title: A randomised double-masked trial comparing the visual outcome after treatment with ranibizumab or bevacizumab in patients with neovascular age-related macular degeneration.
abstract: OBJECTIVE
  The current accepted standard treatment for neovascular age-related macular degeneration (AMD) consists of antivascular endothelial growth factor agents including ranibizumab and bevacizumab. The aim of the study was to examine whether bevacizumab is inferior to ranibizumab with respect to maintaining/improving visual acuity.
  
  
  METHODS
  In this prospective randomised parallel group multicentre trial patients aged more than 50 years with treatment naive nAMD were included at 10 Austrian centres. Patients were randomised to treatment either with 0.5 mg ranibizumab or 1.25 mg bevacizumab. Both groups received three initial monthly injections and thereafter monthly evaluation of visual acuity and the activity of the lesion. Re-treatment was scheduled as needed. Outcome measures were early treatment of diabetic retinopathy visual acuity, retinal thickness, lesion size and safety evaluation.
  
  
  RESULTS
  A total of 321 patients were recruited of which four had to be excluded due to different reasons. Of the 317 remaining patients 154 were randomised into the bevacizumab group and 163 into the ranibizumab group. At month 12, there was a mean increase of early treatment of diabetic retinopathy visual acuity of 4.9 letters in the bevacizumab and 4.1 letters in the ranibizumab group (p=0.78). Furthermore, there were no significant differences in the decrease of retinal thickness, change of lesion size and number of adverse events between the groups.
  
  
  CONCLUSIONS
  Bevacizumab was equivalent to ranibizumab for visual acuity at all time points over 1 year. There was no significant difference of decrease of retinal thickness or number of adverse events.
authors.affiliation: The Ludwig Boltzmann Institute for Retinology and Biomicroscopic Laser Surgery, Vienna, Austria. Ilse.Krebs@wienkav.at
authors.forename: Ilse
authors.initials: I
authors.lastname: Krebs
authors.forename: Leopold
authors.initials: L
authors.lastname: Schmetterer
authors.forename: Agnes
authors.initials: A
authors.lastname: Boltz
authors.forename: Reinhard
authors.initials: R
authors.lastname: Told
authors.forename: Veronika
authors.initials: V
authors.lastname: Vécsei-Marlovits
authors.forename: Stefan
authors.initials: S
authors.lastname: Egger
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schönherr
authors.forename: Anton
authors.initials: A
authors.lastname: Haas
authors.forename: Siamak
authors.initials: S
authors.lastname: Ansari-Shahrezaei
authors.forename: Susanne
authors.initials: S
authors.lastname: Binder
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D011446:Prospective Studies; D000069579:Ranibizumab; D015861:Retinal Neovascularization / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab