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Genetic Polymorphisms Affecting Ranibizumab Response in High Myopia Patients. Pharmaceutics 2021; 13:pharmaceutics13111973. [PMID: 34834388 PMCID: PMC8620862 DOI: 10.3390/pharmaceutics13111973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 11/17/2022] Open
Abstract
High myopia is an ophthalmic pathology that affects half of the young adults in the United States and Europe and it is predicted that a third of the world’s population could be nearsighted at the end of this decade. It is characterized by at least 6 diopters or axial length > 26 mm and, choroidal neovascularization (CNV) in 5 to 11% of cases. Ranibizumab is a recombinant humanized monoclonal antibody fragment. It is an anti-vascular endothelial growth factor (anti-VEGF) drug used in the treatment of CNV. Many genetic polymorphisms have been associated with interindividual differences in the response to ranibizumab, but these associations were not yet assessed among patients with high myopia and CNV. We performed a retrospective study assessing the association of genetic polymorphisms with response to ranibizumab in patients with CNV secondary to high myopia (mCNV). We included genetic polymorphisms previously associated with the response to drugs used in CNV patients (bevacizumab, ranibizumab, aflibercept, and photodynamic therapy (PDT)). We also included genetic variants in the VEGFA gene. Based on our results, ARMS2 (rs10490924) and CFH (rs1061170) are associated with response to ranibizumab in high myopia patients; and, included VEGFA genetic polymorphisms are not associated with ranibizumab response in our population but might be related to a higher risk of CNV.
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Liukkonen MPK, Paterno JJ, Kivinen N, Siintamo L, Koskela AKJ, Kaarniranta K. Epithelial-mesenchymal transition-related serum markers ET-1, IL-8 and TGF-β2 are elevated in a Finnish wet age-related macular degeneration cohort. Acta Ophthalmol 2021; 100:e1153-e1162. [PMID: 34699684 DOI: 10.1111/aos.15051] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 09/16/2021] [Accepted: 10/11/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE It has been hypothesized that epithelial-mesenchymal transition (EMT) may occur in the retinal pigment epithelium of advanced stage age-related macular degeneration (AMD). Various serum and plasma growth factors and inflammatory mediators have been linked to AMD. We were interested in finding out whether systemic levels of EMT-associated markers were altered in the serum of wet AMD patients. Serum biomarkers associated with the various pathological processes of AMD may present an avenue towards identifying and characterizing the birth mechanisms of wet AMD, its progression and severity, paving the way towards the application of precision medicine. METHODS We chose to measure the serum levels of known biomarkers of EMT - EGF (epidermal growth factor), ET-1 (endothelin 1), IL-8 (interleukin 8), TGF-β1 and TGF-β2 (transforming growth factor-beta 1 and 2) and VEGF-A (vascular endothelial growth factor A) - using enzyme-linked immunosorbent assays. We measured them from 71 Finnish wet AMD patients who were receiving intravitreal anti-VEGF-A injection treatments, as well as 64 age-adjusted controls. RESULTS We found significantly elevated levels of ET-1, IL-8 and TGF-β2 in the serums of wet AMD patients. CONCLUSIONS ET-1, IL-8 and TGF-β2 appear to be useful serum biomarkers in understanding active wet AMD. However, we cannot conclude that local retinal EMT-processes could be observed from the corresponding systemic serum biomarkers in patients undergoing anti-VEGF-A treatments.
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Affiliation(s)
- Mikko P. K. Liukkonen
- Department of Ophthalmology Institute of Clinical Medicine University of Eastern Finland Kuopio Finland
| | - Jussi J. Paterno
- Department of Ophthalmology Institute of Clinical Medicine University of Eastern Finland Kuopio Finland
- Department of Ophthalmology Kuopio University Hospital Kuopio Finland
| | - Niko Kivinen
- Department of Ophthalmology Kuopio University Hospital Kuopio Finland
| | - Leea Siintamo
- Department of Ophthalmology Kuopio University Hospital Kuopio Finland
| | - Ali K. J. Koskela
- Department of Ophthalmology Institute of Clinical Medicine University of Eastern Finland Kuopio Finland
| | - Kai Kaarniranta
- Department of Ophthalmology Institute of Clinical Medicine University of Eastern Finland Kuopio Finland
- Department of Ophthalmology Kuopio University Hospital Kuopio Finland
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Ulhaq ZS, Soraya GV. Roles of IL-8 -251A/T and +781C/T polymorphisms, IL-8 level, and the risk of age-related macular degeneration. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2021; 96:476-487. [PMID: 34479704 DOI: 10.1016/j.oftale.2020.02.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 02/19/2020] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To clarify the association between IL-8 gene polymorphisms, IL-8 level, towards the risk of age-related macular degeneration (AMD). METHODS Meta-analysis was performed from available studies that investigated IL-8 -251A/T (rs4073) and +781C/T (rs2227306) polymorphisms and IL-8 levels in patients with AMD and controls. RESULTS Overall, the pooled result showed a significant association between AMD with allelic (T vs. C; OR 1.53; p = 0.005), dominant (TT + CT vs. CC; OR 1.95; p = 0.017), homozygous (TT vs. CC; OR 2.03; p = 0.039) and heterozygous (CT vs. CC; OR 1.92; p = 0.032) models of rs2227306; while subgroup analysis revealed a significant association between rs2227306 with wet AMD in allelic (T vs. C; OR 1.69; p = 0.016), recessive (TT vs. CT + CC; OR 1.81; p = 0.00007), and homozygous (TT vs. CC; OR 2.64; p = 0.003) models. No significant association was observed between rs4073 with AMD in all inheritance models. In parallel, patients with AMD, particularly wet AMD had an elevated level of IL-8 compared to control. CONCLUSION This meta-analysis suggests that patients with AMD or wet AMD have higher IL-8 levels compared to control, which is also supported by the evidence that carrier T allele of rs2227306 exhibited an increase in the risk of AMD or wet AMD. Thus, IL-8 +781C/T (rs2227306) polymorphism and the level of intraocular IL-8 may be useful as a biomarker for early detection and a therapeutic target of AMD.
