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The Standard Care vs Corticosteroid for Retinal Vein Occlusion (SCORE) Study Report 5

The SCORE Study Research Group^*

Arch Ophthalmol. 2009;127(9):1101-1114.

Objective  To compare the efficacy and safety of 1-mg and 4-mg doses of preservative-free intravitreal triamcinolone with observation for eyes with vision loss associated with macular edema secondary to perfused central retinal vein occlusion (CRVO).

Methods  Multicenter, randomized, clinical trial of 271 participants.

Main Outcome Measure  Gain in visual acuity letter score of 15 or more from baseline to month 12.

Results  Seven percent, 27%, and 26% of participants achieved the primary outcome in the observation, 1-mg, and 4-mg groups, respectively. The odds of achieving the primary outcome were 5.0 times greater in the 1-mg group than the observation group (odds ratio [OR], 5.0; 95% confidence interval [CI], 1.8-14.1; P = .001) and 5.0 times greater in 4-mg group than the observation group (OR, 5.0; 95% CI, 1.8-14.4; P = .001); there was no difference identified between the 1-mg and 4-mg groups (OR, 1.0; 95% CI, 0.5-2.1; P = .97). The rates of elevated intraocular pressure and cataract were similar for the observation and 1-mg groups, but higher in the 4-mg group.

Conclusions  Intravitreal triamcinolone is superior to observation for treating vision loss associated with macular edema secondary to CRVO in patients who have characteristics similar to those in the SCORE-CRVO trial. The 1-mg dose has a safety profile superior to that of the 4-mg dose.

Application to Clinical Practice  Intravitreal triamcinolone in a 1-mg dose, following the retreatment criteria applied in the SCORE Study, should be considered for up to 1 year, and possibly 2 years, for patients with characteristics similar to those in the SCORE-CRVO trial.

Trial Registration  clinicaltrials.gov Identifier: NCT00105027

Authors/Writing Committee: Michael S. Ip, MD (Chair); Ingrid U. Scott, MD, MPH; Paul C. VanVeldhuisen, PhD; Neal L. Oden, PhD; Barbara A. Blodi, MD; Marian Fisher, PhD; Lawrence J. Singerman, MD; Michael Tolentino, MD; Clement K. Chan, MD; Victor H. Gonzalez, MD.

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