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Alternating Bi-Weekly Intravitreal Ranibizumab and Bevacizumab for Refractory Neovascular Age-Related Macular Degeneration with Pigment Epithelial Detachment.
Semin Ophthalmol 2017; 32(3):309-315SO

Abstract

OBJECTIVE

To describe visual and anatomical outcomes following bi-weekly intravitreal ranibizumab/bevacizumab injections in eyes with refractory neovascular age-related macular degeneration (AMD) and pigment epithelial detachment (PED).

DESIGN

Retrospective, consecutive, interventional case series.

PARTICIPANTS

Eighteen patients diagnosed with neovascular AMD that were refractory to anti-VEGF therapy and received alternating biweekly ranibizumab/bevacizumab injections were included.

METHODS

Patients with neovascular AMD and PED that were refractory to at least 11 monthly ranibizumab or bevacizumab injections were included in this study at a large, single retina practice. Following inclusion, patients received four bi-weekly alternating ranibizumab/bevacizumab intravitreal injections. After completing a course of four bi-weekly injections, patients were treated with variable regimens of intravitreal anti-vascular endothelial growth factor (VEGF) therapy. The primary outcomes of the study included change in visual acuity (VA) and central foveal thickness (CFT) at eight weeks follow-up.

RESULTS

Study eyes had previously received a mean of 22 intravitreal anti-VEGF injections. At enrollment, mean VA was 20/95 and mean CFT was 455 µm. After four bi-weekly anti-VEGF injections, mean VA improved to 20/65 (p < 0.001), and mean CFT decreased to 387 µm (p = 0.029). In patients with PED, there was a mean 27.9% reduction in height (p = 0.046) at eight weeks' follow-up.

CONCLUSIONS

Four injections of bi-weekly alternating ranibizumab/bevacizumab improved visual acuity and reduced macular thickness in a number of patients with refractory neovascular AMD and PED.

Authors+Show Affiliations

a Tufts Medical Center , Department of Ophthalmology , Boston , MA , USA.b Mid Atlantic Retina, The Retina Service of Wills Eye Hospital , Philadelphia , PA , USA.b Mid Atlantic Retina, The Retina Service of Wills Eye Hospital , Philadelphia , PA , USA.b Mid Atlantic Retina, The Retina Service of Wills Eye Hospital , Philadelphia , PA , USA.b Mid Atlantic Retina, The Retina Service of Wills Eye Hospital , Philadelphia , PA , USA.b Mid Atlantic Retina, The Retina Service of Wills Eye Hospital , Philadelphia , PA , USA.b Mid Atlantic Retina, The Retina Service of Wills Eye Hospital , Philadelphia , PA , USA.b Mid Atlantic Retina, The Retina Service of Wills Eye Hospital , Philadelphia , PA , USA.b Mid Atlantic Retina, The Retina Service of Wills Eye Hospital , Philadelphia , PA , USA.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

26337539

Citation

Witkin, Andre J., et al. "Alternating Bi-Weekly Intravitreal Ranibizumab and Bevacizumab for Refractory Neovascular Age-Related Macular Degeneration With Pigment Epithelial Detachment." Seminars in Ophthalmology, vol. 32, no. 3, 2017, pp. 309-315.
Witkin AJ, Rayess N, Garg SJ, et al. Alternating Bi-Weekly Intravitreal Ranibizumab and Bevacizumab for Refractory Neovascular Age-Related Macular Degeneration with Pigment Epithelial Detachment. Semin Ophthalmol. 2017;32(3):309-315.
Witkin, A. J., Rayess, N., Garg, S. J., Maguire, J. I., Storey, P., Kaiser, R. S., ... Ho, A. C. (2017). Alternating Bi-Weekly Intravitreal Ranibizumab and Bevacizumab for Refractory Neovascular Age-Related Macular Degeneration with Pigment Epithelial Detachment. Seminars in Ophthalmology, 32(3), pp. 309-315. doi:10.3109/08820538.2015.1072222.
Witkin AJ, et al. Alternating Bi-Weekly Intravitreal Ranibizumab and Bevacizumab for Refractory Neovascular Age-Related Macular Degeneration With Pigment Epithelial Detachment. Semin Ophthalmol. 2017;32(3):309-315. PubMed PMID: 26337539.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Alternating Bi-Weekly Intravitreal Ranibizumab and Bevacizumab for Refractory Neovascular Age-Related Macular Degeneration with Pigment Epithelial Detachment. AU - Witkin,Andre J, AU - Rayess,Nadim, AU - Garg,Sunir J, AU - Maguire,Joseph I, AU - Storey,Philip, AU - Kaiser,Richard S, AU - Hsu,Jason, AU - Vander,James F, AU - Ho,Allen C, Y1 - 2015/09/04/ PY - 2015/9/5/pubmed PY - 2017/6/13/medline PY - 2015/9/5/entrez KW - Bevacizumab KW - bi-weekly KW - neovascular age-related macular degeneration KW - pigment epithelial detachment KW - ranibizumab, refractory SP - 309 EP - 315 JF - Seminars in ophthalmology JO - Semin Ophthalmol VL - 32 IS - 3 N2 - OBJECTIVE: To describe visual and anatomical outcomes following bi-weekly intravitreal ranibizumab/bevacizumab injections in eyes with refractory neovascular age-related macular degeneration (AMD) and pigment epithelial detachment (PED). DESIGN: Retrospective, consecutive, interventional case series. PARTICIPANTS: Eighteen patients diagnosed with neovascular AMD that were refractory to anti-VEGF therapy and received alternating biweekly ranibizumab/bevacizumab injections were included. METHODS: Patients with neovascular AMD and PED that were refractory to at least 11 monthly ranibizumab or bevacizumab injections were included in this study at a large, single retina practice. Following inclusion, patients received four bi-weekly alternating ranibizumab/bevacizumab intravitreal injections. After completing a course of four bi-weekly injections, patients were treated with variable regimens of intravitreal anti-vascular endothelial growth factor (VEGF) therapy. The primary outcomes of the study included change in visual acuity (VA) and central foveal thickness (CFT) at eight weeks follow-up. RESULTS: Study eyes had previously received a mean of 22 intravitreal anti-VEGF injections. At enrollment, mean VA was 20/95 and mean CFT was 455 µm. After four bi-weekly anti-VEGF injections, mean VA improved to 20/65 (p < 0.001), and mean CFT decreased to 387 µm (p = 0.029). In patients with PED, there was a mean 27.9% reduction in height (p = 0.046) at eight weeks' follow-up. CONCLUSIONS: Four injections of bi-weekly alternating ranibizumab/bevacizumab improved visual acuity and reduced macular thickness in a number of patients with refractory neovascular AMD and PED. SN - 1744-5205 UR - https://www.unboundmedicine.com/medline/citation/26337539/Alternating_Bi_Weekly_Intravitreal_Ranibizumab_and_Bevacizumab_for_Refractory_Neovascular_Age_Related_Macular_Degeneration_with_Pigment_Epithelial_Detachment_ L2 - http://www.tandfonline.com/doi/full/10.3109/08820538.2015.1072222 DB - PRIME DP - Unbound Medicine ER -