The British journal of ophthalmology · 2026
Suspending vascular endothelial growth factor inhibitors in eyes with retinal vein occlusion.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Hunt Adrian Robert, Hashimoto Yohei, O'Toole Louise, Ponsioen Theodorus Leonardus, Jaross Nandor, Fraser-Bell Samantha, Kusenda Pavol, Alforja Socorro, Barthelmes Daniel, Gillies Mark C, Fight Retinal Blindness! Investigators
Аннотация
BACKGROUND/AIMS: To identify predictors of continued discontinuation of vascular endothelial growth factor (VEGF) inhibitors for retinal vein occlusion (RVO) after it has been suspended.
METHODS: Eyes with RVO were identified in the Fight Retinal Blindness! registry that suspended VEGF inhibitors for ≥180 days when visual acuity (VA) was ≥35 letters, from 1 December 2011-2021. The primary outcome was not resuming therapy through 24 months which defined success.
RESULTS: Half (186/362 (51%)) of the eligible 6-month suspensions successfully continued through 24 months. Successful cessation attempts began earlier (9 vs 14 months; p=0.001), after greater VA improvement (mean, +12.6 vs +8.5 letters; p=0.01) following more injections in the first 6 months (median, 5 vs 4; p<0.001) and more intensive treatment than unsuccessful attempts (176/362 (49%)). At month 6 without treatment, the mean (95% CI) changes in VA and central subfield thickness (CST) were in successful attempts +1.8 letters (+0.4 to +3.1) and -20 µm (-34 to -6); unsuccessful attempts +0.5 letters (-1.1 to 2.0) and -2 µm (-22 to +18). When therapy resumed in unsuccessful attempts (median, 9.5 months), VA and CST had deteriorated by -3.5 letters (-5.6 to -1.4) and +38 µm (+20 to +57) since suspension. These trends were more pronounced in eyes with central retinal vein occlusion.
CONCLUSION: Eyes with RVO that achieve good outcomes early, following more intensive VEGF inhibition and that improve further over 6 months without therapy are likely to achieve sustained, treatment-free quiescence through 24 months.
METHODS: Eyes with RVO were identified in the Fight Retinal Blindness! registry that suspended VEGF inhibitors for ≥180 days when visual acuity (VA) was ≥35 letters, from 1 December 2011-2021. The primary outcome was not resuming therapy through 24 months which defined success.
RESULTS: Half (186/362 (51%)) of the eligible 6-month suspensions successfully continued through 24 months. Successful cessation attempts began earlier (9 vs 14 months; p=0.001), after greater VA improvement (mean, +12.6 vs +8.5 letters; p=0.01) following more injections in the first 6 months (median, 5 vs 4; p<0.001) and more intensive treatment than unsuccessful attempts (176/362 (49%)). At month 6 without treatment, the mean (95% CI) changes in VA and central subfield thickness (CST) were in successful attempts +1.8 letters (+0.4 to +3.1) and -20 µm (-34 to -6); unsuccessful attempts +0.5 letters (-1.1 to 2.0) and -2 µm (-22 to +18). When therapy resumed in unsuccessful attempts (median, 9.5 months), VA and CST had deteriorated by -3.5 letters (-5.6 to -1.4) and +38 µm (+20 to +57) since suspension. These trends were more pronounced in eyes with central retinal vein occlusion.
CONCLUSION: Eyes with RVO that achieve good outcomes early, following more intensive VEGF inhibition and that improve further over 6 months without therapy are likely to achieve sustained, treatment-free quiescence through 24 months.