In this analysis of patients with cystoid macular edema due to retinal vein occlusion and initial good visual acuity, the majority of participants received intravitreal therapy and maintained good visual acuity over follow-up period of two years.

In this analysis of patients with cystoid macular edema due to retinal vein occlusion and initial good visual acuity, the majority of participants received intravitreal therapy and maintained good visual acuity over follow-up period of two years. Photo: NIH. Click image to enlarge.

A recent analysis of patients with retinal vein occlusion (RVO) and initial visual acuity better than 6/12 indicates that most individuals sustained good visual acuity. These findings, recently published in the journal Retina, also showed that anti-VEGF treatment maintained and improved VA in this patient population.

“The approach to managing patients with RVO and cystoid macular edema (CME) with good initial visual acuity better than 6/12 has not been investigated,” the research team noted in their report. “This study aimed to evaluate functional and anatomical outcomes of intravitreal treatment and observation in patients with CME due to retinal vein occlusion, who presented with good initial visual acuity.”

This multicenter, retrospective cohort study included 79 eyes of 79 patients with cystoid macular edema secondary to retinal vein occlusion and initial visual acuity better than 6/12. Study participants were either treated with anti-VEGF therapy or observed.

Investigators documented clinical parameters and OCT measures. The main outcome measure of this analysis was the proportion of patients losing ≥1 line of VA at 12 months. Secondary outcomes included visual and anatomical results at 12 and 24 months as well as the correlation between number of injections and VA outcomes.

Data showed that 53% of patients maintained visual acuity at month 12. The study authors reported that visual acuity of 6/6 - 6/7.5 was maintained in 59% and 57% of patients at 12 and 24 months, respectively. At 24 months, a strong correlation was observed between anti-VEGF injections and visual acuity among patients with branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO).

“This study marks the first exploration of patients with vein occlusions and good initial visual acuity better than 6/12, indicating that most patients maintained good VA, and anti-VEGF treatment notably maintained and improved visual acuity,” the study authors noted in their recent Retina paper.

“These findings support our recommendation to closely monitor and consider treatment in patients with macular edema due to RVO and good visual acuity,” they concluded. “The study opens a door for a prospective randomized controlled trial in patient with retinal vein occlusion and good VA to compare treatment and observation outcomes.”

Gomel N, D'Aloisio R, Wattad A, et al. Good Initial Visual Acuity in Patients with Macular Edema due to Retinal Vein Occlusion – Management and Outcomes. Retina. August 9, 2024 [Epub ahead of print].