1.125-3.317, p = 0.017) than those carrying the CC genotype. The polymorphism rs1061170/Y402H might be a genetic predictor of treatment response to anti-VEGF therapy in AMD patients. Further prospective research including a larger number of patients is needed to validate this finding.

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“…; Saeed et al. ). A series of clinical trials have supported the efficacy of anti‐VEGF agents for treating AMD (Rosenfeld et al.…”

Section: Introductionmentioning

confidence: 98%

Association of the polymorphism Y402H in the CFH gene with response to anti‐VEGF treatment in age‐related macular degeneration: a systematic review and meta‐analysis

Hong

Shen

et al. 2016

Acta Ophthalmologica

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“…Several clinical trials have shown that intravitreal injections prevent vision loss in the majority of patients and in some cases, significantly improved vision 16 20–22 with low numbers of serious adverse effects. 8 Subsequently, anti-VEGF therapy has become the standard clinical option to treat patients with AMD.…”

Section: Introductionmentioning

confidence: 99%

“… 8 Subsequently, anti-VEGF therapy has become the standard clinical option to treat patients with AMD. 18 20 21 In 2011, anti-VEGF therapy was also introduced as treatment for diabetic macular oedema and central retinal vein occlusion. 1 18 23 …”

Section: Introductionmentioning

confidence: 99%

Diffusion of anti-VEGF injections in the Portuguese National Health System

Marques

Macedo

Perelman³

et al. 2015

BMJ Open

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ObjectivesTo analyse the temporal and geographical diffusion of antivascular endothelial growth factor (anti-VEGF) interventions, and its determinants in a National Health System (NHS).SettingNHS Portuguese hospitals.ParticipantsAll inpatient and day cases related to eye diseases at all Portuguese public hospitals for the period 2002–2012 were selected on the basis of four International Classification of Diseases 9th revision, Clinical Modification (ICD-9-CM) codes for procedures: 1474, 1475, 1479 and 149.Primary and secondary outcome measuresWe measured anti-VEGF treatment rates by year and county. The determinants of the geographical diffusion were investigated using generalised linear modelling.ResultsWe analysed all hospital discharges from all NHS hospitals in Portugal (98 408 hospital discharges corresponding to 57 984 patients). National rates of hospitals episodes for the codes for procedures used were low before anti-VEGF approval in 2007 (less than 12% of hospital discharges). Between 2007 and 2012, the rates of hospital episodes related to the introduction of anti-VEGF injections increased by 27% per year. Patients from areas without ophthalmology departments received fewer treatments than those from areas with ophthalmology departments. The availability of an ophthalmology department in the county increased the rates of hospital episodes by 243%, and a 100-persons greater density per km2 raised the rates by 11%.ConclusionsOur study shows a large but unequal diffusion of anti-VEGF treatments despite the universal coverage and very low copayments. The technological innovation in ophthalmology may thus produce unexpected inequalities related to financial constraints unless the implementation of innovative techniques is planned and regulated.

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“…Should venous outflow improve naturally or through prompt treatment, collateralisation may become unnecessary. While many clinicians consider collateralisation to be beneficial, it may not serve to expedite the resolution of macular oedema despite reducing interstitial hydrostatic pressure within the retina . In fact, final VA may be worse in the presence of collaterals, perhaps testament to the severity of the initial occlusion.…”

Section: Clinical Featuresmentioning

confidence: 99%

The ABCs of RVO: A review of retinal venous occlusion

MacDonald¹

2014

Clinical and Experimental Optometry

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Retinal vein occlusions are important causes of loss of vision; indeed, they are the second most common retinal vascular disease, following diabetic retinopathy. For this reason alone, primary eye-care providers must be well versed in diagnosis and management. Risk factors, though not universally agreed upon, include but are not limited to advancing age, systemic hypertension, arteriolarsclerosis, diabetes, hyperlipidaemia, blood hyperviscosity, thrombophilia, ocular hypertension and glaucoma. Typically, visual loss is secondary to macular oedema and/or retinal ischaemia. Treatment modalities have included observation, systemic thrombolysis and haemodilution, radial optic neurotomy, chorioretinal anastomosis, vitrectomy, laser photocoagulation and intravitreal injection of anti-inflammatory and, most recently, anti-vascular endothelial growth factors.

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Emerging roles for antiangiogenesis factors in management of ocular disease

Cited by 17 publications

References 88 publications

Association of the polymorphism Y402H in the CFH gene with response to anti‐VEGF treatment in age‐related macular degeneration: a systematic review and meta‐analysis

Association of the polymorphism Y402H in the CFH gene with response to anti‐VEGF treatment in age‐related macular degeneration: a systematic review and meta‐analysis

Diffusion of anti-VEGF injections in the Portuguese National Health System

The ABCs of RVO: A review of retinal venous occlusion

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