Treatment strategy for BVO-ME based on long-term outcomes correlating retinal structure by OCT image and visual...

Area of Science:

• Ophthalmology
• Retinal Diseases
• Vascular Medicine

Background:

• Intravitreal anti-vascular endothelial growth factor (VEGF) injections are standard for treating macular edema secondary to branch retinal vein occlusion (BVO-ME).
• Existing research primarily focuses on short-term outcomes of anti-VEGF therapy for BVO-ME.
• Long-term prognostic indicators for visual outcomes in BVO-ME remain underexplored.

Purpose of the Study:

• To identify long-term indicators of visual prognosis in patients with BVO-ME treated with intravitreal anti-VEGF.
• To investigate the correlation between retinal structural integrity, assessed by Optical Coherence Tomography (OCT), and long-term visual acuity.

Main Methods:

• Retrospective analysis of patients with BVO-ME treated with intravitreal anti-VEGF at Kansai Medical University Hospital (June 2012 - March 2022).
• Inclusion criteria: first-line treatment with anti-VEGF, minimum 36-month follow-up.
• Exclusion criteria: other ocular diseases, prior BVO-ME treatment. Patients categorized by final best-corrected visual acuity (BCVA).

Main Results:

• Forty-seven eyes from 45 patients were analyzed with a mean follow-up of 64.38 months.
• Eyes with intact EZ band and foveal bulge showed significantly better visual acuity.
• Lower recurrence of subretinal fluid (SRD) was observed in eyes with better long-term visual outcomes.

Conclusions:

• The integrity of the EZ band and foveal bulge are significant predictors of long-term visual acuity in BVO-ME.
• Recurrent SRD is associated with poor long-term visual prognosis, even with initial good visual acuity.
• Long-term structural integrity is crucial for sustained visual function in BVO-ME.