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Reading speed in patients with retinal vein occlusion improves after anti-VEGF treatment
There were statistically significant differences in reading speed between patients treated with ranibizumab and sham injections.
Reading speed in patients with macular edema secondary to retinal vein occlusion improved with monthly injections of ranibizumab, according to a study.
“[Treatment] not only reduced the number of patients in the lower vision speed (less than 40 words per minute) from 15% at baseline to 2% at 6 months, but also increased the numbers in the patients at the higher reading speed (greater than 160 words per minute) from 8% at baseline to 16% at 6 months,” first author Ivan J. Suñer, MD, told Ocular Surgery News.
BRAVO, CRUISE subjects
The analysis was derived from the 789 eyes of 789 patients with macular edema secondary to branch or central retinal vein occlusion who took part in the multicenter, double-masked phase 3 BRAVO and CRUISE trials.
The subjects in the 6-month trials were randomized into three groups: sham, Lucentis 0.3 mg (ranibizumab, Genentech) or Lucentis 0.5 mg. Sham treatments were administered to 132 BRAVO patients and 130 CRUISE patients; intravitreal injections of ranibizumab 0.3 mg were administered to 134 BRAVO patients and 132 CRUISE patients; and intravitreal injections of ranibizumab 0.5 mg were administered to 131 BRAVO patients and 130 CRUISE patients.
Patients were tested for reading speed at baseline and at 1, 3 and 6 months with enlarged text approximately the size of 20/1500 letters.
Mean gains
At 6 months, patients who received ranibizumab had greater increases in reading speed than patients who received sham treatments.
Patients with BRVO treated with ranibizumab 0.3 mg gained 21.9 words per minute (wpm), while patients with CRVO treated with ranibizumab 0.3 mg gained 23.7 wpm.
Patients with BRVO treated with ranibizumab 0.5 mg gained 31.3 wpm, while patients with CRVO treated with ranibizumab 0.5 mg gained 20.5 wpm.
Patients with BRVO treated with sham gained 15 wpm, while patients with CRVO treated with sham gained 8.1 wpm.
The differences in reading speed between the sham and treatment groups were statistically significant.
“A gain of 15 or more letters of best corrected visual acuity letter score corresponded to an increase in reading speed of 12.3 wpm and 15.8 wpm in patients with branch and central RVO, respectively,” the study authors wrote.
Importance of study
Suñer said the study is important because it shows functional visual outcomes, not just visual acuity or optical coherence tomography results.
“This is important for patients as it gives them a sense of how this treatment may impact the quality of the vision and, as a result, their independence and function,” he said. “It is important also for the payers (insurance companies, Medicare) as it allows them to calculate the ‘bang for their buck’ in terms of visual function, not just visual acuity.”
The improvement in reading speed is a direct performance assessment of visual function, the study authors said. However, the study was limited because changes in reading speed may depend on whether the treated eye or the untreated eye had better visual function at baseline. In addition, literacy and reading comprehension tests were not conducted.
“In the future, other functional visual outcomes, such as driving on a simulator, simulating shopping or paying bills, will play a role in studies in terms of measuring the impact of these treatments on everyday activities,” Suñer said. – by Cheryl DiPietro