Background/aims To evaluate the outcomes of eyes with macular oedema due to retinal vein occlusion (RVO) that are lost to follow-up (LTFU) after antivascular endothelial growth factor (VEGF) injections.
Method A retrospective, single-centre, consecutive case series of RVO patients receiving injections who were LTFU >6 months was conducted. Data were collected from the visit before LTFU; return visit; 3 months, 6 months and 12 months after return; and the final visit.
Results Ninety eyes of 83 patients were included. Fifty (55.5%) eyes had branch RVO and 40 (44.5%) had central RVO. Mean LTFU duration was 277.8 days with additional mean follow-up for 748.1 days after return. Mean logarithm of the minimum angle of resolution visual acuity (VA) (Snellen) at the visit before LTFU was 0.72 (20/105) which worsened on return [1.04 (20/219), p<0.001) and remained worse at all timepoints after return: 0.92 (20/166) at 3 months (p<0.001), 0.97 (20/187) at 6 months (p<0.001), 0.94 (20/174) at 12 months (p<0.001) and 1.01 (20/205) at final visit (p<0.001). Mean central foveal thickness (CFT) increased from 252 µm at the visit before LTFU to 396 µm at the return visit (p<0.001). No difference in CFT was noted by 3 months (258 µm, p=0.71), 6 months (241 µm, p=0.54) or 12 months after return (250 µm, p=0.95). CFT was thinner at the final visit (215 µm, p=0.018).
Conclusion RVO patients receiving anti-VEGF injections who were LTFU experienced a decline in VA that did not return to the levels seen before LTFU despite improvement in CFT after restarting therapy, underscoring the importance of ongoing treatment.
Data availability statement
Data are available on reasonable request. No.
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Contributors MS, RM, J-CW, DP, SNP, AO and JH were responsible for data collection and analysis as well asdrafting and editing the manuscript. AS, JV, SG, ACH, CR and JH were responsible for planning as well as editing the manuscript. JH was responsible for the overallcontent of the study.
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.
Competing interests MS, RM, J-CW, DP, SNP, AO, JV and AS: no financial disclosures. JH is a consultant for Gyroscope Therapeutics (London, UK), IVERICbio (New York, New York, USA) and OccuRx (Melbourne, Australia). He has received grants from Roche/Genentech (San Francisco, California, USA), Aldeyra Therapeutics (Lexington, Massachusetts, USA) and IVERICbio (New York, New York, USA). ACH is a consultant for Allergan (Dublin, Ireland), Roche/Genentech (San Francisco, California, USA) and Regeneron (Tarrytown, New York, USA). He has also received grants from Allergan (Dublin, Ireland), Genentech (San Francisco, California, USA), and Regeneron (Tarrytown, New York, USA). CR has received grants from Roche/Genentech (San Francisco, California, USA), Regeneron (Tarrytown, New York, USA), Allergan (Dublin, Ireland), Novartis (Basel, Switzerland) and Iconic (San Francisco, Iconic). He is a consultant for Roche/Genentech (San Francisco, California, USA), Alcon (Fort Worth, Texas, USA), Allergan (Dublin Ireland), Iconic (San Francisco, Iconic), Notal Vision (Prince William County, Virginia, USA), Kodiak (Palo Alto, California, USA), Santen (Osaka, Japan), Shire (Lexington, Massachusetts, USA) and Novartis (Basel, Switzerland). SG has received personal fees from Bausch and Lomb (Bridgewater, New Jersey, USA), Johnson and Johnson (New Brunswick, New Jersey, USA), Merck Manuals (Kenilworth, New Jersey, USA), Genentech (San Francisco, California, USA), Santen Pharmaceutical (Osaka, Japan) and Deciphera (Waltham, Massachusetts, USA).
Provenance and peer review Not commissioned; externally peer reviewed.