Journal
ACTA OPHTHALMOLOGICA
Volume 97, Issue 1, Pages 107-112Publisher
WILEY
DOI: 10.1111/aos.13774
Keywords
age-related macular degeneration; bevacizumab; treatment; anti-VEGF
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Funding
- Stichting voor Ooglijders Funding Source: Medline
- SWOO-Flieringa Funding Source: Medline
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Purpose Intravitreal anti-vascular endothelial growth factor (VEGF) injections are an effective treatment for neovascular age-related macular degeneration (nARMD). Bevacizumab appears to be a cost-effective off-label anti-VEGF alternative to ranibizumab, but an optimal injection schedule has not yet been determined. In this study, we investigate whether on-demand bevacizumab treatment every 8 weeks is non-inferior to on-demand bevacizumab every 4 weeks in treating nARMD. Methods A total of 120 nARMD patients were randomly assigned to an on-demand regimen of intravitreal bevacizumab (IVB) every 4 (n = 60) or 8 weeks (n = 60). The primary outcome was visual acuity (VA) change after 1 year of treatment. Results Visual acuity (VA) improved between baseline and 1 year in both treatment groups. The mean change in the VA score at 1 year was not significantly different between bevacizumab administration on-demand every 4 weeks [5.6 +/- 10.2 Early Treatment Diabetic Retinopathy Study (ETDRS) letter] or 8 weeks (4.6 +/- 12.0 ETDRS letters). A reduction in the central retinal thickness was observed in both groups. At 1 year, the mean decrease in central foveal thickness ranged from 61 +/- 90 mu m in the 4-week group to 91 +/- 83 mu m in the 8-week group (p = 0.07). The mean number of IVB treatments during the study period was 8.7 +/- 2.3 in the 4-week group and 5.9 +/- 1.0 in the 8-week group. Conclusion At 1 year, bevacizumab administration on-demand every 8 weeks was non-inferior to administration every 4 weeks. The results strongly suggest that bevacizumab acts longer than 4 weeks in ARMD, reducing the burden of injections for patients.
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