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

Jessica C Liu; Thanvi Vatti; Kanika Seth; Carolina C S Valentim; Aleksandra V Rachitskaya; Rishi P Singh

doi:10.1038/s41433-023-02488-x

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

Eye (Lond). 2023 Oct;37(15):3203-3208. doi: 10.1038/s41433-023-02488-x. Epub 2023 Mar 22.

Authors

Jessica C Liu¹, Thanvi Vatti¹, Kanika Seth², Carolina C S Valentim², Aleksandra V Rachitskaya², Rishi P Singh³

Affiliations

¹ Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH, 44106, USA.
² Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
³ Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. singhr@ccf.org.

PMID: 36949245
PMCID: PMC10564869 (available on 2024-10-01)
DOI: 10.1038/s41433-023-02488-x

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.