Fluctuations in Macular Thickness in Patients with Retinal Vein Occlusion Treated with Anti–Vascular Endothelial Growth Factor Agents

Purpose To evaluate macular thickness fluctuations in patients with retinal vein occlusions (RVOs) treated with anti–vascular endothelial growth factor (VEGF) agents and to assess whether patients with larger fluctuations have poorer visual outcomes. Design Retrospective cohort study. Participants Treatment-naive patients with RVO. Methods Central subfield thickness (CST), cube volume (CV), and cube average thickness (CAT) were collected from OCT images obtained at baseline and 3, 6, 9, and 12 months, and standard deviations (SDs) across 12 months were calculated. Mixed-effects regression was performed to examine the relationship between macular thickness SD and 12-month visual acuity (VA). Standard multiple regression was performed to identify predictors of macular thickness SD. Main Outcome Measures Standard deviations across 12 months for CST, CV, and CAT and VA at 12 months. Results One hundred thirty-four eyes, including 71 with branch RVO (BRVO) and 63 with central RVO (CRVO), were evaluated. Mean baseline and 12-month CST were 488.6 ± 165.0 μm and 334.3 ± 131.9 μm (change, –154.3 ± 210.2 μm; P Conclusions Larger macular thickness fluctuations are associated with poorer visual outcomes in patients with RVO treated with anti-VEGF agents. Macular thickness fluctuations, in addition to absolute macular thickness, may be an important prognostic biomarker in these patients.