Purpose. To compare the efficacy of intravitreal bevacizumab versus ranibizumab in the treatment of neovascular age-related macular degeneration (nAMD). Methods. Retrospective, comparative study. The newly diagnosed nAMD patients who were treated with intravitreal bevacizumab or ranibizumab on an as-needed treatment regimen were included in the study. Main outcome measures were the change in best corrected visual acuity (BCVA), and central retinal thickness (CRT). Secondary outcome measures were the number of injections, and complications. Results. A total of 154 patients were included in the study. Bevacizumab group consisted of 79 patients, and ranibizumab group consisted of 74 patients. Mean follow-up time was 18.9 months, and 18.3 months in the bevacizumab and ranibizumab groups, respectively. There was not a significant difference between the two groups regarding the change in BCVA and CRT at all time points ( for all). The mean number of injections at month 12 was 4.8 and 4.7 in bevacizumab and ranibizumab groups, respectively ( ). No serious complications were detected in any of the groups. Conclusion. Both of the bevacizumab and ranibizumab found to be effective in the treatment of nAMD in regards of functional and anatomical outcomes with similar number of treatments and similar side effects. 1. Introduction Neovascular age-related macular degeneration (nAMD) is a leading cause of visual loss among elderly population [1, 2]. Before the introduction of intravitreal antivascular endothelial growth factor (anti-VEGF) agents for the treatment of nAMD, only prevention from visual acuity loss might have been achieved in a limited number of patients with different treatment options like laser photocoagulation, photodynamic therapy, and vitreoretinal surgery [3–9]. Intravitreal treatments with bevacizumab (full length antibody against VEGF-A) and ranibizumab (Fab part of antibody against VEGF-A) have led the majority of the patients to prevent the baseline visual acuity (VA) and even to achieve visual improvement in some of the patients [10, 11]. The multicenter studies with ranibizumab, like MARINA, ANCHOR, PRONTO, and EXCITE, and the comparative study of ranibizumab and bevacizumab, the CATT study, showed that ranibizumab and bevacizumab were effective to prevent VA loss up to 95% of the patients and is effective to make an improvement in VA up to 40% of the patients [11–15]. Today, the CATT trial answered the questions about the efficacy of bevacizumab versus ranibizumab and showed that both drugs had similar effects in the treatment of nAMD.
References
[1]
L.-Y. Ngai, N. Stocks, J. M. Sparrow et al., “The prevalence and analysis of risk factors for age-related macular degeneration: 18-year follow-up data from the Speedwell eye study, United Kingdom,” Eye, vol. 25, no. 6, pp. 784–793, 2011.
[2]
P. A. Keane, A. Tufail, and P. J. Patel, “Management of neovascular age-related macular degeneration in clinical practise: initiation, maintance, and discontinuation of therapy,” Journal of Ophthalmology, vol. 2011, Article ID 752543, 10 pages, 2011.
[3]
M. Votruba and Z. Gregor, “Neovascular age-related macular degeneration: present and future treatment options,” Eye, vol. 15, no. 3, pp. 424–429, 2001.
[4]
Macular Photocoagulation Study Group, “Laser photocoagulation of subfoveal neovascular lesions in age-related macular degeneration: results of a randomized clinical trial,” Archives of Ophthalmology, vol. 109, no. 9, pp. 1220–1231, 1991.
[5]
L. Akduman, M. P. Karavellas, J. C. Macdonald, R. J. Olk, and W. R. Freeman, “Macular translocation with retinotomy and retinal rotation for exudative age-related macular degeneration,” Retina, vol. 19, no. 5, pp. 418–423, 1999.
[6]
G. S. Rubin and N. M. Bressler, “Effects of verteporfin therapy on contrast on sensitivity: results from the treatment of age-related macular degeneration with photodynamic therapy (TAP) investigation-TAP report no. 4,” Retina, vol. 22, no. 35, pp. 536–544, 2002.
[7]
A. ？zkaya, Z. Gürcan, U. Yi？it, ？. E. Gültekin, and H. M. ？zkaya, “Photodynamic therapy results in age related macular degeneration,” Ret-Vit, vol. 4, no. 1, pp. 289–296, 2010.
[8]
J. L. Kovach, S. G. Schwartz, H. W. Flynn Jr., and I. U. Scott, “Anti-VEGF treatment strategies for wet AMD,” Journal of Ophthalmology, vol. 2012, Article ID 786870, 7 pages, 2012.
