Comparison of Ranibizumab to Steroids For Central Retinal Vein Occlusion Interview with:

Prof. Dr. med. Hans Hoerauf Direktor der Augenklinik Universitätsmedizin Göttingen Göttingen

Dr. Hans Hoerauf

Prof. Dr. med. Hans Hoerauf
Direktor der Augenklinik
Universitätsmedizin Göttingen
Göttingen What is the background for this study?

Dr. Hoerauf: Two treatment options, anti-vascular endothelial growth factors (anti-VEGFs) and corticosteroids, with different mechanisms of action are available for the treatment of macular edema secondary to Central Retinal Vein Occlusion (CRVO). Our study, COMRADE-C, is the first head-to-head study to investigate the clinical efficacy and safety of the European labels of ranibizumab (anti-VEGF) versus dexamethasone intravitreal implant (corticosteroid) in patients with CRVO over six months. What are the main findings?

Dr. Hoerauf: We compared the efficacy and safety of the European labels of ranibizumab 0.5mg versus dexamethasone 0.7mg in patients with macular edema secondary to CRVO and found no difference in BCVA between the treatments prior to month 3, suggesting similar initial efficacy. The mean BCVA improvement observed during the first 2 months of treatment was sustained until the end of the study in the ranibizumab group. However, we found that the efficacy of dexamethasone declined from month 3 onwards. The improvements in mean BCVA were accompanied by a statistically significant reduction in CSRT in ranibizumab-treated patients between months one and six. With the dexamethasone intravitreal implant, CSRT was initially reduced, but increased after month three. What should readers take away from your report?

Dr. Hoerauf: Ranibizumab is an effective treatment for patients with macular edema secondary to CRVO over the six month study period, achieving good visual acuity and anatomical outcomes. We found that treating patients with a single dose of dexamethasone was not sufficient to maintain efficacy over the 6 month study and retreatment should be given earlier. In clinical practice, dexamethasone retreatment may be required rather at 4 months than at 6 months in the majority of patients. What recommendations do you have for future research as a result of this study?

Dr. Hoerauf: Further research areas such as improvements in VA maintained beyond six months, long-term outcome of continued treatment with ranibizumab and dexamethasone intravitreal implant based on pre-specified PRN retreatment criteria or number of injections required to achieve optimal outcomes are currently under investigation by the COMRADE investigators. Difficult to treat patients such as ischemic patients are also of interest to us and we are currently investigating the clinical efficacy of ranibizumab versus dexamethasone intravitreal implant in these patients with macular edema secondary to ischemic type of Central Retinal Vein Occlusion . Is there anything else you would like to add?

Dr. Hoerauf: In addition, I would also like to provide some information about other research interests at the Göttingen University Eye Clinic. Our research also focuses on using multimodal imaging techniques to detect prognostic morphological related changes at the early stage of CRVO disease development. We also investigate the neurosynaptic transmission within the retina. Thank you for your contribution to the community.


Clinical Efficacy and Safety of Ranibizumab versus Dexamethasone for Central Retinal Vein Occlusion (COMRADE C): A European Label Study
Hoerauf, Hans et al.
American Journal of Ophthalmology , Volume 0 , Issue 0 ,
Published Online:May 07, 2016

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