Abstract
Purpose :
SCORE2 was a National Eye Institute sponsored clinical trial that demonstrated non-inferiority between aflibercept and bevacizumab in patients with macular edema due to CRVO or HRVO. As a secondary outcome, a subset of patients underwent UWF FA. We assessed SCORE2 UWF FA images for changes in both retinal leakage and retinal nonperfusion measured over 5 years.
Methods :
At baseline, 92 SCORE2 patients were imaged with UWF FA using Optos TX (Optos PLC Dunfermline, Scotland). Grading was performed at the Wisconsin Reading Center using the Networc grid; area measurements were performed using planimetry and corrected for peripheral warping.
Results :
All patients had leakage at baseline and over 80% had persistent leakage over 5 years. The mean leakage area decreased significantly from baseline to month 6 from 34% of the retina within the Networc grid to 7% and stayed between 4-10% throughout 5 years. Non-perfusion was present in 64% of participants at baseline; the mean percentage of the non-perfusion area remained stable at 5 - 10% of the Networc grid at baseline and all follow-up visits. Utilizing the Networc grid, the highest percentage of retinal nonperfusion was found in the far temporal periphery (Zone 3) at all visits.
Conclusions :
In SCORE2, anti-VEGF treatment was associated with a significantly decreased area of retinal leakage over 5 years; the area of retinal nonperfusion did not change. SCORE2 image analysis of UWF FA provided quantitative areas of leakage and nonperfusion in participants with macular edema and RVO. The longitudinal grading protocol allowed for a greater understanding of change in the area and region of retinal nonperfusion and leakage over 5 years.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.