Abstract
Purpose: :
To evaluate the response to change of anti-VEGF agent in patients with neovascular age-related macular degeneration (AMD).
Methods: :
A retrospective review of 29 consecutive eyes which had treatment changed either from intravitreal (IVT) bevacizumab 1.25 mg to IVT ranibizumab 0.5 mg or vice versa due to insufficient effect. Primary outcome measures were change of visual acuity (VA) and central retinal thickness (CRT) measured with optical tomography scans (OCT).
Results: :
11 patients had treatment changed from bevacizumab to ranibizumab (group A), while 18 patients had treatment changed from ranibizumab to bevacizumab (group B). In group A all patients had stable VA 3 months after change of treatment, defined as loosing or gaining less than 3 lines, equivalent to 15 ETDRS letters. This was also reflected in stable mean VA (logMar 0.57 to 0.51, p=0.13) and mean CRT (253 to 230 microns, p=0.10). In group B there were 2 patients who had gained 3 lines or more and the rest of the patients had stable VA at 3 months of follow up. There was no statistically significant change of mean VA (logMar 0.33 to 0.26, p=0.10) or mean CRT (247 to 233 microns, p=0.49).
Conclusions: :
3 months after change of treatment all patients in the study had stable VA with the exception of two who experienced an improvement after changing treatment from ranibizumab to bevacizumab. Mean VA and mean CRT were stable at 3 months after change of treatment in both groups. Even though most patients have similar response to the two anti-VEGF agents, a few might benefit from changing treatment when the effect is not satisfactory.
Keywords: age-related macular degeneration • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • retinal neovascularization