Background/aims: Sequential macular volume and central foveal point thickness (CFPT) measurements on optical coherence tomography (OCT) were used to determine the efficacy and duration of action of ranibizumab versus bevacizumab in wet age-related macular degeneration (AMD).
Methods: Retrospective chart review of patients who received their first treatment of intravitreal ranibizumab or bevacizumab for exudative AMD. 316 patients (202 ranibizumab;114 bevacizumab) who received 823 injections (313 ranibizumab;510 bevacizumab) were identified. 74 patients had pre- and post-treatment OCTs performed to determine CFPT and macular volume changes.
Results: Ranibizumab caused a significant reduction in CFPT (278 (SD 84) before treatment vs 227 (80) µm after treatment; p = 0.001) and macular volume (7.22 (0.96) vs 6.69 (0.74) mm3; p = 0.002). Intravitreal bevacizumab caused a similar reduction in CFPT (288 (94) vs 220 (55) µm; p = 0.008) and macular volume (7.36 (1.08) vs 6.50 (0.42) mm3; p<0.001). The mean duration of action was 74.0 (19.1) days for ranibizumab compared with 101.8 (16.6) days for bevacizumab (p = 0.036; t test). The ratio of the relative duration of action of bevacizumab versus ranibizumab was 1.40 (0.19).
Conclusions: Both drugs are equally effective at reducing CFPT or macular volume. Bevacizumab appears to take longer to achieve the minimum macular volume, and its effects take longer to wear off, suggesting it can be given less often.
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Funding Supported by the Eye Surgery Fund, the Robert L. Burch III Fund, the Foundation Fighting Blindness, the Doris Duke Foundation and unrestricted funds from Research to Prevent Blindness.
Competing interests LVDP—Speakers bureau with Genentech; Consultation with Biogen, Pfizer and Alcon.
Ethics approval Ethics approval was provided by the Institutional Review Board at Columbia University.
ARS and LVDP were both involved in the concept, design, data collection, analysis and article writing.