CD8+ T cell aging is associated with macular neovascularization area change in neovascular age-related macular degeneration: a prospective cohort study.

BACKGROUND: Neovascular age-related macular degeneration (nAMD) is characterized by formation of macular neovascularization (MNV). The aging immune system plays an important role in nAMD pathogenesis. Loss of the costimulatory markers CD27 and CD28 on T cells and increased T cell differentiation is associated with immunosenescence and proinflammatory T cell activation. In this study we investigate the association between MNV area change following anti-VEGF treatment and the aging T cell profile in nAMD patients. METHODS: This prospective cohort study included treatment-naïve nAMD patients. Participants were examined with optical coherence tomography angiography at time of diagnosis and following loading dose to assess the MNV area change. A blood sample was analyzed for circulating aging T cell profile with flow cytometry for the costimulatory markers CD27, CD28, and CD56, as well as T cell differentiation (naïve, central memory, and effector memory) of CD4+ and CD8+ T cells. RESULTS: 54 eyes of 54 patients were included. A significant association was found between a reduction of MNV area and a reduction of the CD8+CD27- T cell proportion (β, 0.71; 95% CI, 0.17 to 1.26; P = 0.035), as well as CD8+CD28- T cell proportion (β, 0.72; 95% CI, 0.20 to 1.23; P = 0.035). A non-significant negative trend was observed between MNV area change and CD8 + naïve T cells (P = 0.099). CONCLUSION: Our results suggest that a less advanced aging T cell profile characterized by lower levels of CD8+CD27- and CD8+CD28- T cells is associated with a greater reduction of MNV area following anti-VEGF treatment in treatment-naïve nAMD patients.