OBJECTIVES: Intravitreal ranibizumab and aflibercept is the mainstream therapy for central retinal vein occlusion (CRVO), a common cause of vision loss in adults. However, the long-term effectiveness of changes in central retinal thickness (CRT) and visual acuity (VA) post ranibizumab and aflibercept therapy remains unclear in Taiwan.

METHODS: This retrospective cohort study analyzed the electronic medical records data from three hospitals in northern Taiwan. We included CRVO eyes newly initiating ranibizumab or aflibercept therapy during 2017-2019, and evaluated the 1-year and 2-year changes of CRT and VA, measured by Snellen charts, after therapy. The VA was converted to the logarithm of the minimum angle of resolution (LogMAR) VA for statistical analysis. We used the mixed model analysis to assess CRT and LogMAR VA changes between the baseline and different time points.

RESULTS: We included a total of 73 and 61 CRVO eyes receiving ranibizumab (mean age: 65.0±15.0 years old; female: 49.3%) and aflibercept (mean age: 66.4±14.1 years old; female: 42.6%), respectively. In ranibizumab users, we found significant decreases in CRT after 1-year (527.3 vs. 338.6 μm, p<0.001) and 2-year therapy (527.3 vs. 316.0 μm, p<0.001), but the LogMAR VA remained stable after 1-year (0.92 vs. 0.93, p=0.97) and 2-year therapy (0.92 vs. 0.97, p=0.40). In aflibercept users, we found significant decreases in CRT after 1-year (606.5 vs. 355.3 μm, p<0.001) and 2-year therapy (606.5 vs. 301.0 μm, p<0.001), but the LogMAR VA remained stable after 1-year (0.89 vs. 0.95, p=0.30) and 2-year therapy (0.89 vs. 0.97, p=0.05).

CONCLUSIONS: Our findings suggested significant reductions of CRT without clinical improvements of VA in CRVO eyes treated with intravitreal ranibizumab or aflibercept in Taiwan’s clinical practice. Future studies should determine the benefits of CRT reductions on other long-term visual outcomes in CRVO patients.