Tiespectus Improves Vision and Retinal Thickness in BRVO

Part one of the RIOJA trial reports no serious adverse events or dose-limiting toxicity.

By: Jim Gallagher, senior managing editor

Retinal Physician October 19, 2025

Clinical Report: Tiespectus Improves Vision and Retinal Thickness in BRVO

Overview

The phase 1/2a RIOJA trial demonstrated that Tiespectus significantly improves visual acuity and reduces retinal thickness in patients with macular edema secondary to branch retinal vein occlusion (BRVO). Patients experienced a mean gain of 16.7 letters in best-corrected visual acuity and a reduction of 157.8 µm in central subfield thickness after three monthly injections.

Background

Branch retinal vein occlusion (BRVO) is a leading cause of vision loss due to retinal vascular disease, making effective treatment options essential. Current first-line therapies primarily include intravitreal anti-VEGF injections, yet there remains a need for novel therapies that can enhance visual outcomes and anatomical improvements. Tiespectus, a bispecific antibody, offers a dual mechanism of action that may provide additional benefits in managing BRVO-related macular edema.

Data Highlights

Outcome	Baseline	12 Weeks	Change
Best-Corrected Visual Acuity (BCVA)	55.6 letters	72.3 letters	+16.7 letters
Central Subfield Thickness (CST)	479.3 µm	321.5 µm	-157.8 µm

Key Findings

Tiespectus showed a mean gain of 16.7 letters in BCVA after three monthly injections.
Mean CST reduction was 157.8 µm at 12 weeks.
No serious ocular or systemic adverse events were reported during the trial.
The trial enrolled 12 treatment-naïve patients across four sequential cohorts.
All dose levels demonstrated improvements in visual function and retinal anatomy.

Clinical Implications

The promising results from the RIOJA trial suggest that Tiespectus may be a viable treatment option for patients with BRVO-related macular edema, potentially enhancing visual outcomes beyond current therapies. Clinicians should consider the dual mechanism of action of Tiespectus when evaluating treatment strategies for this patient population.

Conclusion

Tiespectus represents a novel therapeutic approach for managing macular edema due to BRVO, with significant improvements in both visual acuity and retinal thickness observed in early clinical trials. Further studies are warranted to confirm these findings and establish its role in clinical practice.

PentaVision

Retinal Physician