Real World Comparison Of Ranbiziumab And Bevacizumab For Macular Edema Secondary To Retinal Vein Occlusions

Abstract

Purpose : To determine the efficacy of intravitreal ranibizumab (IVR) versus intravitreal bevacizumab (IVB) for treatment of macular edema (ME) resulting from retinal vein occlusion (RVO).

Methods : A retrospective chart review was performed on patients between January 2011 and December 2014. A total of 173 patients with a diagnosis of retinal vein occlusion (RVO) treated for ME with either IVR or IVB were included. Patients were further subdivided into central retinal vein occlusion/hemiretinal vein occlusion (CRVO/HRVO) or branch retinal vein occlusion (BRVO)-only cohorts. Exclusion criteria included prior treatment for ME or presence of confounding ocular disease. Patients were treated by investigator discretion until anatomically ‘dry’ by OCT. The primary outcome measures were mean change in visual acuity (VA) and in central subfield thickness (CST) at 6- and 12-month follow-up visits.

Results : CRVO/HRVO cohort: A total of 89 patients were included in this cohort. At 6 months follow-up, there was no difference in the mean gain in VA between the two treatment groups (IVR: +9.82 letters, IVB: +10.96 letters, p=0.88). Concurrently the mean change in CST in the IVR group was -117.75µm while that in the IVB group was -155.37µm (p=0.51). A similar trend was noted at the 12 months follow-up. VA improvement was equivalent in both treatment groups (IVR : +12.85 letters, IVB: +6.93 letters, p=0.53) as was CST (IVR: -144.09µm, IVB: -153.90µm, p= 0.88).
BRVO cohort: A total of 84 patients were included in this cohort. At 6 months follow-up, both treatment groups demonstrated a comparable mean gain in VA (IVR: +10.17, IVB: +11.18, p=0.84) . However, a statistically significant difference was noted in the mean change in CST between the two treatment groups at this time point (IVR: +0.71µm, IVB: -88.52µm, p=0.038), although the baseline CST was different between the two treatment groups (p=0.027). Similar trends of changes in VA (IVR: +15.21, IVB: +10.55, p=0.46) and CST (IVR: -23.14, IVB: 91.43, p=0.16) were noted at the 12 months follow-up.

Conclusions : There is no notable difference in the efficacy of IVR and IVB in treatment of ME from CRVO/HRVO or BRVO in our clinical practice at both 6 months and 12 months following treatment initiation.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.