Incidence of Choroidal Neovascularization in the Fellow Eye Among Patients Treated with Ranibizumab or Bevacizumab in the Comparison of Age-related Macular Degeneration Treatments Trials (CATT)

Abstract

Purpose: : To compare the incidence of choroidal neovascularization (CNV) in the non-study (fellow) eye between patients treated with ranibizumab and patients treated with bevacizumab for unilateral CNV.

Methods: : Patients enrolled in the Comparison of Age-related Macular Degeneration Treatments Trials (CATT) were at risk of incident CNV if neither the enrolling ophthalmologist nor the graders at the Photograph Reading Center detected signs of CNV on baseline color photography or angiography. Eligibility criteria for CATT specified that the study eye of patients have evidence on fluorescein angiography and optical coherence tomography (OCT) of CNV secondary to age-related macular degeneration (AMD) and visual acuity between 20/25 and 20/320. Treatment for the study eye was assigned randomly to either ranibizumab or bevacizumab. CATT ophthalmologists examined patients every 28 days through 1 year and noted whether CNV in the fellow eye was present.

Results: : Among 1185 CATT patients, 727 (61%) had no signs of CNV in the fellow eye at enrollment. At one year, CNV had developed in 29 (8.0%) of 365 eyes of patients treated with ranibizumab and 26 (7.2%) of 362 patients treated with bevacizumab (p=0.76; logrank test). After adjusting for known risk factors for CNV and drug dosing regimen, the estimated hazard ratio associated with treatment for bevacizumab was 0.92 (95% confidence interval (0.54, 1.56)).

Conclusions: : The incidence rates for CNV in the fellow eyes of patients treated with anti-VEGF agents may be an indicator of systemic effects of the drugs. Through 1 year, ranibizumab and bevacizumab have similar effects on the incidence of CNV in the fellow eye.

Clinical Trial: : http://www.clinicaltrials.gov NCT00593450

Keywords: choroid: neovascularization • age-related macular degeneration • clinical (human) or epidemiologic studies: outcomes/complications