Background and Importance Intravitreal injections of ranibizumab and aflibercept are established initial therapies for managing macular oedema arising from central retinal vein occlusion (CRVO). However, there is a lack of extensive studies evaluating the prescribing patterns and therapeutic effectiveness of these two drugs.

Aim and Objectives To scrutinise the patients’ characteristics, particularly focusing on the initial severity of the CRVO, and to evaluate the effectiveness of ranibizumab and aflibercept in patients with CRVO eyes.

Material and Methods We performed a retrospective examination of electronic health records data from three hospitals in Northern Taiwan. We included adult patients with CRVO who initiated either intravitreal ranibizumab or aflibercept from 2017 to 2021. Central retinal thickness (CRT) and visual acuity (VA) were evaluated before the treatment and through a follow-up period lasting up to 2 years. For statistical analyses, VA was transcribed into LogMAR (logarithm of the minimum angle of resolution) VA values. Independent t-test and paired t-test analyses were employed to assess the difference of baseline CRT and LogMAR VA between ranibizumab and aflibercept and changes of CRT and LogMAR VA after treatments, respectively.

Results The study cohort consisted of 220 patients (average age: 65.6±13.8 years; 55.9% male) and included 127 eyes intravitreally treated with ranibizumab and 93 eyes treated with aflibercept. Aflibercept-treated eyes displayed a markedly higher initial CRT (577.7 µm vs. 510.8 µm, p=0.006), but no significant differences in initial LogMAR VA were seen (0.92 vs. 0.87, p=0.29), compared to those with ranibizumab. Both medications led to considerable reductions in CRT after 1-year (ranibizumab: 510.8 vs. 343.5 μm, p<0.001; aflibercept: 577.7 vs. 346.5 μm, p<0.001) and 2-year treatments (ranibizumab: 510.8 vs. 310.6 μm, p<0.001; aflibercept: 577.7 vs. 298.5 μm, p<0.001). Nevertheless, neither drug contributed to noteworthy improvements in LogMAR VA after 1-year (ranibizumab: 0.87 vs. 0.92, p=0.51; aflibercept: 0.92 vs. 0.92, p=0.90) or 2-year treatments (ranibizumab: 0.87 vs. 0.92, p=0.49; aflibercept: 0.92 vs. 0.93, p=0.91).

Conclusion and Relevance Both intravitreal ranibizumab and aflibercept for CRVO produced significant reductions in CRT and remained the VA in the routine care from Taiwan. Our data suggest that upcoming comparative studies between these treatments should consider the observed baseline differences in CRT.

Conflict of Interest No conflict of interest.