Different Factors Associated with 2-Year Outcomes in Patients with Branch versus Central Retinal Vein Occlusion Treated with Ranibizumab

Raafay Sophie, Pin wen Wang, Roomasa Channa, Carlos Quezada-Ruiz, Ann Clark, Peter A Campochiaro

Research output: Contribution to journalArticle


Purpose: To investigate characteristics associated with visual and anatomic outcomes in branch and central retinal vein occlusion (BRVO and CRVO) patients treated with ranibizumab. Design: Post hoc analysis of patients with BRVO and CRVO from 2 multicenter clinical trials who completed month 12 of the HORIZON extension trial. Participants: 205 patients with BRVO and 181 patients with CRVO who completed month 12 of the extension trial. Methods: With the use of logistic regression, covariates with a P value < 0.20 from univariate analysis were included in multivariate models to identify independent factors associated with a given outcome (at P < 0.05), with preset variables of disease duration and original treatment assignment. Main Outcome Measures: Best-corrected visual acuity (BCVA) ≥20/40 (≥70 letters), gain ≥15 letters, and central subfield thickness (CST) ≤250 μm at HORIZON month 12. Results: In patients with BRVO, good baseline BCVA (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.30–1.79), male sex (OR, 2.48; 95% CI, 1.20–5.13), and normal hematocrit (low vs. normal, OR, 0.26; 95% CI, 0.12–0.59) predicted BCVA ≥20/40; high central foveal thickness (OR, 1.03; 95% CI, 1.01–1.04) and normal hematocrit (low vs. normal, OR, 0.31; 95% CI, 0.15–0.66) predicted BCVA improvement ≥15 letters; and extensive baseline subretinal fluid modestly predicted CST ≤250 μm (OR, 1.08; 95% CI, 1.00–1.16). In patients with CRVO, good baseline BCVA (OR, 1.59; 95% CI, 1.35–1.89), never smoking (OR, 2.80; 95% CI, 1.27–6.17), and young age (OR, 0.58; 95% CI, 0.41–0.82) predicted BCVA ≥20/40; never smoking (OR, 2.13; 95% CI, 1.03–4.39), young age (OR, 0.41; 95% CI, 0.28–0.59), poor baseline BCVA (OR, 0.82; 95% CI, 0.73–0.93), hypertension (OR, 4.47; 95% CI, 1.70–11.75), and low diastolic ocular perfusion pressure (OPP) throughout the study (OR, 0.39; 95% CI, 0.21–0.72) predicted BCVA improvement ≥15 letters; and young age (OR, 0.65; 95% CI, 0.47–0.90), lower mean hematocrit (low vs. normal, OR, 2.81; 95% CI, 1.06–7.49), high systolic OPP throughout the study (OR, 1.61; 95% CI, 1.14–2.27), large areas of central hemorrhage (OR, 1.44; 95% CI, 1.04–2.00), and no subretinal fluid (OR, 2.15; 95% CI, 1.06–4.40) predicted CST ≤250 μm. Conclusions: There are substantial differences in good outcome factors in CRVO versus BRVO, suggesting differences in pathophysiology. Young age, never smoking, hemodilution, and hypertension/high systolic perfusion pressure are more beneficial in CRVO, suggesting that avoidance of sluggish blood flow and maintenance of perfusion may be particularly important in CRVO.

Original languageEnglish (US)
StateAccepted/In press - Jan 1 2019

ASJC Scopus subject areas

  • Ophthalmology

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