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Switching intravitreal anti-VEGF treatment in neovascular age-related macular degeneration

Abstract

Purpose

To compare the outcomes after switching between bevacizumab and ranibizumab therapy due to poor treatment effect in neovascular age-related macular degeneration (AMD).

Methods

This is a retrospective review of patients with neovascular AMD with first treatment using intravitreal bevacizumab (group 1) or ranibizumab (group 2) who switched to the other drug due to poor treatment effect. Primary outcome measures were change in mean best-corrected visual acuity (BCVA) and mean central retinal thickness (CRT) at 1 year and last visit.

Results

Eighty-seven eyes met the inclusion criteria. In group 1 (43 eyes), the mean BCVA decreased from 20/94 to 20/100 at 1 year after being switched (p = 0.573) and to 20/150 (p = 0.015) at final visit (mean 29.2 months, range 12-53). In group 2 (44 eyes), mean BCVA decreased from 20/72 to 20/90 (p = 0.401) and 20/100 (p = 0.081) at 1 year after switch and at final visit (mean 20.1 months, range 10-40), respectively. The mean CRT at switch, 1 year after switch, and at final visit were 344.4 ± 140 µm (mean ± SD), 286.26 ± 155 µm (p = 0.019), and 290.58 ± 196 µm (p = 0.009) in group 1 and 329.36 ± 144 µm, 302.0 ± 179 µm (p = 0.215), and 309.5 ± 220 µm (p = 0.154) in group 2, respectively.

Conclusions

The mean BCVA decreased over time in both groups; however, nearly 30% of the eyes in each group showed vision improvement after switching. Mean CRT decreased in both groups, which was more pronounced after being switched from bevacizumab to ranibizumab. In neovascular AMD, a switch between ranibizumab and bevacizumab can be considered as a further therapy option if poor treatment effect is seen with the initial therapy.

Eur J Ophthalmol 2015; 25(1): 51 - 56

Article Type: ORIGINAL RESEARCH ARTICLE

Article Subject: Retina MED

DOI:10.5301/ejo.5000480

Authors

Cem Küçükerdönmez, Faik Gelisken, Efdal Yoeruek, Karl Ulrich Bartz-Schmidt, Martin Alexander Leitritz

Article History

Disclosures

Financial Support: No financial support was received for this submission.
Conflict of Interest Statement: None of the authors has conflict of interest with this submission.

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Authors

Affiliations

  • Faculty of Medicine, Department of Ophthalmology, Izmir University - Turkey
  • Centre for Ophthalmology, University of Eberhard Karls, Tübingen - Germany
  • These authors contributed equally to the manuscript

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