Real-World Treatment Patterns for Macular Edema Related to Retinal Vein Occlusion

There are various management options for macular edema due to branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO). Researchers assessed treatment patterns in this patient cohort and found that results differed between U.S. medical claims data and a survey of U.S. retina specialists. The results of the study were published as part of the American Society of Retina Specialists 2020 Virtual Annual Meeting.

Researchers used the Truven MarketScan U.S. claims database to identify adults with a first diagnosis of macular edema due to BRVO or CRVO between January 2017 and June 2017 who had continuous enrollment for ≥180 days before and ≥365 days after diagnosis. The study excluded patients with diabetic macular edema or neovascular age-related macular degeneration or those who received prior treatment for retinal vein occlusion (RVO).

In addition, specialists from 35 randomly selected U.S. retina sites were surveyed between June 2019 and August 2019 regarding their treatment patterns. The final analysis included 246 patients with BRVO (median age, 60 years) and 135 with CRVO (median age, 61 years).

MarketScan claims data indicated that more than half of patients with macular edema due to RVO diagnosis were managed with observation (41% for BRVO and 39% for CRVO), while approximately one-quarter were treated with anti-vascular endothelial growth factor (VEGF) monotherapy during the first year after diagnosis (38% for BRVO and 45% for CRVO).

However, retina specialists reported treating all patients with anti-VEGF therapy, and most initiated treatment either immediately (37%) or within one to two weeks (approximately 39%) of the first visit. The most commonly reported duration of treatment was more than two years for 56% of retina specialists treating BRVO and 72% treating CRVO, with several reporting that they treated for one to two years (n=6/32 and n=6/32, respectively). Among retina specialists, the most commonly reported anti-VEGF regimen was monthly injections (69% for BRVO and 63% for CRVO). Pro-re-nata (11% for both) and treat-and-extend (20% and 26%, respectively) regimens were used less often.

“Based on the differences in treatment patterns … we hypothesize that some RVO patients with macular edema may not be referred to retina specialists until the advanced vision-threatening stage,” the researchers concluded. Further real-world research is needed.

Hershberger VS, Chi G, Chuo CY, et al. Real-World Treatment Patterns in Patients with Macular Edema Due to Retinal Vein Occlusion. Presented during the ASRS 2020 Virtual Annual Meeting, July 24-26, 2020.