Sir,
I read with great interest the recently updated retinal vein occlusion (RVO) guidelines published by The Royal College of Ophthalmologists.1 Ever since the previous guidelines published in 2010 the treatment of RVO in the UK has undergone a rapid evolution, mainly attributed to the recommendation and approval of the use of ranibizumab (Lucentis, Novartis, Basel, Switzerland) and aflibercept (Eylea, Bayer, Berlin, Germany) by The National Institute for Health and Care Excellence (NICE).2, 3 The authors have produced a very clear and comprehensive strategy in stratifying the management plan based on the types of RVO (central vs branch and ischaemic vs non-ischaemic), the visual acuity (>6/12 vs 6/12–6/96 vs <6/96), and the presence of macular ischaemia in branch RVO.
However, I believe there is a very slight error in the section on ‘anti-vascular endothelial growth factor agents for treatment of macular oedema due to RVO’. The authors quoted NICE TA238 in relation to the use of ranibizumab for treating macular oedema secondary to RVO. NICE TA238 refers to the use of tocilizumab for the treatment of systemic juvenile idiopathic arthritis.4 This should be replaced by NICE TA283, which refers to the use of ranibizumab for treating visual impairment caused by macular oedema secondary to RVO.2
In summary, I would like to thank and congratulate the authors on updating the RVO guidelines with the most current evidence, which helps to streamline the current practice in the UK and ultimately benefits the patients whom we are treating.
References
Sivaprasad S, Amoaku WM, Hykin P . RVO Guideline Group.. The Royal College of Ophthalmologists Guidelines on retinal vein occlusions: executive summary. Eye (Lond) 2015; 29 (12): 1633–1638.
NICE TA283. Ranibizumab for treating visual impairment caused by macular oedema secondary to retinal vein occlusion. Available at www.nice.org.uk (accessed May 2013).
NICE 305. Aflibercept for treating visual impairment caused by macular oedema secondary to central retinal vein occlusion. Available at www.nice.org.uk (accessed February 2014).
NICE TA238. Tocilizumab for the treatment of systemic juvenile idiopathic arthritis. Available on www.nice.org.uk (accessed December 2011).
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Ting, D. Comment on ‘The Royal College of Ophthalmologists Guidelines on retinal vein occlusions’. Eye 29, 1631 (2015). https://doi.org/10.1038/eye.2015.210
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DOI: https://doi.org/10.1038/eye.2015.210