Elsevier

Ophthalmology

Volume 118, Issue 2, February 2011, Pages 345-352
Ophthalmology

Original article
Baseline Predictors of Visual Acuity and Retinal Thickness Outcomes in Patients with Retinal Vein Occlusion: Standard Care versus COrticosteroid for REtinal Vein Occlusion Study Report 10

https://doi.org/10.1016/j.ophtha.2010.06.034Get rights and content

Objective

To investigate baseline factors associated with visual acuity and central retinal thickness outcomes in patients with macular edema secondary to retinal vein occlusion in the Standard Care versus COrticosteroid for REtinal Vein Occlusion (SCORE) Study.

Design

Two multicenter, randomized clinical trials: one evaluating participants with central retinal vein occlusion (CRVO) and one evaluating participants with branch retinal vein occlusion (BRVO).

Participants

Participants with follow-up data of 1 year or more, including 238 with CRVO and 367 with BRVO.

Methods

Visual acuity was measured by the electronic Early Treatment Diabetic Retinopathy Study (E-ETDRS) method, and central retinal thickness was measured by optical coherence tomography (OCT). Regression analysis related these outcomes to 20 baseline measures. Multiple P values were adjusted to control the false discovery rate.

Main Outcome Measures

Outcome measures of visual acuity letter score included absolute change from baseline, a gain of ≥15 from baseline, and a loss of ≥15 from baseline. Outcome measures of center point thickness included absolute change from baseline, a measurement of ≤250 μm, and a measurement of ≥500 μm. Outcomes were assessed at 1 and 2 years.

Results

For CRVO and BRVO, younger age was associated with improved visual acuity and central retinal thickness outcomes. For CRVO, triamcinolone treatment and less severe anatomic abnormalities of the retina (center point thickness and areas of retinal hemorrhage, thickening, and fluorescein leakage) were predictive of better visual acuity outcomes. For BRVO, no history of coronary artery disease was predictive of improved visual acuity outcomes. For center point thickness outcomes, shorter duration of macular edema was associated with improvement in both disease entities. For CRVO, higher baseline visual acuity letter score was predictive of favorable OCT outcomes. For BRVO, lower baseline visual acuity letter score, presence of dense macular hemorrhage, and no prior grid photocoagulation were predictive of favorable OCT outcomes.

Conclusions

Several factors were predictive of better visual acuity outcomes and more favorable OCT outcomes, including younger age and shorter duration of macular edema, respectively. These factors may assist clinicians in predicting disease course for patients with CRVO and BRVO.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found after the references.

Section snippets

Materials and Methods

The SCORE Study design and methods have been described in detail1 and are summarized in this article. The study adhered to the tenets of the Declaration of Helsinki. Institutional review board approval for the protocol was obtained from a central institutional review board (Jaeb Center for Health Research) or local institutional review boards, and informed consent was obtained from all participants before eligibility screening and again before randomization into the study. The eligible eye of

Results

Table 1 provides a summary of the 3 visual acuity and 3 OCT-measured center point thickness outcome measures at 1 and 2 years that are examined in this report. Note that the number of participants at these follow-up visits is less than the number of enrolled eyes because of participant dropout and death before year 1. In eyes of CRVO participants, more eyes had a loss in visual acuity letter score of ≥15 (31%–34%) than a gain (20%–23%) at years 1 and 2, respectively, with a mean loss in visual

Discussion

This analysis was conducted to identify factors associated with visual acuity and OCT-measured central retinal thickness outcomes in patients treated with SC or intravitreal triamcinolone for macular edema secondary to CRVO or BRVO in the SCORE Study. Because of the large number of variables evaluated, only associations with an FDR <5% were considered significant.

Age was the only predictive factor that was significant across both disease entities (CRVO and BRVO) for predicting visual acuity

References (24)

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  • A. Domalpally et al.

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    • Cited by (0)

    Manuscript no. 2009-1444.

    Financial Disclosure(s): Dr. Michael S. Ip has received financial support from Allergan, Inc.

    Supported by the National Eye Institute (National Institutes of Health, Department of Health and Human Services) grants 5U10EY014351, 5U10EY014352, and 5U10EY014404. Support also provided in part by Allergan, Inc. (Irvine, CA), through donation of investigational drug and partial funding of site monitoring visits and secondary data analyses.

    This article contains online-only material. The following will appear online-only: Tables 2 and 4.

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    Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.