Ophthalmologist May Soon Have an Answer For Strokes In the Eye
A large clinical trial led by a physician at the University of Wisconsin School of Medicine and Public Health has identified the first long-term, effective treatment to improve vision and reduce vision loss associated with blockage of large veins in the eye.
The study is expected to lead to immediate changes in the way eye doctors treat the second-most common cause of vision loss.
“This is excellent news,” says Michael S. Ip, MD and chair of the nationwide study. “We’ve never had an effective treatment for central vein retinal occlusion - commonly referred to as 'a stroke in the eye' - and for years we’ve had to tell patients we can’t do anything about it.”
Ip, a UW Health ophthalmologist, explains that vein occlusion occurs when a blood clot slows or stops circulation in the eye’s light-sensitive retinal tissue, leading to reduced retinal circulation, blood vessel leakage, retinal tissue swelling and, finally, vision loss.
In the United States, vein occlusion is estimated to be the second-most common condition affecting blood vessels after diabetic retinopathy. There are 160,000 new cases each year, about 80 percent occurring in the branch veins (BRVO) and 20 percent in the central vein (CRVO).
Although there has been no proven, effective way to treat CRVO, some ophthalmologists had reported good results treating patients with eye injections of an anti-inflammatory corticosteroid called triamcinolone.
The Standard Care vs. Corticosteroid for Retinal Vein Occlusion (SCORE) study, conducted at 84 clinical sites, was the first clinical trial to compare the safety and effectiveness of standard-care observation with two different dosages of triamcinolone.
Results showed that eye injections of the corticosteroid medication could reduce vision loss related to the blockage of major blood vessels within the eye. Treated patients were also five times more likely to gain vision after one year than patients receiving standard observational care.
“We found that the lower dose of the medication was just as effective and had significantly lower side effects,’’ Ip adds.
A second part of the study, also co-chaired by Ip, compared laser treatment versus corticosteroid injections for branch retinal vein occlusion (BRVO) and concluded that laser treatment leads to better long-term results when blood clots block the smaller veins in the back of the eyes.
Both studies were published in the Archives of Ophthalmology, along with an accompanying editorial, which read: “These well-designed studies will influence future research, treatment paradigms and clinical practice patterns for years to come.”
Date Published: 08/09/2010