Treatment of Retinal Disorders

Approximately 0.1% to 0.5% of patients of middle age and older will suffer from a central retinal vein occlusion. Vision loss can be devastating rendering patients to be legally blind in the affected eye. The Central Vein Occlusion Study published in 1997 showed that patients presenting with less than 20/200 vision only had a 20% chance of improving their vision.4 Approximately 31% of patients with less than 20/200 vision developed iris and angle neovascularization. Loss of vision can be due to nonperfusion/ retinal ischemia with resultant macular edema. Clinical trials in the management of central retinal vein occlusions over the last three years have revolutionized how retina specialists treat macular edema. Goals are to reduce capillary permeability and inhibit expression of VEGF genes and their metabolic pathways.5 As a result, multiple options exist now as part of the armamentarium. Unfortunately, many of these new treatments (intravitreal triamcinolone acetonide, intravitreal anti-vascular endothelial g w factor (anti-VEGF) agents, sustained release dexamethasone intravitreal implant) require repeated treatments. Patients have benefited from the newer modalities by improving chances of gaining functional vision after experiencing a devastating visually compromising disease.