Bevacizumab and ranibizumab are both anti-VEGF agents used intravitreally. Ranibizumab is preferred in some protocols because it:

• A Has a higher molecular weight and longer duration of action
• B Binds all VEGF isoforms including VEGF-B and PlGF
• C Is administered every 6 weeks compared to monthly for bevacizumab
• D Is a Fab fragment lacking an Fc region, reducing systemic absorption and cardiovascular risk ✓

Explanation

Ranibizumab is a humanised anti-VEGF-A Fab fragment (molecular weight ~48 kDa); lacking the Fc region, it has less systemic absorption from the vitreous and theoretically a lower risk of systemic thromboembolic events compared to full-length antibodies. Bevacizumab is a full-length antibody (149 kDa) with an Fc region. Both bind VEGF-A isoforms. Aflibercept (not ranibizumab) binds VEGF-A, VEGF-B, and PlGF. Standard ranibizumab dosing is monthly or PRN, not 6-weekly.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.