Feng Xue-Feng, Constable Ian J, McAllister Ian L, Isaacs Timothy
Department of Ophthalmology, Peking University Third Hospital, Peking University, Beijing 100191, China.
Int J Ophthalmol. 2011;4(1):85-8. doi: 10.3980/j.issn.2222-3959.2011.01.20. Epub 2011 Feb 18.
To compare visual acuity (VA) outcomes between intravitreal injection of bevacizumab and ranibizumab in the treatment of neovascular age-related macular degeneration (AMD).
We conducted a consecutive, retrospective case series study in patients with newly diagnosed all type choroidal neovascularization (CNV) secondary to AMD who received an intravitreal injection of bevacizumab (1.25mg) or ranibizumab (0.3mg) at Lions Eye Institute, Western Australia from Mar. 2006 to May 2008. All patients received injection at baseline with additional monthly injections given at the discretion of the treating physician. Main outcome measures were changes in VA.
There were 371 consecutive patients received injection at least in one eye with at least 6 months of follow up (median of 12.0 months). Bevacizumab treatment prevented 221 out of 278 (79.5%) patients from losing < 15 letters in VA compared with 79 out of 93 (84.9%) of ranibizumab treated patients (P=0.25). While 68 (24.5%) of bevacizumab treated patients gained ≥15 letters of VA compared with 24 (25.8%) of ranibizumab treated patients (P=0.79). 75.3% and 66.2% patients benefited from ranibizumab and bevacizumab respectively with final VA better than 6/60 (P=0.10). Multivariate analysis showed that pre-treatment VA was negatively associated with benefit outcome. Assignment of injection was not associated with VA outcome of benefit after adjusting the covariate (P=0.857).
There are no difference in treatment efficacy in terms of VA between bevacizumab and ranibizumab in routine clinical condition.
比较玻璃体内注射贝伐单抗和雷珠单抗治疗新生血管性年龄相关性黄斑变性（AMD）的视力（VA）结果。
我们对2006年3月至2008年5月在西澳大利亚狮子眼研究所新诊断的所有类型继发于AMD的脉络膜新生血管（CNV）患者进行了一项连续的回顾性病例系列研究。这些患者接受了玻璃体内注射贝伐单抗（1.25mg）或雷珠单抗（0.3mg）。所有患者在基线时接受注射，治疗医生可酌情每月额外注射。主要观察指标为VA的变化。
共有371例患者至少一只眼接受了注射，且至少随访6个月（中位随访时间为12.0个月）。与雷珠单抗治疗的93例患者中的79例（84.9%）相比，贝伐单抗治疗使278例患者中的221例（79.5%）避免了VA下降<15个字母（P=0.25）。而贝伐单抗治疗的患者中有68例（24.5%）VA提高了≥15个字母，雷珠单抗治疗的患者中有24例（25.8%）（P=0.79）。分别有75.3%和66.2%的患者从雷珠单抗和贝伐单抗治疗中获益，最终视力优于6/60（P=0.10）。多因素分析显示，治疗前VA与获益结果呈负相关。在调整协变量后，注射药物的分配与获益的VA结果无关（P=0.857）。
在常规临床情况下，贝伐单抗和雷珠单抗在VA治疗效果方面没有差异。
