Choroidal vascular index alterations in branch retinal vein occlusion: a comparative analysis of anti-VEGF and steroid implants.

PURPOSE: The aim was to evaluate the effects of anti-VEGF and dexamethasone (DEX) implants on choroidal vascular structures in eyes with branch retinal vein occlusion (BRVO).

METHODS

Eyes with temporal BRVO, unaffected fellow eyes, and age- and gender-matched healthy control eyes were retrospectively analyzed. Swept-source optical coherence tomography (SS-OCT) images were collected initially and at the 12-month follow-up visit. Choroidal vascularity index (CVI), choroidal thickness (CT), and central macular thickness (CMT) were measured. Demographic characteristics, treatment modalities, and best-corrected visual acuity (BCVA) were recorded.

RESULTS

The study involved 305 eyes: 104 with BRVO, 104 healthy fellow eyes, and 97 eyes from healthy controls. Initially, BRVO eyes had lower CVI than fellow eyes and controls (p = 0.032, p = 0.001, respectively). CT was lower in BRVO eyes compared to fellow eyes and controls. Among BRVO eyes, 50 received DEX implants, 54 received anti-VEGF treatment. Significant CVI decrease at 12 months was seen in the anti-VEGF group (p = 0.014), while it remained similar in the DEX implant group (p = 0.619). No difference was observed among anti-VEGF agents.

CONCLUSION

The study primarily showed how different treatment approaches affected choroidal parameteres in a condition largely triggered by hypoxia. It suggested the use of CVI as a prognostic indicator to monitor anti-VEGF drug treatment in BRVO patients.