Penn State College of Medicine’s Dr. Ingrid U. Scott has been awarded a five-year, $8 million grant from the National Institutes of Health to conduct a national clinical trial for treatment of vision loss due to blood vessel blockage in the retina.
The National Eye Institute grant funds the Study of Comparative Treatments for Retinal Vein Occlusion 2, called SCORE2. Scott, professor of ophthalmology and public health sciences, will lead the study, which will recruit patients from throughout the country at more than 70 sites.
SCORE2 will compare treatments for vision loss caused by swelling in the retina from a blockage in the central retinal vein (called a central retinal vein occlusion).
“A blockage in one of the blood vessels in the retina of the eye is the most common retinal vascular disease after diabetic retinopathy,” Scott said. “This condition is estimated to affect 1 to 2 percent of the population older than 40 years.” Retinal swelling is the most common cause of vision loss in patients with blood vessel blockage in the retina.
SCORE2 compares two drugs given in the eye: bevacizumab and aflibercept. Aflibercept has been shown in studies to be an effective treatment; however, bevacizumab would be more cost-effective if it works as well as aflibercept since bevacizumab is a less expensive drug. The trial will also investigate whether the frequency of medication injections into the eye can be reduced in eyes that respond well to treatment, and the effect of alternative treatments in eyes that do not respond well to initial treatment.
“The SCORE2 trial contains an innovative design which will use an adaptive treatment strategy,” Scott said. Participants will be randomized to receive either bevacizumab or aflibercept. The outcome of the treatment will be measured and if the patient has had a good response, the patient will then be randomized again, this time varying the frequency of medical injection. If the patient has had a poor or marginal response, the patient will receive a different treatment.
“SCORE2 will not only address the question of first-line treatment choice, but will also provide insight into second-line treatment regimens as well as whether the frequency of treatments can be reduced,” Scott said. “Reducing the frequency of treatments would be more cost-effective and have a lower risk of adverse events for patients.”