Intravitreal Bevacizumab and Ranibizumab for Age-Related Macular Degeneration: A Multicenter, Retrospective Study
Presented in part at: the Annual Meeting of the American Academy of Ophthalmology, November 2008, Atlanta, Georgia.
Received 19 February 2009; received in revised form 7 July 2009; accepted 20 July 2009. published online 07 December 2009.
Objective
To compare visual acuity (VA) outcomes after bevacizumab or ranibizumab treatment for AMD.
Design
Comparative, retrospective case series.
Participants
We followed 452 patients in a retrospective study of exudative AMD treated with anti-vascular endothelial growth factor drugs; 324 patients were treated with bevacizumab and 128 patients with ranibizumab.
Methods
All treatment-naïve patients who received either bevacizumab or ranibizumab were followed for 1 year. Baseline characteristics and VA were recorded using standard descriptive statistics.
Main Outcome Measures
Visual acuity.
Results
At 12 months, the distribution of VA improved in both groups with 22.9% of bevacizumab and 25.0% of ranibizumab attaining ≥20/40. Improvement in vision was observed in 27.3% of the bevacizumab group and 20.2% of the ranibizumab group. The mean number of injections at 12 months was 4.4 for bevacizumab and 6.2 for ranibizumab. There were 8 (2%) deaths in the bevacizumab group and 4 (3%) in the ranibizumab group. Two patients developed endophthalmitis in the bevacizumab group and the ranibizumab group. The bevacizumab group had slightly worse acuity at baseline, but both groups showed improvement and stability of vision over time.
Conclusions
Both treatments seem to be effective in stabilizing VA loss. There was no difference in VA outcome between the 2 treatment groups. Because the study is a nonrandomized comparison, selection bias could mask a true treatment difference. Results from the Comparison of the Age-related Macular Degeneration Treatment Trials will provide more definitive information about the comparative effectiveness of these drugs.
Financial Disclosure(s)
Proprietary or commercial disclosure may be found after the references.
Available online: December 9, 2009.
1Department of Ophthalmology, Southern California Permanente Medical Group, Baldwin Park, California
2Clinical Trials Research, Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena, California
3Department of Ophthalmology, Southern California Permanente Medical Group, San Diego, California
4Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena, California
Correspondence: Donald S. Fong, MD, MPH, Clinical Trials Research, Department of Research and Evaluation, 100 S. Los Robles, Pasadena, CA 91101
Manuscript no. 2009-239.
Financial Disclosure(s): The authors have made the following disclosures: Peter Custis - Lecturer - Med E Direct.
Funded by the Southern California Permanente Medical Group.
ABSTRACT