Abstract
Purpose :
Macular edema secondary to Retinal Vein Occlusion (RVO) is a sight-threatening condition treated with anti-VEGF injections, which are variably effective in improving outcomes. It was previously shown that early responders (ER) who respond well to anti-VEGF injections within the first 3 months of treatment have improved functional and anatomical outcomes as measured by best visual acuity (BVA) and central subfield thickness (CST), respectively, at 12 months post injection initiation when compared to limited early responders (LER). This retrospective study analyzed whether the initial benefits seen in ER over LER are sustained over the 24- and 36-month time period after injection initiation. This study also aimed to identify comorbidities associated with response status.
Methods :
Patients above age 18 with RVO-related macular edema treated with anti-VEGF injections were categorized as ER or LER. Eyes with CST reduction < 10%, BVA gain < 5 ETDRS letters, or both at 3-months after anti-VEGF initiation were characterized as LER. Based on availability of optical coherence tomography (OCT) data, the larger cohort was divided into smaller cohorts for 24- and 36-month time points. BVA and CST changes over the 24-month and 36-month period following first anti-VEGF treatment were compared between ER and LER. Chart review was conducted to identify patient characteristics and systemic comorbidities. Statistical analysis involved Levene test, Welch’s t-test, and Welch’s ANOVA.
Results :
The 24-month cohort included 68 ER and 39 LER and the 36-month cohort included 58 ER and 33 LER. At the 24-month time point, there were significant differences in BVA and CST gains between ER (+19.8 letters, -221.um) and LER (-2.4 letters, -90.1 um) (p < 0.0001, p < 0.01). Similarly, at the 36-month time point, there were significant differences in BVA and CST gains between ER (+17.7 letters, -229.3 um) and LER (+1.3 letters, -128 um) (p < 0.001, p < 0.05). There were no significant associations between response status and cardiopulmonary, endocrine, and oncologic comorbidities.
Conclusions :
This study suggests that ER eyes continue to have better responses to anti-VEGF injections at 24 and 36 months compared to LER eyes. This study highlights the importance of early identification of eyes as ER or LER to be able to predict long-term prognoses with anti-VEGF treatment and help with clinical decision-making.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.