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Baseline choroidal thickness as a short-term predictor of visual acuity improvement following antivascular endothelial growth factor therapy in branch retinal vein occlusion
  1. Nadim Rayess1,2,
  2. Ehsan Rahimy2,3,
  3. Gui-Shuang Ying4,
  4. Maria Pefkianaki2,
  5. Jason Franklin2,
  6. Carl D Regillo2,
  7. Allen C Ho2,
  8. Jason Hsu2
  1. 1USC Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
  2. 2Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania, USA
  3. 3Department of Ophthalmology, Palo Alto Medical Foundation, Palo Alto, California, USA
  4. 4Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Jason Hsu, Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, PA 19107, USA; jhsu{at}midatlanticretina.com

Abstract

Purpose To evaluate the association between subfoveal choroidal thickness (SFCT) and branch retinal vein occlusion (BRVO) eyes treated with antivascular endothelial growth factor (anti-VEGF) therapy.

Methods Retrospective cohort study of treatment naïve BRVO eyes treated with 3 monthly anti-VEGF injections. All patients received enhanced depth imaging spectral-domain optical coherence tomography scans to determine SFCT and central macular thickness (CMT). Baseline predictors (particularly SFCT) for functional response (best-corrected visual acuity (BCVA) gain ≥2 lines) were assessed at 3 months using univariate and multivariate analyses.

Results Forty eyes from 39 patients were included. Mean baseline SFCT was higher in functional responders (240.4±73.1 µm), compared with both non-responders (193.3±63.6 µm; p=0.036) and their corresponding fellow eye (202.2±67.1 µm; p=0.022). A higher baseline SFCT (for every 100 µm increase in SFCT) was found to be a positive predictor for functional response (regression coefficient: 1.1; p=0.03) on univariate analysis but not multivariate analysis. A worse baseline BCVA (for every 0.1 logMAR increase) was a positive predictor for visual improvement with an adjusted OR of 1.30 (95% CI 1.03 to 1.63; p=0.0009) on multivariate analysis.

Conclusions Patients with BRVO with a worse initial BCVA are most likely to achieve visual improvement following anti-VEGF therapy. Additionally, baseline SFCT may also help predict which patients with BRVO have favourable visual outcomes. Patients with an initial choroidal thickness thicker than their fellow eye are more likely to have short-term visual improvement following treatment.

  • retina
  • treatment medical
  • imaging

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Footnotes

  • Contributors NR, ER and JH: concept and design. NR, ER, G-sY, MP, JF, CDR, ACH and JH: data collection, analysis and interpretation of the data; preparation, review or approval of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The sponsor or funding organization had no role in the design or conduct of this research.

  • Competing interests None declared.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Ethics approval Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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