Comparing bevacizumab and ranibizumab for initial reduction of central macular thickness in patients with retinal vein occlusions

PURPOSE To examine short-term effects of ranibizumab versus bevacizumab on reduction of optical coherence tomography (OCT) central macular thickness (CMT) in patients with macular edema secondary to retinal vein occlusions (RVOs). METHODS This is a retrospective analysis in which patients with RVOs were injected with either bevacizumab or ranibizumab. At 2 weeks, all patients were injected with a dexamethasone intravitreal implant (Ozurdex®). CMT on OCT and best-corrected visual acuity were obtained at baseline, at 2 weeks (just prior to the dexamethasone intravitreal implant), and 6 weeks. RESULTS Sixty-four patients received injections (32 bevacizumab; 32 ranibizumab). At 2 weeks, bevacizumab group had a mean (±standard error of mean [SEM]) CMT reduction of 26.2% ± 3.4% versus 47% ± 3.5% reduction with ranibizumab (P < 0.0001). At 6 weeks, there was a 31.6% ± 3.2% CMT reduction with bevacizumab versus 52% ± 3.2% with ranibizumab (P < 0.0001). At 2 weeks, 15 (9%) of bevacizumab patients versus 25 (78.1%) ranibizumab patients achieved OCT CMT < 300 μm (P = 0.0192). At 6 weeks, 18 (56.3%) of bevacizumab compared to 30 (93.8%) of ranibizumab patients achieved CMT < 300 μm (P = 0.0010). Visual acuity was not significantly different at each time interval between the groups. CONCLUSION Ranibizumab appears to have a greater effect in the short-term of decreasing macular edema on OCT when compared to bevacizumab in patients with RVOs.