Intravitreal Bevacizumab vs. Ranibizumab for the Management of DME
In the following prospective, randomized trial, investigators compared visual acuity and spectral-domain optical coherence tomography (SD-OCT) outcomes associated with intravitreal (IV) bevacizumab vs. IV ranibizumab for the management of diabetic macular edema (DME).
The randomly assigned 48 patients (63 eyes) with center-involved DME to receive 1.5 mg (0.06 cc) IV bevacizumab or 0.5 mg (0.05 cc) IV ranibizumab at baseline and monthly if central subfield thickness was greater than 275 µm.
According to the investigators, 45 patients (60 eyes) completed 48 weeks of follow-up. They noted that at baseline, mean ± standard error best-corrected visual acuity (BCVA) (logMAR) was 0.60 (20/80) ± 0.05 in the IV bevacizumab group and 0.63 (20/85) ± 0.05 in the IV ranibizumab group. A significant improvement in mean BCVA was observed in both groups at all study visits (p<.05); this improvement was significantly greater in the IV ranibizumab group compared with the IV bevacizumab group at weeks eight (p=.032) and 32 (p=.042). A significant reduction in mean central subfield thickness was observed in both groups at all study visits compared with baseline (p<.05), with no significant difference in the magnitude of macular thickness reduction between groups. The mean number of injections was significantly higher (p=.005) in the IV bevacizumab group (9.84) than in the IV ranibizumab group (7.67).
The investigators concluded that IV bevacizumab and IV ranibizumab are associated with similar effects on central subfield thickness in patients with DME through one year of follow-up. IV ranibizumab is associated with greater improvement in BCVA at some study visits, and the mean number of injections is higher in the IV bevacizumab group.