Abstract
Purpose :
To assess impact of exposure to residual intraretinal fluid (IRF) and central subfield thickness (CST) fluctuations on visual outcomes in patients with macular edema following central retinal vein occlusion.
Methods :
This analysis of COPERNICUS and GALILEO included eyes that received intravitreal aflibercept injection (IAI) 2 mg every 4 weeks through Week 24, then dosed as needed through Week 52, and had <3 missing IRF assessments. Analyses used the integrated COPERNICUS and GALILEO dataset through Week 24 and the GALILEO dataset alone through Week 52 as CST was not measured every 4 weeks after Week 24 in COPERNICUS. Extent of exposure to residual IRF was evaluated in subgroups of eyes by number of visits with IRF (integrated analysis: 0–1 [n=84], 2–3 [n=67], 4–7 [n=53]; GALILEO: 0–3 [n=32], 4–7 [n=36], 8–14 [n=20]). CST fluctuation was evaluated in quartiles or tertiles of the standard deviation of CST of each eye from Weeks 4–24 and Weeks 4–52 (integrated analysis: ≤12.7 [n=53], >12.7–≤19.1 [n=51], >19.1–≤30.7 [n=52], >30.7 [n=51] µm; GALILEO: ≤24.6 [n=32], >24.6–≤99.5 [n=33], >99.5 [n=32] µm).
Results :
In the integrated dataset, at Week 24 eyes with greatest versus least IRF exposure had lower best-corrected visual acuity (BCVA) gains from baseline (least-square mean difference [95% confidence interval]: –5.9 [–10.0, –1.7] letters). Similar observations were made in GALILEO at Weeks 24 (–8.7 [–15.1, –2.2] letters) and 52 (–5.9 [–13.0, +1.1] letters). In the integrated dataset, at Week 24, eyes with highest versus lowest CST fluctuation had relatively lower BCVA gains from baseline (–4.6 [–9.3, 0.1] letters). Similar observations were made in GALILEO at Weeks 24 (–7.6 [–13.2, –1.9] letters) and 52 (–9.5 [–15.7, –3.3] letters). Changes in Visual Function Questionnaire-25 composite and subscale scores from baseline were similar between the greatest versus least IRF exposure or CST fluctuation at Weeks 24 and 52.
Conclusions :
Greater exposure to residual IRF and larger CST fluctuation was associated with lower BCVA gains. Similar vision-related quality of life was observed across subgroups, potentially driven by the better-seeing eye in patients with macular edema following central retinal vein occlusion treated with IAI.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.