Delayed anti-vascular endothelial growth factor therapy in patients with type 2 diabetes mellitus and branch retinal vein occlusion-associated macular edema negatively affects visual outcomes.

All treatment groups showed BCVA improvement and CMT reduction at six months, with the early treatment group showing the greatest improvement.

• Patients were stratified into early treatment (≤7 days, n=67), intermediate treatment (8-14 days, n=52), and delayed treatment (>14 days, n=29) groups
• All groups received intravitreal ranibizumab as their first anti-VEGF injection
• BCVA and CMT were recorded at 1, 3, and 6 months post-injection
• This was a single-center retrospective cohort study of 148 patients diagnosed between January 2024 and May 2025

Delayed treatment was identified as the only independent factor associated with six-month BCVA improvement in multivariable linear regression.

• β = -0.008, 95% CI: -0.014 to -0.002, P = 0.010
• Multivariable linear regression was used to identify independent factors affecting six-month BCVA improvement
• The negative beta coefficient indicates delayed treatment was associated with reduced BCVA improvement
• Baseline demographic, systemic, and ophthalmic parameters were included in the analysis

ROC analysis demonstrated that a 14-day cutoff for treatment delay had good predictive ability for insufficient six-month visual improvement.

• AUC of 0.823 (95% CI: 0.751-0.884, P < 0.001) for delayed treatment predicting insufficient six-month visual improvement
• Sensitivity of 89.4% and specificity of 61.4% using a 14-day cutoff
• The 14-day threshold corresponds to the boundary between the intermediate and delayed treatment groups in the study stratification

The study population consisted of patients with T2DM complicated by branch retinal vein occlusion-associated macular edema receiving their first intravitreal ranibizumab injection.

• Total sample size was 148 patients
• Study design was a single-center retrospective cohort
• Patients were included if diagnosed with BRVO-ME and receiving first intravitreal ranibizumab between January 2024 and May 2025
• Patients were stratified into three groups based on interval from diagnosis to initial anti-VEGF injection: ≤7 days (n=67), 8-14 days (n=52), and >14 days (n=29)

Initiating anti-VEGF therapy within seven days of diagnosis was associated with greater six-month visual improvement in patients with BRVO-ME and T2DM.

• The early treatment group (≤7 days) showed the greatest BCVA improvement at six months compared to intermediate and delayed groups
• Delayed treatment (>14 days) was independently associated with reduced six-month BCVA improvement (β = -0.008, P = 0.010)
• The findings suggest delayed treatment may contribute to suboptimal visual recovery in this patient population