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Baseline VEGF levels predict resistance to anti-VEGF treatment, could tailor future treatments
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NUSA DUA, Indonesia — Aqueous vascular endothelial growth factor levels measured at baseline correlated to persistent leakage at 3 months, a small study showed; the researcher suggested this could help tailor future treatments.
 Timothy Y.Y. Lai |
"Higher aqueous VEGF concentration at baseline was associated with an increased risk of persistent leakage at 3 months," Timothy Y.Y. Lai, MD, FRCS, said during the joint meeting of the Asia-Pacific Academy of Ophthalmology and the American Academy of Ophthalmology.
Dr. Lai presented a study of 50 eyes of 50 patients with subfoveal CNV, all of whom underwent 3 monthly load doses of intravitreal bevacizumab. Fluorescein angiography was performed at baseline and month 3, and aqueous tap was performed prior to injections at baseline and then again at month 1 and month 3.
Eyes with persistent leakage on angiography had significantly higher baseline VEGF levels than those who showed no leakage; eyes within the highest quartile of VEGF at baseline were the most likely to have persistent leakage at 3 months. After examination with a logistic regression model, baseline aqueous VEGF level was the only significant factor associated with persistent leakage at 3 months.
"We might be able to use this VEGF level in order to tailor our anti-VEGF therapy. For example, we might consider offering more anti-VEGF injections in patients with high initial VEGF level and we have to offer closer monitoring in case they have a higher VEGF level," Dr. Lai said.