Efficacy of intravitreal ranibizumab in eyes with prior history of intravitreal bevacizumab for age-related macular degeneration

1. Chikako Ueno
2. Fumi Gomi
3. Miki Sawa
4. Motokazu Tsujikawa
5. Kohji Nishida

Department of ophthalmology, Osaka University Graduate school of Medicine

Purpose: To evaluate the efficacy of intravitreal ranibizumab in the eyes with age-related macular degeneration that had histories of intravitreal bevacizumab.

Methods: We included 20 eyes of 20 patients with the mean age of 75.1. All eyes were first treated with intravitreal bevacizumab and switched to ranibizumab. The central retinal thickness (CRT) and the morphological abnormalities on OCT were examined at baseline, 1, 3 and 6 months after the initial injection of each drug.

Results: During 6 months, the mean number of injections was 2.9 of bevacizumab and 3.0 of ranibizumab. Mean retinal thickness before bevacizumab and ranibizumab was 503 µm and 483 µm respectively. Bevacizumab reduced the CRT significantly at 1 and 3 months after the first injection. Ranibizumab reduced the CRT at 1 and 6 months. Both drugs showed the maximum reduction in thickness at 1 month (p＝0.0003 and 0.0002, respectively). At baseline, the major morphological abnormalities were pigment epithelial detachment (PED) in11eyes, subretinal detachment (SRD) in 7 eyes and macular edema in 2 eyes. In five eyes with PED and 2 eyes with SRD, the CRT did not show the significant (30 % or more) decrease after bevacizumab treatment and 6 of those eyes did not show the reduction of CRT even after ranibizumab injection.

Conclusion: The responses of retinal thickness to these drugs were similar in the same eye. Both drugs seemed less effective in eyes with PED.