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Affiliation(s)
- Z S Ulhaq
- Departamento de Ciencia Bioquímica, Facultad de Medicina y Ciencias de la Salud, Universidad Estatal Islámica Maulana Malik Ibrahim, Batu, Indonesia.
| | - G V Soraya
- Departamento de Bioquímica, Facultad de Medicina, Universidad Hasanuddin, Macasar, Indonesia
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RETRACTED ARTICLE: Associations of IL-8 gene polymorphisms and IL-8 levels with predisposition to age-related macular degeneration: a meta-analysis. Aging Clin Exp Res 2020; 32:2703. [PMID: 32157592 DOI: 10.1007/s40520-020-01501-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 01/30/2020] [Indexed: 12/29/2022]
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Díaz-Villamarín X, Blánquez-Martínez D, Pozo-Agundo A, Pérez-Gutiérrez AM, Muñoz-Ávila JI, Antúnez-Rodríguez A, Fernández-Gómez AE, García-Navas P, Martínez-González LJ, Dávila-Fajardo CL. Genetic Variants Affecting Anti-VEGF Drug Response in Polypoidal Choroidal Vasculopathy Patients: A Systematic Review and Meta-Analysis. Genes (Basel) 2020; 11:E1335. [PMID: 33198211 PMCID: PMC7697983 DOI: 10.3390/genes11111335] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 12/12/2022] Open
Abstract
Polypoidal choroidal vasculopathy (PCV) is usually regarded as a subtype of choroidal neovascularization (CNV) that is secondary to age-related macular degeneration (AMD) characterized by choroidal vessel branching, ending in polypoidal lesions. Despite their close association, PCV and neovascular AMD have shown differences, especially regarding patients' treatment response. Currently, antivascular endothelial growth factor (anti-VEGF) drugs, such as ranibizumab, bevacizumab and aflibercept, have demonstrated their efficacy in CNV patients. However, in PCV, anti-VEGF treatments have shown inconclusive results. Many genetic polymorphisms have been associated with a variable response in exudative/wet AMD patients. Thus, the aim of this study is to explore the genetic variants affecting anti-VEGF drug response in PCV patients. In this regard, we performed a systematic review and meta-analysis. We found four variants (CFH I62V, CFH Y402H, ARMS2 A69S, and HTRA1-62A/G) that have been significantly related to response. Among them, the ARMS2 A69S variant is assessed in our meta-analysis. In conclusion, in order to implement anti-VEGF pharmacogenetics in clinical routines, further studies should be performed, distinguishing physio-pathogenic circumstances between PCV and exudative AMD and the combined effect on treatment response of different genetic variants.
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Affiliation(s)
- Xando Díaz-Villamarín
- Pharmacy Department, Hospital Universitario Clínico San Cecilio—Instituto de Investigación Biosanitaria (ibs.Granada), 18016 Granada, Spain; (A.E.F.-G.); (P.G.-N.); (C.L.D.-F.)
- Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research (GENYO), 18016 Granada, Spain; (A.P.-A.); (A.A.-R.); (L.J.M.-G.)
| | | | - Ana Pozo-Agundo
- Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research (GENYO), 18016 Granada, Spain; (A.P.-A.); (A.A.-R.); (L.J.M.-G.)
| | - Ana María Pérez-Gutiérrez
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18011 Granada, Spain;
| | | | - Alba Antúnez-Rodríguez
- Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research (GENYO), 18016 Granada, Spain; (A.P.-A.); (A.A.-R.); (L.J.M.-G.)
| | - Ana Estefanía Fernández-Gómez
- Pharmacy Department, Hospital Universitario Clínico San Cecilio—Instituto de Investigación Biosanitaria (ibs.Granada), 18016 Granada, Spain; (A.E.F.-G.); (P.G.-N.); (C.L.D.-F.)
| | - Paloma García-Navas
- Pharmacy Department, Hospital Universitario Clínico San Cecilio—Instituto de Investigación Biosanitaria (ibs.Granada), 18016 Granada, Spain; (A.E.F.-G.); (P.G.-N.); (C.L.D.-F.)
| | - Luis Javier Martínez-González
- Pfizer-University of Granada-Junta de Andalucía Centre for Genomics and Oncological Research (GENYO), 18016 Granada, Spain; (A.P.-A.); (A.A.-R.); (L.J.M.-G.)
| | - Cristina Lucía Dávila-Fajardo
- Pharmacy Department, Hospital Universitario Clínico San Cecilio—Instituto de Investigación Biosanitaria (ibs.Granada), 18016 Granada, Spain; (A.E.F.-G.); (P.G.-N.); (C.L.D.-F.)
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Lorés-Motta L, Riaz M, Grunin M, Corominas J, van Asten F, Pauper M, Leenders M, Richardson AJ, Muether P, Cree AJ, Griffiths HL, Pham C, Belanger MC, Meester-Smoor MA, Ali M, Heid IM, Fritsche LG, Chakravarthy U, Gale R, McKibbin M, Inglehearn CF, Schlingemann RO, Omar A, Chen J, Koenekoop RK, Fauser S, Guymer RH, Hoyng CB, de Jong EK, Lotery AJ, Mitchell P, den Hollander AI, Baird PN, Chowers I. Association of Genetic Variants With Response to Anti-Vascular Endothelial Growth Factor Therapy in Age-Related Macular Degeneration. JAMA Ophthalmol 2018; 136:875-884. [PMID: 29852030 PMCID: PMC6142943 DOI: 10.1001/jamaophthalmol.2018.2019] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 04/02/2018] [Indexed: 02/04/2023]
Abstract
Importance Visual acuity (VA) outcomes differ considerably among patients with neovascular age-related macular degeneration (nAMD) treated with anti-vascular endothelial growth factor (VEGF) drugs. Identification of pharmacogenetic associations may help clinicians understand the mechanisms underlying this variability as well as pave the way for personalized treatment in nAMD. Objective To identify genetic factors associated with variability in the response to anti-VEGF therapy for patients with nAMD. Design, Setting, and Participants In this multicenter genome-wide association study, 678 patients with nAMD with genome-wide genotyping data were included in the discovery phase; 1380 additional patients with nAMD were genotyped for selected common variants in the replication phase. All participants received 3 monthly injections of bevacizumab or ranibizumab. Clinical data were evaluated for inclusion/exclusion criteria from October 2014 to October 2015, followed by data analysis from October 2015 to February 2016. For replication cohort genotyping, clinical data collection and analysis (including meta-analysis) was performed from March 2016 to April 2017. Main Outcomes and Measures Change in VA after the loading dose of 3 monthly anti-VEGF injections compared with baseline. Results Of the 2058 included patients, 1210 (58.8%) were women, and the mean (SD) age across all cohorts was 78 (7.4) years. Patients included in the discovery cohort and most of the patients in the replication cohorts were of European descent. The mean (SD) baseline VA was 51.3 (20.3) Early Treatment Diabetic Retinopathy Study (ETDRS) score letters, and the mean (SD) change in VA after the loading dose of 3 monthly injections was a gain of 5.1 (13.9) ETDRS score letters (ie, 1-line gain). Genome-wide single-variant analyses of common variants revealed 5 independent loci that reached a P value less than 10 × 10-5. After replication and meta-analysis of the lead variants, rs12138564 located in the CCT3 gene remained nominally associated with a better treatment outcome (ETDRS letter gain, 1.7; β, 0.034; SE, 0.008; P = 1.38 × 10-5). Genome-wide gene-based optimal unified sequence kernel association test of rare variants showed genome-wide significant associations for the C10orf88 (P = 4.22 × 10-7) and UNC93B1 (P = 6.09 × 10-7) genes, in both cases leading to a worse treatment outcome. Patients carrying rare variants in the C10orf88 and UNC93B1 genes lost a mean (SD) VA of 30.6 (17.4) ETDRS score letters (ie, loss of 6.09 lines) and 26.5 (13.8) ETDRS score letters (ie, loss of 5.29 lines), respectively, after 3 months of anti-VEGF treatment. Conclusions and Relevance We propose that there is a limited contribution of common genetic variants to variability in nAMD treatment response. Our results suggest that rare protein-altering variants in the C10orf88 and UNC93B1 genes are associated with a worse response to anti-VEGF therapy in patients with nAMD, but these results require further validation in other cohorts.
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Affiliation(s)
- Laura Lorés-Motta
- Department of Ophthalmology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Moeen Riaz
- Centre for Eye Research Australia, Department of Surgery in Ophthalmology, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- Public Health Genomics, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Michelle Grunin
- Department of Ophthalmology, Hebrew University Hadassah Medical School, Hadassah Medical Center–Hebrew University, Jerusalem, Israel
| | - Jordi Corominas
- Department of Ophthalmology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Human Genetics, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Freekje van Asten
- Division of Epidemiology and Clinical Application, National Eye Institute, National Institutes of Health, Bethesda, Maryland
- Neurobiology, Neurodegeneration, and Repair Laboratory, National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | - Marc Pauper
- Department of Ophthalmology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Human Genetics, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Mathieu Leenders
- Department of Ophthalmology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Andrea J. Richardson
- Centre for Eye Research Australia, Department of Surgery in Ophthalmology, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Philipp Muether
- Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany
| | - Angela J. Cree
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, England
| | - Helen L. Griffiths
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, England
| | - Connie Pham
- Department Ophthalmology, McGill University Health Centre, Montreal, Québec, Canada
| | | | | | - Manir Ali
- Section of Ophthalmology and Neuroscience, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, England
| | - Iris M. Heid
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
| | - Lars G. Fritsche
- Norwegian University of Science and Technology, Trondheim, Norway
| | | | | | | | - Chris F. Inglehearn
- Section of Ophthalmology and Neuroscience, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, England
- Eye Clinic, St James’s University Hospital, Leeds, England
| | - Reinier O. Schlingemann
- Department of Ophthalmology, Ocular Angiogenesis Group, Academic Medical Center, Amsterdam, the Netherlands
- Netherlands Institute for Neuroscience, Amsterdam, the Netherlands
| | - Amer Omar
- Montreal Retina Institute, Westmount, Québec, Canada
| | - John Chen
- Department of Pediatric Surgery, McGill University Health Centre, Montreal, Québec, Canada
- Department of Human Genetics, McGill University Health Centre, Montreal, Québec, Canada
- Department of Ophthalmology, McGill University Health Centre, Montreal, Québec, Canada
| | - Robert K. Koenekoop
- Department of Pediatric Surgery, McGill University Health Centre, Montreal, Québec, Canada
- Department of Human Genetics, McGill University Health Centre, Montreal, Québec, Canada
- Department of Ophthalmology, McGill University Health Centre, Montreal, Québec, Canada
| | - Sascha Fauser
- Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany
- Roche Pharma Research and Early Development, Hoffmann–La Roche, Basel, Switzerland
| | - Robyn H. Guymer
- Centre for Eye Research Australia, Department of Surgery in Ophthalmology, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Carel B. Hoyng
- Department of Ophthalmology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Eiko K. de Jong
- Department of Ophthalmology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Andrew J. Lotery
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, England
| | - Paul Mitchell
- Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Anneke I. den Hollander
- Department of Ophthalmology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Human Genetics, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Paul N. Baird
- Centre for Eye Research Australia, Department of Surgery in Ophthalmology, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Itay Chowers
- Department of Ophthalmology, Hebrew University Hadassah Medical School, Hadassah Medical Center–Hebrew University, Jerusalem, Israel
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Lorés-Motta L, de Jong EK, den Hollander AI. Exploring the Use of Molecular Biomarkers for Precision Medicine in Age-Related Macular Degeneration. Mol Diagn Ther 2018; 22:315-343. [PMID: 29700787 PMCID: PMC5954014 DOI: 10.1007/s40291-018-0332-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Precision medicine aims to improve patient care by adjusting medication to each patient's individual needs. Age-related macular degeneration (AMD) is a heterogeneous eye disease in which several pathways are involved, and the risk factors driving the disease differ per patient. As a consequence, precision medicine holds promise for improved management of this disease, which is nowadays a main cause of vision loss in the elderly. In this review, we provide an overview of the studies that have evaluated the use of molecular biomarkers to predict response to treatment in AMD. We predominantly focus on genetic biomarkers, but also include studies that examined circulating or eye fluid biomarkers in treatment response. This involves studies on treatment response to dietary supplements, response to anti-vascular endothelial growth factor, and response to complement inhibitors. In addition, we highlight promising new therapies that have been or are currently being tested in clinical trials and discuss the molecular studies that can help identify the most suitable patients for these upcoming therapeutic approaches.
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Affiliation(s)
- Laura Lorés-Motta
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Philips van Leydenlaan 15, 6525 EX, Nijmegen, The Netherlands
| | - Eiko K de Jong
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Philips van Leydenlaan 15, 6525 EX, Nijmegen, The Netherlands
| | - Anneke I den Hollander
- Department of Ophthalmology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Philips van Leydenlaan 15, 6525 EX, Nijmegen, The Netherlands.
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
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Arslan J, Baird PN. Changing vision: a review of pharmacogenetic studies for treatment response in age-related macular degeneration patients. Pharmacogenomics 2018; 19:435-461. [DOI: 10.2217/pgs-2017-0183] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Nonresponsiveness to age-related macular degeneration (AMD) treatments has become a growing concern in ophthalmology. Disparity among publications that have assessed pharmacogenetic (PGx) connections between AMD disease genes and treatments has delayed the implementation of PGx testing in AMD. We assessed all AMD PGx publications to identify the degree of agreement for publications within similar ethnic cohorts and worldwide, and the causes for differences in study outcomes. There are no accepted genotype–phenotype correlations, either within similar ethnic cohorts or worldwide. The diversity of measured outcomes, treatment protocols and statistical methods used may be causing this discrepancy. A universally accepted treatment protocol and the creation of agreed response group classification may bridge the gap between AMD PGx publications.
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Affiliation(s)
- Janan Arslan
- Department of Surgery (Ophthalmology), Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye & Ear Hospital, East Melbourne, Victoria, 3002, Australia
| | - Paul N Baird
- Department of Surgery (Ophthalmology), Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye & Ear Hospital, East Melbourne, Victoria, 3002, Australia
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Yamashiro K, Mori K, Honda S, Kano M, Yanagi Y, Obana A, Sakurada Y, Sato T, Nagai Y, Hikichi T, Kataoka Y, Hara C, Koyama Y, Koizumi H, Yoshikawa M, Miyake M, Nakata I, Tsuchihashi T, Horie-Inoue K, Matsumiya W, Ogasawara M, Obata R, Yoneyama S, Matsumoto H, Ohnaka M, Kitamei H, Sayanagi K, Ooto S, Tamura H, Oishi A, Kabasawa S, Ueyama K, Miki A, Kondo N, Bessho H, Saito M, Takahashi H, Tan X, Azuma K, Kikushima W, Mukai R, Ohira A, Gomi F, Miyata K, Takahashi K, Kishi S, Iijima H, Sekiryu T, Iida T, Awata T, Inoue S, Yamada R, Matsuda F, Tsujikawa A, Negi A, Yoneya S, Iwata T, Yoshimura N. A prospective multicenter study on genome wide associations to ranibizumab treatment outcome for age-related macular degeneration. Sci Rep 2017; 7:9196. [PMID: 28835685 PMCID: PMC5569099 DOI: 10.1038/s41598-017-09632-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 07/27/2017] [Indexed: 01/23/2023] Open
Abstract
We conducted a genome-wide association study (GWAS) on the outcome of anti-VEGF treatment for exudative age-related macular degeneration (AMD) in a prospective cohort. Four hundred and sixty-one treatment-naïve AMD patients were recruited at 13 clinical centers and all patients were treated with 3 monthly injections of ranibizumab followed by pro re nata regimen treatment for one year. Genomic DNA was collected from all patients for a 2-stage GWAS on achieving dry macula after the initial treatment, the requirement for an additional treatment, and visual acuity changes during the 12-month observation period. In addition, we evaluated 9 single-nucleotide polymorphisms (SNPs) in 8 previously reported AMD-related genes for their associations with treatment outcome. The discovery stage with 256 patients evaluated 8,480,849 SNPs, but no SNPs showed genome-wide level significance in association with treatment outcomes. Although SNPs with P-values of <5 × 10−6 were evaluated in replication samples of 205 patients, no SNP was significantly associated with treatment outcomes. Among AMD-susceptibility genes, rs10490924 in ARMS2/HTRA1 was significantly associated with additional treatment requirement in the discovery stage (P = 0.0023), and pooled analysis with the replication stage further confirmed this association (P = 0.0013). ARMS2/HTRA1 polymorphism might be able to predict the frequency of injection after initial ranibizumab treatment.
