Impact of Loading Phase, Initial Response and CFH Genotype on the Long-Term Outcome of Treatment for

Objective: Factors influencing the outcome of anti-VEGF treatment in neovascular AMD are still investigated. We analyzed the impact of a loading phase, the significance of an initial response for the long-term and the effect of the CFH polymorphism (p.His402Tyr) on treatment outcome. Methods: Patients treated with ranibizumab for neovascular AMD were analyzed over a period of 24 months by assessing effects of loading phase, initial response and genotype of CFH rs1061170 (c.1204C.T, p.His402Tyr). Results: 204 eyes were included. A change of +5.0 [21;+11] letters and +1.5 [25.5;+9.5] was observed with a median of 4 [3;7] and 10 [7;14] ranibizumab injections during 12 and 24 months, respectively. Loading phase was no significant predictor for treatment as VA outcome in eyes with and without loading phase was similar (p = 0.846 and p = 0.729) at 12 and 24 months. In contrast, initial response was a significant predictor for improving vision of 5 or more letters at 12 (p = 0.001; OR = 6.75) and 24 months (p = 0.01; OR = 4.66). Furthermore, the CT genotype at CFH rs1061170 was identified as a significant predictor for a favorable VA outcome at 12 and 24 months (OR = 6.75, p = 0.001 and OR = 4.66, p = 0.01). Conclusions: Our data suggest that clinical decisions regarding treatment may be guided by observing patients ’ initial response as well as their genotype of SNP rs1061170, while the criterion of loading phase may not bear the customar