Baseline VEGF levels predict resistance to anti-VEGF treatment Aqueous vascular endothelial growth factor (VEGF) levels measured at baseline correlated to persistent leakage at 3 months, a small study showed; the researcher suggested this could help tailor future treatments.

"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 2009 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 Avastin (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.

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