title: Bevacizumab and ranibizumab for neovascular age-related macular degeneration: a treatment approach based on individual patient needs.
abstract: OBJECTIVE
  To compare the efficacy of intravitreal bevacizumab and ranibizumab for the treatment of neovascular age-related macular degeneration using an as-needed treatment regimen.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  One hundred and ninety two eyes of 184 patients.
  
  
  METHODS
  Patients received an initial treatment of 3 monthly intravitreal injections of ranibizumab or bevacizumab and retreatment is individually considered for each patient on the basis of optical coherence tomography, angiography, and clinical examination.
  
  
  RESULTS
  Fifty eyes treated with ranibizumab and 142 eyes treated with bevacizumab were included. The average age of the patients at baseline was 76.9 ± 8 years and 76.4 ± 8 years in the ranibizumab and bevacizumab group respectively. Mean visual acuity improved from 0.69 to 0.55 logMAR at 12 months in the ranibizumab group and from 0.70 to 0.67 logMAR in the bevacizumab group. At 12 months, 92% of eyes treated with ranibizumab had lost fewer than 0.3 logMAR, as compared with 83% in the bevacizumab group. The ranibizumab group received a mean of 4.92 injections, compared to 4.75 injections in the bevacizumab group over 12 months. After the first 3 injections, 20% of patients in the ranibizumab group and 26% in the bevacizumab group never needed another injection.
  
  
  CONCLUSIONS
  An approach based on clinical onset and choroidal neovascularization progression at angiography may provide benefit by reducing the number of intravitreal injections required.
authors.affiliation: Department of Ophthalmology, Saint-Sacrement Hospital, Laval University, Québec, Canada.
authors.forename: Claudine
authors.initials: C
authors.lastname: Bellerive
authors.forename: Benoît
authors.initials: B
authors.lastname: Cinq-Mars
authors.forename: Gilles
authors.initials: G
authors.lastname: Lalonde
authors.forename: Mario
authors.initials: M
authors.lastname: Malenfant
authors.forename: Eric
authors.initials: E
authors.lastname: Tourville
authors.forename: Yvon
authors.initials: Y
authors.lastname: Tardif
authors.forename: Marcelle
authors.initials: M
authors.lastname: Giasson
authors.forename: Marc
authors.initials: M
authors.lastname: Hébert
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage* / Q000009:adverse effects; D000068258:Bevacizumab; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D000069579:Ranibizumab; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab