Outliers of Treatment Frequency in Retinal Vein Occlusion: 24‐Month Comparative Analysis of Fight Retinal Blindness! Practitioners

Background We aimed to describe a 2‐year outcome of eyes managed by practitioners benchmarked using a funnel plot by their frequency of treatment using vascular endothelial growth factor (VEGF) inhibitors for naive retinal vein occlusion (RVO). Methods A multicentre, international, observational study of 29 doctors in 12 countries managing 1110 eyes with RVO commencing VEGF inhibitors between 1 January 2012–2022 tracked in the Fight Retinal Blindness! registry. Results We identified 3 outlying ‘intensive’ practitioners (managing 350/1110 eyes [32%]), 22 ‘typical’ practitioners (604/1110, [54%]) and 4 outlying ‘relaxed’ practitioners (156/1110, [14%]) with respective 24‐month outcomes in Branch and Central RVO including the primary outcome, mean adjusted change in visual acuity (VA) in BRVO: +16.2, +13.6, +9.3 letters (p < 0.01) and CRVO: +14.2, +12.7, +4.8 letters (p < 0.01); adjusted change in macular thickness in BRVO −179, −150, −159 μm (p < 0.01) and CRVO −324, −283, −232 μm (p < 0.01); time‐in‐range with VA > 68 letters in BRVO 90, 78, 68 weeks (p < 0.01) and CRVO 69, 60, 54 weeks (p = 0.04); median injections 18, 13 and 10; median final injection intervals, BRVO 6, 9, 10 weeks and CRVO 6, 9 and 12 weeks; with no significant difference in adverse outcomes. Conclusions At 24 months, the intensive practitioners were treating RVO using VEGF inhibitors with twice the frequency of the relaxed practitioners; however, their patients had gained twice (BRVO) to three times (CRVO) more letters of VA.