NICE has announced that EYLEA (aflibercept solution for intravitreal injection) is recommended as a treatment option for visual impairment due to macular oedema secondary to central retinal vein occlusion (CRVO), a serious condition affecting the main vein in the eye which, if left untreated, can cause blindness and other painful eye conditions. 

This final appraisal determination (FAD) means that eligible patients with this challenging eye condition will now have access to a new medication that improves vision from the start of treatment without the need to visit the hospital every month for monitoring or treatment once the condition has stabilised. 

Moin Mohamed, Consultant Ophthalmologist, St Thomas’ Hospital, commented on the decision, “This is good news for ophthalmologists and patients with this unpredictable and difficult to treat condition. Macular oedema following CRVO can cause people to lose their central vision meaning they need to rely more heavily on their family or carers for help. Having Eylea, an established and effective treatment, available for these people is an important step forward in the management of this debilitating condition, where, until recently, very limited treatment options were available.”

Macular oedema, or fluid beneath the macula (a tiny part of the retina at the back of the eye), is one of the complications of CRVO, a common and serious eye condition that occurs when there is a blockage in the main vein that carries blood away from the eye. According to NICE, in England and Wales, it has been estimated that for every 100,000 population approximately 17 people aged 40 years or over will require treatment for macular oedema secondary to CRVO each year. The impact of the associated vision loss can have a profound effect on vision-related quality of life. Patients may struggle with daily tasks, lose confidence and become increasingly dependent.

Helen Jackman, Chief Executive of the Macular Society said ’Losing central vision puts a massive strain on patients, as well as their families, as it takes away their independence because they need help to carry out daily tasks like dressing, cooking or simply getting around the house safely. Not only does this mean they lose confidence, it also means that some patients feel like a hindrance to loved ones. This is why it is important to have effective treatment options available for this difficult to treat condition and we urge the NHS to implement this guidance within the mandated 90 days so patients can get access to it as soon as possible.’

EYLEA was licensed in the UK for the treatment of visual impairment due to macular oedema secondary to central retinal vein occlusion (CRVO) in August 20136 and the Scottish Medicines Consortium (SMC) is currently reviewing EYLEA for this indication, with the outcome expected in Q2 2014.

This final recommendation from NICE marks the second indication for EYLEA that has received a final FAD, without the need for additional consulation.8 EYLEA has been licensed in the UK for the treatment of wet age related macular degeneration (wAMD) since November 2012. It was recommended by NICE for this use on the NHS in England and Wales in July 2013 and availability to eligible wAMD patients is now mandated across England and Wales.8 EYLEA has also been accepted by the SMC for use within NHS Scotland for the treatment of wAMD.