Aqueous humour proteins and treatment outcomes of anti-VEGF therapy in neovascular age-related macular degeneration.

We aimed to construct a better model for predicting treatment outcomes of anti-vascular endothelial growth factor therapy for neovascular age-related macular degeneration (nAMD) using the concentrations of aqueous humour proteins at baseline and during treatment. From the data of 48 treatment-naïve nAMD eyes that received intravitreal ranibizumab pro re nata for up to 12 months, we used the aqueous humour concentrations of C-X-C motif chemokine ligand 1 (CXCL1), CXCL12, CXCL13, interferon-γ-induced protein 10, monocyte chemoattractant protein 1 (MCP-1), C-C motif chemokine ligand 11, interleukin 6 (IL-6), IL-10, and matrix metalloproteinase 9 (MMP-9). After stepwise regression, multivariate analysis was performed to identify which predictors were significantly associated with best-corrected visual acuity (BCVA) changes and the number of injections. The results demonstrated that besides male sex (β coefficient = -0.088, P = 0.040) and central retinal thickness (β coefficient = 0.00051 per μm, P = 0.027), MCP-1 (β coefficient = 0.44, P < 0.001) and IL-10 (β coefficient = -0.16, P = 0.033) were significantly correlated with baseline BCVA. Additionally, high MCP-1 at baseline (β coefficient = -0.20, P = 0.015) and low CXCL13 at baseline (β coefficient = 0.10, P = 0.0054) were independently associated with better BCVA change at 12 months. High MMP-9 at the first injection (β coefficient = 0.56, P = 0.01), CXCL12 at the third injection (β coefficient = 0.10, P = 0.0002), and IL-10 at the third injection (β coefficient = 1.3, P = 0.001) were predictor variables associated with the increased number of injections. In conclusion, aqueous humour protein concentrations may have predictive abilities of BCVA change over 12 months and the number of injections in pro re nata treatment of exudative nAMD.

Déclaration de conflit d'intérêts

Dr Takahashi received lecturer’s fees from Kowa Pharmaceutical, Novartis Pharmaceuticals, Bayer Yakuhin, and Santen Pharmaceuticals, and grants from Bayer Yakuhin and Novartis Pharma, outside this work. Dr Inoue received lecturer’s fees from Kowa Pharmaceuticals, Novartis Pharmaceuticals, Bayer Yakuhin, and Santen Pharmaceuticals outside this work. Dr Kawashima received lecturer’s fees from Kowa Pharmaceutical, Novartis Pharmaceuticals, and Santen Pharmaceuticals outside this work. Dr Yanagi received lecturer’s fees and grants from Santen Pharmaceuticals outside this work. He is an advisory board member for Bayer Pharmaceuticals and a consultant for Santen Pharmaceuticals. Dr Arai, Dr Tan, Dr Inoda, Dr Sakamoto, and Dr Fujino declare no potential conflict of interest. This does not alter our adherence to PLOS ONE policies on sharing data and materials.