Purchase this article with an account.
Jessica Hsueh, Karen Wai, Felipe Conti, Rishi P Singh; Impact of Time to anti-VEGF Intervention on Visual Outcomes for Patients Diagnosed with Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4277.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Anti-vascular endothelial growth factor (anti-VEGF) agents are a common treatment for macular edema secondary to retinal vein occlusion (RVO). Previous studies have shown that a delay of at least 6 months of treatment is associated with reduced visual recovery compared to immediate treatment. However, it is unclear what impact shorter delays have on final visual outcomes. This study analyzes the impact of time to treatment with anti-VEGF agents for patients with macular edema and RVO in routine clinical practice.
A retrospective study was conducted at a single academic institution. 155 patients naïve to anti-VEGF therapy with macular edema secondary to RVO were identified. Patients were divided into initiation of anti-VEGF treatment at ≤28 days after symptom onset (n=72, Group A), between 28 and 84 days (n=43, Group B), and ≥84 days (n=40, Group C). The main outcome measures were change in best corrected visual acuity (BCVA) and central subfield thickness (CST) at 3, 6, and 12 months of treatment. Patients missing outcome measures at ≥2 time points were excluded. Unpaired t tests and one-way ANOVA were used to compare BCVA and CST outcomes between groups.
Patients baseline demographics were well balanced between groups. The average patient age for groups A, B, and C was 67, 70, and 72 years (p=0.0757). Average time to treatment for groups A, B, and C was 15.4, 52.9, and 346 days (p<0.0001). Baseline CST for groups A, B, and C was 484.15, 484.21, 490.90 µm (p=0.9749). Baseline ETDRS for groups A, B, and C was 50.33, 46.35, 58.37 letters (p=0.1218). Average injections over 12 months for groups A, B, and C was 6.87, 6.50, 6.25 injections (p=0.9773). There was a significant CST decrease from baseline over 12 months for all groups (-184.14,-204.55, and -170.71µm for groups A, B, and C, respectively. p <0.0001). However, there was no significant difference between CST decrease between groups (p= 0.8493). Groups A and B showed significant BCVA improvement from baseline over 12 months (19.14 and 21.11, respectively. p<0.001 for both). However, there was not a significant BCVA improvement in Group C (4.01. p=0.2672).
While the anatomical response as measured by CST did not differ between groups, smaller BCVA improvements were related with longer time to treatment with anti-VEGF agents for patients with macular edema and RVO in routine clinical practice.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
This PDF is available to Subscribers Only