Bevacizumab Versus Ranibizumab For Age Related Macular Degeneration: 1-year Outcomes Of An Interventional Study

Abstract Purpose:To report visual and anatomical outcomes of this interventional study comparing the efficacy of bevacizumab vs ranibizumab for the treatment of age-related macular degeneration (AMD). Methods:56 eyes of 56 patients were involved in this interventional study between March 2009 and September 2010. Inclusion criteria were naïve choroidal neovascularization (CNV) secondary to AMD, intravitreal injection of bevacizumab 1.25mg or ranibizumab 0.5mg as monotherapy for CNV and follow up using a variable dosing regimen. Follow up visit was scheduled at month 3 and then monthly until month 12. 34 eyes were treated with bevacizumab (Group 1) and 22 with ranibizumab (Group 2). Mean age at baseline was respectively 65.4±6.2 years old and 64.3±5.6 years old. Clinical data included visual acuity (VA), central macular thickness (CMT) on Spectral Domain OCT (SDOCT) and lesion dimension from HRA2 obtained from patients records at each visit until 12 month of follow up. T Student test was performed at the end of the study to compare data. Results:Mean BCVA ± standard deviation for Group 1 and 2 was respectively 0.33±0.23 LogMAR and 0.38±0.16 LogMAR at baseline with a change to 0.33±0.32 LogMAR (p>0.05) and 0.33±0.28 LogMAR (p>0.05) at 12 months follow up. Mean CMT at baseline was respectively 279±90µm and 340±150µm; at 12 months a significative reduction of CMT was reported on Group 1, with a mean CMT of 176±50 µm (p=0.006); on Group 2 we observed a macular thickness increase to 284±170µm (p>0.05). Mean lesion size area didn’t show a statistically significant variation in both groups at 12 months, with a mean value respectively of 7.69±6.72mm2 (p>0.05) and 10.21±10.30mm2 (p>0.05). The average number of injections was 4.21±1.1 in Group 1 and 4.86±1.5 in Group 2 (p=0.04). Conclusions:Our study showed comparable results on both Groups at 12 months referring to VA stability: on Group 2, we observed even a significant visual acuity increase from baseline within month 3 (p=0.01). CMT evaluation at 12 months showed a recurrence of macular edema on Group 1, besides Group 2 maintained a significant decrease (p=0.006). Lesion dimension didn’t represent a significant morphological data to be compared. Our study underlined further the key role of SDOCT evaluation to better explain nowadays functional prognosis.