Abstract
Purpose: :
To compare visual acuity outcomes and required number of intravitreal injections after 1 year in patients treated for neovascular age related macular degeneration (AMD) with bevacizumab or ranibizumab using a variable-dosing regimen.
Methods: :
This is a retrospective chart review of patients treated with an optical coherence tomography (OCT) guided regimen of bevacizumab or ranibizumab for neovascular AMD at the VA Boston Healthcare System from 01/01/2006 to present. Data from clinical visits over a 1-year treatment period were analyzed. Patients were subdivided into a low dose number (4 or fewer required injections) and a high dose number (7 or more required injections). Pretreatment characteristics of these two groups were analyzed to determine factors that may predict the required injection number.
Results: :
A total of 112 patients with neovascular AMD received either bevacizumab or ranibizumab. Of these, 34 (30.1%) met the inclusion criteria for the study. Ten received bevacizumab (29%) while 24 were treated with ranibizumab (71%). Pretreatment groups were matched in terms of visual acuity (logMAR 0.52 bevacizumab vs. logMAR 0.52 ranibizumab, p=0.97) and central macular thickness (269 bevacizumab vs. 308 ranibizumab, p=0.1). There was no statistically significant difference in the number of injections received at 1 year (5.3 bevacizumab vs. 5.6 ranibizumab, p=0.73), and visual acuity outcomes were also similar (logMAR 0.38 bevacizumab vs. logMAR 0.40 ranibizumab, p=0.9) Fourteen of thirty-four (41%) of patients required 4 or fewer injections while eleven of thirty-four (32%) required 7 or more. There was no statistical difference noted between the two groups when parametric values such as visual acuity, central macular thickness (CMT), lesion size and non parametric values such as presence of pigment epithelial detachment, hemorrhage, and lesion locations were compared.
Conclusions: :
This case series of 34 patients treated with OCT guided dosing of bevacizumab and ranibizumab for neovascular AMD yielded similar injection numbers and similar visual acuity outcomes at 1 year. No pretreatment characteristics were identified that predict required injection number. Further studies with larger sample sizes are needed for confirmation of these findings.
Keywords: age-related macular degeneration • retinal neovascularization