Journal
EYE
Volume 37, Issue 3, Pages 453-458Publisher
SPRINGERNATURE
DOI: 10.1038/s41433-022-01960-4
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This study found that patients with Retinal Vein Occlusion (RVO) are at risk for poorer anatomical and visual outcomes after a lapse in anti-vascular endothelial growth factor (VEGF) treatment. Lapse patients experienced an increase in central subfield thickness (CST) that did not fully recover even after treatment was resumed. Additionally, lapse patients had a decrease in best corrected visual acuity (BCVA) after the lapse, but it recovered after 6 months of anti-VEGF treatment.
Background Anti-vascular endothelial growth factor (VEGF) treatments are the first-line treatment for Retinal Vein Occlusion (RVO). Although effectiveness and safety of these treatments is well documented, knowledge regarding the effect of lapses in anti-VEGF treatment among RVO patients is lacking. The purpose of this study is to analyse the anatomic and visual outcomes from a lapse in anti-VEGF treatment in patients with RVO. Methods This retrospective case-control study evaluated 136 patients diagnosed with RVO and treated with anti-VEGF between January 2012 and June 2020 at Cole Eye Institute, Cleveland Clinic. Patients were divided into two cohorts: RVO patients with no lapse in anti-VEGF treatment (control group) and RVO patients with a lapse >= 3 months (lapse group). Central subfield thickness (CST) and best corrected visual acuity (BCVA) were collected pre-lapse, the first appointment post-lapse, and at 3-, 6-, and 12-month follow-up appointments. Results Lapse patients (n = 68) and control patients (n = 68) had similar pre-lapse CST (p = 0.466) and BCVA (p = 0.303). Lapse patients experienced a significant increase in CST after discontinuing anti-VEGF therapy (lapse: 400.6 +/- 192.1 mu m, control: 333.0 +/- 111.1 mu m, p = 0.024). This persisted 12 months post-lapse after re-initiation of anti-VEGF agents (lapse: 381.6 +/- 161.1 mu m, control: 307.5 +/- 95.4 mu m, p = 0.030). Lapse patients also experienced a decrease in BCVA after lapse (lapse: 54.3 +/- 25.1 ETDRS, control: 64.4 +/- 17.8 ETDRS, p < 0.001) that recovered after 6 months of anti-VEGF treatment. Conclusions RVO patients with any lapse of anti-VEGF treatment are at risk for poorer anatomic and visual outcomes. Though BCVA normalizes upon treatment resumption, patients experience a statistically significant increase in CST that does not recover.
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