ABSTRACT
PURPOSE: To investigate the influence of the Factor H (CFH) Tyr4°²His polymorphism on the plasma levels of the alternative pathway proteins CFH, C3, Factor B (FB), Factor D (FD), and Factor I (FI) and the inflammatory marker C-reactive protein (CRP) in 119 patients with age-related macular degeneration (AMD) and 152 unrelated control individuals. METHODS: Patients with AMD and the control group were separated according to CFH polymorphism, age, and gender. Plasma complement proteins and CRP concentrations were determined with enzyme-linked immunosorbent assay, immunodiffusion, or nephelometry. RESULTS: Significant differences in the concentrations of FD and FI were observed between the patients with AMD and the control individuals. We observed significantly reduced FD plasma levels in patients with AMD. We also identified a significant decrease in CFH plasma levels in female patients with AMD in relation to female controls. Plasma FI levels were significantly increased in patients with AMD compared to the control group. Regarding gender, a significant increase in FI plasma levels was observed in male patients. Finally, we found no significant correlation between the CFH Tyr(402)His polymorphism and the CFH, C3, FB, FD, FI, and CRP plasma levels. CONCLUSIONS: Patients with AMD present altered levels of FD and FI in a manner independent of this CFH polymorphism, and gender apparently contributes to the plasma levels of these two proteins in patients with AMD and control individuals.
Subject(s)
Complement Factor H/genetics , Complement Pathway, Alternative/genetics , Macular Degeneration/genetics , Aged , Aged, 80 and over , C-Reactive Protein/metabolism , Case-Control Studies , Complement C3/metabolism , Complement Factor B/metabolism , Complement Factor D/metabolism , Complement Factor H/metabolism , Complement Factor I/metabolism , Enzyme-Linked Immunosorbent Assay , Female , Genotype , Humans , Macular Degeneration/blood , Male , Middle Aged , Polymorphism, Single Nucleotide , Sex FactorsABSTRACT
BACKGROUND AND OBJECTIVE: To evaluate visual acuity and anatomical outcomes of choroidal neovascularization (CNV) associated with angioid streaks after treatment with intravitreal bevacizumab injections. PATIENTS AND METHODS: Best-corrected visual acuity, optical coherence tomography measurements (OCT), fluorescein and indocyanine green angiography, and ophthalmoscope examination at baseline and at each follow-up visit were performed. Five patients with CNV associated with angioid streaks were treated with injections of intravitreal bevacizumab (1.25 mg/0.05 mL). Re-treatment was recommended with symptomatic lesions, new subretinal hemorrhages, leakage on fluorescein and indocyanine green angiography, and/or fluid documented by OCT. Follow-up ranged between 18 and 32 months. RESULTS: All eyes showed an improvement of visual acuity and were treated with at least four injections of intravitreal bevacizumab. Reduction of the leakage shown by fluorescein angiography and OCT was noted in all patients. CONCLUSION: Intravitreal bevacizumab appears to be effective in stabilizing and recovering visual acuity in eyes with CNV associated with angioid streaks. Patients with early symptoms might benefit more.
Subject(s)
Angiogenesis Inhibitors/administration & dosage , Angioid Streaks/complications , Antibodies, Monoclonal/administration & dosage , Choroidal Neovascularization/drug therapy , Choroidal Neovascularization/etiology , Adult , Angioid Streaks/drug therapy , Angioid Streaks/physiopathology , Antibodies, Monoclonal, Humanized , Bevacizumab , Choroidal Neovascularization/physiopathology , Coloring Agents , Fluorescein Angiography , Follow-Up Studies , Humans , Indocyanine Green , Intravitreal Injections , Male , Middle Aged , Retreatment , Tomography, Optical Coherence , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Visual Acuity/physiology , Young AdultABSTRACT
PURPOSE: The aim of this study was investigate the association between complement Factor H polymorphism (Y402H) and age-related macular degeneration (AMD) in Brazilian patients. METHODS: Patients with AMD aged 50 or more and age-matched healthy controls were enrolled in the study. Genomic DNA was isolated from leucocytes of patients and controls; the Y402H polymorphism of complement Factor H gene (CFH) was determined by polymerase chain reaction directed sequencing. RESULTS: The frequency of 1277C allele of Factor H was 56.30% in patients with AMD compared with 36.51% in controls (p-value=0.001). The genotypic distribution differed significantly between the two groups (1277CC 36.98%, 1277CT 38.65% and 1277TT 24.37% for AMD group; 1277CC 13.16%, 1277CT 46.71% and 1277TT 40.13% for controls, p-value=0.001). The odds ratio for patients with AMD carrying only one 1277C allele was 1.36 and for those carrying two 1277C alleles was 4.63, when compared to the control group. CONCLUSIONS: These results suggest the Y402H polymorphism of CFH is a risk factor to the development of AMD in Brazilian patients. This is in accordance with findings from the majority of previous study population in Europe and North American.
