Cost regulators are now backing NHS use of Bayer's Eylea for all patients with visual impairment due to branch retinal vein occlusion (BRVO), having initially recommended its use only in the second-line setting.

The National Institute for Health and Care Excellence has now published a draft final appraisal determination that will give around 13,000 patients first-line access to the treatment, which Bayer says has been proven to achieve superior improvements in vision compared to existing options (laser).

BRVO is caused by a blood clot in one of the branches of the main vein in the retina, the light sensitive layer at the back of the eye, increasing the pressure in small blood vessels that can lead to blood and fluid leaking beneath the macula (macular oedema). If not treated effectively, macular oedema secondary to BRVO can significantly impact a person's vision.

Eylea (aflibercept) is an anti-VEGF treatment designed to block the growth of new blood vessels and decrease vascular permeability to rapidly deliver sustainable improvements in vision, while offering patients and healthcare professionals a predictable dosing programme.

"It is great news that patients will have access to an anti-VEGF treatment at the start of the treatment journey, as it will mean that they will not have to go through the pain and discomfort that can often be associated with laser treatment and will have the opportunity to preserve their eye sight as much as possible so they are able maintain their independence and the quality of life," said Cathy Yelf, chief executive of the Macular Society.

The drug is licensed in the UK for the treatment of wet age-related macular degeneration (wAMD), visual impairment due to macular oedema secondary to central retinal vein occlusion (CRVO) and BRVO, visual impairment due to diabetic macular oedema (DMO) and myopic choroidal neovascularisation (mCNV).

There are around 15,000 cases of macular oedema secondary to BRVO in England and Wales each year.