Branch Retinal Vein Occlusion Clinical Trial
Official title:
Open Label Macugen for the Treatment of Macular Edema Secondary to Branch Retinal Vein Occlusion
The purpose of this study is to evaluate the effect of intravitreal injections of Macugen every 6 weeks for the treatment of macular edema secondary to branch retinal vein occlusion (BRVO). We hypothesize that macular edema secondary to BRVO is mediated by VEGF 165 and that chronic suppression of VEGF 165 will successfully treat BRVO related macular edema.
Retinal venous occlusive disease, which includes central retinal vein occlusion (CRVO) and
branch retinal vein occlusion (BRVO), is second only to diabetic retinopathy as a cause of
vision loss due to retinal disease. The main cause of vision loss in all of these disorders
is the development of macular edema. Current clinical practice based on randomized
controlled clinical trials (ETDRS, BVOS) employs laser photocoagulation, either in a focal
or grid pattern, to treat macular edema associated with diabetic retinopathy and branch
retinal vein occlusion. Unfortunately, laser photocoagulation is ineffective in central
retinal vein occlusion (CRVO), and no proven therapy exists for CRVO.
The pathogenesis of macular edema in retinal vascular diseases is generally accepted to be
increased levels of vascular endothelial growth factor (VEGF) due to ischemic or other
stimuli. VEGF is known to be one of the most potent stimulators of vascular leakage in
humans. Therefore, it seems sensible to study inhibition of VEGF to reduce vascular leakage,
reduce macular edema, and improve vision in these retinal vascular disorders.
Phase 2 randomized, controlled clinical trials of Macugen in diabetic macular edema and in
macular edema associated with CRVO have been conducted. In the diabetes trial, patients
treated with Macugen had improved vision, reduced macular edema as measured by optical
coherence tomography (OCT), and reduced need for laser treatment compared to patients
treated with sham injections. In the CRVO trial, patients treated with Macugen 1 mg every 6
weeks for 24 weeks had improved vision and reduced macular edema at week 30 compared to
sham. This is the first randomized trial of treatment for CRVO to show a benefit over
control. Based on these positive findings, we plan to study Macugen treatment of macular
edema due to BRVO.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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