title: Large subretinal haemorrhage following change from intravitreal bevacizumab to ranibizumab.
abstract: BACKGROUND
  To report 2 cases of large subretinal haemorrhage in 2 patients with age-related macular degeneration when the intravitreal injections were changed from bevacizumab (Avastin) to ranibizumab (Lucentis).
  
  
  METHODS
  Both patients were treated initially with intravitreal bevacizumab 1.25 mg for 4 months (4 injections) and then switched to 0.5 mg ranibizumab which continued for another 6 months. Best-corrected visual acuity measurements, slit-lamp examination, contact lens biomicroscopy, optical coherence tomography and fluorescein angiography were performed at baseline examination and every month.
  
  
  RESULTS
  Both patients showed initial improvement when treated with intravitreal bevacizumab followed by deterioration and development of a large subretinal haemorrhage when changing to intravitreal ranibizumab.
  
  
  CONCLUSIONS
  There is not enough experience switching from one anti-vascular-endothelial-growth-factor agent to another. A prospective study with large series of patients and controls may be necessary in order to determine whether it is safe enough to change from one medication to another.
authors.affiliation: Second Department of Ophthalmiatrio, Eye Hospital of Athens, Athens, Greece. dimitrioskaragiannis@doctors.org.uk
authors.forename: Dimitrios A
authors.initials: DA
authors.lastname: Karagiannis
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Mitropoulos
authors.forename: Ioannis D
authors.initials: ID
authors.lastname: Ladas
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D003937:Diagnosis, Differential; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D007267:Injections; D008268:Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D000069579:Ranibizumab; D012166:Retinal Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis; D042461:Vascular Endothelial Growth Factor A; D014792:Visual Acuity / Q000187:drug effects; D014822:Vitreous Body
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab