Influence of ARMS2 gene polymorphism on the number of ranibizumab injections needed in exudative AMD in a pro re-nata regimen: Four-year study

Session Details

Session Title: Free Paper Session 3: AMD I

Session Date/Time: Thursday 07/09/2017 | 08:30-10:00

Paper Time: 09:24

Venue: Room 118

First Author: : A.Valverde-Megías SPAIN

Co Author(s): :    S. Veganzones-de Castro   J. Donate-Lopez   C. Calvo-Gonzalez   J. Reche-Frutos   A. Megias-Fresno   J. Garcia-Feijoo              

Abstract Details


To investigate whether genotype for single-nucleotide polymorphism AMRS2 is associated with the number of retreatments needed by exudative AMD patients treated with Ranibizumab in a pro re nata regimen during a four-year study period


Pro re nata regimes prescribe retreatments when reactivation is present. There is a great inter-individual variability in the number of ranibizumab injections needed. Identification of factors involved would help with management of planification of medical burden and tailoring of strategies.


This prospective study included 103 treatment-naïve patients (103 eyes) that were initially treated with 3 consecutive monthly intravitreal injections of ranibizumab, and thereafter, followed-up by an as-needed regimen for a 4-year period. Genotype determination for the CFH Y402H and ARMS2 A69S polymorphisms was performed by restriction fragment length polymorphism detection and sequence analysis, and their association with lesion recurrence and visual outcome was analyzed.


The number of injections needed by the patients was related to ARMS2 polymorphism. TT is considered the high risk genotype for development of exudative AMD. By the fourth year, there was a mean difference of 4.1 injections between the TT group and the other two groups (P=0.03 if TT is compared with grouped GG +GT). Considering that the first three injections are mandatory for all patients (loading dose), this difference means indeed 37% more injections in the TT group. Genotypes had no influence on baseline characteristics or visual outcome after four year follow-up.


The ARMS2 A69S polymorphism was related to the number of injections needed in our study. Prediction of the risk of recurrence would help to design more appropriate follow-up treatment strategies for patients with neovascular AMD.

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