Prognostics optical coherence tomography biomarker in macular oedema secondary to retinal vein occlusion

Abstract

Background: Identifying biomarkers predictive of future best-corrected visual acuity (BCVA) in macular oedema secondary to retinal vein occlusion (RVO-MO) is crucial for improving risk assessment, management strategies and patient consultations. Aim: This study aimed to identify baseline optical coherence tomography (OCT) predictors of visual prognosis in RVO-MO following intravitreal bevacizumab (IVB) injection. Setting: The study was conducted at Cicendo Eye Hospital, Bandung, Indonesia. Methods: Retrospective study of 36 treatment-naïve eyes with RVO-MO (22 eyes with central retinal vein occlusion and 14 eyes with branch retinal vein occlusion). Each eye received at least three monthly IVB injections with a minimum follow-up of 4 months. Assessment of baseline OCT images focused on a 3-mm-wide retinal area centred on the fovea. Univariate and multivariate regression analyses were performed. Result: There was a significant improvement in mean BCVA from 1.15 ± 0.42 logMAR to 0.80 ± 0.55 logMAR (P < 0.001) and a reduction in mean central macular thickness (CMT) from 732.2 μm ± 298.9 μm to 437.7 μm ± 352.9 μm (P < 0.001). Univariate regression analysis highlighted worse baseline BCVA and higher baseline CMT as factors correlating with poorer outcomes post-treatment. Several OCT biomarkers such as disorganisation of the retinal inner layer (DRIL) and disruption of the ellipsoid zone (EZ) and the external limiting membrane (ELM) were identified but did not show significant associations with final BCVA after multivariate analysis. Conclusion: Baseline OCT biomarkers may elucidate the extent of vision loss; however, they may not be reliable in predicting treatment outcomes.