Intravitreal corticosteroid MWS 2012 Han.ppt (Read-Only)
Intravitreal corticosteroid MWS 2012 Han.ppt (Read-Only) 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
12/12/11 CRUISE Trial Mean Change from Baseline in VA Letter Score Case Presentation D7 M1 M2 M3 M4 M5 M6 Mean change from baseline in visual acuity letter score 20 16 12 8 4 0 -4 Sham 0.3mg 0.5mg 11.9 letters 14.1 letters 7/31/08, 4 months after 2 nd IVTA injection (SCORE trial), VA 20/60, IOP 17, lens clear Patient underwent 3 rd injection of IVTA on 7/31/08; 9/2/08 (5 weeks later) VA was 20/100, residual IVTA in vitreous cavity; observation elected 34 12/21/10 OCT OD; VA 20/150 11/17/08, 3.5 months after IVTA (SCORE); VA 20/160 From 11/17/08 to 11/16/10 Patient received Avastin 1.25 mg every month for a total of 19 injections VA 11/6/10 (after 2 years of Avastin) was 20/150 35 Administered intravitreal Lucentis q 1 month x 7, from 1/11/11 to 7/12/11 36 9
- Page 1 and 2: 12/12/11 Disclosure Intravitreal Co
- Page 3 and 4: 12/12/11 Intravitreal triamcinolone
- Page 5 and 6: 12/12/11 Ozurdex for DME (PLACID tr
- Page 7: 12/12/11 Mean Change in Visual Acui
12/12/11<br />
Retinal Vein Occlusion<br />
Ø Benefits of IVTA shown in CRVO but not<br />
BRVO (SCORE trial); 1 mg dose with better<br />
risk profile compared to 4 mg dose*<br />
Ø Benefit of Dexamethasone implant in eyes<br />
with BRVO and CRVO combined w/o<br />
subgroup analysis on outcome**<br />
Ø No direct comparisons exist between<br />
<strong>corticosteroid</strong>s and anti-VEGF agents<br />
*Standard Care vs Corticosteroid for Retinal Vein Occlusion. Report 6. SCORE<br />
Study Research Group. Arch Ophthamol 2009;127:1115-1128<br />
**Haller JA, et al. Dexamethasone <strong>Intravitreal</strong> Implant in Patients with Macular<br />
29<br />
Edema Due to Retinal Vein Occlusion. Ophthalmology 2010;117:1134-1146<br />
Mean Change from Baseline in<br />
VA Letter Score<br />
Mean change from baseline<br />
in visual acuity letter score<br />
5<br />
0<br />
-5<br />
-10<br />
-15<br />
Obs 1mg 4mg<br />
SCORE CRVO Trial<br />
M4 M8 M12 M16 M20 M24<br />
RVO and ranibizumab: CRUISE<br />
and BRAVO studies<br />
Ø Ranibizumab beneficial for CRVO<br />
and BRVO associated ME given<br />
monthly for 6 months<br />
Ø No significant increase in risk of<br />
cataract or IOP elevation<br />
Ø Open label extension study with<br />
lower dosing frequency after 6<br />
months (HORIZON) showed<br />
sustained benefit in BRVO eyes, but<br />
deterioration in CRVO eyes 31<br />
Mean Change from Baseline in<br />
VA Letter Score<br />
Mean change from baseline<br />
in visual acuity letter score<br />
20<br />
16<br />
12<br />
8<br />
4<br />
0<br />
D7 M1 M2 M3 M4 M5 M6<br />
Sham 0.3mg 0.5mg<br />
9.3 letters<br />
BRAVO Trial<br />
11 letters<br />
8
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