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Affiliation(s)
- Kenji Yamashiro
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Sakyo, Kyoto, 606-8507, Japan. .,Department of Ophthalmology, Otsu Red Cross Hospital, Otsu, Shiga, 520-8511, Japan.
| | - Keisuke Mori
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, 350-0495, Japan.,Department of Ophthalmology, International University of Health and Welfare, Nasu-Shiobara, Tochigi, 329-2763, Japan
| | - Shigeru Honda
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Chuo, Kobe, 650-0017, Japan
| | - Mariko Kano
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, 960-1247, Japan.,Department of Ophthalmology, Tokyo Women's Medical University, Yachiyo Medical Center, Chiba, 276-0046, Japan
| | - Yasuo Yanagi
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, 113-0033, Japan.,Ophthalmology and Visual Sciences Program, Duke-NUS Medical School, National University of Singapore, Singapore, 119077, Singapore.,Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, 168751, Singapore
| | - Akira Obana
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Shizuoka, 430-8558, Japan
| | - Yoichi Sakurada
- Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, 409-3898, Japan
| | - Taku Sato
- Department of Ophthalmology, Gunma University School of Medicine, Gunma, 371-0034, Japan.,Takasaki Sato Eye Clinic, Gunma, 370-0036, Japan
| | - Yoshimi Nagai
- Department of Ophthalmology, Kansai Medical University, Osaka, 573-1191, Japan
| | - Taiichi Hikichi
- Ohtsuka Eye Hospital, Sapporo, 001-0016, Japan.,Hikichi Eye Clinic, Sapporo, 060-0807, Japan
| | | | - Chikako Hara
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
| | - Yasurou Koyama
- Department of Ophthalmology, Shimane University Faculty of Medicine, Shimane, 693-0021, Japan
| | - Hideki Koizumi
- Department of Ophthalmology, Tokyo Women's Medical University, School of Medicine, Tokyo, 162-8666, Japan
| | - Munemitsu Yoshikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Sakyo, Kyoto, 606-8507, Japan
| | - Masahiro Miyake
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Sakyo, Kyoto, 606-8507, Japan
| | - Isao Nakata
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Sakyo, Kyoto, 606-8507, Japan.,Department of Ophthalmology, Otsu Red Cross Hospital, Otsu, Shiga, 520-8511, Japan
| | - Takashi Tsuchihashi
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, 350-0495, Japan
| | - Kuniko Horie-Inoue
- Division of Gene Regulation and Signal Transduction, Research Center for Genomic Medicine, Saitama Medical University, Hidaka, Saitama, 350-1241, Japan
| | - Wataru Matsumiya
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Chuo, Kobe, 650-0017, Japan
| | - Masashi Ogasawara
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, 960-1247, Japan
| | - Ryo Obata
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, 113-0033, Japan
| | - Seigo Yoneyama
- Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, 409-3898, Japan
| | - Hidetaka Matsumoto
- Department of Ophthalmology, Gunma University School of Medicine, Gunma, 371-0034, Japan
| | - Masayuki Ohnaka
- Department of Ophthalmology, Kansai Medical University, Osaka, 573-1191, Japan
| | | | | | - Sotaro Ooto
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Sakyo, Kyoto, 606-8507, Japan
| | - Hiroshi Tamura
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Sakyo, Kyoto, 606-8507, Japan
| | - Akio Oishi
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Sakyo, Kyoto, 606-8507, Japan
| | - Sho Kabasawa
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, 350-0495, Japan
| | - Kazuhiro Ueyama
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, 350-0495, Japan
| | - Akiko Miki
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Chuo, Kobe, 650-0017, Japan
| | - Naoshi Kondo
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Chuo, Kobe, 650-0017, Japan
| | - Hiroaki Bessho
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Chuo, Kobe, 650-0017, Japan
| | - Masaaki Saito
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, 960-1247, Japan.,Department of Ophthalmology and Visual Sciences, Akita University Graduate School of Medicine, Akita, 010-8543, Japan
| | - Hidenori Takahashi
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, 113-0033, Japan.,Department of Ophthalmology, Jichi Medical University, Tochigi, 329-0498, Japan
| | - Xue Tan
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, 113-0033, Japan
| | - Keiko Azuma
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, 113-0033, Japan
| | - Wataru Kikushima
- Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, 409-3898, Japan
| | - Ryo Mukai
- Department of Ophthalmology, Gunma University School of Medicine, Gunma, 371-0034, Japan
| | - Akihiro Ohira
- Department of Ophthalmology, Shimane University Faculty of Medicine, Shimane, 693-0021, Japan
| | - Fumi Gomi
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan.,Department of Ophthalmology, Hyogo College of Medicine, Hyogo, 663-8501, Japan
