Comparison of ranibizumab and bevacizumab for macular edema associated with retinal vein occlusion
Abstract
Purpose: To assess the effectiveness of intravitreal ranibizumab compared with bevacizumab for the treatment of macular edema associated with retinal vein occlusion (RVO).
Methods: This was a retrospective study of 64 eyes with macular edema associated with RVO. Patients received either 1.25 mg of intravitreal bevacizumab (n = 32) or 0.5 mg of intravitreal ranibizumab (n = 32). Visual acuity, clinical bio-microscopic examination and central macular thickness (CMT) by Optical Coherence Tomography (OCT) was assessed at 6 weeks post injection. The CMT before and six weeks after the injection as assessed by OCT were compared. Statistical analysis was performed using paired student t-test. The improvement in CMT was also compared between the two groups, statistical analysis was performed using un-paired student t-test.
Results: The best-corrected visual acuity significantly improved from logarithm of the minimal angle of resolu¬tion (logMAR) 0.792 ±0.36 at baseline to 0.575 ± 0.34 at 6 weeks in the bevacizumab group (p =0.001) and from logMAR 0.851 ± 0.35 at baseline to 0.336 ± 0.20 at 6 weeks in the ranibizumab group (p = 0.001), which is statistically significant difference. The reduction in CMT was from 545.44 ± 176.43 μm at baseline to 378.34 ±95.13 at 6 weeks in the bevacizumab group (p = 0.001) and 524.25± 195.94 μm at baseline to 243±80.72 μm at 6 weeks in the ranibizumab group (p=0.001) which was also a statistically significant difference (p = 0.001).
Conclusions: Both ranibizumab and bevacizumab were effective for the treatment of RVO. The visual outcome and reduction in macular thickness was better by ranibizumab at the earliest follow-up of 6 weeks.
Downloads
References
Brand CS. Management of retinal vascular diseases: a patient-centric approach. Eye (Lond). 2012;26(2):S1-16. doi: https://doi.org/10.1038/eye.2012.32.
The International Federation on Ageing. Treating retinal diseases in the era of anti-VEGF therapies. 2016:[14 p.]. Available from: https://www.ifa-fiv.org/wp-content/uploads/2016/10/Treating-Retinal-Diseases-in-the-Era-of-Anti-VEGF-therapiesPosition-Paper-Final.pdf .
Ip MS, Scott IU, VanVeldhuisen PC, Oden NL, Blodi BA, Fisher M, et al. A randomized trial comparing the efficacy and safety of intravitreal triamcinolone with observation to treat vision loss associated with macular edema secondary to central retinal vein occlusion: the Standard Care vs Corticosteroid for Retinal Vein Occlusion (SCORE) study report 5. Arch Ophthalmol. 2009;127(9):1101-1114. doi: https://doi.org/10.1001/archophthalmol.2009.234.
Campochiaro P, Brown DM, Awh CC, Lee SY, Gray S, Saroj N, et al. Sustained benefits from ranibizumab for macular edema following central retinal vein occlusion: twelve-month outcomes of a phase III study. Ophthalmol. 2011;118(10):2041-2049. doi: https://doi.org/10.1016/j.ophtha.2011.02.038. Epub 2011 Jun 29.
Pieramici DJ, Rabena M, Castellarin AA, Nasir M, See R, Norton T, et al. Ranibizumab for the treatment of macular edema associated with perfused central retinal vein occlusions. Ophthalmol. 2008;115(10):e47-e54. doi: https://doi.org/10.1016/j.ophtha.2008.06.021. Epub 2008 Aug 16.
Figueroa MS, Contreras I, Noval S, Arruabarrena C. Results of bevacizumab as the primary treatment for retinal vein occlusions. Br J Ophthalmol. 2010;94(8):1052-1056. doi: https://doi.org/10.1136/bjo.2009.173732.
Gregori NZ, Rattan GH, Rosenfeld PJ, Puliafito CA, Feuer W, Flynn HW Jr, et al. Safety and efficacy of intravitreal bevacizumab (avastin) for the management of branch and hemiretinal vein occlusion. Retina. 2009;29(7):913-925. doi: https://doi.org/10.1097/IAE.0b013e3181aa8dfe.
