A randomized trial of intravitreal bevacizumab vs ranibizumab for myopic CNV.

ABSTRACT Aims: To compare the efficacy of intravitreal therapy with bevacizumab and ranibizumab for choroidal neovascularization (CNV) in pathologic myopia (PM). Methods: A prospective multicenter randomized not-blinded trial. Results: In seven centers 78 eyes were randomized 1:1 to treatment with bevacizumab (group B, 40 eyes) or ranibizumab (group R, 38 eyes) given with an ”on demand” regimen (PRN). The mean follow-up was 19 months (SD 2, range 12-24). The mean BCVA at baseline was 0.60 logMAR (20/80 Snellen equivalent, Seq) and 50 letter score (ls). Mean final BCVA was 0.51 LogMAR (20/63 Seq) and 57 ls (p=0.0009 and p=0.0002 respectively). In group B mean basal BCVA was 0.52 logMAR (20/63 Seq) and 54 ls and final BCVA was 0.51 logMar (20/63 Seq) and 57 ls. In group R mean basal BCVA was 0.62 logMAR (20/80 Seq) and 45 ls and final values were 0.50 logMAR (20/63 Seq) and 58 ls. Statistical comparison of the two groups showed no significant difference (logMAR p=0.90 and letters p=0.78). Multivariate analysis showed no influence of age or previous photodynamic treatment (PDT) on final visual changes. The mean number of treatments in the first year was 2.7 in group B and 2.3 in group R (p=0.09). Conclusion: Myopic CNV equally benefits from on-demand intravitreal injection of either bevacizumab or ranibizumab; the therapeutic effect is independent of previous PDT and age.