Visual Outcomes of Ranibizumab Versus Bevacizumab in Diabetic Retinopathy: An Analytical Study

Abstract

Introduction: Diabetic retinopathy (DR) is usually treated with Anti-vascular endothelial growth factor (anti-VEGF) agents. Ranibizumab is an approved drug for ocular use, while bevacizumab has also been introduced as an off-label drug for retinal diseases.

Objective: To compare the clinical efficacy and vision related quality of life of ranibizumab and bevacizumab in patients with diabetic retinopathy.

Methodology: An analytical study was conducted from 2024 September to 2025 March in the Department of Ophthalmology, KLE’s Prabhakar Kore Hospital and Medical Research Centre, Belagavi. Following ethical clearance, 105 subjects (aged ≥35 years) diagnosed with DR were enrolled by universal sampling and divided into two groups A and B. Clinical efficacy was evaluated using Optical Coherence Tomography and Visual Acuity scores and vision-related quality of life through the National Eye Institute Visual Function Questionnaire, at baseline and third follow-up.

Result: Central macular thickness decreased in both the Ranibizumab and Bevacizumab groups at the end of the treatment period, but the mean reduction was substantially larger in the Ranibizumab group (282.0 ± 193 μm) than in the Bevacizumab group (343.0 ± 233 μm) (p = 0.040). In terms of visual acuity, the group that received ranibizumab exhibited a considerably higher improvement in logarithm of minimum angle of resolution scores (0.500 ± 0.4 to 0.22 ± 0.1), while the group that received bevacizumab showed a less noticeable improvement (p <0.05) from (0.60 ± 0.3 to 0.50 ± 0.3). Furthermore, the Ranibizumab group's vision-related quality of life, as measured by the composite score, was significantly higher (64.79 ± 18.01) than the Bevacizumab group's (56.53 ± 17.73), indicating both statistically and clinically significant improvements in the functional and psychosocial domains (p = 0.020).

Conclusion: Both anti-VEGF agents were effective and safe in diabetic retinopathy; however, ranibizumab demonstrated superior efficacy, faster response, and shorter treatment duration, reinforcing its value for improving both clinical and patient-centred outcomes.