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Gloria Chi, Zdenka Haskova, Ching-Yi Chuo, Shih-Chen Chang; Real-world treatment patterns for macular edema secondary to retinal vein occlusion in the United States. Invest. Ophthalmol. Vis. Sci. 2020;61(7):1316.
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Treatment patterns were assessed among treatment-naïve adults newly diagnosed with macular edema (ME) secondary to branch or central retinal vein occlusion (BRVO or CRVO) in the United States.
A retrospective cohort study was conducted using Truven MarketScan claims data from January 2017–June 2018. International Classification of Diseases, Tenth Revision, Clinical Modification codes were used to identify adults with index diagnoses of ME secondary to BRVO (H34.83X0) or CRVO (H34.81X0). Patients with ≥180 days of lookback and ≥365 days of follow-up after index were included. We excluded patients with age-related macular degeneration, diabetic macular edema, and prior history of any treatment of interest (anti-vascular endothelial growth factor [anti-VEGF], laser, corticosteroid, or combination therapy). We described the treatments received by patients within 1 year of diagnosis. Among patients with anti-VEGF injections, the number of anti-VEGF injections received within 1 year were assessed.
We included 331 persons with BRVO and ME and 199 persons with CRVO and ME. Overall median follow-up after index was 1.3 years, and median age was 61 years. For ~60% of patients, no treatment was observed in the first year after diagnosis. The most common treatment was anti-VEGF injection only, representing 21% and 25% of the BRVO and CRVO groups, respectively. Among all patients who received treatment, >70% were observed to receive anti-VEGF alone or in combination with other treatment. Among persons with anti-VEGF injections, the mean number of injections within 1 year was 4.8 (standard deviation [SD]: 3.0) for BRVO and 5.0 (SD: 2.9) for CRVO.
While anti-VEGF injections were the most common therapy, ~60% of treatment-naïve patients newly diagnosed with RVO and ME did not receive treatment within the first year of diagnosis. Using claims data, we were unable to assess how treatment was related to disease severity. It is possible that untreated patients had ME that did not impact vision or had more mild disease that did not result in treatment. Additional research is needed to understand drivers of treatment in patients with RVO with ME.
This is a 2020 ARVO Annual Meeting abstract.
Figure 1. Treatments received within 1 year of diagnosis of macular edema with RVO
Figure 2. Anti-VEGF injections in the first year of diagnosis, among persons with ≥1 anti-VEGF injection
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