Jaissle GB, Leitritz M, Gelisken F, Ziemssen F, Bartz-Schmidt KU, Szurman P. One-year results after intravitreal bevacizumab therapy for macular edema secondary to branch retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol. 2009;247(1):27-33. doi: https://doi.org/10.1007/s00417-008-0916-2. Epub 2008 Aug 12.
Son BK, Kwak HW, Kim ES, Yu SY. Comparison of Ranibizumab and Bevacizumab for Macular Edema Associated with Branch Retinal Vein Occlusion. Korean J Ophthalmol. 2017;31(3):209-216. doi: https://doi.org/10.3341/kjo.2015.0158. Epub 2017 Apr 24.
Spooner K, Fraser-Bell S, Hong T, Chang AA. Five-year outcomes of retinal vein occlusion treated with vascular endothelial growth factor inhibitors. BMJ open Ophthalmol. 2019;4(1):e000249. doi: https://doi.org/10.1136/bmjophth-2018-000249.
Karia N. Retinal vein occlusion: pathophysiology and treatment options. Clinical Ophthalmology (Auckland, NZ). 2010;4:809-816. doi: https://doi.org/10.2147/OPTH.S7631.
Noma H, Funatsu H, Yamasaki M, Tsukamoto H, Mimura T, Sone T, et al. Pathogenesis of macular edema with branch retinal vein occlusion and intraocular levels of vascular endothelial growth factor and interleukin-6. American J Ophthalmol. 2005;140(2):256-e1. doi: https://doi.org/10.1016/j.ajo.2005.03.003
Qian T, Zhao M, Wan Y, Li M, Xu X. Comparison of the efficacy and safety of drug therapies for macular edema secondary to central retinal vein occlusion. BMJ Open. 2018;8(12):e022700. doi: https://doi.org/10.1136/bmjopen-2018-022700.
Narayanan R, Panchal B, Das T, Chhablani J, Jalali S, Ali MH; Marvel study group. A randomised, double-masked, controlled study of the efficacy and safety of intravitreal bevacizumab versus ranibizumab in the treatment of macular oedema due to branch retinal vein occlusion: MARVEL Report No. 1. Br J Ophthalmol. 2015;99(7):954-959. doi: https://doi.org/10.1136/bjophthalmol-2014-306543. Epub 2015 Jan 28.
Rajagopal R, Shah GK, Blinder KJ, Altaweel M, Eliott D, Wee R, et al. Bevacizumab Versus Ranibizumab in the Treatment of Macular Edema Due to Retinal Vein Occlusion: 6-Month Results of the CRAVE Study. Ophthalmic Surg Lasers Imaging Retina. 2015;46(8):844-850. doi: https://doi.org/10.3928/23258160-20150909-09.
Campochiaro PA, Heier JS, Feiner L, Gray S, Saroj N, Rundle AC, et al. Ranibizumab for macular edema following branch retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmol. 2010;117(6):1102-1112.e1. doi: https://doi.org/10.1016/j.ophtha.2010.02.021. Epub 2010 Apr 15.
Yuan A, Ahmad BU, Xu D, Singh RP, Kaiser PK, Martin DF, et al. Comparison of intravitreal ranibizumab and bevacizumab for the treatment of macular edema secondary to retinal vein occlusion. Int J Ophthalmol. 2014;7(1):86-91. doi: https://doi.org/10.3980/j.issn.2222-3959.2014.01.15.
Sangroongruangsri S, Ratanapakorn T, Wu O, Anothaisintawee T, Chaikledkaew U. Comparative efficacy of bevacizumab, ranibizumab, and aflibercept for treatment of macular edema secondary to retinal vein occlusion: a systematic review and network meta-analysis. Expert Rev Clin Pharmacol. 2018;11(9):903-916. doi: https://doi.org/10.1080/17512433.2018.1507735. Epub 2018 Aug 10.
Copyright (c) 2019 Author (s). Published by Siddharth Health Research and Social Welfare Society
This work is licensed under a Creative Commons Attribution 4.0 International License.