International Ophthalmology

, Volume 30, Issue 3, pp 261–266 | Cite as

Bevacizumab versus ranibizumab in the treatment of exudative age-related macular degeneration

  • Maria-Andreea GamulescuEmail author
  • Viola Radeck
  • Bruno Lustinger
  • Bianca Fink
  • Horst Helbig
Original Paper


The purpose of this article is to describe functional and morphological short-term results in patients with exudative age-related macular degeneration (AMD) of all subtypes, treated with intravitreal bevacizumab versus intravitreal ranibizumab. This was a retrospective case-controlled series of 30 patients treated with intravitreal bevacizumab and 30 patients treated with intravitreal ranibizumab for exudative AMD. All patients received three initial injections every 4 weeks. Best corrected visual acuity (BCVA) as well as greatest linear dimension (GLD) of the CNV in fluorescein angiography and central retinal thickness (CRT) in optical coherence tomography (OCT) were monitored 2–4 months after last injection. BCVA stabilized and slightly increased from logMAR 0.74 to 0.62 in the bevacizumab group, and from logMAR 0.76 to 0.58 in the ranibizumab group (P < 0.05 for each group). No statistical difference was seen between both groups at any time-point. CRT was significantly reduced in both groups at last follow-up. In contrast, GLD did not change significantly. Patients with exudative AMD of all subtypes benefit from intravitreal anti-VEGF injections. No significant difference between bevacizumab and ranibizumab is seen in the short-term follow-up.


Ranibizumab Bevacizumab Age-related macular degeneration Vascular endothelial growth factor Anti-VEGF treatment 


  1. 1.
    Michaelson IC (1948) The mode of development of the vascular system of the retina with some observations on its significance for certain retinal diseases. Trans Ophthalmol Soc UK 68:137–180Google Scholar
  2. 2.
    Takahashi H, Shibuya M (2005) The vascular endothelial growth factor (VEGF)/VEGF receptor system and its role under physiological and pathological conditions. Clin Sci (Lond) 109:227–241CrossRefGoogle Scholar
  3. 3.
    Aiello LP, Avery RL, Arrigg PG et al (1994) Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. N Engl J Med 331:1480–1487CrossRefPubMedGoogle Scholar
  4. 4.
    Kvanta A, Algvere PV, Berglin L, Seregard S (1996) Subfoveal fibrovascular membranes in age-related macular degeneration express vascular endothelial growth factor. Invest Ophthalmol Vis Sci 37:1929–1934PubMedGoogle Scholar
  5. 5.
    Hera R, Keramidas M, Peoc′h M (2005) Expression of VEGF and angiopoietins in subfoveal membranes from patients with age-related macular degeneration. Am J Ophthalmol 139(4):589–596CrossRefPubMedGoogle Scholar
  6. 6.
    Folkman J (1971) Tumor angiogenesis: therapeutic implications. N Engl J Med 285:1182–1186PubMedGoogle Scholar
  7. 7.
    Michels S, Rosenfeld PJ, Puliafito CA et al (2005) Systemic bevacizumab (Avastin) therapy for neovascular age-related macular degeneration; twelve-week results of an uncontrolled open-label study. Ophthalmology 112(6):1035–1047CrossRefPubMedGoogle Scholar
  8. 8.
    Rosenfeld PJ, Moshfeghi AA, Puliafito CA (2005) Optical coherence tomography findings after an intravitreal injection of bevacizumab (Avastin) for neovascular age-related macular degeneration. Ophthalmic Surg Lasers Imaging 36(4):331–335PubMedGoogle Scholar
  9. 9.
    Kabbinavar F, Hurwitz HI, Fehrenbacher L et al (2003) Phase II, randomized trial comparing bevacizumab plus fluorouracil (FU)/leucovorin (LV) with FU/LV alone in patients with metastatic colorectal cancer. J Clin Oncol 21(1):60–65CrossRefPubMedGoogle Scholar
  10. 10.
    Spaide RF, Laud K, Fine HF et al (2006) Intravitreal bevacizumab treatment of choroidal neovascularization secondary to age-related macular degeneration. Retina 26(4):383–390CrossRefPubMedGoogle Scholar
  11. 11.
    Algvere PV, Steén B, Seregard S, Kvanta A (2008) A prospective study on intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration of different durations. Acta Ophthalmol 86(5):482–489CrossRefPubMedGoogle Scholar
  12. 12.
    Bashshur ZF, Haddad ZA, Schakal A et al (2008) Intravitreal bevacizumab for treatment of neovascular age-related macular degeneration: a one-year prospective study. Am J Ophthalmol 145:249–256CrossRefPubMedGoogle Scholar
  13. 13.
    Heier JS, Antoszyk AN, Pavan PR et al (2006) Ranibizumab for treatment of neovascular age-related macular degeneration: a phase I/II multicenter, controlled, multidose trial. Ophthalmology 113(4):642.e1–4CrossRefGoogle Scholar
  14. 14.
    Kaiser PK, Blodi BA, Shapiro H, Acharya NR, MARINA Study Group (2007) Angiographic and optical coherence tomographic results of the MARINA study of ranibizumab in neovascular age-related macular degeneration. Ophthalmology 114(10):1868–1875CrossRefPubMedGoogle Scholar
  15. 15.
    Kaiser PK, Brown DM, Zhang K et al (2007) Ranibizumab for predominantly classic neovascular age-related macular degeneration: subgroup analysis of first-year ANCHOR results. Am J Ophthalmol 114(6):850–857CrossRefGoogle Scholar
  16. 16.
    Regillo CD, Brown DM, Abraham P et al (2008) Randomized, double-masked, sham-controlled trial of ranibizumab for neovascular age-related macular degeneration: PIER study year 1. Am J Ophthalmol 145(2):239–248CrossRefPubMedGoogle Scholar
  17. 17.
    Raftery J, Clegg A, Jones J et al (2007) Ranibizumab (Lucentis) versus bevacizumab (Avastin): modelling cost effectiveness. Br J Ophthalmol 91:1244–1246CrossRefPubMedGoogle Scholar
  18. 18.
    Jaissle GB, Szurman P, Bartz-Schmidt KU, German Retina Society, German Society of Ophthalmology, German Professional Association of Ophthalmologists (2005) Recommendation for the implementation of intravitreal injections—statement of the German Retina Society, the German Society of Ophthalmology (DOG) and the German Professional Association of Ophthalmologists (BVA). Klin Monatsbl Augenheilkd 222(5):390–395Google Scholar
  19. 19.
    Emerson MV, Lauer AK, Flaxel CJ et al (2007) Intravitreal bevacizumab (Avastin) treatment of neovascular age-related macular degeneration. Retina 27(4):439–444CrossRefPubMedGoogle Scholar
  20. 20.
    Lazic R, Gabric N (2007) Intravitreally administered bevacizumab (Avastin) in minimally classic and occult choroidal neovascularization secondary to age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 245(1):68–73CrossRefPubMedGoogle Scholar
  21. 21.
    Stewart MW (2007) Predicted biological activity of intravitreal bevacizumab. Retina 27(9):1196–1200CrossRefPubMedGoogle Scholar
  22. 22.
    Zhu Q, Ziemssen F, Henke-Fahle S et al (2008) Vitreous levels of bevacizumab and vascular endothelial growth factor-A in patients with choroidal neovascularization. Ophthalmology 115(10):1750–1755CrossRefPubMedGoogle Scholar
  23. 23.
    Keane PA, Liakopoulos S, Ongchin SC et al (2008) Quantitative subanalysis of optical coherence tomography after treatment with ranibizumab for neovascular age-related macular degeneration. Invest Ophthalmol Vis Sci 49(7):3115–3120CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Maria-Andreea Gamulescu
    • 1
    Email author
  • Viola Radeck
    • 1
  • Bruno Lustinger
    • 1
  • Bianca Fink
    • 1
  • Horst Helbig
    • 1
  1. 1.University Eye ClinicRegensburgGermany

Personalised recommendations