Intravitreal corticosteroid MWS 2012 Han.ppt (Read-Only)

12/12/11
Retinal Vein Occlusion
Ø Benefits of IVTA shown in CRVO but not
BRVO (SCORE trial); 1 mg dose with better
risk profile compared to 4 mg dose*
Ø Benefit of Dexamethasone implant in eyes
with BRVO and CRVO combined w/o
subgroup analysis on outcome**
Ø No direct comparisons exist between
corticosteroids and anti-VEGF agents
*Standard Care vs Corticosteroid for Retinal Vein Occlusion. Report 6. SCORE
Study Research Group. Arch Ophthamol 2009;127:1115-1128
**Haller JA, et al. Dexamethasone Intravitreal Implant in Patients with Macular
29
Edema Due to Retinal Vein Occlusion. Ophthalmology 2010;117:1134-1146
Mean Change from Baseline in
VA Letter Score
Mean change from baseline
in visual acuity letter score
5
0
-5
-10
-15
Obs 1mg 4mg
SCORE CRVO Trial
M4 M8 M12 M16 M20 M24
RVO and ranibizumab: CRUISE
and BRAVO studies
Ø Ranibizumab beneficial for CRVO
and BRVO associated ME given
monthly for 6 months
Ø No significant increase in risk of
cataract or IOP elevation
Ø Open label extension study with
lower dosing frequency after 6
months (HORIZON) showed
sustained benefit in BRVO eyes, but
deterioration in CRVO eyes 31
Mean Change from Baseline in
VA Letter Score
Mean change from baseline
in visual acuity letter score
20
16
12
8
4
0
D7 M1 M2 M3 M4 M5 M6
Sham 0.3mg 0.5mg
9.3 letters
BRAVO Trial
11 letters
8