Abstract
Purpose :
To characterize retinal vein occlusion (RVO)-related macular edema (ME) treatment patterns and its impact on 12 and 24-month best visual acuity (BVA) and central subfield thickness (CST).
Methods :
A retrospective cohort study of patients diagnosed with RVO in a tertiary ophthalmic center was performed. Patients who developed RVO-related ME and received their first anti-vascular endothelial growth factor (anti-VEGF) injection between 2003-2020 were included. Treatment patterns analyzed included steady-state anti-VEGF injection interval, time between diagnosis and treatment of ME, and steroid usage. Linear regression analyzed the relationship between treatment patterns and 12 and 24-month BVA and CST, adjusting for sociodemographic factors and systemic comorbidities.
Results :
Analysis included 215 eyes with branch RVO (BRVO) and 185 eyes with central RVO (CRVO) or hemiretinal RVO (HRVO). 50.2% of BRVO patients received anti-VEGF injections ≤q8 weeks, 25.6% received injections q8-12 weeks, and 24.2% received injections >q12 weeks. 44.3% of CRVO/HRVO patients received anti-VEGF injections ≤q8 weeks, 31.9% received injections q8-12 weeks, and 23.8% received injections >q12 weeks. There was no significant difference in BVA and CST at baseline, 12, or 24 months in all injection interval subgroups in BRVO and CRVO/HRVO patients. 8.4% of BRVO and 9.2% of CRVO/HRVO patients were treated with steroids. In BRVO patients, steroid usage was associated with a 6.61 (95% CI=0.27-12.96, p<0.01) letter loss in BVA at 12 months and a CST increase of 58.32 (95% CI=9.66-106.97, p=0.02) and 68.47 (95% CI=12.42-123.51, p=0.02) μm at 12 and 24 months, respectively (Tables 1 and 2). Delay between diagnosis and treatment of ME was 35.8±130.5 days in BRVO patients and 10.7±34.2 days in CRVO/HRVO patients. In BRVO patients, every day of delay was associated with a 0.03 (95% CI=0.01-0.05, p=0.01) letter loss of BVA at 24 months. CST was found to be increased by 0.18 (95% CI=0.04-0.31, p=0.01) and 0.79 (95% CI=0.22-1.36, p=0.01) μm for every delayed day at 24 months in BRVO and CRVO/HRVO patients, respectively.
Conclusions :
Treatment delay and steroid usage were associated with worse improvements in long term BVA and CST. Steady-state anti-VEGF injection interval was not found to be significant predictor of patient outcomes.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.