What are the options available for the treatment of Retinal vein occlusion?

Retinal vein occlusion (RVO) is the second most common vision-threatening disorder that happens due to retinal vascular disease. If left untreated, RVO can result in vision impairment and a significant amount of other ocular complications. Any kind of blockage in the vein of the eye that carries blood from the retina is referred to as Retinal vein occlusion.  

According to DelveInsight epidemiological analysis, total Retinal vein occlusion prevalence in the 7MM (the US, EU5 (the UK, France, Germany, Italy, and Spain) and Japan) was 2,225,011 cases, which is further expected to increase during the study period 2017–2030. 

Taking into consideration the gender propensity, RVO cases were more prevalent in females as compared to males. The total gender-specific RVO prevalent cases were 916,868 for males and 1,030,628 for females in the year 2017 for 7MM. While 7MM Retinal vein occlusion epidemiological analysis showed the US homing the largest percentage of Retinal vein occlusion diagnosed prevalent cases (approximately 52% of the 7MM diagnosed prevalent cases), Spain accounted for the least number of cases in the 7MM. 

Furthermore, based on the location of the blockade of the vein, RVO can be of two types, namely Central retinal vein occlusion (CRVO) of the main retinal vein and Branch retinal vein occlusion (BRVO) of the smaller branch veins. As per DelveInsight analysis, the total diagnosed CRVO cases were reported to be 392,221 CRVO, while 1,555,274 cases were diagnosed as BRVO in the 7MM in 2017.

DelveInisght further estimates that the RVO prevalence is going to swarm in the coming decade for the forecast period of 2020-30. It has been observed that a general rise in the prevalence of eye disorders can be one of the reasons that are behind the surge in the Retinal vein occlusion prevalence in the 7MM. Furthermore, the increase in the geriatric population is another factor that can be blamed on rising RVO prevalence. However, for such a burdensome and highly prevalent sight-threatening eye disorder, the Retinal vein occlusion treatment market has no curative option to offer.  

Retinal vein occlusion drug market

The primary goal of the available RVO treatment options is to prevent further visual loss and its complications, such as macular edema, ischemia, or neovascularization. The treatment options such as Intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs, and Intravitreal injection of corticosteroid drugs. Intraocular injections of steroids are another potential treatment for eyes that don’t respond to anti-VEGF drugs. Not to lose sight of the fact that intraocular steroids can have some side effects such as an increase in eye pressure and cataract progression; however, in most cases, these can be controlled.  Focal laser therapy, Pan-retinal photocoagulation therapy, and surgical treatment also fall under available choices of RVO treatment that try their best to minimize the damage. 

Fortunately, there are FDA-approved products present in the Retinal vision occlusion drug market including Lucentis (ranibizumab), Eylea (aflibercept), and Ozurdex (dexamethasone intravitreal implant) with Avastin in use as an off-label therapy to help manage the condition and improve the vision. 

Lucentis, a vascular endothelial growth factor (VEGF) inhibitor, is a joint product of Genentech and Novartis. The US FDA approved Lucentis in June 2010 for the treatment of macular edema following RVO. It is a prescription medication given by injection into the eye. However, its user is advised against in patients who have an infection in or around the eye. The cases have also been reported with its use leading to a detached retina and serious eye infection. Regeneron’s Eylea is also a vascular endothelial growth factor (VEGF) inhibitor formulated as an injection for the eye approved by the US FDA in October 2014 for the treatment of Macular Edema following RVO. Then there is intravitreally administered Allergan’s Ozurdex that received FDA approval in June 2009 for the treatment of macular edema following branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO). 

Talking about the European Retinal vein occlusion market, the approved treatment options include Lucentis that was approved in June 2011 by EMA for the treatment of patients with visual impairment due to macular edema secondary to RVO (branch RVO and central RVO); Eylea, approved in August 2013; and Ozurdex for the treatment of RVO In July 2013.

However, there’s no medication available that’s specific for Retinal artery occlusions. The present market lacks an effective treatment to unblock retinal veins. RVO most of the time leads to permanent damage to the ability to see. The associated conditions can be treated albeit the results vary with severity. In some cases, physicians manage to restore vision to some extent, while other cases are met with disappointment. Along with unpredictable results, the duration of treatment is quite long, and years can be consumed for even the slightest of improvements. Non-adherence and non-compliance with the present treatment regimen is another huge hurdle in the road. 

Thus, this calls for effective and potential treatment options for the Retinal vein occlusion patients that will be convenient in terms of route of administration, require lesser hospital visits, and will not dig a hole in the pockets of patients and their caretakers. Amidst the prevailing atmosphere of unmet needs in the Retinal vein occlusion drug market, DelveInsight’s market forecast analysis presents a promising picture for the coming decade. The major key pharma players including Novartis Pharmaceuticals (Brolucizumab (RTH258/ESBA1008)), Taiwan Liposome Company (TLC399 (ProDex)), Aerie Pharmaceuticals (AR1105), Graybug Vision (GB-102), and Outlook Therapeutics (ONS5010/Lytenava (bevacizumab)), hold the potential to create a significant positive shift in the Retinal vein occlusion market size.

The light in the tunnel is mainly beaming due to the entry of recent treatment approaches that will add to the revenue of the present Retinal vein occlusion market which is heavily dominated by dexamethasone drug delivery system and vascular endothelial growth factor inhibitors. Consequently, the growth of the RVO drug market is driven by the deep penetration of the emerging pipeline therapies, the rising geriatric population, and an increase in disease awareness. In addition to this, improved health care infrastructure and technological advancements in healthcare are expected to drive the growth of the Retinal vein occlusion market further in the next decade.