Abstract
Purpose :
To assess correlation between change in central subfield thickness (CST) and change in best-corrected visual acuity (BCVA) in eyes with macular edema due to branch retinal vein occlusion (BRVO) receiving fixed-dosing intravitreal aflibercept injections (IAI) over 52 weeks.
Methods :
Post hoc analysis of the VIBRANT clinical trial, in which eyes were randomized to IAI (6 doses every 4 weeks of 2 mg IAI, followed by IAI every 8 weeks) or macular laser photocoagulation at baseline. The relationship between functional (BCVA) and anatomical (CST) outcomes at weeks 12, 24, and 52 was determined using Pearson correlation coefficient.
Results :
Of 181 eyes, 91 received IAI and represent the analysis cohort. The percentage of eyes with both BCVA and CST measurements available for analysis at weeks 12, 24, and 52 was 97%, 91%, and 80% of enrolled IAI-assigned eyes. At baseline, the correlation (r) between CST and BCVA was -0.41 (95% CI: -0.56 to -0.22). Correlations (r) between change in CST and change in BCVA from baseline at weeks 12, 24, and 52 were -0.34 (95% CI: -0.51 to -0.14), -0.32 (95% CI: -0.50 to -0.11), and -0.36 (95% CI: -0.54 to -0.14), respectively. In a linear regression analysis of correlation between changes in CST and changes in BCVA at week 52 adjusted for baseline factors (age, perfusion status, time since diagnosis, and baseline BCVA), CST changes accounted for only 23% of the variance in BCVA changes. At 52 weeks, every 100 µm decrease in CST was associated with a 2.2 letter increase in BCVA (95% CI: -0.2 to 4.5, P = .07).
Conclusions :
In eyes treated with fixed-dosing IAI for macular edema from BRVO, the magnitude of the correlation between change in CST and change in BCVA was weak to moderate. For any given change in CST from baseline, there was a broad range of change in BCVA at weeks 12, 24, and 52. While changes in CST may be important in determining the need for repeat anti-VEGF to manage macular edema due to BRVO, these findings do not support using changes in CST to predict visual acuity outcomes.
This is a 2021 ARVO Annual Meeting abstract.