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khagihara
khagihara, Doctor (non-eye specialty)
Category: Eye
Satisfied Customers: 6479
Experience:  Trained in multiple medical fields for many years.
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Rick I have had a CRVO in my left eye for 7 months due to

Customer Question

Hi Dr. Rick
I have had a CRVO in my left eye for 7 months due to Behçet's disease, I've been treated so far by Prof. Stamford at London St. Thomas hospital, however I've only been taking prednisone steroids to help control my systemic disease & the eye inflammation which is said to be better now, but I was wondering if I have a chance of regaining better vision if I were to have injections done like Avastin/Lucentis/Eylea? I can only read the first two lines on the eye chart and my central vision is blurry with dimmed vision and floaters at present.
Thank you for any advice in advance
Hakan
Submitted: 2 months ago.
Category: Eye
Expert:  khagihara replied 2 months ago.

In the six-month CRUISE trial, in which 392 patients with macular edema from CRVO were randomly assigned to Lucentis intraocular injections (0.3 or 0.5 mg) or sham injections, more patients receiving Lucentis had greater improvements in visual acuity of at least 15 letters (46 and 48 percent versus 17 percent). Lucentis-treated eyes were also more likely to achieve visual acuity of ≥20/40 (44 and 47 percent versus 21 percent). Patients received intraocular Lucentis injections as often as monthly if they met prespecified criteria (best-corrected visual acuity ≤20/40 or mean central subfield thickness >250 µm on optical coherence tomography).

An update to the CRUISE trial has extended and confirmed the results through month 12, with greater improvements in visual acuity in the Lucentis group. In a long-term follow-up of a subset of patients from the CRUISE trial, edema resolution occurred at 49 months in 44 percent of patients with CRVO treated with Lucentis, but 56 percent still required frequent injections.

A similarly designed study (COPERNICUS) involving intravitreal Eylea in patients with CRVO has also shown a beneficial effect on visual acuity at six months and one year, although visual acuity diminished somewhat when the dosing schedule changed at 24 weeks from monthly injections to injections as needed and to less frequent monitoring (at least quarterly) beyond one year. Intravitreal Eylea for CRVO was also compared with sham injections in the GALILEO Study, in which patients received injections every 4 weeks to week 24, and then as needed up to 76 weeks; patients in the Eylea group had more visual and anatomic improvement at both 24 and 76 weeks, compared with the sham group.