Date Posted: 04 November 2009
A multicenter, prospective, randomized clinical trial designed to compare 1-mg and 4-mg doses of intravitreal triamcinoclone with standard care for treatment of vision loss associated with macular edema (secondary to perfused CRVO and branch retinal vein occlusion [BRVO]) has reported the benefits of the corticosteroid injections in reducing vision loss. The results of the study appear in the Archives of Ophthalmology (Vol. 127, No. 9, 2009, 1101-1114).
Retinal vein occlusion in the US is estimated to be the second most common cause of severe vision loss. Occurrence of an occlusion or blood clot in a large retinal vein can slow or stop circulation resulting in reduced blood flow. Such reduced circulation can lead to new blood vessel growth and blood vessel leakage causing retinal tissue swelling and vision loss.
The Standard Care vs. Corticosteroid for Retinal Vein Occlusion (SCORE) 3-year study, sponsored by the NEI, compared the safety and efficacy of 1-mg and 4-mg does of triamcinoclone acetonide with standard of care (i.e., laser photocoagulation for macular edema in non-hemorrhagic BRVO or observation for macular edema associated with CRVO). The Phase III clinical trial conducted across 84 clinical sites and including 271 participants, demonstrated that participants receiving intravitreal injections of 1-mg and 4-mg triamcinoclone were 5 times more likely to gain 15 or more letters of vision compared with observation. The results suggest that treatment with triamcinoclone should be considered in the management of patients with macular edema following perfused CRVO and that the 1-mg dose may be the preferable choice given the similar efficacy but lower incidence of cataracts and IOP elevation when compared to the 4-mg dose. Commenting on the data Professor Michael S. IP (MD) of the University of Wisconsin, Madison and chair of the SCORE study stated that "these are extremely compelling results because a large, longer term clinical trial has never before shown that patients with central retinal vein occlusion could experience a visual improvement with treatment".
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