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Outcomes in patients with retinal vein occlusion with good baseline visual acuity

Eye volume 37, pages 3203–3208 (2023)Cite this article

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Abstract

Background

Intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) are first-line therapy for macular oedema in retinal vein occlusion (RVO). Appropriate management for RVO with good visual acuity at diagnosis has not been evaluated. The purpose of this study is to analyse the visual and anatomic outcomes from anti-VEGF treatment among RVO patients with good vision at baseline.

Methods

This retrospective cohort study evaluated patients diagnosed with macular oedema secondary to RVO from January 2012 to February 2021 at a tertiary ophthalmic centre. Patients had a Snellen acuity of 20/32 or better at diagnosis. Three cohorts were compared: patients with no anti-VEGF treatment, delayed anti-VEGF treatment (initial injection >30 days post-diagnosis) and immediate anti-VEGF treatment (initial injection ≤30 days post-diagnosis). Central subfield thickness (CST) and best visual acuity (BVA) were collected at diagnosis and 6-, 12- and 24-month follow-up appointments.

Results

Among 131 eyes, mean BVA values among treatment groups did not differ at 6-, 12- or 24-month follow up visits (P = 0.521, 0.426, 0.356, respectively). The percentage of eyes with at least a 5-letter BVA decrease at 24 months was 24.1%, 65.0% and 30.8% in the no treatment, delayed and immediate treatment groups respectively (P = 0.010). There was no significant difference in the percentage of eyes with at least a 10% decrease in CST at 24 months among groups (P = 0.095).

Conclusions

Close observation with initiation of treatment in patients with good visual acuity with macular oedema secondary to RVO as indicated has similar outcomes in the setting of routine clinical practice.

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Fig. 1: Mean BVA and CST Values per Treatment Group.

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Data availability

Data available on request from the authors.

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Funding

The authors report no additional funding for this research.

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Authors and Affiliations

  1. Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH, 44106, USA

    Jessica C. Liu & Thanvi Vatti

  2. Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Kanika Seth, Carolina C. S. Valentim, Aleksandra V. Rachitskaya & Rishi P. Singh

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  1. Jessica C. Liu
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Contributions

JCL was responsible for conducting the search, screening patients, analysing data and writing. TV contributed to conducting the search and analysing data. KS contributed to analysing data. CCSV contributed to the study design, interpreting results and editing. AR and RPS contributed to the study design and editing.

Corresponding author

Correspondence to Rishi P. Singh.

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Competing interests

RPS reports personal fees from Genentech/Roche, Alcon/Novartis, Zeiss, Bausch + Lomb, Regeneron Pharmaceuticals, Inc, Gyroscope, Asceplix and Apellis. AR reports personal fees from Alcon, Allergan, Regeneron, Samsara and Zeiss as well as research and personal fees from Genentech and Novartis.

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Liu, J.C., Vatti, T., Seth, K. et al. Outcomes in patients with retinal vein occlusion with good baseline visual acuity. Eye 37, 3203–3208 (2023). https://doi.org/10.1038/s41433-023-02488-x

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