Abstract
Purpose: :
To evaluate the therapeutic effect of intravitreal bevacizumab and ranibizumab in choroidal neovascularisation (CNV) secondary to age related macular degeneration (AMD).
Methods: :
A retrospective chart review of 94 eyes of 81 patients treated with bevacizumab or ranibizumab between June 2006 and December 2008. Inclusion criterias are CNV secondary to AMD, intravitreal bevacizumab 1,25 mg or ranibizumab 0,5 mg as mono treatment for CNV and a follow-up of minimum 3 months. Exclusion criterias are previous treatment for CNV and incomplete records of parameters being studied at baseline. If changing to other or additional treatment for AMD, the patient was excluded from that moment. Clinical data including visual acuity (VA) and central macular thickness on optical coherence tomography (OCT) were obtained from patient records for the time of the initial injection and at each visit until 6 months of follow-up. VA measurements were obtained using Snellen charts or Early Treatment Diabetic Retinopathy Study (ETDRS) LogMAR charts. Snellen VA values were converted into logMAR units for statistical analyses.
Results: :
46 eyes were treated with bevacizumab and 48 with ranibizumab. Mean age at baseline was 80,1 and 79,9 years respectively. Mean VA at baseline were logMAR 0,72 for the bevacizumab group and 0,57 for the ranibizumab group, with a change to logMAR 0,42 and 0,47 respectively for the two groups at 6 months follow-up. Mean central macular thickness at baseline was 377 µm for patients treated with bevacizumab, and 314 µm for those treated with ranibizumab. A reduction of central macular thickness was registered for both groups at 6 months of follow-up, with mean central macular thickness of 259 µm and 231 µm for bevacizumab and ranibizumab groups respectively. Mean number of injections was 0,75 inj./month in the bevacizumab group, and 0,90 inj./month in the ranibizumab group.
Conclusions: :
Short-term results for bevacizumab and ranibizumab as treatment for neovascular AMD shows a trend of greater improvement in VA for patients treated with bevacizumab. Central macular thickness is different in the two groups both before treatment and at follow-up, with higher values in the bevacizumab group. Fewer injections were given per month to eyes treated with bevacizumab. Longer follow up and more extensive analyses to prove whether these differences are significant, will follow during spring 2009. However, the retrospective, non-random nature of this study should be considered before drawing any firm conclusions.
Keywords: age-related macular degeneration • choroid: neovascularization • vascular endothelial growth factor