Changes in expression of DNA-methyltransferase in neovascular age-related macular degeneration: Anti-VEGF response or disease severity?

Purpose

Recent studies suggest distinct patterns of DNA methyltransferase (DNMT) expression across different stages of age-related macular degeneration (AMD). However, whether these variations can be modulated by conventional therapeutic approaches remains unexplored. This study investigates DNMT expression dynamics in two patients with exudative neovascular AMD (nAMD) during the initial months of anti-VEGF treatment. Observations: Case 1, a female in her 90s was seen for sudden loss of vision secondary to macular hemorrhage. During type 1 macular neovascularization (t1MNV) anti-VEGF treatment, DNMT analysis revealed sustained upregulation of DNMT1 (+116%) and DNMT3b (+179%) while exudative MNV remained presisted.Case 2, a female in her 70s and asymptomatic subretinal fluid secondary to t1MNV showed a distinct DNMT expression pattern, with a more modest increase in DNMT1 (+28.9%) and DNMT3b (+17.6%) when exudation was resolved.