Anti-vascular endothelial growth factor dosing frequency and visual outcomes in macular oedema following branch retinal vein occlusion

Eye (Lond). 2023 Nov;37(16):3423-3428. doi: 10.1038/s41433-023-02527-7. Epub 2023 May 8.

Abstract

Objectives: To determine the relationship between treatment frequency with intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents and visual acuity (VA) outcomes in eyes with macular oedema (MO) secondary to branch retinal vein occlusion (BRVO) in US clinical practice.

Methods: Study eyes that initiated anti-VEGF injections between January 2012 and May 2016 were followed for ≥1 year in a retrospective analysis of medical records (Vestrum Health database). Eyes were analysed in 2 cohorts by treatment duration (years 1 and 2) and then in 2 subcohorts by injection frequency (≤6 or ≥7 injections/year).

Results: Among 3099 eyes with MO secondary to BRVO, 1197 (38.6%) received ≤6 injections (mean injections, 4.6; baseline mean VA, 53 letters) and 1902 (61.4%) received ≥7 injections through 1 year (mean injections, 8.8; baseline mean VA, 52 letters). At year 1, mean VA gain from baseline was 10.4 versus 13.9 letters in eyes receiving ≤6 versus ≥7 injections (p < 0.001). At year 2, mean VA in eyes receiving ≤6 (n = 42) versus ≥7 injections (n = 227) was 64 versus 68 letters, respectively (p = 0.19). Mean VA change between the start and end of year 2 in eyes receiving ≥7 injections in year 1 and ≤6 in year 2 differed significantly from that of eyes receiving ≥7 injections in both years (-3.0 vs 0.7 letters, respectively; p < 0.001).

Conclusions: In routine clinical practice, more frequent dosing with anti-VEGF agents was associated with greater visual benefits in eyes with MO secondary to BRVO.

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Bevacizumab / therapeutic use
  • Endothelial Growth Factors / therapeutic use
  • Humans
  • Intravitreal Injections
  • Macular Edema* / drug therapy
  • Macular Edema* / etiology
  • Ranibizumab / therapeutic use
  • Retinal Vein Occlusion* / complications
  • Retinal Vein Occlusion* / drug therapy
  • Retrospective Studies
  • Vascular Endothelial Growth Factor A / therapeutic use

Substances

  • Ranibizumab
  • Angiogenesis Inhibitors
  • Bevacizumab
  • Endothelial Growth Factors
  • Vascular Endothelial Growth Factor A