2M.D., Dogubeyazit State Hospital, Eye Clinic, Agri/TURKEY Purpose: To evaluate the efficacy of a loading dose of ranibizumab for three months followed by a pro re nata (PRN) dosing regimen of bevacizumab for the treatment of neovascular age-related macular degeneration (AMD).
Material and Methods: The medical reports of patients with neovascular AMD treated with 3 monthly ranibizumab injections followed by bevacizumab PRN were reviewed retrospectively. Visual acuity (VA) assessed with an ETDRS chart and central foveal thickness (CFT) determined with optical coherence tomography (OCT) were recorded at baseline and monthly thereafter.
Results: Fifty-four eyes of 53 patients were involved in the study. The mean duration of follow-up was 10 months (range, 7-12 months). The mean VA was 1.07±0.51 logarithm of the minimum angle of resolution (logMAR) before treatment, which increased to 0.91±0.64 logMAR at the 3rd month (p=0.04) and 0.89±0.66 logMAR at the last visit (p=0.034 vs. baseline). VA was the same in 23 eyes (42.6%) and increased by at least 1 line (5 letters) in 25 (46.3%) eyes at the last visit. After switching to bevacizumab, VA was maintained in 39 (72.2%) eyes and increased by at least one line in 8 (14.8%) eyes with respect to values after ranibizumab loading. The mean CFT in OCT was 324.8±93.1 μm before treatment, 256.3±35.4 μm at the 3rd month (p=0.039 vs. baseline), and 242.35±34.13 μm at the last visit (p=0.031 vs. baseline). The mean number of bevacizumab PRN injections was 0.42/eye/month.
Conclusion: The increase in VA obtained by the ranibizumab loading dose could be maintained with bevacizumab PRN treatment in patients with neovascular AMD.
Keywords : Bevacizumab, ranibizumab, visual acuity, macular degeneration