Aqueous vascular and inflammatory biomarkers in retinal vein occlusion
Research type
Research Study
Full title
Can pre-treatment measurement of aqueous vascular and inflammatory biomarkers guide approach to treatment in patients with macular oedema secondary to retinal vein occlusion?
IRAS ID
269524
Contact name
Jai Shankar
Contact email
Sponsor organisation
Betsi Cadwaladr University Health Board
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Swelling of the retina due to retinal vein occlusion is the second most common cause of visual loss in adults. There are two types of vein occlusion – branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). National Institute of Clinical Excellence (NICE) and The Royal College of Ophthalmologists (RCOphth) have approved treatment with two main drugs – anti-vascular endothelial growth factor (anti-VEGF) agents and a steroid implant (Dexamethasone).
No guidance has been issued as to which drug should be first line. Both drugs are expensive, costing
between £500 & £870 and need to be administered repeatedly as an injection into the jelly of the eye (intra-vitreal) injection in a hospital setting. This study may help avoiding the use of an ineffective drug by determining which is the primary cause of retinal swelling, VEGF or inflammation.
The study will involve obtaining a 100- 200 μl sample of fluid from the patient with a known diagnosis of retinal occlusion by inserting a thin needle (30G gauge) into the anterior chamber of the eye (area between the lens and cornea) before administering treatment. For a control, samples from patients who are undergoing cataract surgery will be collected from the anterior chamber using a cannula. This fluid would have otherwise collected in a sterile bag only to be discarded at the end of the operation. The sampling from both groups of patients will be performed by an experienced surgeon. The fluid sampled will be tested to determine whether levels of VEGF and various inflammatory markers can guide clinicians to select the most appropriate treatment option. Intra-ocular samples obtained from patients undergoing routine cataract surgery will act as normal controls. The study aims to compare the levels of bio-markers in those with known vascular occlusion versus those control patients with no history or signs of venous occlusion. Comparisons will also be made between the two type of occlusion - BRVO and CRVO.REC name
Wales REC 4
REC reference
20/WA/0023
Date of REC Opinion
10 Feb 2020
REC opinion
Favourable Opinion