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Ramón Domínguez Fernández, ANDREA GOVETTO, Maria Teresa Alves Perez, Ramon Lorente; Ranibizumab versus Bevacizumab in the treatment of subfoveal choroidal neovascular membrane secondary to pathologic myopia. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4936.
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To report the short-term safety and efficacy of intravitreal ranibizumab (IVR) compared to intravitreal bevacizumab ( IVB ) in patients with subfoveal choroidal neovascular membrane (CNVM) secondary to pathologic myopia (PM).
16 consecutive eyes of 15 patients with subfoveal CNVM secondary to PM treated at our institution between January 2009 and October 2012 were included. Clinical charts and OCT scans of all patients were retrospectively reviewed. 8 patients received 0,05 ml of IVR while the other 8 received 0,05 ml of IVB. Retreatment criteria were: decrease in visual acuity of 5 letters and any fluid on OCT, or persistent or increased fluid on OCT. Main outcome measures were occurrence of treatment-related ocular or systemic complications, mean change in best corrected visual acuity (BCVA) and change in CNVM thickness (CNVMT).
The mean follow-up was 6,5 months for IVR group and 10,13 months for IVB group. Mean number of injections was 1,6 for IVR group and 2,9 for IVB group. Mean baseline BCVA was 0,14 (±0,09) for IVR group and 0,12 (±0,08) for IVB group. In the IVR group, mean BCVA gain during the first month was 0,1 (±0,13), at 3, 6 and 12 months was respectively 0,16 (± 0,16), 0,19 (± 0,13) and 0,17 (±0,1). In the IVB group, mean BCVA gain during the first month was 0,8 (±0,1), at 3, 6 and 12 months was respectively 0,07 (± 0,1), 0,9 (± 0,1) and 0,15 (± 0,16). Mean CNVMT at baseline was 259 µm (±175) in the IVR group and 242 µm (±79) in the IVB group. In the IVR group, a mean CNVMT decrease of 78,63 µm (±87,3) in the fist month, of 88,14 µm (±149,7) at 3 months, of 86,83 µm (±152,7) at 6 months and of 88,5 µm (±82,7) at 12 months were reported. In the IVB group, mean CNVM decrease during the first month was 10,7 µm (±49,5). At 3 months a mean increase of 31,5 µm was reported. At 6 and 12 months, mean CNVMT decreases by respectively 40 µm (±33) and 75 µm (± 31,2).
Short-term results suggest that intravitreal ranibizumab and bevacizumab provides significant functional and anatomical improvement with no significant adverse events in patients with CNVM. Although differences between groups did not reach statistical significance, we clinically noticed better improvements in BCVA and CNMVT in the group treated with intravitreal ranibizumab.
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