Real-Life Management of Central and Branch Retinal Vein Occlusion: A Seven-Year Follow-Up Study.

Abstract

Retinal vein occlusion is the second most common retinal vascular pathology after diabetic retinopathy and a major cause of vision impairment. Nowadays, both central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) can be well-managed by intravitreal treatments. However, considering the long-life expectance of the patients, few data are present in the literature about the very long-term outcome of CRVO and BRVO. The present study was an interventional, retrospective analysis of the morphological and functional long-term outcome of CRVO and BRVO patients, followed in an Italian referral center. We collected data from 313 eyes (178 CRVO eyes and 135 BRVO eyes). Mean follow-up was 45\u2009±\u200925 months (range 12-84 months). Both CRVO and BRVO eyes experience a significant visual acuity improvement secondary to anti-vascular endothelial growth factor/dexamethasone treatments (from 0.57\u2009±\u20090.25 to 0.41\u2009±\u20090.24 LogMAR in CRVO and from 0.53\u2009±\u20090.42 to 0.30\u2009±\u20090.41 LogMAR in BRVO, respectively) (p\u2009<\u20090.01). Also, central macular thickness (CMT) resulted significant recovery at the end of the follow-up (from 585.54\u2009±\u2009131.43 to 447.88\u2009±\u2009245.07 μm in CRVO and from 585.54\u2009±\u2009131.43 to 447.88\u2009±\u2009245.07 μm in BRVO, respectively) (p\u2009<\u20090.01). CRVO eyes received a mean of 10.70\u2009±\u20094.76 intravitreal treatments, whereas BRVO underwent 9.80\u2009±\u20095.39 injections over the entire 7-year follow-up. Our analyses highlighted different time points indicating the best obtainable improvement. This was the first year for CRVO (12-month follow-up) and the second year for BRVO (24-month follow-up). After these two time points, both visual acuity and CMT resulted stable up to the end of the follow-up. Ischemia was associated with significantly worse outcome.