Researchers recently reported that larger macular thickness fluctuations are associated with poorer visual outcomes in patients with retinal vein occlusion (RVO) treated with anti-VEGF agents.

This retrospective cohort study followed 134 eyes of treatment-naïve patients over 12 months of treatment—71 had branch RVO (BRVO) and 63 had central RVO (CRVO). The team assessed central subfield thickness (CST), cube volume (CV) and cube average thickness (CAT) at baseline and at three, six, nine and 12 months.

The investigators observed mean baseline and 12-month CST of 488.6±165.0μm and 334.3±131.9μm, respectively, with a standard deviation of 114.1±77.0μm. They found baseline and 12-month visual acuities (VA) of 52.8±20.9 letters and 65.9±17.3 letters, respectively. They noted that CST standard deviation was a significant negative predictor of 12-month acuity (-5.21 letters/100μm) after adjusting for baseline factors and injections, while baseline CST and number of injections were not predictive.

They added that stratification by CST standard deviation demonstrated a 10-letter difference in 12-month visual acuity between the first and fourth quartiles. They also discovered that baseline CST and RVO diagnosis were the only significant predictors of CST standard deviation (+34.64μm/100μm and +22.13μm for CRVO and BRVO, respectively). They found similar associations using cube volume and cube average thickness.

“Macular thickness fluctuations, in addition to absolute macular thickness, may be an important prognostic biomarker in these patients,” the study authors concluded in their paper.

Chen AX, Greenlee TE, Conti TF, et al. Fluctuations in macular thickness in patients with retinal vein occlusion treated with anti-vascular endothelial growth factor agents. Ophthalmology. May 28, 2020. [Epub ahead of print].