[9]
D. M. Brown, P. K. Kaiser, M. Michels et al., “Ranibizumab versus verteporfin for neovascular age-related macular degeneration,” The New England Journal of Medicine, vol. 355, no. 14, pp. 1432–1444, 2006.
[10]
P. J. Rosenfeld, D. M. Brown, J. S. Heier et al., “Ranibizumab for neovascular age-related macular degeneration,” The New England Journal of Medicine, vol. 355, no. 14, pp. 1419–1431, 2006.
[11]
G. A. Lalwani, P. J. Rosenfeld, A. E. Fung et al., “”A variable-dosing regimen with intravitreal ranibizumab for neovascular age-related macular degeneration: year 2 of the PrONTO Study,” American Journal of Ophthalmology, vol. 148, no. 1, pp. 43–e1, 2009.
[12]
U. Schmidt-Erfurth, B. Eldem, R. Guymer et al., “Efficacy and safety of monthly versus quarterly ranibizumab treatment in neovascular age-related macular degeneration: the EXCITE study,” Ophthalmology, vol. 118, no. 5, pp. 831–839, 2011.
[13]
D. F. Martin, M. G. Maguire, G.-S. Ying, J. E. Grunwald, S. L. Fine, and G. J. Jaffe, “Ranibizumab and bevacizumab for neovascular age-related macular degeneration,” The New England Journal of Medicine, vol. 364, no. 20, pp. 1897–1908, 2011.
[14]
L. Hjelmqvist, C. Lindberg, P. Kanulf, H. Dahlgren, I. Johansson, and A. Siewert, “One-year outcomes using ranibizumab for neovascular age-related macular degeneration: results of a prospective and retrospective observational multicentre study,” Journal of Ophthalmology, vol. 2011, Article ID 405714, 8 pages, 2011.
[15]
I. Zampros, A. Praidou, P. Brazitikos, P. Ekonomidis, and S. Androudi, “Antivascular endothelial growth factor agents for neovascular age-related macular degeneration,” Journal of Ophthalmology, vol. 2012, Article ID 319728, 12 pages, 2012.
[16]
G. Landa, W. Amde, V. Doshi et al., “Comparative study of intravitreal bevacizumab (avastin) versus ranibizumab (lucentis) in the treatment of neovascular age-related macular degeneration,” Ophthalmologica, vol. 223, no. 6, pp. 370–375, 2009.
[17]
X. F. Feng, I. J. Constable, I. L. McAllister, and T. Isaacs, “Comparison of visual acuity outcomes between ranibizumab and bevacizumab treatment in neovascular age-related macular degeneration,” International Journal of Ophthalmology, vol. 4, no. 1, pp. 85–88, 2011.
[18]
D. S. Fong, P. Custis, J. Howes, and J.-W. Hsu, “Intravitreal bevacizumab and ranibizumab for age-related macular degeneration a multicenter, retrospective study,” Ophthalmology, vol. 117, no. 2, pp. 298–302, 2010.
[19]
C. Bellerive, B. Cinq-Mars, G. Lalonde et al., “Bevacizumab and ranibizumab for neovascular age-related macular degeneration: a treatment approach based on individual patient needs,” Canadian Journal of Ophthalmology, vol. 47, no. 2, pp. 165–169, 2012.
[20]
D. F. Martin, M. G. Maguire, S. L. Fine et al., “Ranibizumab and bevacizumab for neovascular age-related macular degeneration; two-year results,” Ophthalmology, vol. 119, no. 7, pp. 1388–1398, 2012.
[21]
S. Day, K. Acquah, P. Mruthyunjaya, D. S. Grossman, P. P. Lee, and F. A. Sloan, “Ocular complications after antivascular endothelial growth factor therapy in medicare patients with age-related macular degeneration,” American Journal of Ophthalmology, vol. 152, no. 2, pp. 266–272, 2011.
[22]
R. J. Brechner, P. J. Rosenfeld, J. D. Babish, and S. Caplan, “Pharmacotherapy for neovascular age-related macular degeneration: an analysis of the 100% 2008 medicare fee-for-service part b claims file,” American Journal of Ophthalmology, vol. 151, no. 5, pp. 887–895, 2011.
[23]
L. H. Curtis, B. G. Hammill, K. A. Schulman, and S. W. Cousin, “Risks of mortality, myocardial infarction, bleeding, and stroke associated with therapies for age-related macular degeneration,” Archives of Ophthalmology, vol. 128, no. 10, pp. 1273–1279, 2010.
