Short-term effectiveness of intravitreal bevacizumab versus ranibizumab injections for patients with neovascular age-related macular degeneration.

PURPOSE To compare the effectiveness of three consecutive intravitreal injections of bevacizumab (Avastin) and ranibizumab (Lucentis) in patients with treatment-naïve neovascular age-related macular degeneration. METHODS This is a retrospective comparative study of qualifying consecutively treated patients (n = 176) with new-onset subfoveal choroidal neovascularization presenting at 6 retina referral centers. Patients were treated with 3 consecutive monthly injections of ranibizumab (0.5 mg) or 3 injections of bevacizumab every 6 weeks (1.25 mg) as determined by physician and patient preference. Ophthalmologic evaluations included monthly visual acuity measurements, ocular examinations, and optical coherence tomography imaging at each visit. RESULTS A 29.2% reduction in the mean central foveal thickness measurement through optical coherence tomography was found in the ranibizumab-treated patients versus a 20.9% reduction in the bevacizumab-treated patients (P <or= 0.02). Fifty-three percent of ranibizumab-treated patients had returned to a central foveal thickness of <200 microm by the completion of 3 injections compared with 35% of patients treated with bevacizumab (P <or= 0.07). No ocular or systemic adverse events were reported in either group. CONCLUSION Short-term effectiveness of ranibizumab treatment, as measured by incremental improvement in optical coherence tomography parameters, was significantly greater than bevacizumab treatment, suggesting that there is a difference in the biologic activities of ranibizumab and bevacizumab.