NICE recommends use of Eylea (aflibercept) in branch retinal vein occlusion only after laser photocoagulation therapy- Bayer HealthCare

The UK National Institute for Health and Care Excellence has recommended the use of Eylea (aflibercept), from Bayer HealthCare, to treat visual impairment due to macular oedema secondary to branch retinal vein occlusion (BRVO) when laser photocoagulation has offered no benefit or is not suitable for use. Treating this visual impairment in the second-line setting goes against guidelines from the Royal College of Ophthalmologists which recommends prompt first-line treatment with anti-VEGF agents and suggests restricting laser photocoagulation to when these treatments fail.

NICE has previously published guidance recommending laser photocoagulation as a first-line therapy in visual impairment due to BRVO, plus drug therapy as second-line treatment options. Laser photocoagulation is not recommended by the Royal College of Ophthalmologists as a first line option due to the following factors: poor benefits with laser, potential delays in treatment if macular haemorrhage is present, and the fact that newer treatments are associated with better outcomes.