Baseline Optical Coherence Tomography Features and Visual Outcomes After Anti-vascular Endothelial Growth Factor Therapy for Retinal Vein Occlusion-Associated Macular Edema: A Prospective Observational Study
- 1Ophthalmology, Gandhi Medical College, Bhopal, IND
- 2Ophthalmology, Civil Hospital Sihora, Jabalpur, IND
Abstract
Background
Macular edema is a major cause of visual loss in retinal vein occlusion (RVO). Although anti-vascular endothelial growth factor (anti-VEGF) therapy reduces retinal thickening, visual recovery varies. The primary objective was to assess whether baseline optical coherence tomography (OCT) features were associated with visual acuity one month after the third anti-VEGF injection using a prespecified 6/18 threshold. Secondary objectives assessed demographic and clinical associations, while central macular thickness (CMT) reduction was evaluated exploratorily.
Methodology
This prospective observational study included 60 eyes of 60 patients with center-involving, RVO-associated macular edema treated between September 2022 and February 2024. Each eye received three intravitreal anti-VEGF injections, with assessment one month after each injection. A good outcome was defined as final visual acuity of 6/18 or better. Baseline OCT features included CMT, macular volume, hyperreflective foci, serous macular detachment, ellipsoid zone (EZ) and external limiting membrane (ELM) integrity, disorganization of the retinal inner layers (DRIL), foveal bulge, and ganglion cell layer (GCL) cystic spaces. Categorical variables were compared using Fisher’s exact or Fisher-Freeman-Halton exact tests, and continuous variables using the independent-samples t-test.
Results
Good visual outcome occurred in 21 (35.0%) eyes. Younger age, branch RVO, and non-ischemic disease were associated with good outcomes (p = 0.001, p = 0.003, and p < 0.001, respectively). Baseline and final CMT were lower in the good-outcome group (both p < 0.001). Higher baseline macular volume, EZ disruption, DRIL, and ELM disruption were associated with poor outcomes, whereas foveal bulge was associated with good outcomes (all p < 0.001). CMT reduction >100 µm was not associated with visual outcome (p = 0.778).
Conclusions
Several baseline OCT features were associated with final visual outcome, whereas CMT reduction was not. These findings are exploratory and do not establish independent predictive value or clinical utility. Larger studies with standardized treatment, multivariable adjustment, and external validation are needed.
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BibTeX
@article{mandloi2026baseline,
title = {{Baseline Optical Coherence Tomography Features and Visual Outcomes After Anti-vascular Endothelial Growth Factor Therapy for Retinal Vein Occlusion-Associated Macular Edema: A Prospective Observational Study}},
author = {Garima Mandloi and Ekta Thakur and Anshul Tiwari and Sneha Alaway and Ahtesham Ansari},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.117185},
url = {https://europepmc.org/article/PMC/PMC13720275},
note = {CC BY},
}
RIS
TY - JOUR
TI - Baseline Optical Coherence Tomography Features and Visual Outcomes After Anti-vascular Endothelial Growth Factor Therapy for Retinal Vein Occlusion-Associated Macular Edema: A Prospective Observational Study
AU - Garima Mandloi
AU - Ekta Thakur
AU - Anshul Tiwari
AU - Sneha Alaway
AU - Ahtesham Ansari
PY - 2026
DA - 2026/09/29
JO - Cureus
DO - 10.7759/cureus.117185
UR - https://europepmc.org/article/PMC/PMC13720275
AB - Background Macular edema is a major cause of visual loss in retinal vein occlusion (RVO). Although anti-vascular endothelial growth factor (anti-VEGF) therapy reduces retinal thickening, visual recovery varies. The primary objective was to assess whether baseline optical coherence tomography (OCT) features were associated with visual acuity one month after the third anti-VEGF injection using a prespecified 6/18 threshold. Secondary objectives assessed demographic and clinical associations, while central macular thickness (CMT) reduction was evaluated exploratorily. Methodology This prospective observational study included 60 eyes of 60 patients with center-involving, RVO-associated macular edema treated between September 2022 and February 2024. Each eye received three intravitreal anti-VEGF injections, with assessment one month after each injection. A good outcome was defined as final visual acuity of 6/18 or better. Baseline OCT features included CMT, macular volume, hyperreflective foci, serous macular detachment, ellipsoid zone (EZ) and external limiting membrane (ELM) integrity, disorganization of the retinal inner layers (DRIL), foveal bulge, and ganglion cell layer (GCL) cystic spaces. Categorical variables were compared using Fisher’s exact or Fisher-Freeman-Halton exact tests, and continuous variables using the independent-samples t-test. Results Good visual outcome occurred in 21 (35.0%) eyes. Younger age, branch RVO, and non-ischemic disease were associated with good outcomes (p = 0.001, p = 0.003, and p < 0.001, respectively). Baseline and final CMT were lower in the good-outcome group (both p < 0.001). Higher baseline macular volume, EZ disruption, DRIL, and ELM disruption were associated with poor outcomes, whereas foveal bulge was associated with good outcomes (all p < 0.001). CMT reduction >100 µm was not associated with visual outcome (p = 0.778). Conclusions Several baseline OCT features were associated with final visual outcome, whereas CMT reduction was not. These findings are exploratory and do not establish independent predictive value or clinical utility. Larger studies with standardized treatment, multivariable adjustment, and external validation are needed.
SN - 2168-8184
ER -