Antivascular Endothelial Growth Factor Dosing Frequency and Visual Outcomes in Macular Edema Following Central Retinal Vein Occlusion

Yasha S Modi; Lediana Goduni; Hadi Moini; Andrea Gibson; Nick Boucher; Genevieve Lucas; Dilsher S Dhoot

doi:10.1177/2474126421989225

Antivascular Endothelial Growth Factor Dosing Frequency and Visual Outcomes in Macular Edema Following Central Retinal Vein Occlusion

J Vitreoretin Dis. 2021 Mar 1;5(6):505-512. doi: 10.1177/2474126421989225. eCollection 2021 Nov-Dec.

Authors

Yasha S Modi¹, Lediana Goduni¹, Hadi Moini², Andrea Gibson², Nick Boucher³, Genevieve Lucas³, Dilsher S Dhoot⁴

Affiliations

¹ New York University Langone Health, New York, NY, USA.
² Regeneron Pharmaceuticals Inc, Tarrytown, NY, USA.
³ Vestrum Health, Naperville, IL, USA.
⁴ California Retina Consultants/Retina Consultants of America, Santa Barbara, CA, USA.

Abstract

Purpose: We evaluated the relationship between dosing frequency of intravitreal antivascular endothelial growth factor (anti-VEGF) agents and visual acuity (VA) outcomes over 2 years in eyes with macular edema (ME) secondary to central retinal vein occlusion (CRVO) in the US routine clinical practice setting.

Methods: This retrospective analysis assessed electronic medical records of eyes with ME secondary to CRVO that received their first anti-VEGF injection January 1, 2012, to May 31, 2016, and were followed for 1 year or more in the US-based Vestrum Health Treatment and Outcomes database. Eyes were divided into 2 injection frequency subcohorts (≤6 or ≥7 injections/year).

Results: Overall, 851 (34.6%) of 2458 eyes with ME secondary to CRVO received 6 or fewer injections, and 1607 (65.4%) received 7 or more injections through 1 year. The mean number of injections in patients receiving 6 or fewer injections and 7 or more injections was 4.7 and 8.8, respectively, and baseline mean VA was 35 and 37 letters, respectively. At year 1, mean letter gain from baseline was less in eyes receiving 6 or fewer injections vs in those receiving 7 or more injections (7.0 vs 12.2, P < .001). Mean VA at year 2 was 50 letters in eyes receiving 6 or fewer injections (n = 50) and 55 letters in eyes receiving 7 or more injections (n = 157).

Conclusions: In routine clinical practice, more frequent dosing with anti-VEGF agents was associated with greater visual benefits in eyes with ME secondary to CRVO.

Keywords: antivascular endothelial growth factor; bevacizumab; central retinal vein occlusion; intravitreal aflibercept; ranibizumab; real-world outcomes; treatment frequency; visual acuity.