Association between early and late response in eyes with central or hemiretinal vein occlusion treated with anti-VEGF agents SCORE2 report 12: secondary analysis of the SCORE2 clinical trial

Purpose To assess whether early visual acuity letter score change from baseline (Delta VALS) and early spectral domain optical coherence tomography (SD-OCT) measures of center point thickness (CPT) are associated with later Delta VALS in eyes with macular edema due to central or hemiretinal vein occlusion treated with intravitreal aflibercept or bevacizumab. Methods Secondary analysis of a randomized clinical trial of 362 participants. Results Considered separately at month 3, CPT (categorized as <= 300 mu m, > 300 mu m) and Delta VALS (categorized as < 5, 5-9, >= 10) are predictive of Delta VALS at month 6 (aflibercept: P = 0.02 for CPT and P < 0.0001 for Delta VALS; bevacizumab: P = 0.007 for CPT and P < 0.0001 for Delta VALS) and, except for CPT in the bevacizumab arm, also predictive of Delta VALS at month 12 (aflibercept: P = 0.03 for CPT and P < 0.0001 for Delta VALS; bevacizumab: P = 0.18 for CPT and P < 0.0001 for Delta VALS). Month 3 predictors are also associated with average Delta VALS from months 4 to 12 (CPT P = 0.01 in the aflibercept arm, P = 0.02 in the bevacizumab arm; Delta VALS > 10 versus < 5; P < 0.001 for both aflibercept and bevacizumab). When month 3 measures are considered jointly, Delta VALS effect remains significant for average Delta VALS from months 4 to 12 (aflibercept: P = 0.002; bevacizumab: P < 0.0001) but not CPT (aflibercept: P = 0.18; bevacizumab: P = 0.22). Conclusion While both month 3 Delta VALS and CPT are predictive of Delta VALS after month 3 through month 12, early Delta VALS has a stronger relationship than CPT with later Delta VALS. SCORE2 registration number is NCT01969708.

Automated summary

This study found that early changes in visual acuity letter score (Delta VALS) and center point thickness (CPT) measured by spectral domain optical coherence tomography (SD-OCT) were associated with later changes in visual acuity in eyes with macular edema. Early Delta VALS had a stronger predictive relationship with later visual acuity changes compared to CPT.