A prospective randomized trial of intravitreal bevacizumab versus ranibizumab for the management of diabetic macular edema

Antonio Brunno Nepomuceno, Erika Takaki, Felipe Piacentini Paes De Almeida, Renato Peroni, José Augusto Cardillo, Rubens Camargo Siqueira, Ingrid Ursula Scott, André Messias, Rodrigo Jorge

Research output: Contribution to journalArticle

52 Scopus citations

Abstract

Purpose: To compare visual acuity and spectral-domain optical coherence tomography (SDOCT) outcomes associated with intravitreal (IV) bevacizumab vs IV ranibizumab for the management of diabetic macular edema (DME). Design: Prospective randomized trial. Methods: Forty-eight patients (63 eyes) with center-involved DME were randomly assigned to receive 1.5 mg (0.06 cc) IV bevacizumab or 0.5 mg (0.05 cc) IV ranibizumab at baseline and monthly if central subfield thickness was greater than 275 μm. Results: Forty-five patients (60 eyes) completed 48 weeks of follow-up. At baseline, mean ± standard error best-corrected visual acuity (BCVA) (logMAR) was 0.60 (20/80) ± 0.05 in the IV bevacizumab group and 0.63 (20/85) ± 0.05 in the IV ranibizumab group. A significant improvement in mean BCVA was observed in both groups at all study visits (P <.05); this improvement was significantly greater in the IV ranibizumab group compared with the IV bevacizumab group at weeks 8 (P =.032) and 32 (P =.042). A significant reduction in mean central subfield thickness was observed in both groups at all study visits compared with baseline (P <.05), with no significant difference in the magnitude of macular thickness reduction between groups. The mean number of injections was significantly higher (P =.005) in the IV bevacizumab group (9.84) than in the IV ranibizumab group (7.67). Conclusions: IV bevacizumab and IV ranibizumab are associated with similar effects on central subfield thickness in patients with DME through 1 year of follow-up. IV ranibizumab is associated with greater improvement in BCVA at some study visits, and the mean number of injections is higher in the IV bevacizumab group.

Original languageEnglish (US)
Pages (from-to)502-510.e2
JournalAmerican Journal of Ophthalmology
Volume156
Issue number3
DOIs
StatePublished - Sep 2013

    Fingerprint

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Cite this

Nepomuceno, A. B., Takaki, E., Paes De Almeida, F. P., Peroni, R., Cardillo, J. A., Siqueira, R. C., Scott, I. U., Messias, A., & Jorge, R. (2013). A prospective randomized trial of intravitreal bevacizumab versus ranibizumab for the management of diabetic macular edema. American Journal of Ophthalmology, 156(3), 502-510.e2. https://doi.org/10.1016/j.ajo.2013.04.026