Baseline Choroidal Thickness as a Predictor for Treatment Outcomes in Central Retinal Vein Occlusion

Am J Ophthalmol. 2016 Nov:171:47-52. doi: 10.1016/j.ajo.2016.08.026. Epub 2016 Aug 24.

Abstract

Purpose: To evaluate the association between initial subfoveal choroidal thickness and response to anti-vascular endothelial growth factor (anti-VEGF) therapy in central retinal vein occlusion (CRVO) eyes.

Design: Retrospective cohort study.

Methods: Forty-three eyes from 42 patients with treatment-naïve CRVO were included. All patients included were treated with a standard algorithm of 3 monthly anti-VEGF injections. Serial enhanced depth imaging optical coherence tomography scans were used to measure subfoveal choroidal thickness and central macular thickness (CMT). Baseline predictors (particularly choroidal thickness) for functional response (best-corrected visual acuity gain ≥2 lines) were assessed at 3 months follow-up using univariate and multivariate analyses.

Results: Forty-three eyes from 42 patients were included. Initial choroidal thickness in CRVO eyes (246 ± 102 μm) was greater than in their fellow eye (197 ± 86 μm; P = .023). In addition, mean choroidal thickness at baseline for functional responders (272.2 ± 107.3 μm) was greater than that of nonresponders (209.6 ± 85.8 μm; P = .039). A higher baseline choroidal thickness (for every 100-μm increase in choroidal thickness) was found to be a positive predictor for functional response (regression coefficient: 0.7; P = .04) on univariate analysis, whereas age (<70 years old) was the only positive predictor for functional response with an odds ratio of 6.49 (95% confidence interval: 1.11-38.1; P = .03) on multivariate regression analysis.

Conclusions: Baseline choroidal thickness and age may help predict which patients with CRVO have favorable visual outcomes following short-term anti-VEGF therapy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors
  • Bevacizumab / administration & dosage*
  • Choroid / diagnostic imaging*
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Fundus Oculi
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Prognosis
  • Ranibizumab / administration & dosage*
  • Retinal Vein Occlusion / diagnosis
  • Retinal Vein Occlusion / drug therapy*
  • Retrospective Studies
  • Tomography, Optical Coherence / methods*
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors*
  • Visual Acuity
  • Young Adult

Substances

  • Angiogenesis Inhibitors
  • Vascular Endothelial Growth Factor A
  • Bevacizumab
  • Ranibizumab