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Matus Rehak, Catharina Busch, Pia-Sophie Lamprecht, Peter MH Wiedemann; Predictors for very Long time visual outcome in macular edema secondary to retinal vein occlusion treated in real-world setting. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2568.
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To evaluate the functional and anatomical ≧4-year outcome in patients with macular edema (ME) due to central (CRVO) and branch retinal vein occlusion (BRVO) treated with anti-VEGF drugs as ranibizumab (RAN) and aflibercept (AFL) and dexamethasone implant (DEX) in real life setting and to identify its clinical predictors.
The retrospective, single center, real-world chart review evaluated the best-corrected visual acuity (BCVA), central subfield thickness (CST), demographic and retinal morphological baseline characteristics in consecutive patients with ME secondary to CRVO/BRVO with follow-up time ≥ 48 months.
A total of 92 eyes (43 CRVO, 49 BRVO eyes) from 92 patients were analyzed. The mean follow-up time was 56.3 months (range 48-99 months). The mean BCVA improved significantly during the follow up of 48 months in CRVO group from 55.2±14.1 ETDRS letters to 64.4±19.6 ETDRS letters and BRVO patients from 59.7±11,7 ETDRS letters to 68.2±15.5 ETDRS letters. In CRVO the mean number of injections within this period was 19.3 and in BRVO 16.1 injections. A higher patients age (>70 years); worse baseline BCVA; baseline CRT>500µm; VA gain <6 ETDRS letters at 6 months; the duration of RVO >3 months, and increased foveolar avascular zone with disruption of the external limiting membrane and IS/OS layer were correlated with a worse final functional outcome. Patients that gained ≥ 10 ETDRS letters after 6 months were more likely to reach the gain of ≥ 5 ETDRS letter also after 48 months (P < 0.001).
For the long-term functional outcomes in patients with ME secondary to BRVO/CRVO treated in a real-world setting following negative predictive factors were found: age >70 years, the baseline macular thickness> 500µm, the duration of RVO >3 months, VA gain <6 ETDRS letters at 6 months as well as increased foveolar avascular zone, and the disruption of the external limiting membrane and the IS/OS layer.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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