Outcomes of anti-VEGF treatment for macular edema secondary to central retinal vein occlusion in patients with poor baseline visual acuity

Bahar Demir; Amit Mishra; Maria Pilar Martin Gutierrez; Rajna Rasheed; Maria Charitaki; Ella Preston; Sobha Sivaprasad; Philip Hykin; Luke Nicholson

doi:10.1016/j.jcjo.2023.07.004

Outcomes of anti-VEGF treatment for macular edema secondary to central retinal vein occlusion in patients with poor baseline visual acuity

Can J Ophthalmol. 2023 Jul 27:S0008-4182(23)00206-5. doi: 10.1016/j.jcjo.2023.07.004. Online ahead of print.

Authors

Bahar Demir¹, Amit Mishra², Maria Pilar Martin Gutierrez², Rajna Rasheed², Maria Charitaki², Ella Preston², Sobha Sivaprasad³, Philip Hykin², Luke Nicholson²

Affiliations

¹ Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom. Electronic address: bahar.demir@nhs.net.
² Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.
³ Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; Institute of Ophthalmology, University College London, London, United Kingdom.

PMID: 37517804
DOI: 10.1016/j.jcjo.2023.07.004

Abstract

Objective: To report the visual outcomes of intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment for macular edema secondary to central retinal vein occlusion (CRVO) in patients with baseline visual acuity of ≤23 ETDRS letters vision.

Design: Retrospective observational cohort study.

Methods: This is a single-institution study. A total of 173 eyes from 173 patients who had completed 3 consecutive monthly anti-VEGF injections for macular edema secondary CRVO and best-corrected visual acuity (BCVA) ≤23 ETDRS letters were included. The main outcome measures were visual acuity at month 3 and month 12.

Results: At month 3, BCVA increased to 34.1 ETDRS letters (95% CI, 30.7-37.5), with a gain of 25.0 letters (95% CI, 22.0-28.5; p < 0.001). The mean central subfield thickness decreased by 519 μm (95% CI, 475.5-567.0; p < 0.001). Most patients (67.6%) gained >15 ETDRS letters. A total of 160 patients were followed up for 12 months, and the mean BCVA was 31.2 ETDRS letters (95% CI, 27.5-34.9) at the end of this period. A third of eyes that did not respond (<5-letter gain) after a single injection experienced a 15-letter or more improvement after 3 consecutive injections.

Conclusions: Anti-VEGF treatment in eyes with CRVO and poor baseline visual acuity results in significant visual improvement, and moderate improvement is still noted despite a poor response after a single injection.