Predicting response of ischemic central retinal vein occlusion to bevacizumab injections: 1 year follow-up

Purpose: To identify baseline optical coherence tomography (OCT) factors in ischemic central retinal vein occlusion (CRVO) that predict response to bevacizumab injections. Methods: Patients underwent OCT at diagnosis and the central macular thickness, subretinal fluid width and height as well as the presence of intraretinal cysts were measured. The extent of disorganized retinal inner layers, outer plexiform layer (OPL), external limiting membrane, ellipsoid zone and cone outer segment tips (COST) was recorded. Patients received three consecutive monthly injections of bevacizumab followed by pro re nata treatment. Results: Overall 32 eyes of 32 patients aging 69.4 ± 12.7 years were included. In univariate correlational analyses baseline OPL disruption (− 41, p = 0.02), EZ disruption (r = − 0.36, p = 0.05) and COST disruption (r = − 0.37, p = 0.04) correlated with deterioration in BCVA at 1 year. Partial least squares demonstrated that the factors most largely associated with deterioration in BCVA were COST disruption and OPL disruption followed by EZ disruption, while worst vision at baseline was associated with improvement in vision. Conclusion: In patients with ischemic CRVO treated with bevacizumab, BCVA improvement at 1 year can be partially predicted from baseline OCT measurements by the extent of COST, OPL and EZ disruption.