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Treatment arms for CRVO yield no difference in visual acuity results

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BOSTON — Dexamethasone implant, ranibizumab injections or a combination of the two each yielded no statistically significant difference in visual acuity or central retinal thickness changes in treatment of central retinal vein occlusion, according to a speaker here.

“The two approaches that we have currently for treatment [of CRVO] include the dexamethasone implant and the anti-VEGF agents,” Victor H. Gonzalez, MD, said at the American Society of Retina Specialists meeting, where he gave an interim analysis of the ORION study. “Because the etiology of CRVO macular edema finds its basis in both inflammatory and vascular changes, we found it of interest to see if a multimodal approach may help in the treatment of this condition.”

The ORION study protocol was established to look at the efficacy of Ozurdex (dexamethasone intravitreal implant, Allergan) every 16 weeks vs. Lucentis (ranibizumab, Genentech) monthly vs. a combination of dexamethasone every 16 weeks with ranibizumab for the treatment of these patients with central-involved macular edema resulting from CRVO.

In the 24-week analysis, 11 patients were enrolled in the ranibizumab group, 13 in the dexamethasone group and nine in the combination group. Primary outcome was change in best corrected visual acuity at 24 weeks; secondary outcome was number of injections received during 24 weeks. Whereas there was no statistically significant difference in BCVA outcomes, there were differences in mean total injections: 1.9 in the dexamethasone group, 3.6 in the combination group and 5.9 in the ranibizumab group.

“In order for us to get to these visual acuity outcomes, there was an important difference in the injections,” Gonzalez said.

The differences in the overall number of injections between treatment arms were statistically significant, he said, favoring combination therapy over ranibizumab alone and favoring dexamethasone over combination therapy. – by Patricia Nale, ELS

Reference:

Gonzalez VH. Ozurdex vs. ranibizumab vs. combination for central retinal vein occlusion (ORION). Presented at: American Society of Retina Specialists annual meeting; Aug. 11-15, 2017; Boston.

Disclosure: Gonzalez reports he is a consultant for Genentech and Allergan.