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A randomised double-masked trial comparing the visual outcome after treatment with ranibizumab or bevacizumab in patients with neovascular age-related macular degeneration
  1. Ilse Krebs1,2,
  2. Leopold Schmetterer3,4,
  3. Agnes Boltz3,4,
  4. Reinhard Told3,4,
  5. Veronika Vécsei-Marlovits5,
  6. Stefan Egger6,
  7. Ulrich Schönherr7,
  8. Anton Haas8,
  9. Siamak Ansari-Shahrezaei1,2,
  10. Susanne Binder1,2,
  11. for the MANTA Research Group
  1. 1The Ludwig Boltzmann Institute for Retinology and Biomicroscopic Laser Surgery, Vienna, Austria
  2. 2Department of Ophthalmology, Rudolph Foundation Clinic, Vienna, Austria
  3. 3Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
  4. 4Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
  5. 5Department of Ophthalmology, Hospital Hietzing, Vienna, Austria
  6. 6Department of Ophthalmology, Medical University of Salzburg, Salzburg, Austria
  7. 7Department of Ophthalmology, Hospital Barmherzige Brüder Linz, Linz, Austria
  8. 8Department of Ophthalmology, Medical University Graz, Graz, Austria
  1. Correspondence to Dr Ilse Krebs, Department of Ophthalmology, Rudolf Foundation Clinic, Teaching Hospital of the Medical University Vienna, Juchgasse 25, Vienna 1030, Austria; Ilse.Krebs{at}


Aim The current accepted standard treatment for neovascular age-related macular degeneration (AMD) consists of antivascular endothelial growth factor agents including ranibizumab and bevacizumab. The aim of the study was to examine whether bevacizumab is inferior to ranibizumab with respect to maintaining/improving visual acuity.

Methods In this prospective randomised parallel group multicentre trial patients aged more than 50 years with treatment naive nAMD were included at 10 Austrian centres. Patients were randomised to treatment either with 0.5 mg ranibizumab or 1.25 mg bevacizumab. Both groups received three initial monthly injections and thereafter monthly evaluation of visual acuity and the activity of the lesion. Re-treatment was scheduled as needed. Outcome measures were early treatment of diabetic retinopathy visual acuity, retinal thickness, lesion size and safety evaluation.

Results A total of 321 patients were recruited of which four had to be excluded due to different reasons. Of the 317 remaining patients 154 were randomised into the bevacizumab group and 163 into the ranibizumab group. At month 12, there was a mean increase of early treatment of diabetic retinopathy visual acuity of 4.9 letters in the bevacizumab and 4.1 letters in the ranibizumab group (p=0.78). Furthermore, there were no significant differences in the decrease of retinal thickness, change of lesion size and number of adverse events between the groups.

Conclusions Bevacizumab was equivalent to ranibizumab for visual acuity at all time points over 1 year. There was no significant difference of decrease of retinal thickness or number of adverse events.

  • Retina
  • Treatment Surgery
  • Neovascularisation
  • Macula

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