| | | | - Kanji Takahashi
- Department of Ophthalmology, Kansai Medical University, Osaka, 573-1191, Japan
| | - Shoji Kishi
- Department of Ophthalmology, Gunma University School of Medicine, Gunma, 371-0034, Japan.,Maebashi Central Eye Clinic, Gunma, 371-0031, Japan
| | - Hiroyuki Iijima
- Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, 409-3898, Japan
| | - Tetsuju Sekiryu
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, 960-1247, Japan
| | - Tomohiro Iida
- Department of Ophthalmology, Tokyo Women's Medical University, School of Medicine, Tokyo, 162-8666, Japan
| | - Takuya Awata
- Department of Diabetes, Endocrinology and Metabolism, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasu-Shiobara, Tochigi, 329-2763, Japan
| | - Satoshi Inoue
- Division of Gene Regulation and Signal Transduction, Research Center for Genomic Medicine, Saitama Medical University, Hidaka, Saitama, 350-1241, Japan
| | - Ryo Yamada
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, 606-8507, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, 606-8507, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Sakyo, Kyoto, 606-8507, Japan.,Department of Ophthalmology, Kagawa University Faculty of Medicine, Miki, Kagawa, 761-0793, Japan
| | - Akira Negi
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Chuo, Kobe, 650-0017, Japan
| | - Shin Yoneya
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, 350-0495, Japan
| | - Takeshi Iwata
- Division of Molecular and Cellular Biology, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, 152-8902, Japan
| | - Nagahisa Yoshimura
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Sakyo, Kyoto, 606-8507, Japan
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ANTERIOR CHAMBER FLARE DURING BEVACIZUMAB TREATMENT IN EYES WITH EXUDATIVE AGE-RELATED MACULAR DEGENERATION. Retina 2017; 36:2183-2190. [PMID: 27135211 DOI: 10.1097/iae.0000000000001061] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE To study the anterior chamber flare during bevacizumab treatment of exudative age-related macular degeneration. METHODS During a 2-year prospective follow-up, 50 patients recently diagnosed with exudative age-related macular degeneration were treated at once-a-month visits if subretinal or intraretinal fluid or a new hemorrhage was present in the lesion area. Flare was measured weekly during the first month and then monthly in both eyes. RESULTS Higher flare was associated with older age (P = 0.007, Linear Mixed Model), higher number of smoking pack-years (P = 0.019), macular cysts (P = 0.041), and pseudophakia (P = 0.003). The levels gradually increased during the follow-up (P < 0.0001) but less in the eyes with classic CNV (P = 0.011). Flare decreased during treatment-free periods lasting for at least two consecutive visits (P = 0.005). A peak in flare was observed 1 week after the first injection (P = 0.034, Wilcoxon signed rank test). In the fellow eyes, higher flare values in the beginning of the follow-up were associated with later conversion into exudative age-related macular degeneration (P = 0.015, Mann-Whitney U test). CONCLUSION Anterior chamber flare correlated poorly with the CNV activity. Higher levels may, however, precede or exist early in the process that leads to the development of exudative age-related macular degeneration.
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11
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Hong N, Shen Y, Yu CY, Wang SQ, Tong JP. Association of the polymorphism Y402H in the CFH gene with response to anti-VEGF treatment in age-related macular degeneration: a systematic review and meta-analysis. Acta Ophthalmol 2016; 94:334-45. [PMID: 27151934 DOI: 10.1111/aos.13049] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 02/04/2016] [Indexed: 12/19/2022]
Abstract
To explore whether the complement factor H (CFH) polymorphism rs1061170/Y402H is associated with responsiveness to antivascular endothelial growth factor (VEGF) agents in age-related macular degeneration (AMD). We reviewed the English literature to examine the association between the polymorphism rs1061170/Y402H of the CFH gene and responsiveness to treatment with anti-VEGF drugs in AMD patients. A meta-analysis of eligible studies was also performed. Pooled odds ratios (ORs) and 95% CIs were estimated using Stata V.12.0. Statistical heterogeneity was measured using Q-statistic testing. Fourteen relevant studies including a total of 2963 AMD patients were eligible. In AMD patients without a treatment history, individuals carrying the rs1061170/Y402H TT genotype were more likely to achieve a better outcome (OR = 1.932, 95% CI = 1.125-3.317, p = 0.017) than those carrying the CC genotype. The polymorphism rs1061170/Y402H might be a genetic predictor of treatment response to anti-VEGF therapy in AMD patients. Further prospective research including a larger number of patients is needed to validate this finding.
