Título / Title

INTRAVITREAL RANIBIZUMAB VERSUS BEVACIZUMAB FOR PERSISTENT RETINAL NEOVASCULARIZATION IN PROLIFERATIVE DIABETIC RETINOPATHY

Introdução / Purpose

The proliferative diabetic retinopathy is characterized by the growth of new vessels in the disk, iris and retina, vitreous hemorrhages (VH), and retinal detachment. 60% of patients with PDR respond to laser treatment with regression of neovascularization within 3 months. However, even in treated patients, it’s estimated that the rate of VH is 40%, which suggests the presence of NV refractory to treatment.

Material e Método / Methods

This is a randomized, prospective, and comparative clinical study. 2 groups of 16 eyes using IVB and 19 eyes using IVR, of diabetic patients with actively leaking retinal NV were separated, in which group A received an intravitreal injection of bevacizumab (IVB) and, group B, an intravitreal injection ranibizumab (IVR) vitreous to control NV. Comprehensive ophthalmic evaluation was performed at baseline and at weeks 1, 6, 12 following IVR and IVB. Main outcome measures were total fluorescein leakage area (FLA) from NV.

Resultados / Results

16 patients from group A and 19 patients from group B were included. In group A, at baseline, total FLA was 146.55 mm2 and reduced to 11.08mm2 at week 1. In group B, at baseline, total FLA was 77.19 mm2, with almost complete resolution at week 1, presented a residual area of NV measuring 0.04mm2. At week 6, the total FLA was 20.69mm2 in group A and 19.73mm2 in group B. There was no significant difference between the groups for the areas of NV measured at baseline, (P=0.4565) and there was a marked reduction in this area between baseline and week 1 for both groups (P<0001) and between baseline and week 6 (P<0.001 in group A and P=0.0002 in group B. After 12 weeks of follow-up, no statistical difference was observed for baseline, with P= 0.3789 for IVB and P=0.9798 for IVR.

Discussão e Conclusões / Conclusion

There was no statistical difference between the treated groups.The major response is observed at week 1 and 6 and defining the ideal interval between anti-VEGF applications to control the neovessels. So, IVB and IVR are equivalent for active new vessels control at the short term.

Palavras Chave

diabetic retinopathy; ranibizumab; bevacizumab; persistent neovascularization

Area

CLINICAL RETINA

Institutions

HCRP - Ribeirão Preto - São Paulo - Brasil

Authors

THAIS BASTOS, LETICIA OLIVEIRA AUDI, FRANCYNE VEIGA REIS CYRINO, ANNELISE NICOTTI GONCALVES, ANDRE MESSIAS, RODRIGO JORGE