Management of patients with macular oedema secondary to central retinal vein occlusion: new findings from SCORE2 and LEAVO studies

Abstract

Central retinal vein occlusion (CRVO) and its complication, which includes macular oedema (MO), is one of the leading causes of visual impairment [1]. The treatment of MO secondary to CRVO is mainly based on repeated intravitreal antivascular endothelial growth factor (antiVEGF) injections. Three different kinds of anti-VEGF have been used in the clinical practice: the licensed agents (ranibizumab and aflibercept) and an unlicensed low-cost agent (bevacizumab). Bevacizumab is a monoclonal antibody widely used in the treatment of retinal diseases, although its intraocular use is considered off-label. Recently, two different studies, the “Study of Comparative Treatments for Retinal Vein Occlusion 2” (SCORE2) [2] and the “Lucentis, Eylea, Avastin in Vein Occlusion” (LEAVO) trial [3], compared the efficacy of different antiVEGF monotherapies (including Bevacizumab) in the treatment of MO secondary to CRVO. The SCORE2 study reported that bevacizumab was not inferior to aflibercept in the visual acuity outcomes at 6 months [2]. Furthermore, the LEAVO study reported aflibercept to be noninferior compared with ranibizumab in mean changes in vision at 100-week follow-up, but the results of the comparison between bevacizumab and ranibizumab were inconclusive regarding vision outcomes [3].