Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Sep 7;14(17):1983.
doi: 10.3390/diagnostics14171983.

Integrated Assessment of OCT, Multimodal Imaging, and Cytokine Markers for Predicting Treatment Responses in Retinal Vein Occlusion Associated Macular Edema: A Comparative Review of Anti-VEGF and Steroid Therapies

Marion R Munk  1   2   3   4 , Lala Ceklic  2   3 , Richard Stillenmunkes  1 , Varun Chaudhary  5   6 , Nadia Waheed  7 , Jay Chhablani  8 , Marc D de Smet  9   10   11 , Anne Tillmann  1
Affiliations
Review

Integrated Assessment of OCT, Multimodal Imaging, and Cytokine Markers for Predicting Treatment Responses in Retinal Vein Occlusion Associated Macular Edema: A Comparative Review of Anti-VEGF and Steroid Therapies

Marion R Munk et al. Diagnostics (Basel). .

Abstract

Retinal vein occlusion (RVO) is a significant cause of vision loss, characterized by the occlusion of retinal veins, leading to conditions such as central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO). Macular edema (ME), a prevalent consequence of RVO, is the primary cause of vision impairment in affected patients. Anti-VEGF agents have become the standard treatment, showing efficacy in improving visual acuity (VA) and reducing ME. However, a subset of patients exhibit a suboptimal response to anti-VEGF therapy, necessitating alternative treatments. Corticosteroids, which address inflammatory pathways implicated in ME, have shown promise, particularly in cases resistant to anti-VEGF. This review aims to identify biomarkers that predict treatment response to corticosteroids in RVO-associated ME, utilizing multimodal imaging and cytokine assessments. Baseline imaging, including SD-OCT and OCT-A, is essential for evaluating biomarkers like hyperreflective foci (HRF), serous retinal detachment (SRF), and central retinal thickness (CRT). Elevated cytokine levels, such as IL-6 and MCP-1, correlate with ME severity and poor anti-VEGF response. Early identification of these biomarkers can guide timely transitions to corticosteroid therapy, potentially enhancing treatment outcomes. The practical conclusion of this review is that integrating biomarker assessment into clinical practice enables personalized treatment decisions, allowing for earlier and more effective management of RVO-associated ME by transitioning patients to corticosteroid therapy when anti-VEGF agents are insufficient. Advanced diagnostics and machine learning may further refine personalized treatment strategies, improving the management of RVO-associated ME.

Keywords: anti-VEGF therapy; branch retinal vein occlusion; central retinal vein occlusion; corticosteroid treatment; cytokine assessments; imaging biomarkers; macular edema; retinal vein occlusion.

PubMed Disclaimer

Conflict of interest statement

A.T.: none, L.C.: none, R.S.: none, V.C.: advisory board member: Alcon, Roche, Bayer, Novartis, Appelis, Boehringer Ingelheim; grants: Bayer, Novartis, Roche, N.W.: research support to institution: Zeiss, Topcon, Nidek; consultant: Nidek, Topcon, Complement Therapeutics, Olix Pharma, Iolyx Pharmaceuticals; equity interest: Ocydyne, Valitor, Beacon, Iolyx; office holder: Ocular Therapeutics, J.C.: owner: NetraMind Innovations; consultant: Allergan, Novartis, Salutaris, OS-OS, Erasca, B&L, Iveric Bio; equity: Ocular therapeutics, AcuViz, Abbvie; royalty: Springer, Elsevier, M.R.M.: consultant: Abbvie, Alcon, Apellis, Bayer, Isarna Therapeutics, Novartis, GenSight, Lumithera, Zeiss, Roche, RetinAI, Ikerian, Ocuterra, Kubota, Dandelion, Eyepoint and Iveric Bio. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this review.

References

    1. Song P., Xu Y., Zha M., Zhang Y., Rudan I. Global epidemiology of retinal vein occlusion: A systematic review and meta-analysis of prevalence, incidence, and risk factors. J. Glob. Health. 2019;9:010427. doi: 10.7189/jogh.09.010427. - DOI - PMC - PubMed
    1. Ramin S., Rostami F., Ahmadieh H., Daftarian N., Nourinia R., Abbasi A., Kheiri B., Sabbaghi H., Sheibani K. Vision-related quality of life in patients with retinal vein occlusion. Int. Ophthalmol. 2024;44:114. doi: 10.1007/s10792-024-02916-1. - DOI - PubMed
    1. McIntosh R.L., Rogers S.L., Lim L., Cheung N., Wang J.J., Mitchell P., Kowalski J.W., Nguyen H.P., Wong T.Y. Natural history of central retinal vein occlusion: An evidence-based systematic review. Ophthalmology. 2010;117:1113–1123.e15. doi: 10.1016/j.ophtha.2010.01.060. - DOI - PubMed
    1. Rogers S.L., McIntosh R.L., Lim L., Mitchell P., Cheung N., Kowalski J.W., Nguyen H.P., Wang J.J., Wong T.Y. Natural history of branch retinal vein occlusion: An evidence-based systematic review. Ophthalmology. 2010;117:1094–1101.e1095. doi: 10.1016/j.ophtha.2010.01.058. - DOI - PubMed
    1. Zhang M., Liu Y., Song M., Yu Y., Ruan S., Zheng K., Wang F., Sun X. Intravitreal Dexamethasone Implant Has Better Retinal Perfusion than Anti-Vascular Endothelial Growth Factor Treatment for Macular Edema Secondary to Retinal Vein Occlusion: A Five-Year Real-World Study. Ophthalmic Res. 2023;66:247–258. doi: 10.1159/000527447. - DOI - PubMed

LinkOut - more resources