Foveal thickness fluctuation on visual and morphologic outcomes in anti-vascular endothelial growth factor treatments for branch retinal vein occlusion

Abstract

Purpose : To examine the effects of foveal thickness (FT) fluctuation (FTF) of visual and morphologic outcomes in anti-vascular endothelial growth factor (VEGF) treatments with pro re nata regimen for Branch retinal vein occlusion (BRVO)- macular edema (ME).

Methods : We conducted a retrospective, observational case series (2012-2021) at a multi-center retinal practice among 309 treatment-naïve patients (309 eyes) with BRVO. FT was assessed via optical coherence tomography (OCT) at each study visit. We evaluated the logarithm of the minimal angle of resolution best corrected visual acuity (logMAR BCVA) and the defect length of the foveal ellipsoid zone (EZ) band measured via OCT.

Results : At baseline, the mean logMAR BCVA was 0.30±0.30 and the mean FT was 503±162 µm. The number of anti-VEGF injections for BRVO-ME was 5.8±4.6 during the mean follow-up period (50.6±22.2 months). At the final examination, the mean logMAR BCVA and FT values were significantly improved compared with the baseline. Multiple regression analyses showed that age, baseline logMAR BCVA, and FTF were significantly associated with the final logMAR BCVA (β=0.20, 0.35, and 0.30, respectively). FTF (divided into Groups 0-3 in ascending order of FTF) was significantly associated with the logMAR BCVA and the defect length of the foveal EZ band at the final examination. The defect lengths of the foveal EZ band were longitudinally shortened in Groups 0-1 and were slightly prolonged in Groups 2-3. The logMAR BCVA maintained improvements in Groups 0-1, and worsened slightly in Groups 2-3.

Conclusions : FTF was significantly associated with visual acuity and foveal photoreceptor status. Thus, we conclude that morphologic and functional prognoses of eyes with BRVO may be improved by identifying the characteristics of eyes with a larger FTF and consequently controlling the FTF more strictly.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.