SCORE2 Report 20: Relationship of Treatment Discontinuation With Visual Acuity and Central Subfield Thickness Outcomes
2023 Apr
Journal Article
Authors:
Scott, I.U.;
Oden, N.L.;
VanVeldhuisen, P.C.;
Ip, M.S.;
Blodi, B.A.
Secondary:
Am J Ophthalmol
Volume:
248
Pagination:
157-163
PMID:
36584835
URL:
https://pubmed.ncbi.nlm.nih.gov/36584835/
Keywords:
Angiogenesis Inhibitors; Bevacizumab; Humans; Intravitreal Injections; macular edema; Receptors, Vascular Endothelial Growth Factor; retinal vein occlusion; Tomography, Optical Coherence; Vascular Endothelial Growth Factor A; visual acuity
Abstract:
PURPOSE: To investigate the relationship of anti-vascular endothelial growth factor (anti-VEGF) treatment discontinuation with baseline factors and outcomes in eyes treated initially with aflibercept or bevacizumab for macular edema from central or hemiretinal vein occlusion.DESIGN: Long-term follow-up after a randomized clinical trial from 64 US centers.METHODS: Analysis included 150 SCORE2 Month 60 completers classified into 3 groups: discontinued treatment early, treated intermittently, and treated continuously. Outcomes included visual acuity (VA) and central subfield thickness (CST).RESULTS: Patients who discontinued treatment early were younger (60.9 years, vs 66.7 and 70.5 for the treated intermittently and treated continuously groups; P = .001), and 17.4% were Black, compared to 19.5% and 4.7% for the treated intermittently and treated continuously groups (P = .006). At Month 60, the discontinued treatment early group had a higher proportion with complete resolution of macular edema (69.6%) than those treated intermittently (15.0%) and treated continuously (15.7%) (P < .001). Least-squares means analyses over follow-up demonstrated that the discontinued treatment early group had a lower mean CST (257 µm) than the treated intermittently (CST = 303 µm, P = .02) and treated continuously (CST = 300 µm, P = .01) groups.CONCLUSIONS: Compared to those treated continuously, those who discontinued treatment early were younger and more likely Black. The discontinued treatment early group had a higher proportion with complete resolution of macular edema at Month 60, and a lower mean CST over follow-up, but not better VA, than the treated continuously and treated intermittently groups. Results support the need for continued monitoring and individualized treatment for patients treated with anti-VEGF for macular edema from central or hemiretinal vein occlusion.
