The aim of this study is to investigate the influencing factors in the treatment of retinal vein occlusion (RVO) complicated with macular edema.

A total of 30 patients (32 eyes) diagnosed with RVO complicated with macular edema in the Department of Ophthalmology, the Fourth Affiliated Hospital of Anhui Medical University from October 2023 to March 2025 received anti-vascular endothelial growth factor (anti-VEGF) treatment for 3 months, were selected as the research subjects. There were 20 males (21 eyes) and 10 females (11 eyes) with an average age of (58.2±11.4) years (ranging from 35 to 85 years) of the 30 patients (32 eyes). Swept-source optical coherence tomography angiography (SS-OCTA) was used to measure choroidal thickness (CT), choroidal vascular index (CVI), and choroidal capillary layer vessel density (CCVD) before and after treatment. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), central macular thickness (CMT), CT, CVI, and CCVD before treatment, after treatment for 1 month and 3 months conformed to a normal distribution and were expressed as ±s. Comparisons among different time points were performed using ANOVA, and pairwise comparisons were conducted using LSD method. Univariate linear regression analysis and multivariate linear regression analysis was performed with changes in BCVA and CMT as dependent variables and basic data as independent variables.

There were 18 patients (20 eyes) with hypertension, and 12 patients (12 eyes) with no hypertension, accouting for 62.50% and 37.50%, respectively. The BCVA of patients before treatment, after treatment for 1 month and 3 months after treatment was (0.813±0.456) logarithmus of the minimal angle of resolution (logMAR), (0.666±0.386) logMAR, and (0.484±0.401) logMAR, respectively; the IOP was (16.219±2.366)mmHg (1 mmHg=0.133 kPa), (15.969±1.732)mmHg, and (16.500±2.514)mmHg, respectively; the CMT was (474.625±191.370)μm, (397.094±155.446)μm, and (360.219±173.240)μm, respectively; the CT was (244.813±86.086)μm, (234.563±86.853)μm, and (229.063±88.710)μm, respectively; the CVI was (39.938±4.683)%, (39.375±5.552)%, and (39.625±5.950)%, respectively; the CCVD was (46.188±3.788)%, (46.813±2.361)%, and (47.125±1.755)%, respectively. Comparisons of BCVA, CMT, and CT among different time points showed statistically significant differences (F=34.556, 14.373, 11.955; P<0.05), while no statistically significant differences were observed in IOP, CVI, and CCVD (F=0.959, 0.979, 1.610; P> 0.05). Further pairwise comparisons revealed that after treatment for 1 month, BCVA, CMT, and CT of patients showed statistically significant differences compared with those before treatment (t= 4.027, 3.645, 3.452; P<0.05), whereas IOP, CVI, and CCVD exhibited no statistically significant differences (t=0.701, 1.605, -1.177; P> 0.05). After treatment for 3 months, BCVA, CMT, and CT were significantly different from those before treatment (t= 6.837, 3.990, 3.549; P<0.05), while no significant differences were found in IOP, CVI, and CCVD (t= -0.722, 0.583, -1.368; P> 0.05). After treatment for 3 months, the BCVA of all patients increased by 0.329 logMAR compared with that before treatment, and the CMT decreased by 24.1% relative to the pre-treatment level. Univariate linear regression analysis indicated that hypertension, pre-treatment CMT, and pre-treatment CCVD were influencing factors for the change in BCVA after anti-VEGF treatment for 3 months (β= 0.328, -0.001, 0.027; 95% confidence interval (CI): 0.173 to 0.484, -0.001 to 0.000, 0.003 to 0.050; P<0.05); hypertension, pre-treatment BCVA, and pre-treatment CCVD were influencing factors for the change in CMT after treatment for 3 months (β= -0.226, 0.235, -0.036; 95%CI: -0.359 to -0.092, 0.095 to 0.376, -0.053 to -0.019; P<0.05). Multivariate linear regression analysis showed that hypertension was an independent risk factor for the change in BCVA after anti-VEGF treatment in RVO patients (β= 0.269, 95%CI: 0.102 to 0.436; P<0.05); pre-treatment BCVA and pre-treatment CCVD were influencing factors for the change in CMT after treatment (β=0.155, -0.024; 95%CI: 0.029 to 0.280, -0.043 to -0.006; P<0.05).

Hypertension is an independent risk factor for the change in BCVA after anti-VEGF treatment in RVO patients. Pre-treatment BCVA is an independent protective factor for the change in CMT, and pre-treatment CCVD is an independent risk factor for the change in CMT.