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Pawarissara Osathanugrah, Minali Prasad, Nayan Sanjiv, Steven Ness, Nicole H. Siegel, Xuejing Chen, Manju L Subramanian; The Impact of Race on the Efficacy of Bevacizumab for Macular Edema Secondary to Retinal Vein Occlusions. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1760 – F0220.
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Anti-VEGF injections are often used for the treatment of macular edema from retinal vein occlusions (RVO). Variable response to intravitreal bevacizumab has been reported for treatment of diabetic macular edema (DME). In this study, we performed a retrospective chart review to examine potential racial variances in treatment response to bevacizumab in patients with macular edema secondary to RVO.
Intravitreal anti-VEGF naïve patients aged over 18 who received at least one intravitreal bevacizumab injection for central and branch RVO were included. Data were collected before treatment, 1-3 months after the first injection, and 1-3 months after 3 injections. Primary outcome measures were percentage of patients with visual acuity (VA) improvement (defined as >0.1 on logMAR scale), reduction in central macular thickness (CMT), and the presence of systemic disease. Analysis was performed using multivariate regression for percentage change of CMT and logistic regression for percentage of patients with VA improvement.
156 eyes were included for the single injection analysis and 101 for the 3-injection analysis. There was no significant difference in odds of VA improvement between Black (B) and White (W) patients after one injection (B=51.9%, W=55.7%, OR 1.20, P=0.66) and after 3 injections (B=70.4%, W=68.1%, OR 1.48, P=0.55) after controlling for age, sex, baseline VA, baseline CMT, laser history, injection time course, follow-up delay, and presence of hypertension, diabetes, and hyperlipidemia. Similarly, there were no differences in %CMT reduction among the race groups after one injection (B= -30.8%, W= -27.5%, p=0.78) and after 3 injections (B= -25.8%, W= -32.8%, p=0.52) using the same controls. Among all patients, there were higher rates of hypertension in Black compared to White patients (66% vs 46%, p= 0.02). Rates of diabetes appeared higher in Black compared to White patients but were not statistically significant (B=25%, W=12%, p=0.06).
There were no statistically significant differences in treatment response to a single or a series of 3 bevacizumab injections in patients with macular edema secondary to RVO across different races despite a significant difference in presence of hypertension. These results are in contrast to a prior study done by our group with similar methodology for DME.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
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