| Summary: | Introduction Age-related macular degeneration (AMD) is an eye disease that can cause severe vision loss. At present there is no curative treatment. However, anti-vascular endothelial growth factor (VEGF) can slow down the process and prevent blindness. Ranibizumab and aflibercept are registered anti- VEGF drugs for AMD but more expensive compared to bevacizumab that is used off-label. Previous studies show no significant differences between the three drugs. Aim The aim was to study the outcome of switching to bevacizumab, after initial treatment with aflibercept, in terms of visual acuity and central retinal thickness. Material and methods This retrospective case-control study included 26 cases and 28 controls. The cases were initially treated with aflibercept and then with bevacizumab and the controls were only treated with aflibercept. Data was selected from the Swedish Macula Registry and from medical records at Örebro University Hospital. Results The treatment with bevacizumab is non-inferior compared to aflibercept when it comes to achieving successful scores for visual acuity, z=2,4 > 𝑧𝑧1−𝛼𝛼(=1.96, α=0,05, one-sided confidence interval). Results show no significant difference in the scores for central retinal thickness at 24 months between case and control, p=0,335. Discussion The limitation of the study is the small number of participants and the selection of participants. Selection bias can not be ruled out. Conclusion The conclusion is that switching to bevacizumab after initial aflibercept treatment is non-inferior compared to aflibercept injections only. Still, no certain conclusions can be drawn since the study only included 54 participants.
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