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    The authors compared real-world visual acuity in neovascular AMD patients who were treated with a single anti–VEGF drug for 1 year.

    Study design

    This retrospective, non-randomized, comparative study of real-world visual acuity assessed outcomes after 1 year of treatment with a single anti-VEGF agent (aflibercept, bevacizumab or ranibizumab) for neovascular AMD. The analysis included IRIS Registry data from 13,859 patients, of which 6,723 received bevacizumab, 2,749 received ranibizumab and 4,387 received aflibercept.


    Overall, there were no statistical differences in the age-adjusted or multivariate-adjusted mean vision change among treatment groups. The mean number of injections over the 1-year study period was higher in the ranibizumab (6.4) and aflibercept groups (6.2), compared with the bevacizumab group (5.9; P<0.0001).


    This study uses electronic medical records from the IRIS Registry, which contains a tremendous amount of patient data, but these records are less controlled than those analyzed in standard randomized controlled trials. Despite these shortcomings, the real-world findings provided by this study are valuable.

    Clinical significance

    To date, this is the largest head-to-head comparison of visual acuity outcomes among 3 anti-VEGF agents in neovascular AMD in US clinical practice. Overall, bevacizumab, ranibizumab and aflibercept were found to be similarly effective in improving vision when used as monotherapy.