Remote Monitoring of Patients with Retinal Vein Occlusions Treated with Anti-VEGF: A Pilot Study

Abstract

Purpose: To assess the feasibility and effectiveness of remote monitoring for patients with retinal vein occlusion (RVO) treated with intravitreal anti-VEGF injections. Methods: A retrospective analysis was conducted at the Eye Clinic of the University of Catania. Thirty-four eyes of 34 patients with RVO were included for a 12-month follow-up period. After a comprehensive baseline ophthalmic examination, the patients received a loading treatment consisting of three monthly intravitreal injections of anti-VEGF, followed by monthly or bimonthly remote follow-up visits at peripheral centers. Optical coherence tomography (OCT) images and clinical data were shared online with our eye clinic for remote evaluations. Data on hospital and peripheral center visits, intravitreal injections, and OCT scans were collected and analyzed. Results: The patients had an average of 5.71 ± 1.14 visits to peripheral centers and 2.1 ± 0.8 visits to our center for fluorescein angiography. The mean number of injections was 5.26 ± 1.29 and the mean improvement in best-corrected visual acuity (BCVA) was 11.47 ± 5.56 letters. Remote OCT evaluations accounted for 194 scans, there was a high agreement between two expert in-hospital examinators (Cohen's κ = 0.927) with only 14 cases requiring hospital visits for inconclusive results. Conclusions: Remote monitoring for RVO patients significantly reduced hospital admissions for follow-up visits, reducing the clinical burden on medical staff, patients, and caregivers, while maintaining reliable patient assessments.

Keywords: anti-VEGF; macular edema; optical coherence tomography; retinal vein occlusion; telemedicine.

Figure 1

Representative horizontal OCT scans through the fovea of a patient with branch retinal vein occlusion captured at (A) baseline and (B) after a 3-month follow-up visit post intravitreal anti-VEGF treatment, after which OCT monitoring continued at the peripheral center.

Figure 2

Representative horizontal OCT scans through the fovea of a patient with central retinal vein occlusion who followed up at a peripheral center, showing (A) baseline and (B) 3 months post-treatment. Persistent macular edema was observed, necessitating the patient’s return to our center for further intravitreal injections.