Fellow ophthalmologists, take note! This new study delves into the complexities of treating central retinal vein occlusion with macular edema (CRVO-ME) and highlights the potential impact of foveal thickness fluctuations (FTF) on long-term outcomes.

The Study:

This retrospective, multicenter study followed 141 treatment-naive patients with CRVO-ME receiving anti-VEGF injections based on a pro re nata (PRN) regimen. By analyzing foveal thickness (FT) using OCT at each visit, researchers categorized patients into four groups based on increasing FTF.

Key Findings:

• Visual acuity (BCVA) and FT improved overall, suggesting the effectiveness of anti-VEGF treatment.
• However, higher FTF was associated with worse final BCVA and a longer foveal ellipsoid zone (EZ) band defect, indicating impaired photoreceptor function.
• Interestingly, neovascular complications did not show a direct link to FTF, suggesting other factors might be at play.

Implications for Practice:

• Monitoring FTF alongside traditional parameters like BCVA and OCT findings could provide valuable insights into treatment response and prognosis.
• Patients with higher FTF might benefit from more frequent monitoring or adjustments to their treatment regimen, potentially including earlier intervention or combination therapies.
• Further research is needed to understand the mechanisms underlying FTF and explore strategies to minimize its impact on visual outcomes.

Take-Home Message:

While anti-VEGF injections remain the mainstay of CRVO-ME treatment, FTF emerges as a potential factor influencing long-term visual function. Incorporating FTF assessment into our clinical practice might refine treatment approaches and ultimately improve patient outcomes.