BMJ open ophthalmology · 2025
Association of plasma metabolites with treatment response after intravitreal anti-vascular endothelial growth factor injections in treatment-naïve neovascular age-related macular degeneration.
СтатьяПоддержка NIH: внешняя программаНазвание и аннотация: Перевод пока не подготовлен
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Kang Hae Min, Mendez Kevin M, Laíns Inês, Sourirajan Krupa, Bhat Roshni, Nigalye Archana, Katz Raviv, Kozak Georgiy, Choi Hanna, Bannerman Augustine, Alvarez Rodrigo A, Wu David, Kim Ivana K, Liang Liming, Miller John B, Vavvas Demetrios G, Miller Joan W, Lasky-Su Jessica, Husain Deeba
Аннотация
BACKGROUND/AIMS: To investigate the association between plasma metabolomic profiles and treatment response after intravitreal anti-vascular endothelial growth factor (VEGF) injections in treatment-naïve neovascular age-related macular degeneration (nAMD).
METHODS: This is part of a prospective longitudinal study that included patients with treatment-naïve nAMD who have undergone three loading intravitreal anti-VEGF injections. All patients underwent ophthalmological examinations including spectral domain optical coherence tomography (SD OCT). Fasting blood samples were collected at the time of study enrolment (not to first anti-VEGF injection) and metabolomic profiling was conducted using ultra-performance liquid chromatography-mass spectrometry. Treatment response was defined as no evidence of any subretinal and intraretinal fluid on SD OCT 4-6 weeks after the third injection. Multilevel mixed-effects linear modelling was used to assess associations between plasma metabolites and treatment response. Multiple comparisons were accounted for using the effective number of tests to explain 80% of the variance (ENT80), with a p value threshold of 0.0017.
RESULTS: We included 131 eyes of 101 patients, and 69 patients (68.3%) were female. 51 eyes (38.9%) were treatment responders. Taurodeoxycholate (TDCA) was the only plasma metabolite significantly associated with treatment response (β=1.6, ENT80=0.001).
CONCLUSION: In our study, TDCA was the most significant plasma metabolite associated with treatment response after three-loading dose of anti-VEGF therapy in patients with nAMD. Bile acids may have a beneficial impact on treatment response in nAMD through their neuroprotective property. Plasma metabolites may be used as biomarkers to predict responses to initial anti-VEGF therapy in patients with nAMD, providing a more individualised treatment plan.
METHODS: This is part of a prospective longitudinal study that included patients with treatment-naïve nAMD who have undergone three loading intravitreal anti-VEGF injections. All patients underwent ophthalmological examinations including spectral domain optical coherence tomography (SD OCT). Fasting blood samples were collected at the time of study enrolment (not to first anti-VEGF injection) and metabolomic profiling was conducted using ultra-performance liquid chromatography-mass spectrometry. Treatment response was defined as no evidence of any subretinal and intraretinal fluid on SD OCT 4-6 weeks after the third injection. Multilevel mixed-effects linear modelling was used to assess associations between plasma metabolites and treatment response. Multiple comparisons were accounted for using the effective number of tests to explain 80% of the variance (ENT80), with a p value threshold of 0.0017.
RESULTS: We included 131 eyes of 101 patients, and 69 patients (68.3%) were female. 51 eyes (38.9%) were treatment responders. Taurodeoxycholate (TDCA) was the only plasma metabolite significantly associated with treatment response (β=1.6, ENT80=0.001).
CONCLUSION: In our study, TDCA was the most significant plasma metabolite associated with treatment response after three-loading dose of anti-VEGF therapy in patients with nAMD. Bile acids may have a beneficial impact on treatment response in nAMD through their neuroprotective property. Plasma metabolites may be used as biomarkers to predict responses to initial anti-VEGF therapy in patients with nAMD, providing a more individualised treatment plan.
Предметные рубрики MeSH
HumansFemaleMaleAngiogenesis InhibitorsProspective StudiesTomography, Optical CoherenceIntravitreal InjectionsVascular Endothelial Growth Factor AAgedWet Macular DegenerationRanibizumabBiomarkersBevacizumabVisual AcuityTreatment OutcomeAged, 80 and overFollow-Up StudiesMetabolomicsFluorescein Angiography