Predictive value of retinal oximetry, optical coherence tomography angiography and microperimetry in patients with treatment-naive branch retinal vein occlusion

Vascular endothelial growth factor inhibitors have substantially improved the visual outcomes in patients with macular edema (ME) caused by branch retinal vein occlusion (BRVO), but treatment outcomes are highly variable and early prediction of expected clinical outcome would be important for individualized treatment. As non-invasive metabolic, structural and functional retinal markers might act as early predictors of clinical outcomes, we performed a 12-month, prospective study aimed to evaluate if baseline retinal oximetry, optical coherence tomography angiography (OCT-A) or microperimetry were able to predict need of treatment, structural or functional outcome in patients with ME caused by treatment-naive BRVO. We evaluated 41 eyes of 41 patients with a mean age of 69.6 years and 56% females. We found a strong tendency towards a higher retinal arteriolar oxygen saturation in patients without a need of additional aflibercept treatment after the loading phase (99.8% vs. 92.3%, adjusted odds ratio 0.80 (95% confidence interval 0.64-1.00), adjusted p = 0.058), but otherwise, retinal oximetry, OCT-A or microperimetry were not able to predict need of treatment, structural nor functional outcomes. (Trial registration: clinicaltrials.gov, S-20,170,084. Registered 24 August 2014, https://clinicaltrials.gov/ct2/show/NCT03651011)

Automated summary

Vascular endothelial growth factor inhibitors have improved visual outcomes in macular edema caused by branch retinal vein occlusion. However, predicting clinical outcomes is important for personalized treatment. In a 12-month prospective study, baseline retinal oximetry, OCT-A, and microperimetry were evaluated as predictors. A higher retinal arteriolar oxygen saturation was found in patients not needing additional treatment, but overall, these markers were not predictive of treatment or outcome.