Central Retinal Vein Occlusion (CRVO) Medication

Updated: Apr 18, 2019
  • Author: Lakshmana M Kooragayala, MD; Chief Editor: Douglas R Lazzaro, MD, FAAO, FACS  more...
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Medication

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.

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Vascular Endothelial Growth Factor (VEGF) Inhibitors

Class Summary

These agents bind to VEGF-A receptors to arrest macular edema and improve visual acuity associated with CVRO.

Ranibizumab (Lucentis)

VEGF antibody. Indicated for macular edema following retinal vein occlusion.

Aflibercept intravitreal (Eylea)

Binds and prevents activation of vascular endothelial growth factors (VEGF-A) and placental growth factor (PIGF). Activation of VEGF-A and PIGF can result in neovascularization and vascular permeability. It is indicated for treatment of macular edema following retinal vein occlusion (branched or central retinal vein occlusion).

Bevacizumab (Avastin)

Bevacizumab (Avastin, Genentech, Inc.) is a recombinant, humanized monoclonal antibody that binds all isoforms of VEGF-A. It is used as an off-label medication in various ocular conditions associated with up-regulation of VEGF and increased vascular permeability and neovascularization.

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Corticosteroids

Class Summary

These agents have anti-inflammatory properties and cause profound and varied metabolic effects. Corticosteroids modify the body's immune response to diverse stimuli.

Triamcinolone (Aristospan, Kenalog)

Intraocular steroid injection has been shown to be effective in decreasing macular edema. Although the exact mechanism of action is unknown, steroids work by targeting various inflammatory pathways and decreasing expression of VEGF, reducing vascular permeability, stabilizing endothelial tight junctions, and decreasing macular edema.

Dexamethasone intravitreal implant (Ozurdex)

Intraocular steroid injection has been shown to be effective in decreasing macular edema. Although the exact mechanism of action is unknown, steroids work by targeting various inflammatory pathways and decreasing expression of VEGF, reducing vascular permeability, stabilizing endothelial tight junctions, and decreasing macular edema.

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