Abstract
Purpose: :
To compare safety and efficacy of two anti-vascular endothelial growth factor drugs - bevacizumab (Avastin) versus ranibizumab (Lucentis) - in the treatment of patients with exudative form of age-related macular degeneration (AMD).
Methods: :
Retrospective review of medical charts of patients who received injections at monthly intervals of intravitreal Avastin or Lucentis for exudative AMD. Primary outcome measures were: change in best-corrected visual acuity (BCVA), central macular thickness assessed by optical coherence tomography (OCT) and screening for adverse events.
Results: :
The average number of injections was 118 in Avastin group and 108 in Lucentis Group. The baseline mean LogMAR BCVA was 0.97 (Snellen equivalent of 20/200) and 0.94 (Snellen equivalent of 20/200) in Avastin and Lucentis group, respectively. All patients showed final visual improvement and after the last injection the mean logMAR BCVA improved by 0.18 in Avastin Group and be 0.17 in Lucentis Group. The average OCT central foveal thickness reduced from 342 microns at baseline to 310 microns at the final follow-up in Avastin group and from 288 microns at baseline to 269 microns at the final follow-up in Lucentis group.Adverse affects related to the injections were as follows. In Avastin group - one patient had lower extremety pain (thromboembolic event has been ruled out by US Doppler exam). In Lucentis group -2 patients had increased intraocular pressure.
Conclusions: :
Intravitreal Avastin injections appeared to be at least as effective as intravitreal injection of Lucentis in the treatment of exudative AMD, resulting in similar visual gain and reduction in macular thickness. Further clinical trials with a larger population are required to evaluate the long-term visual outcomes and complication profiles of treatment with such medications.
Keywords: age-related macular degeneration • vascular endothelial growth factor • clinical (human) or epidemiologic studies: outcomes/complications