Real-World Insights on Switching Aflibercept Dosage for Enhanced Outcomes in Retinal Vein Occlusion (RISE-RVO): visual, anatomical and durability outcomes

Background/aims: Evaluation of durability outcomes after switching to aflibercept 8 mg for macular oedema in retinal vein occlusion (RVO). Methods: We evaluated eyes with branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO), switching from other anti-vascular endothelial growth factor treatments to off-label aflibercept 8 mg under an observe-and-plan regimen. Eyes receiving ongoing treatment with ≥10 prior injections were eligible. Treatment discontinuation during the 12-month follow-up period resulted in exclusion. All data were obtained through the review of medical records. Results: The overall cohort of eyes with RVO (n=156) achieved a mean interval gain of +1.6 weeks at 12 months (p<0.0001). The proportion of eyes treated at ≤6-week intervals decreased from 37.8% at switch to 17.9% at 12-month follow-up (p<0.0001) while the proportion on intervals ≥9 weeks increased from 37.8% at switch to 60.3% (p<0.0001). The CRVO subgroup (n=65) achieved a mean increase in interval length at 12 months of +2.0 weeks (p<0.0001) and +3.0 weeks in the case of a dry macula at switch (p<0.0001). The BRVO subgroup (n=91) achieved an overall increase in interval length of +1.3 weeks (p<0.0001) and +2.3 weeks for eyes with a dry macula at switch (p<0.0001). The central retinal thickness decreased from 262.8±79.4 µm to 244.6±59.5 µm (p=0.0012) while best recorded visual acuity remained unchanged at 68.2 Early Treatment Diabetic Retinopathy Study letters at 12 months. Conclusion: Switching to aflibercept 8 mg substantially reduced the proportion of eyes on short intervals without compromising visual outcomes.