Visual and anatomical outcomes following intravitreal treatment of macular oedema secondary to retinal vein occlusion

Abstract

Aims/Purpose: We sought to measure the visual and anatomical outcomes of patients treated for macular oedema secondary to retinal vein occlusion (RVO) with anti‐vascular endothelial growth factor (VEGF) medications or intravitreal steroids.Methods: We retrospectively identified eyes with RVO in our Trust treated with anti‐VEGF injections or intravitreal steroids. Patient data such as age, gender and visual acuity (VA) were obtained from electronic patient records. Central retinal thickness (CRT) was measured via optical coherence tomography (OCT). Macular perfusion and ischaemia were assessed by fundus fluorescein angiography (FFA) on initiation of treatment. VA and CRT data were obtained for 24 months from starting treatment with anti‐VEGF injections or intravitreal steroids.Results: 56 eyes (26 with branch RVO (BRVO), 22 with central RVO (CRVO) and 8 with hemi‐RVO (HRVO)) were identified and followed up for 24 months after starting anti‐VEGF treatment or intravitreal steroids. Mean change in VA at 24 months was +7.0 ± 16.3 letters among CRVO eyes and + 3.9 ± 21.3 letters among BRVO eyes, whereas for HRVO mean VA change was +20.3 ± 16.8 letters. Mean CRT decreased by 334.2 ± 163.5 μm in eyes with CRVO, 147.1 ± 193.1 μm in eyes with BRVO and 300.3 ± 118.6 μm in eyes with HRVO. Furthermore, we achieved VA stabilization or improvement in 91% of eyes treated under ‘optimal’ conditions, in line with the meta‐analysis of studies on RVO outcomes by Hunter & Williams (2022).Conclusions: Current Trust protocols for intravitreal steroids and anti‐VEGF injections show good outcomes in RVO patients. Patients on treatment should be followed up regularly to minimize delays, while early treatment agent switches should be pursued if VA is dropping or macular oedema persists.ReferencesHunter A, Williams M. Long‐term outcomes for patients treated for macular oedema secondary to retinal vein occlusion: a systematic review. BMJ Open Ophthalmol. 2022;7(1):e001010. doi:10.1136/bmjophth‐2022‐001010