Long-term Visual Outcomes and OCT Biomarkers in Eyes with Macular Edema Secondary to Retinal Vein Occlusion following Anti-VEGF Therapy

Purpose: To evaluate the structural characteristics and long-term visual outcomes in eyes impacted by macular edema as a consequence of retinal vein occlusion (RVO) that have undergone effective treatment with anti-vascular endothelial growth factor (VEGF) therapy. Methods: Inclusion criteria comprised 42 eyes of 41 patients, subjected to long-term follow-up, displaying resolved macular edema after a minimum of 5 years since the commencement of anti-VEGF therapy. During the final visit, two experienced observers evaluated several qualitative parameters using spectral-domain optical coherence tomography (SD-OCT), such as the integrity of the external limiting membrane (ELM), the state of the ellipsoid zone (EZ) and retinal pigment epithelium (RPE), and the presence of retinal inner layer disorganization (DRIL). Additionally, a quantitative evaluation of the inner and outer retinal thicknesses was conducted for the purpose of topographical analysis. Results: The most prominent qualitative correlation identified with best-corrected visual acuity (BCVA) during the final visit was connected to the presence of DRIL (P=0.004) and the integrity of the ELM (P=0.015). In relation to quantitative aspects, a noteworthy correlation was noted between the visual acuity during the last visit and the parafoveal thickness in both the inner (P=0.003) and outer retina (P=0.018). Conclusions: In eyes where macular edema resulting from RVO has been successfully resolved with anti-VEGF therapy, changes in the status of the ELM and the presence of DRIL serve as valuable OCT biomarkers, indicating prolonged visual outcomes.