Treatment patterns and long-term outcomes in anti-VEGF-treated macular oedema secondary to retinal vein occlusion: a retrospective observational study

Background/objectives This study reported real-world visual acuity (VA), treatment patterns, and ocular safety outcomes from patients with macular oedema secondary to branch, central, or hemi-retinal vein occlusion (BRVO, CRVO, HRVO) treated with anti-vascular endothelial growth factor (VEGF). Methods Data were collected from Medisoft electronic medical records across 16 NHS ophthalmology sites in England over 60 months. Results 3511/3465 eyes/patients with BRVO and 3568/3514 eyes/patients with CRVO or HRVO were included; <2% of patients had bilateral RVO and had both eyes included. VA change from index anti-VEGF treatment was lower with longer follow-up. In BRVO eyes, mean (95% CI) change in VA from index was +11.2 (10.6, 11.7) approximate Early Treatment Diabetic Retinopathy Study (ETDRS) letters at Month (M)6 and +8.3 (6.7, 10.0) at M60. Mean (95% CI) change in VA for CRVO/HRVO eyes was +11.5 (10.7, 12.3) approximate ETDRS letters at M6 and +7.0 (4.8, 9.2) at M60. Eyes receiving more injections displayed greater average VA gains. Median (Q1–Q3) annual number of anti-VEGF injections was lower in BRVO and CRVO/HRVO eyes with longer follow-up: M12, 7.0 (5.0–8.0) and 6.0 (4.0–8.0); M60, 2.0 (0.0–5.0) and 1.0 (0.0–5.0). Ocular safety outcome incidence through 60 months was low (endophthalmitis, retinal tears, and retinal detachment <1%). Conclusions VA improvements were observed soon after anti-VEGF treatment, but were lower with longer follow-up through 60 months, alongside lower annual injection numbers, suggesting that current single-target intravitreal anti-VEGFs may not be sufficiently durable for long-term RVO management in routine practice.

Citation

Dinah, C., Dodds, M., Lotery, A., Salvatore, S., Fletcher, E., Lake, A. V. R., Parker, A., Paris Pereira, L., Retiere, A. C., Saffar, I., Arrisi, P., United Kingdom Retinal Vein Occlusion Electronic Medical Records Users Group (UK RVO EMR Users Group), & Chi, G. C. (2025). Treatment patterns and long-term outcomes in anti-VEGF-treated macular oedema secondary to retinal vein occlusion: a retrospective observational study. Eye (London, England), 10.1038/s41433-025-04089-2. Advance online publication. https://doi.org/10.1038/s41433-025-04089-2

DOI

10.1038/s41433-025-04089-2

URI

https://hdl.handle.net/20.500.14709/1183

Usage rights

CC BY 4.0

License

https://creativecommons.org/licenses/by/4.0/