Abstract
Purpose :
Patients with Retinal Vein Occlusion (RVO) have differing degrees of response to anti-VEGF treatment. A retrospective comparative study was performed to determine if response to anti-VEGF treatment at 3 months post-initiation of anti-VEGF treatment could predict RVO outcomes, namely Central Subfield Thickness (CST) and Best Visual Acuity (BVA), at the 12-month time point.
Methods :
Patients over age 18 with treatment naïve RVO-related macular edema and treated with anti-VEGF injections were included in the study. A machine learning algorithm (Notal Vision Ltd., Tel Aviv, Israel) quantified total retinal fluid (TRF), intraretinal fluid (IRF), and subretinal fluid (SRF). Patients were categorized as early responders (ER) or limited early responders (LER); LER eyes were defined as having CST reduction < 10%, BVA gain < 5 ETDRS letters, or both at 3-months after anti-VEGF initiation. BVA and CST changes over the 12-month period following first anti-VEGF treatment were compared. Statistical analysis involved Levene test, Welch’s t-test, and Welch’s ANOVA.
Results :
116 eyes met inclusion criteria (74 ER, 42 LER). Baseline VA differed between ER (45.8 letters) and LER (62.9 letters) (p < 0.0001). Both 12-month change in BVA and CST varied significantly between early response statuses. Specifically, change in BVA for ER was 21.4 letters and 0.8 letters for LER (p < 0.0001), and the change in CST was -187.1 mm for ER and -104.4 mm for LER (p < 0.05). VA (+19.9 letters, p < 0.0001) and TRF (-613 nl, p < 0.01) significantly improved for ER eyes, but only in the initial 3-month period. Changes in VA and fluid compartments were not significant across all other time points and responder categories.
Conclusions :
Functional and anatomical improvements at 12-months were more impressive for ER than LER defined at 3 months. Additionally, this study highlights the potential for 3-month TRF reduction as a marker of early response. Most functional and anatomical gains in ER occurred during the initial 3 months of treatment, with no significant improvements in VA or TRF after the first 3 months. Thus, the 3-month response to anti-VEGF treatments may be a useful biomarker to predict the prognosis of eyes with RVO treated with anti-VEGF.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.