Abstract
Purpose: :
To investigate baseline factors significantly associated with visual acuity (VA) and central retinal thickness outcomes in patients with macular edema secondary to retinal vein occlusion in the Standard Care versus COrticosteroid for REtinal Vein Occlusion (SCORE) Study.
Methods: :
The SCORE Study evaluated intravitreal triamcinolone injection(s) (1mg or 4mg) versus standard care for vision loss associated with macular edema secondary to central or branch retinal vein occlusion (CRVO or BRVO, respectively). Visual acuity was measured by the electronic Early Treatment Diabetic Retinopathy Study method and central retinal thickness by optical coherence tomography (OCT). Outcome measures of visual acuity letter score include absolute change from baseline, a gain of 15 letters or more from baseline, and a loss of 15 letters or more from baseline. Outcome measures of center point thickness include absolute change from baseline, a measurement of 250 microns or less, and a measurement of 500 microns or more. Outcomes were assessed at 1 and 2 years. Logistic and ordinary least squares regression related these outcomes to 20 baseline measures. Multiple p-values were adjusted to control the false discovery rate.
Results: :
For CRVO and BRVO, younger age was significantly associated with improved VA and central retinal thickness outcomes. For CRVO, treatment with triamcinolone and less severe anatomical abnormalities of the retina (center point thickness and areas of retinal hemorrhage, thickening, and fluorescein leakage) were predictive of better VA outcomes. For BRVO, lack of coronary artery disease history was predictive of improved VA outcomes. For OCT outcomes, shorter duration of macular edema and anatomical features of the retina were significantly associated with improvement in both disease entities. For CRVO, higher baseline VA letter score, and for BRVO, lower baseline VA letter score, dense macular hemorrhage and absence of prior grid photocoagulation were predictive of favorable OCT outcomes.
Conclusions: :
Several baseline factors were predictive of better VA and OCT outcomes. These factors may assist in predicting the disease course for patients similar to those in the SCORE Study.
Clinical Trial: :
www.clinicaltrials.gov NCT00105027