Bevacizumab in age‐related macular degeneration: a randomized controlled trial on the effect of injections every 4 weeks, 6 weeks and 8 weeks

. Purpose:  Several clinical trials have established the efficacy of ranibizumab therapy administered every 4 weeks to treat exudative age‐related macular degeneration (ARMD). Bevacizumab appears to be a cost‐effective alternative to ranibizumab, although an optimal injection schedule has not yet been determined. In this study, we set out to determine whether bevacizumab treatment in exudative ARMD every 6 or 8 weeks is non‐inferior to bevacizumab treatment every 4 weeks. Methods:  A total of 191 patients with exudative ARMD were randomly assigned to a 1‐year continuous regimen of intravitreal bevacizumab every 4 ( n  = 64), 6 ( n  = 63) or 8 weeks ( n  = 64). The primary outcome was visual acuity change after 1 year of treatment. Results:  In all three treatment groups, visual acuity improved between baseline and 1 year. There was no statistically significant difference in the mean change of visual acuity score at 1 year for bevacizumab administered every 4 (1.96 ± 13.70), 6 (1.60 ± 10.98) or 8 weeks (5.98 ± 8.88). Reduction in central retinal thickness was observed in all three study groups. At 1 year, the mean decrease in central foveal thickness ranged from 86 ± 97 μm in the every 6 weeks group to 109 ± 90 μm in the group every 8 weeks group (p = 0.30). Conclusion:  At 1 year, bevacizumab administered every 6 or 8 weeks was not inferior to therapy administered every 4 weeks.