Several Common Genetic Variations Associate With Functional or Anatomic Effects of Anti-VEGF Treatment in Conditions With Macular Edema.

PURPOSE: This study aimed to identify genetic factors that may influence the effectiveness of anti-vascular endothelial growth factor (VEGF) treatment for macular edema (ME).

METHODS

We performed a genome-wide association study (GWAS) on 606 patients with macular edema that were treated with bevacizumab or ranibizumab from three randomized clinical trials, using a Infinium Global Screening Array. Well-characterized patient groups included diabetic macular edema (DME), retinal vein occlusion (RVO), and neovascular age-related macular degeneration (nAMD), with changes in best-corrected visual acuity (BCVA) and anatomical changes in central subfield thickness (CST) as outcomes. We conducted a meta-analysis on the combined patient groups, a targeted analysis on 28 previously reported genetic variants related to anti-VEGF response, and on variants of six genes involved in ME pathophysiology.

RESULTS

GWAS meta-analysis identified 12 SNPs (P < 1 × 10-6), of which three SNPs reached genome-wide significance (P < 5 × 10-8) and were linked to changes in CST after 6 months of anti-VEGF treatment. In addition, a genomic locus in the SGCZ gene was linked to changes in BCVA. Targeted GWAS revealed significant associations between changes in BCVA and variants in KDR, IL6, NRP1, and SPNS2, all known for their roles in VEGF signaling and retinal vascular permeability. Furthermore, changes in CST were associated with PLVAP, an important gene in vascular hyperpermeability in ME.

CONCLUSIONS

This GWAS meta-analysis uncovered genetic variants potentially linked to responses to anti-VEGF treatment in patients with retinal conditions featuring vascular leakage and/or ME. These findings could aid in identifying genetic markers for treatment response prediction or uncover new pathways relevant to retinal vascular leakage and ME.