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S. Fonseca, Â. Carneiro, L. Mendonça, M. Falcão, E. Brandão, F. Falcão-Reis; Comparison of Intravitreal Bevacizumab versus Intravitreal Ranibizumab for the Treatment of Choroidal Neovascularization Secondary to Pathologic Myopia - 6 Month Results. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2222.
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To compare the safety and efficacy of intravitreal therapies with bevacizumab and ranibizumab for the treatment of choroidal neovascularization (CNV) secondary to pathologic myopia (PM).
Prospective, nonrandomized, cohort study. The 6 month results of 25 eyes treated with 1.25mg of intravitreal bevacizumab (Group 1) for CNV secondary to PM were compared with 19 eyes treated with 0.5 mg of intravitreal ranibizumab (Group 2). We used a 1 plus PRN schedule in both groups. Patients were evaluated monthly with best corrected visual acuity (BCVA) using ETDRS charts and OCT. Fluorescein angiography (FA) was performed every three months or when necessary. Retreatment decision was based on the presence of metamorphopsia, fluid on OCT, and/or leakage on FA. At baseline mean age, mean BCVA and angiographic type of lesions were similar in both groups.
The mean age was 58.8 years. The baseline mean BCVA was 35.8 letters in group 1 and 43.7 letters in group 2. Both groups gained letters in 6 months , a mean of +10.7 letters in group 1 and +13.2 letters in group 2, with no statistical differences between the 2 groups (p=0.575). At 1 month the mean BCVA improved significantly in bevacizumab (+6.9 letters, p=0.002) and in ranibizumab groups (+6.3 letters, p=0.041). In group 1, 88.0% (n=22) of the patients improved vision, 24.0 % (n=6) gained 15 or more letters and none lost 15 or more letters. In group 2, 89.5% (n=17) of the patients improved vision, 26.3% (n=5) gained 15 or more letters and none lost 15 or more letters. The rate of injections was the same in both groups, 0,59 injections per month per patient. No cases of severe visual acuity loss nor systemic side-effects were observed.
Ranibizumab and Bevacizumab are safe and effective in treating CNV secondary to PM. During the first six months, both drugs have similar visual results. This is a small and nonrandomized series; prospective and randomized clinical trials are needed to ascertain these findings.
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