Foveal Thickness Fluctuation Associated with Visual Acuity in Eyes with BRVO

Akitaka Tsujikawa, MD, PhD

A recent study analyzed the effects of foveal thickness fluctuation on visual and morphologic outcomes of anti-VEGF treatments for branch retinal vein occlusion (BRVO) administered via a pro re nata regimen.

The findings suggest foveal thickness fluctuation was significantly associated with visual acuity and foveal photoreceptor status.

“Thus, the morphologic and functional prognoses of eyes with BRVO may improve with the identification of the characteristics of eyes with greater foveal thickness fluctuation and consequently controlling the foveal thickness fluctuation more strictly,” wrote study author Akitaka Tsujikawa, MD, PhD, Kyoto University.

As BRVO may cause macular edema (ME), the disease can be controlled with anti-VEGF treatments. The treatments, however, are not curative and require additional anti-VEGF treatments at recurrence.

Still, the long-term results, optimal anti-VEGF treatment regimens, and the comprehensive effects of ME recurrence remains unknown. The current study thus examined the effects of foveal thickness on the outcomes of anti-VEGF treatments for BRVO-ME.

The retrospective, observational case series study examined 309 treatment-naive patients (309 eyes) with BRVO-ME between 2012 and 2021 at a multicenter retinal practice. Each patient had foveal thickness assessed at each study visit.

The main outcome evaluated the logarithm of the minimal angle of resolution (logMAR) best-corrected visual acuity (BCVA) and the defect length of the foveal ellipsoid zone (EZ) band using OCT.

At baseline, the data show the mean logMAR BCVA was 0.30 ± 0.30 and the mean foveal thickness was 503 ± 162 μm. Moreover, the number of anti-VEGF injections for BRVO-ME was 5.8 ± 4.6 during the mean follow-up period (50.6 ± 22.2 months).

Investigators noted the final examination revealed the mean logMAR BCVA and foveal thickness values were significantly improved in comparison to those at the baseline. Multiple regression analyses further showed that age, baseline logMAR BCVA, and foveal thickness fluctuation had significant associations with the final logMAR BCVA (β = 0.20, 0.35, and 0.30, respectively).

Other significant associations included foveal thickness fluctuation (divided into groups 0 – 3 in ascending order) with logMAR BCVA and the defect length of the foveal EZ band at the final examination.

Data suggest the defect lengths of the foveal EZ band were longitudinally shortened in groups 0 and 1 and were slightly prolonged in groups 2 and 3. The logMAR BCVA was improved in groups 0 and 1 and worsened slightly in groups 2 and 3.

The study, “Foveal Thickness Fluctuations in Anti-VEGF Treatment for Branch Retinal Vein Occlusion: A Long-term Study,” was published in Ophthalmology Retina.