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Gisela Velez; Ranibizumab for the treatment of diabetic macular edema in patients treated with Bevacizumab. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2395. doi: https://doi.org/.
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Anti-VEGF agents have been shown to be effective in the treament and management of diabetic maculat edema. The CATT study has shown that Ranibizumab (Lucentis) and Bevacizumab (Avastin), are similarly effective for the treatment of exudative macular degeneration. The purpose of our study is to determine whether or not there is an advantage to the use of Ranibizumab over Bevacizumab; in the management and treatment of diabetic macular edema.
The records of all patients treated with anti-VEGF agents for diabetic macular edema were reviewed. 25 eyes (of 16 patients) were identified which had been treated first with Bevacizumab (1.25 mg), then switched to Ranibizumab (0.3 mg). Visual acuity was measurred by Snellen chart and retinal thickness was measured using Cirrus OCT. All eyes were treated at monthly intervals.
All eyes treated with Bevacizumab showed an improvement in visual acuity, with a reduction in retinal thickening on OCT. On average, each eye received a total of 8 intravitreal Bevacizumab injections before switching to Ranibizumab. All of the eyes had persistent thickening on OCT after treatment with Bevacizumab. After Bevacizumab, each eye received an average of 6 Ranibizumab treatments. Although Ranibizumab injections did not result in a significant improvement in VA, there was an observed decrease in retinal thickness as measured by OCT, in patients switched from Bevacizumab to Ranibizumab.
Although Ranibizumab can result in better anatomical results, Bevacizumab is equally effective and results in VA improvement. Bevacizumab is therefore a viable alternative to Ranibizumab for the treatment of diabetic macular edema.
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