June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Fluctuations in Retinal Thickness in Patients with Retinal Vein Occlusion Treated with Anti-Vascular Endothelial Growth Factor Agents
Author Affiliations & Notes
  • Andrew Xie Chen
    Case Western Reserve University School of Medicine, Saline, Michigan, United States
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Jessica L. Cao
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Tyler E Greenlee
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
    Center for Ophthalmic Bioinformatics, Cleveland Clinic, Cleveland, Ohio, United States
  • Thais Conti
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
    Center for Ophthalmic Bioinformatics, Cleveland Clinic, Cleveland, Ohio, United States
  • Rishi P Singh
    Case Western Reserve University School of Medicine, Saline, Michigan, United States
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Andrew Chen, None; Jessica Cao, None; Tyler Greenlee, None; Thais Conti, None; Rishi Singh, Alcon/Novartis (F), Alcon/Novartis (C), Apellis (F), Bausch and Lomb (C), Genentech/Roche (F), Genentech/Roche (C), Graybug (F), Ophthea (C), Regeneron (F), Regeneron (C), Zeiss (C)
  • Footnotes
    Support  Dr. Singh reports personal fees from Genentech/Roche, personal fees from Alcon/Novartis , grants from Apellis, personal fees from Zeiss, personal fees from Bausch + Lomb, personal fees from Ophthea, grant from Graybug, personal fees from Regeneron Pharmaceutigals, Inc. This project also cites support from an unrestricted grant award from Research to Prevent Blindness to the Department of Ophthalmology at Cole Eye Institute (RPB1508DM).
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 1345. doi:
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      Andrew Xie Chen, Jessica L. Cao, Tyler E Greenlee, Thais Conti, Rishi P Singh; Fluctuations in Retinal Thickness in Patients with Retinal Vein Occlusion Treated with Anti-Vascular Endothelial Growth Factor Agents. Invest. Ophthalmol. Vis. Sci. 2020;61(7):1345.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Anti-vascular endothelial growth factor (anti-VEGF) agents have emerged as a mainstay of therapy for macular edema secondary to retinal vein occlusion (RVO). While reductions in retinal thickness have been associated with a response to therapy and subsequent improvement in visual acuity (VA), few studies have examined fluctuations in retinal thickness and their relationship to VA outcomes. This retrospective, observational cohort study tests the hypothesis that patients with larger fluctuations in retinal thickness have poorer visual outcomes.

Methods : This study evaluated 134 treatment-naïve RVO (71 branch RVO/hemi-RVO, 63 central RVO) eyes seen at Cole Eye Institute, Cleveland Clinic, from January 1, 2012 to October 30, 2019 over 12 months of anti-VEGF treatment. From optical coherence tomography scans (OCT), central subfield thickness (CST) was collected at baseline, 3, 6, 9, and 12 months. Eyes were excluded if confounding maculopathy was present or if they received steroid or laser treatment during the study period. Eyes were divided into quartiles based on CST standard deviation (SD) and 12-month VA was compared. A mixed effects regression model was used to examine the relationship between the CST SD and 12-month VA, while adjusting for baseline CST, baseline VA, and number of injections.

Results : Mean CST SD for the cohort was 114.1±7.0 µm (mean±SD). Initial CST was 488.6±165 µm and final CST was 334.3±131.9 µm (p<0.001). Mean number of injections was 7.4±2.2. Initial and final VA were 52.8±20.9 and 65.9±17.3 ETDRS letters, respectively (p<0.001). Mixed effects regression revealed that CST SD had a significant, negative association with 12 month VA (p=0.012) when adjusting for baseline factors and injections.

Conclusions : Larger fluctuations in retinal thickness are associated with poorer visual outcomes in patients with RVO who are treated with anti-VEGF agents. Ongoing work will explore other measures of retinal thickness, such as cube volume and cube average thickness, and relationships between thickness fluctuations and morphologic outcomes such as persistence of macular fluid on OCT.

This is a 2020 ARVO Annual Meeting abstract.

 

Figure 1. Visual outcomes stratified by retinal thickness variability. Eyes were divided into quartiles based on CST SD. First quartile is set as reference group. Dots and error bars represent 12-month VA mean and SD, respectively.

Figure 1. Visual outcomes stratified by retinal thickness variability. Eyes were divided into quartiles based on CST SD. First quartile is set as reference group. Dots and error bars represent 12-month VA mean and SD, respectively.

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