SD-OCT-based biomarkers in predicting treatment outcomes of macular oedema secondary to retinal vein occlusion treated with anti-VEGF therapy

Abstract

Purpose: To investigate the role of spectral domain optical coherence tomography (SD-OCT)-based biomarkers in predicting treatment response of macular oedema (MO) secondary to retinal vein occlusion (RVO) to anti-vascular endothelial growth factor (VEGF) therapy. Methods: Retrospective cohort study including consecutive cases of RVO associated MO who received anti-VEGF injections between January 2020 and April 2021. LogMAR visual acuity (VA) at baseline, 12 and 24 months was correlated with a panel of SD-OCT-based biomarkers, including vitreomacular status, size of intra-retinal cysts (IRC), presence of disorganization of retinal inner layers (DRIL), hyper-reflective foci (HRF) in the retina, integrity of the external limiting membrane (ELM), ellipsoid zone (EZ), cone outer segment tip (COST) and presence of subretinal fluid (SRF). Results: One hundred and thirty eyes were included with 81 and 49 eyes in the BRVO and CRVO subgroup, respectively. In both subgroups, baseline disrupted EZ/ELM [BRVO: (β = 0.144 p = 0.008; β = 0.111 p = 0.014; β = 0.096 p = 0.042) and CRVO: (β = 0.316 p < 0.001; β = 0.336 p < 0.001; β = 0.327 p < 0.001)] were associated with worse VA from baseline through 24 months. In the BRVO subgroup, the presence of HRF (β = 0.209 p < 0.001) correlated with worse baseline VA. Improvement in DRIL extent [OR = 4.355 (1.109–17.094) p = 0.035; OR = 4.510 (1.707–11.917) p = 0.002] and EZ/ELM integrity [OR = 4.474 (1.783–11.223) p = 0.001; OR = 3.214 (1.414–7.305) p = 0.005] were associated with a higher likelihood of achieving at least a 5 letters gain at 12 and 24 months. Conclusion: A comprehensive system of SD-OCT-based features could predict functional outcomes of MO secondary to RVO with anti-VEGF therapy up to 24 months.