NICE Recommends OZURDEX(R), an Innovative Treatment for Retinal Vein Occulsion (RVO), a Common Cause of Vision Loss
that the National Institute for Health and Clinical Excellence (NICE) has
recommended OZURDEX(R) (dexamethasone 0.7mg intravitreal implant in
applicator) for the treatment of macular oedema due to central retinal vein
occlusion (CRVO) and also for branch retinal vein occlusion (BRVO) where
laser photocoagulation is neither beneficial nor appropriate.
RVO is an eye condition that can lead to severe damage to the retina,
visual impairment and even blindness. The visual impairment that often
results from RVO can significantly impact on patients’ quality of life and
ability to do everyday things, such as reading a newspaper, watching a film
or driving. Up to 25,000 patients in the UK every year suffer from macular
oedema associated with RVO and may be suitable for treatment with OZURDEX.
OZURDEX is an innovative, first-of-its-kind biodegradable intravitreal
implant containing dexamethasone, a highly potent corticosteroid,
administered via a specially designed, single use applicator.[3,4]
Dexamethasone is slowly released from the implant into the eye and acts
locally to control oedema, reduce inflammation around the occlusion and
improve vision. A single injection can offer long lasting improvement with
benefits demonstrated to last for up to six months.
representative of the Royal College of Ophthalmologists said: “The
availability of a licensed, effective and now NICE recommended treatment is a
significant step forward for management of RVO patients in
and we look forward to ophthalmologists providing the treatment ASAP.”
“RVO is the second most common cause of reduced vision due to retinal
vascular disease. The decision announced today represents the first NICE
recommendation for a licensed treatment for macular oedema associated with
RVO and with it NICE has made available to retinal specialists and their
patients an important treatment for this potentially devastating condition,”
specialists, hospitals and commissioning groups in the UK to support the
National Health Service in rapidly adopting this cost effective solution to
maximise patient benefits and to minimise premature vision loss as a result
“We are really pleased with this decision from NICE to recommend that
suitable patients with RVO are treated with OZURDEX on the National Health
Service. As with many other eye conditions, it is really important that RVO
is treated as early as possible. Anyone noticing any change in their vision
should have their eyes checked as soon as possible,” said
Policy and Campaigns Manger for the Royal National Institute of Blind People
OZURDEX clinical data
The efficacy of OZURDEX was assessed in two 6-month, prospective,
double-masked, parallel-group studies in which 1267 patients with macular
oedema due to either branch or central retinal vein occlusion (BRVO or CRVO)
were randomised to receive either OZURDEX or a sham (placebo) procedure.
Clinically significant improvement in vision (defined as [greater than or
equal to]15 letters or 3 lines on an eye chart) was seen after 2 months in up
to 30% of patients with macular oedema due to RVO following just one
injection of OZURDEX. In some patients this improvement was maintained for up
to 6 months. Importantly, up to 80% of patients had an improvement or no
worsening in vision over the 6 months (defined as >0 letters on an eye
chart). The most frequently reported adverse reactions in patients who
received OZURDEX(R) were increased intraocular pressure (24.0%) and
conjunctival haemorrhage (14.7%).
Notes to Editor
About Retinal Vein Occlusion
RVO is an important and common cause of vision loss, affecting 5 in
every 1,000 people over the age of 30. It is estimated that more than
200,000 people suffer from RVO in the UK.[9,10]
RVO occurs when a retinal vein in the eye becomes blocked (occluded). 
This blockage in the retinal vein leads to an inflammatory response,
resulting in a build up of fluid in the retina and thickening of the macula
(called macular oedema). Macular oedema is a leading cause of vision loss
in patients with RVO.[12,13] OZURDEX is the only approved medicine for the
treatment of macular oedema in RVO. Other interventions include surgery and
laser photocoagulation therapy, although these are not universally
effective.[14,15] RVO can cause significant direct healthcare costs, as well
as indirect costs to patients and society, such as loss of income and costs
to adapt a person’s home.[16,17]
About Macular Oedema Caused by Retinal Vein Occlusion (RVO)
Macular oedema is a common consequence of a number of retinal diseases,
with inflammation playing a significant role.[3,8,18] Macular oedema is an
excessive build up of fluid in the retina and thickening of the macula.
Macular oedema can lead to vision impairment if left untreated and it is the
primary cause of vision loss in patients with branch RVO (occlusion in a
branch retinal vein), and is one of the leading causes of visual loss in
patients with central RVO (occlusion in a central retinal vein). Macular
oedema is a common complication of diabetic retinopathy and is the leading
cause of vision loss in patients with diabetes. Uveitis can lead to
macular oedema through an inflammatory process and macular oedema is one
of the main reasons for visual loss in uveitis.
 Deramo VA, Cox TA, Syed AB, et al. Vision-related quality of life in
people with central retinal vein occlusion using the 25-item National Eye
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 Data on File, Allergan, Inc.
 Kuppermann BD, Blumenkranz MS, Haller JA, et al. Randomized
controlled study of an intravitreous dexamethasone drug delivery system in
patients with persistent macular edema. Arch Ophthalmol 2007;125:309-17.
 Haller JA, Dugel P, Weinberg DV, et al. Evaluation of the safety and
performance of an applicator for a novel intravitreal dexamethasone drug
delivery system for the treatment of macular edema. Retina 2009;29:46-51.
 Haller JA, Bandello F, Belfort R et al. .Randomized, sham-controlled
trial of dexamethasone intravitreal implant in patients with macular edema
due to retinal vein occlusion. Ophthalmology 2010,117:1134-46.
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 Johnson MW. Etiology and treatment of macular edema. Am J Ophthalmol
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In: DM Albert, FA Jakobiec. Principles and Practice of Ophthalmology.
 The Branch Vein Occlusion Study Group. Argon laser photocoagulation
for macular edema in branch vein occlusion. Am J Ophthalmol 1984;98:271-82.
 The Central Vein Occlusion Study Group M report. Evaluation of grid
pattern photocoagulation for macular edema in central vein occlusion.
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blindness in the UK adult population. Executive summary. RNIB
 Lafuma A, Brezin A, Lopatriello S, et al. Evaluation of non-medical
costs associated with visual impairment in four European countries.
 Tranos PG, Wickremasinghe SS, Stangos NT et al. Macular edema. Surv
 Forrester JV. Uveitis:pathogenesis. Lancet 1991;338:1498-501.
 Durrani OM, Tehrani NM, Marr JE et al. Degree, duration, and causes
of visual loss in uveitis. Br J Opthalmol 2004;88:1159-62.