Background: This meta-analysis aims to compare the efficacy and safety of intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents and intravitreal steroids for the treatment of macular edema (ME) secondary to retinal vein occlusion (RVO). Methods: A systematic literature search was conducted on Ovid MEDLINE, EMBASE, and the Cochrane Controlled Register of Trials for studies published between January 2005 and November 2021. Randomized controlled trials (RCTs) reporting on patients with ME secondary to RVO who were treated with intravitreal steroids or anti-VEGF agents were included. A random effects meta-analysis was performed. Results: 867 eyes from 11 RCTs were included. At last study observation, intravitreal anti-VEGF agents were associated with a significantly better BCVA (WMD=-0.14 logMAR, 95% CI=[-0.19,-0.09], p<0.00001) and lower retinal thickness (WMD=-38.01 µm, 95% CI=[-56.17,-19.85], p<0.0001) relative to intravitreal steroids. Similar findings were found at 3-12 month timepoints. Intravitreal anti-VEGF agents were associated with a significantly lower incidence of IOP-related adverse events (RR=0.28, 95% CI=[0.15,0.51], p<0.0001), cataract development/progression (RR=0.22, 95% CI=[0.09,0.49], p=0.0003) and conjunctival hemorrhage (RR=0.52, 95% CI=[0.32,0.86], p=0.01). Conclusion: Our meta-analysis found superiority of intravitreal anti-VEGF agents relative to intravitreal steroids for the treatment of ME secondary to RVO with regards to visual acuity, anatomic outcomes, and safety endpoints.

S19 01The Queen Bee phenomenon in Canadian surgical subspecialties: an evaluation of gender biases in the resident training environment.

IntroductionGlaucoma is a progressive, chronic condition that can have a significant impact on a patient’s health-related quality of life (HRQoL). Validated, disease-specific HRQoL tools such as the Health Utility for Glaucoma (HUG-5) tool and the Glaucoma Quality of Life Questionnaire (GlauQoL-17) can be used to monitor a patient’s quality of life. However, the utility of these tools in outpatient clinic practice is not well established. The primary objective of this study is to characterise the feasibility of administering periodic HRQoL questionnaires in glaucoma using a semi-automated workflow.Methods and analysisThis study will be a single-centre, unblinded, randomised, parallel-group study with an exploratory data analysis framework. We aim to determine the feasibility of administering the HUG-5 in an outpatient clinic using a semi-automated workflow and determine patient engagement through email and telephone contact methods. We will also be investigating the association of the HUG-5 and GlauQoL-17 with patient visual field testing and visual acuity. Mean differences between groups will be tested with analysis of variance to determine if the frequency of calls affects burden, satisfaction and perceived value of information.Ethics and disseminationThis study has been approved by the Hamilton Integrated Research Ethics board (ID: 13046) and will be conducted within Canadian Tri-Council Statement policy. Personal information of the study’s participants will be anonymised with identification codes and data will be kept on an encrypted server. Results of this study will be disseminated through peer-reviewed journals, conferences and internal meetings.