title: Impact of initial visual acuity on anti-VEGF treatment outcomes in patients with macular oedema secondary to retinal vein occlusions in routine clinical practice.
abstract: To determine the impact of initial visual acuity (VA) on anti-vascular endothelial growth factor (VEGF) treatment outcomes in patients with macular oedema secondary to retinal vein occlusions in routine clinical practice.
  
  
  
  A retrospective study was conducted at a single academic institution to identify 177 treatment naïve patients with macular oedema secondary to branch retinal vein occlusion (BRVO), hemiretinal vein occlusion (HRVO) and central retinal vein occlusion (CRVO) treated with intravitreal anti-VEGFs. Exclusion criteria included prior intravitreal injection or presence of active confounding ocular disease. Patients were stratified by initial VA; main outcomes measured were average change in VA and mean absolute change in central subfield thickness (CST) at 6 and 12 months.
  
  
  
  Patients with BRVO with initial VA of 20/40 or better had no significant changes in average letters gained and CST from baseline (+2.6 letters, p=0.42; -48.94 µm, p=0.12) compared with patients with initial VA between 20/50 and 20/300 (+13.2 letters, p<0.001; -98.20 µm, p<0.001) after 12 months. Patients with CRVO/HRVO with initial VA of 20/320 or worse had the most improvement in average letters gained and CST from baseline (+42.2 letters, p<0.001; -182.84 µm, p=0.004) with anti-VEGF therapy compared with patients with initial VA between 20/50 and 20/300 (+9.4 letters, p=0.016; -160.87 µm, p<0.001) and patients with initial VA of 20/40 or better (-9.6 letters, p=0.14; -47.92 µm, p=0.38).
  
  
  
  For macular oedema secondary to retinal vein occlusion, anti-VEGF treatment can result in a greater improvement in average letters gained and in CST for those with poor initial VA compared with those with better initial VA.
authors: Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors: Karen M
authors: KM
authors: Wai
authors: Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors: Mehnaz
authors: M
authors: Khan
authors: Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors: Sunil
authors: S
authors: Srivastava
authors: Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors: Aleksandra
authors: A
authors: Rachitskaya
authors: Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors: Fabiana Q
authors: FQ
authors: Silva
authors: Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors: Ryan
authors: R
authors: Deasy
authors: Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors: Andrew P
authors: AP
authors: Schachat
authors: Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors: Amy
authors: A
authors: Babiuch
authors: Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors: Justis P
authors: JP
authors: Ehlers
authors: Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors: Peter K
authors: PK
authors: Kaiser
authors: Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors: Alex
authors: A
authors: Yuan
authors: Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors: Rishi P
authors: RP
authors: Singh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000068258:Bevacizumab; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D012170:Retinal Vein Occlusion / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology*
chemical_list: D020533:Angiogenesis Inhibitors; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab
keywords: Macula; Retina; Treatment Medical; Vision