Abstract
Purpose :
This study aims to analyze the impact of anti-vascular endothelial growth factor (VEGF) loading dose administration on 5-year visual acuity (VA) in patients with macular edema (ME) secondary to branch retinal vein occlusion (BRVO).
Methods :
A retrospective study including patients ≥18 years of age with a BRVO diagnosis treated with anti-VEGF, a minimum of 5-year follow-up, and available optical image topography (OCT) scans. Patients with a history of ocular comorbidities were excluded.
Results :
Of 60 patients, 36 (60.0%) received the full loading dose (F group), 12 (20%) no loading dose (N group), and 12 (20%) an incomplete 3-injection series (I group). At baseline, N group patients had a higher VA (-0.45 ±0.35) than F (-0.81 ±0.54) and I group (-0.68 ±0.49) patients (p<0.05). At 5-year follow-up, only F group patients saw a significant increase in VA compared to baseline (+0.34 LogMAR) (p<0.05). In parallel, over the 5-year study period, N and I groups experienced a decrease in VA (-0.03 and -0.31, respectively), although these results did not reach significance (Figure 1). Central macular thickness (CMT) was similar between study groups at baseline (N: 627.8 ±175.9µm, F: 568.1 ±183.7µm, and I: 515.3 ±187.2µm) (p>0.05). However, only F and N group patients saw a significant decrease at 5 years (p<0.05). F group patients received a greater number of injections in the 1st year than N and I group patients (F: 6.92 ±2.25, N: 2.08 ±2.43, and I: 5.08 ±2.19) (p<0.001). On univariate analysis, increased age and higher prevalence of cardiovascular disease and dyslipidemia corresponded with lower 5-year VA while higher baseline VA and higher 3-month VA were predictive of increased 5-year VA.
Conclusions :
The full-loading dose regimen is associated with better visual acuity outcomes over a 5-year period compared to no-loading dose or incomplete injection series regimens. Baseline and 3-month VA may also act as important predictors of long-term VA gain in patients with ME secondary to BRVO.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.