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A. M. Carneiro, L. Mendonca, M. Falcao, S. Fonseca, E. Brandao, F. Falcao-Reis; Comparative Study of Ranibizumab versus Bevacizumab in the Treatment of Neovascular Age-Related Macular Degeneration With a 1+PRN Regimen. Invest. Ophthalmol. Vis. Sci. 2010;51(13):903.
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To compare the safety and efficacy of intravitreal therapies with bevacizumab or ranibizumab for the treatment of subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) using a 1 + PRN (pro re nata) regimen
The six-month results of the first 60 consecutive eyes treated with ranibizumab (Group 1) for CNV secondary to AMD in our department were compared with 60 consecutive eyes treated with bevacizumab (Group 2) before availability of Lucentis®. None of the eyes had received previous treatment. At baseline mean age, mean best corrected visual acuity (BCVA) using ETDRS charts and angiographic type of lesions were similar in both groups. Patients were evaluated monthly with BCVA and optical coherence tomography (OCT).
Mean initial BCVA was 20/160 for both groups (1: 37.8 vs 2: 39.5 letters; p=.68). At six months, there was a mean gain of 5.4 letters (p=.007) with ranibizumab, and 6.1 letters (p<.001) with bevacizumab. Visual gain results did not statistically differ between groups (p= .55). Significant visual gain (≥15 letters) occurred in 15 vs 12 eyes (1: 25.0% vs 2: 20.0%; p=.57). Mean initial foveal thickness was statistically different between groups (1: 330.2 vs 2: 265.9 µm; p=.021), but after six months this difference faded (1: 177.6 vs 2: 187.9 µm; p=.529). The mean number of treatments performed per eye during this six months follow-up was 4.63 for Group 1, and 4.15 for Group 2. This difference was statistically different (P = .04). Two acute cardiovascular events were registered during follow-up: one patient from Group 1 had a stroke, and another had a myocardial infarction in Group 2.
Intravitreal therapies with ranibizumab or bevacizumab have good and similar visual outcomes in this small series and short-term analysis. The difference in mean initial foveal thickness might have determined a greater need for retreatment with ranibizumab. Longer and larger prospective clinical trials are needed to compare its efficacy and safety.
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