New Treatment Reduces Vision Loss From Central Retinal Vein Occlusion

Corticosteroid for Retinal Vein Occlusion (SCORE) clinical trial to compare the safety and effectiveness of standard care (observation) with two different dosages of intravitreal triamcinolone (IVT): 1 mg and 4 mg. The researchers followed 271 participants at 84 clinical sites with CRVO, who were an average of 68 years old. Patients in the treatment group could receive a maximum of three corticosteroid injections every year for up to three years, based on the state of their disease. The main outcome measure was gain in visual acuity letter score from baseline to month 12.

The researchers found that at one year, patients who received either dose of IVT corticosteroid medication were five times more likely than those who did not receive treatment to experience a substantial visual gain of three or more lines on a vision chart--equivalent to identifying letters that were half as small as they could read before treatment. However, patients in the 1 mg group had fewer side effects related to increased eye pressure and cataract formation than those in the 4mg group. The study was published in the September 2009 issue of Archives of Ophthalmology.

"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,” said Michael S. Ip, M.D., an associate professor at WISC and chair of the SCORE study.

Triamcinolone is a synthetic corticosteroid that is used to reduce macular edema that may occur in diabetes, CRVO, or other macular disease. Generally, the improvement in vision is temporary, as the macular edema reduces, with a maximum reduction at 2 weeks, and starts to wear off after 3 months.

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