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Jennifer A. Day, Sundeep Dev; A Review Of The Indications For And Subsequent Visual, Anatomic And Safety Results After Switching From One Anti-VEGF Therapy Agents To Another In AMD Patients. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6524.
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To assess the indications for switching anti-VEGF medications for the treatment of wet age-related macular degeneration (AMD) and evaluate the related visual, anatomical, and safety effects.
Billing records identified patients receiving both bevacizumab and ranibizumab for AMD during a 52-month period. Charts were reviewed consecutively. Data collected about the treatment course include date of visit, visual acuity (VA), intraocular pressure, topical ocular medications used, central foveal thickness (CFT) measured by ocular coherence tomography, drug for each visit, injection number, and any noted ocular or systemic events.
Billing records and consecutive review of charts identified 212 eyes that qualified for inclusion. The number of eyes switching from bevacizumab to ranibizumab (Initial Avastin) was 160. The reasons reported for the switch in Initial Avastin are as follows: 84.4% for persistent or worsening CNV activity, 15% for adverse effects, and 0.6% for non-medical reasons. The number of eyes switching from ranibizumab to bevacizumab (Initial Lucentis) was 52. The reasons for switch in Initial Lucentis: 57.7% for persistent or worsening CNV activity, 3.8% for adverse effects, and 38.5% for non-medical reasons.Eyes that were switched for persistent or worsening CNV activity included 135 eyes from Initial Avastin and 30 eyes from Initial Lucentis. The average change in VA and CFT between various important milestones in the patient’s course were determined.
The study suggests that there is not much benefit in switching anti-VEGF medications in AMD patients not responding to initial treatment. These preliminary findings would be better evaluated in a prospective study.
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