Pegaptanib for choroidal neovascularization in treatment-naïve exudative age-related macular degeneration.

Abstract

BACKGROUND AND OBJECTIVE:

To evaluate the use of intravitreal pegaptanib in the treatment of choroidal neovascularization secondary to age-related macular degeneration (AMD) in treatment-naive patients.

PATIENTS AND METHODS:

In a consecu-tive, retrospective case series, treatment-naïve patients with exudative AMD were treated with intravitreal pegaptanib. Intravitreal injections were typically given every 6 weeks at the discretion of the treating physician. Snellen visual acuity (VA), clinical course, and adverse events were monitored. A minimum of three pegaptanib injections were given. Retreatment criteria included persistent submacular fluid, macular edema, new macular hemorrhage, and loss of vision.

RESULTS:

The average change in VA for all lesions was a loss of 2.9 lines. Fifteen (14%) patients gained more than 3 lines of VA. The average number of in-jections was 4.8. Ninety-two of 111 lesions were able to be categorized by size. Sixty-six patients had small lesions (< 4 disc areas) with an average change of -2.0 lines, and 26 had large lesions (> or = 4 disc areas) with an average change of -5.4 lines (P < .02). Patients with larger lesions were at greater risk for severe visual loss (P < .01). The average follow-up was approximately 31 weeks (range: 12 to 82 weeks) after the first injection.

CONCLUSIONS:

Pegaptanib therapy resulted in a 2.9 average line loss in patients when all lesions were considered. Small lesions responded favorably, with 15% of patients gaining more than 3 lines of VA. Larger lesions had an increased risk of progression and poor visual outcome.

• Authors: Justis P Ehlers, David R Fintak, Omesh P Gupta, Carl D Regillo, Mitchell S Fineman, Allen C Ho
• Journal: Ophthalmic surgery, lasers & imaging : the official journal of the International Society for Imaging in the Eye (Ophthalmic Surg Lasers Imaging) 2007 Sep-Oct Vol. 38 Issue 5 Pg. 371-7 ISSN: 1542-8877 [Print] United States
• PMID: 17955841 (Publication Type: Journal Article)

Chemical References

• Aptamers, Nucleotide
• pegaptanib

Topics

• Aged
• Aged, 80 and over
• Aptamers, Nucleotide (administration & dosage, adverse effects, therapeutic use)
• Choroidal Neovascularization (complications, diagnosis, drug therapy, etiology)
• Exudates and Transudates (metabolism)
• Female
• Fluorescein Angiography
• Follow-Up Studies
• Humans
• Injections
• Macular Degeneration (complications, metabolism)
• Male
• Middle Aged
• Retrospective Studies
• Risk Factors
• Severity of Illness Index
• Time Factors
• Treatment Outcome
• Vision Disorders (etiology, physiopathology, prevention & control)
• Visual Acuity
• Vitreous Body