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Intravitreal Ranibizumab injection for treatment of MO secondary to RVO

16 May 2013

College Statement

The Royal College of Ophthalmologists welcomes the decision by the National Institute for Health and Care Excellence (NICE) to recommend 0.5mg ranibizumab intravitreal injection as an option for the treatment of macular oedema secondary to central retinal vein occlusion (CRVO) and selected cases of branch retinal vein occlusion (BRVO) when laser has either been unsuccessful or where the extent of macular haemorrhage precludes the use of laser. This makes a further treatment option available to this group of patients along with the previously recommended dexamethasone implant.

NICE further recommends that patients who are currently receiving ranibizumab but whose disease does not meet the criteria outlined above should be able to continue treatment until they and their ophthalmologist consider it appropriate to stop. The Independent Appraisal Committee accepted that the loss of vision has a significant impact on the independence of people with the condition and concluded that ranibizumab is not only clinically effective but also a cost effective treatment.

The College believes that there should be no barrier to introduction of this treatment and expects clinical commissioning groups to support the rapid implementation of the guidance. The introduction of this and other new therapies for retinal disease will have implications for service delivery within the NHS. It is estimated that there are approximately 442 and 80 new cases per million of BRVO and CRVO respectively, annually in the UK with up to half requiring treatment for macular oedema.

The College’s published interim guideline on the management of RVO provides a useful reference tool which reviews the pivotal studies, and provides pragmatic advice for service development.