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S. M. Fernando, G. J. Ko, D. M. Berinstein, R. J. Sanders; Efficacy of Intravitreal Ranibizumab in Patients With Neovascular Age-Related Macular Degeneration Previously Treated With Intravitreal Bevacizumab. Invest. Ophthalmol. Vis. Sci. 2008;49(13):309. doi: https://doi.org/.
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To evaluate the efficacy of ranibizumab in patients with neovascular age-related macular degeneration (ARMD) previously treated with bevacizumab.
A retrospective chart review was completed of 165 consecutive patients with neovascular age-related macular degeneration treated with one or more intravitreal bevacizumab injections, and then transitioned to ranibizumab following its approval by the Food and Drug Administration. All intravitreal injections dosages were 1.25mg of bevacizumab in 0.05ml and 0.5mg of ranibizumab in 0.05 ml. The decision and timing of therapy was under the discretion of the treating physician. Data collected included best corrected visual acuity (BCVA), central retinal thickness (CRT), number of injections, and treatment intervals.
Mean age of the patient population was 82 years, mean BCVA was 20/157, and mean CRT was 295. The average treatment interval between injections was 56 days, and the average interval between last bevacizumab and first ranibizumab injection was 101 days.During the period of bevacizumab treatment, visual acuity improved significantly (mean 5 letters, p<0.001), whereas there was no further significant improvement during the subsequent period of ranibizumab treatment (mean 1.7 letters, p=0.28). Overall, the mean improvement of 6.8 letters (p<0.5) was maintained when patients were transitioned from bevacizumab to ranibizumab. In addition, from the time of study initiation to final ranibizumab follow up, there was a 53 micron improvement in CRT (p<0.001).
Ranibizumab is effective following bevacizumab treatment for ARMD. Generally, for patients whose therapies were transitioned from bevacizumab to ranibizumab, the mean improvement in vision was maintained. Overall, there appears to be no difference in visual outcome when patients were switched from bevacizumab to ranibizumab.
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