Before the recent approvement of ranibizumab (Lucentis) for the treatment of neovascular age-related macular degeneration (AMD), bevazicumab (Avastin) had been successfully used as an off-label treatment for this condition.1 As a consequence, in daily practice we are confronted with a large number of patients having received Avastin injections in the past, now facing a recurrence of the disease and therefore requiring additional injections.2 This leaves the ophthalmologist in a medical dilemma: should one continue with the off-label drug Avastin or switch to Lucentis? From a clinical point of view and disregarding the legal aspects of continuing …