Leukocyte Telomere Length and Response to Antiangiogenic Therapy in Patients with Neovascular Age-Related Macular Degeneration

Abstract

Age-related macular degeneration (AMD) is becoming the leading cause of vision loss in people over 60 yr of age. The neovascular form of AMD (nAMD) is characterized by choroidal neovascularization (CNV), the main trigger of which is vascular endothelial growth factor (VEGF), the inhibition of which is the current standard of treatment. Significant variability of response to anti-VEGF therapy determines the relevance of the search for biological markers—prognostic criteria of treatment response. We analyzed the response of 110 nAMD patients to anti-VEGF therapy depending on the functional and anatomical parameters of the retina (according to optical coherence tomography, OCT) and leukocyte telomere length (LTL, was assessed by quantitative PCR). Positive dynamics of best corrected visual acuity (BCVA) was observed in 100% of eyes. The central retinal thickness (CRT) decreased after the 3rd injection to 265 [234–306] µm, by the end of the observation period—to 211 [190–262] µm. The retention of activity of the subretinal neovascular membrane (SNM) at the end of the observation period correlated with lower values of the initial BCVA and high values of the initial CRT. An association of LTL with response to treatment was revealed: in patients with longer LTL the active form of SNM was more often switched to inactive after three injections, while with shorter LTL, the activity of SNM was more often preserved, which determined the need for more intravitreal injections.