Abstract
Purpose :
To describe the selection of anti-VEGF agents for the treatment of branch retinal vein occlusion (BRVO) with cystoid macular edema (CME) across the dimensions of race and socioeconomic status (SES) and compare visual acuity (VA) outcomes in patients who received bevacizumab, ranibizumab, or aflibercept monotherapy or were switched to a second or third anti-VEGF agent.
Methods :
A retrospective chart review was conducted of all patients with BRVO and CME treated with anti-VEGF injections at Wake Forest Baptist Health from 2013 to 2022. Patient demographic factors including age, race, gender, insurance status, and national area deprivation index (NADI) were recorded. Baseline VA, central macular thickness (CMT), anti-VEGF injection type, change in anti-VEGF agent, total number of anti-VEGF injections, and final VA were recorded. Analysis was performed to evaluate if initial and subsequent anti-VEGF agent choice was significantly different based on baseline and demographic factors. Final VA was compared between patients who were treated with bevacizumab, ranibizumab, or aflibercept monotherapy, bevacizumab with a switch to either ranibizumab or aflibercept, and ranibizumab or aflibercept with a switch to bevacizumab.
Results :
252 eyes were included. Bevacizumab, ranibizumab, and aflibercept were the initial agents used in 74.7%, 9.09%, and 16.2% of patients respectively. There was no significant difference in initial agent choice by race (p=0.242), insurance status (p=0.525), NADI (p=0.753), or gender (p=0.435). 81 patients (32%) were switched to a second agent, most commonly aflibercept in 79% of patients. There was no difference in the choice of second agent choice by any of the analyzed demographic factors. Overall mean final logMAR VA improved from 0.665 to 0.497. There was no statistically significant difference in final VA between patients who received monotherapy with any of the anti-VEGF agents, or those that switched to a second agent
Conclusions :
Demographic factors did not impact anti-VEGF agent choice for BRVO with CME in this study. Final VA was not significantly different among patients receiving different anti-VEGF agents or switching to a second agent. Further study is warranted to assess the impacts of social determinants of health on treatment and outcomes in BRVO with CME.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.