Increased lucentis dose does not offer additional benefit in retinal venous occlusions

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Increasing the dose of ranibizumab (lucentis) did not offer any additional benefit in eyes with retinal vein occlusion, neither did laser photocoagulation improve vision or reduce edema significantly more than ranibizumab, according to the results of the RELATE study presented in Macula 2015. 

The outcomes of this study were presented by Peter A. Campochiaro, MD, who also mentioned that even though there was a greater reduction of macular edema in patients with central retinal venous occlusion (CRVO) who were given higher doses of ranibuzumab, visual improvement was not seen in patients at 6 months. There was no benefit observed in patients with branch retinal venous occlusion (BRVO)

The Ranibizumab Dose Comparison and the Role of Laser in the Management of Retinal Vein Occlusion (RELATE) study included 42 patients with BRVO and 39 patients with CRVO randomized to receive 0.5 mg or 2 mg Lucentis every 4 weeks. At 24 weeks, patients were re-randomized to receive ranibizumab plus laser treatment or ranibizumab as needed. Study endpoints were at 48, 96 and 144 weeks. The primary outcome measures evaluated were mean change in best corrected visual acuity (BCVA), central subretinal thickness and number of ranibizumab treatments. 

The outcomes from the study so far have shown that patients with BRVO receiving either 2 mg or 0.5 mg injections had similar visual outcomes, including similar reduction in central subretinal thickness. In patients with CRVO, mean central subretinal thickness reduced significantly in patients who received 2 mg injections compared to the patients who received 0.5 mg injections.

At 48 weeks, there was no difference in mean BCVA between patients in the ranibizumab plus laser photocoagulation group and those in the ranibizumab as-needed group. Central subretinal thickness did increase initially but went back to baseline in both the groups. Laser treatment also did not reduce the mean number of ranibizumab injections.

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