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Affiliation(s)
- Nan Hong
- Department of Ophthalmology; the First Affiliated Hospital of College of Medicine; Zhejiang University; Hangzhou China
| | - Ye Shen
- Department of Ophthalmology; the First Affiliated Hospital of College of Medicine; Zhejiang University; Hangzhou China
| | - Chen-Ying Yu
- Department of Ophthalmology; the First Affiliated Hospital of College of Medicine; Zhejiang University; Hangzhou China
| | - Shu-Qun Wang
- Department of Ophthalmology; the First Affiliated Hospital of College of Medicine; Zhejiang University; Hangzhou China
| | - Jian-Ping Tong
- Department of Ophthalmology; the First Affiliated Hospital of College of Medicine; Zhejiang University; Hangzhou China
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12
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Lazzeri S, Orlandi P, Piaggi P, Sartini MS, Casini G, Guidi G, Figus M, Fioravanti A, Di Desidero T, Ripandelli G, Parravano M, Varano M, Nardi M, Bocci G. IL-8 and VEGFR-2 polymorphisms modulate long-term functional response to intravitreal ranibizumab in exudative age-related macular degeneration. Pharmacogenomics 2015; 17:35-9. [PMID: 26653034 DOI: 10.2217/pgs.15.153] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
AIM To investigate possible associations between VEGFR-2 and IL-8 gene SNPs and 1-year response to intravitreal ranibizumab for exudative age-related macular degeneration. MATERIALS & METHODS Sixty-four eyes underwent a loading phase of three monthly intravitreal injections of ranibizumab 0.5 mg/0.05 ml followed by Pro Re Nata retreatment. VEGFR-2 rs2071559 (-604 A/G) and IL-8 rs4073 (-251 A/T) were analyzed. RESULTS Ranibizumab was significantly more effective as measured by visual acuity in patients harboring the IL-8 rs4073 TT genotype (p = 0.045), whereas patients carrying the VEGFR-2 rs2071559 CC genotype revealed better functional response as measured by mean retinal sensitivity (p = 0.034). CONCLUSION IL-8 rs4073 and VEGFR-2 rs2071559 genotypes may represent important molecular determinants to modulate final outcomes in neovascular age-related macular degeneration patients.
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Affiliation(s)
- Stefano Lazzeri
- Ophthalmology Unit, University of Pisa, Pisa, Italy.,Fondazione G. B. Bietti, IRCCS Rome, Italy
| | - Paola Orlandi
- Division of Pharmacology, Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - Paolo Piaggi
- Department of Endocrinology & Metabolism, University of Pisa, Pisa, Italy.,Department of Energy & Systems Engineering, University of Pisa, Pisa, Italy
| | | | | | | | | | - Anna Fioravanti
- Division of Pharmacology, Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | - Teresa Di Desidero
- Division of Pharmacology, Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
| | | | | | | | - Marco Nardi
- Ophthalmology Unit, University of Pisa, Pisa, Italy
| | - Guido Bocci
- Division of Pharmacology, Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy
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13
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Hautamäki A, Seitsonen S, Holopainen JM, Moilanen JA, Kivioja J, Onkamo P, Järvelä I, Immonen I. The genetic variant rs4073 A→T of the Interleukin-8 promoter region is associated with the earlier onset of exudative age-related macular degeneration. Acta Ophthalmol 2015; 93:726-33. [PMID: 26154559 PMCID: PMC4758390 DOI: 10.1111/aos.12799] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 05/31/2015] [Indexed: 12/13/2022]
Abstract
Purpose To study the association of the single nucleotide polymorphism (SNP) rs4073 in the interleukin‐8 (IL‐8) promoter region with the diagnosis and age of onset of exudative age‐related macular degeneration (AMD) in association with the known genetic risk factors for AMD and tobacco smoking. Methods Medical records, smoking history and angiograms or fundus photographs of 301 patients with exudative AMD, 72 patients with dry AMD and 119 control subjects were analysed retrospectively. The associations of IL‐8 rs4073 A→T, CFH rs1061170 T→C, ARMS2 rs10490924 G→T and C3 rs2230199 C→G SNPs with the presence of AMD and with the age of onset of exudative AMD were analysed. Results Younger age of exudative AMD onset was associated with the homozygous AA genotype of IL‐8 rs4073 (p = 0.009, Mann–Whitney U‐test), CC genotype of CFH rs1061170 (p = 0.016), TT genotype of ARMS2 rs10490924 (p = 0.001) and with current smoking (p = 0.002). The risk alleles C in CFH rs1061170 (p < 0.0001, Pearson chi‐square) and T in ARMS2 rs10490924 (p < 0.0001), as well as smoking (p < 0.0001), were more prevalent in AMD patients compared with controls. No association was found between the IL‐8 rs4073 genotype and the presence of AMD. Conclusion Out of the factors associated with the earlier onset of exudative AMD, only the genotype of IL‐8 rs4073 did not appear as a risk factor for AMD in general. IL‐8 may have a role in accelerating the development of the choroidal neovascularization in exudative AMD.
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Affiliation(s)
- Asta Hautamäki
- Department of Ophthalmology University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Sanna Seitsonen
- Department of Ophthalmology University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Juha M. Holopainen
- Department of Ophthalmology University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Jukka A. Moilanen
- Department of Ophthalmology University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Jarno Kivioja
- Department of Medical Genetics University of Helsinki Helsinki Finland
| | - Päivi Onkamo
- Department of Biological and Environmental Sciences University of Helsinki Helsinki Finland
| | - Irma Järvelä
- Department of Medical Genetics University of Helsinki Helsinki Finland
| | - Ilkka Immonen
- Department of Ophthalmology University of Helsinki and Helsinki University Hospital Helsinki Finland
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