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Ezio Cappello, Pietro Monaco, Antonio Frattolillo, Michele Del Borrello, Luigina Tollot, Gianni Virgili; Bevacizumab Vs Ranibizumab For Exudative Amd In A Clinical Setting: One Year’S Study. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3528.
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To compare visual acuity and central macular thickness outcomes after treatment with Bevacizumab or Ranibizumab for exudative age related macular degeneration.
Between January 2 and December 31, 2007, we enrolled 85 consecutive patients with exudative AMD, 34 were treated with combination therapy with PDT and excluded from the study, 51 were treated with intravitreal Bevacizumab injections alone. After March 2009, when Ranibizumab was approved in Italy, and until March 2010, we enrolled 82 consecutive patients, previously untreated, and performed Ranibizumab injections. For each patient at baseline were recorded visual acuity with ETDRS charts, type of lesion based on fluorescein angiography, and OCT measurements. Treatment regimen was based on a starting dose of 2 injections in Bevacizumab group, 3 monthly injections in Ranibizumab group, followed by retreatment if signs of recurrency were detected. Follow-up was made at 3-6-9 months in Ranibizumab group, and until 12 months in Bevacizumab group, recording visual acuity and central macular thickness on OCT.
In both group the type of lesion on average was 22% classic or predominantly classic CNV, 66% occult or minimally classic and 10% Rap lesions. At baseline, mean visual acuity was 0,75 LogMar in Bevacizumab group, 0,50 LogMar in Ranibizumab group. Central macular thickness was 345 microns in Bevacizumab goup and 317 microns in Ranibizumab group. Mean number of injection was 3 (range 1-9) in Bevacizumab group and 4 (range 3-8) in Ranibizumab group. During treatment visual acuity was stable in both groups at the first follow-up of 3 months, and worsened at the final follow-up visit (+0.2 LogMar in Bevacizumab group, +0.16 LogMar in Ranibizumab group). Central macular thickness reduction was greater in Ranibizumab group (mean change -49 microns in Bevacizumab group, -85 microns in Ranibizumab group).
There was no change in visual acuity outcome between the two treatment groups. The results showed a stabilization of visual acuity during the starting dose period and a similar worsening during the follow-up with an "as needed" retreatment protocol. In our opinion patients treated with anti-VEGF agents need a long regular follow-up and a greater number of injections in order to achieve a stabilization or even a gain in visual acuity .
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