Abstract
Purpose :
To characterize treatment patterns and long-term visual acuity (VA) outcomes in patients with macular edema secondary to retinal vein occlusion (RVO) treated in routine clinical practice in the UK.
Methods :
This was a retrospective observational study using Medisoft electronic health record data from 2013 to 2023 contributed by 16 UK National Health Service trusts. Patients with treatment-naïve eyes with macular edema secondary to branch RVO (BRVO), central RVO (CRVO), or hemiretinal vein occlusion (HRVO) that received ≥ 1 intravitreal anti-vascular endothelial growth factor (VEGF) injection on or after diagnosis, had VA measured at index injection, and had ≥ 3 months follow-up after index injection, were included. Eyes were observed for up to 60 months after index injection. Treatment patterns and VA outcomes were evaluated descriptively. CRVO and HRVO eyes were analyzed together.
Results :
3511 eyes from 3465 BRVO patients and 3568 eyes from 3514 C/HRVO patients were included. Of all RVO eyes, 57.4% were followed up for ≥ 24 months and 19.1% for 60 months after index injection. BRVO and C/HRVO eyes received 4.3 and 4.1 anti-VEGF injections from months 0–6 and 2.1 and 2.0 injections from months 7–12, respectively. Mean injection numbers in BRVO and C/HRVO eyes decreased from 3.4 and 3.2 in year 2 to 2.5 and 2.4 in year 5, respectively. Mean VA change (95% CI) from index injection at month 3 was 11.1 (10.6, 11.6) ETDRS letters for BRVO and 13.8 (13.1, 14.4) letters for C/HRVO. By month 60, mean VA change (95% CI) decreased to 8.3 (6.7, 10.0) letters for BRVO and 7.0 (4.8, 9.2) letters for C/HRVO. VA changes were lower in eyes with low vs high injection numbers. Mean VA change from index injection at month 12 in BRVO and C/HRVO eyes with low (< 4), medium (4–8), and high (> 8) injection numbers in year 1 were 7.5 and 6.1 letters, 11.9 and 11.3 letters, and 13.4 and 15.5 letters, respectively (Figure).
Conclusions :
These data from the UK show that anti-VEGF injections for macular edema secondary to RVO improve vision on average. Vision gains (particularly for C/HRVO) and injection numbers decreased over 5 years, and a higher number of injections were related to greater vision improvements, highlighting a need for more durable treatments and long-term monitoring to maintain vision.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.