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Daniel Choi, Jennifer Lim; Intravitreal Bevacizumab and Ranibizumab for Diabetic Macular Edema; A single center retrospective study. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2412.
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To compare visual acuity outcomes and optical coherence tomography (OCT) meaurements after bevacizumab or ranibizumab intravitreal injections in patients with diabetic macular edema (DME).
A retrospective chart review was conducted to determine visual and anatomic outcomes for diabetic macular edema patients who were treated with either bevacizumab or ranibizumab. Patients with less than six months follow up or who had received both types of treatments were excluded. Visual acuities before and after each injection were recorded and converted to logMAR for statistical analysis. OCT central subfield thickness (CST) measurements were recorded. Visual acuity and CST were compared between drugs at 3, 6, 9, and 12 months.
32 patients (43 eyes) received intravitreal bevacizumab and 9 patients (13 eyes) received intravitreal ranibizumab for DME. The difference in average visual acuity at baseline, 3, 6, 9, and 12 months was not statistically significant. Bevacizumab patients had a baseline logMAR of 0.685 while ranibizumab patients had a baseline logMAR of 0.808 (p = 0.41). At 12 months, logMAR improved to 0.467 and 0.411 for the bevacizumab and ranibizumab treated groups respectively (p = 0.61). The difference in CST findings was not statistically significant at any time point. At 6 months, 35% and 45% of patients treated with bevacizumab and ranibizumab respectively had gained at least 3 lines of visual acuity (logMAR +.3). The proportion of patients gaining this level of visual acuity was not statistically significant (p = 0.79) despite a statistically different mean number of injections by 6 months: bevacizumab 3.29 vs ranibizumab 4.77 (p = 0.04).
Our study demonstrates no statistically significant difference in the visual acuity outcomes following intravitreal bevacizumab versus intravitreal ranibizumab treatment of diabetic macular edema. However, a larger prospective clinical trial will be necessary to further evaluate the differences in efficacy and complications of these two treatment regimens.
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