Pegaptanib sodium in treatment of choroidal neovascularization secondary to age-related macular degeneration. One year results

Purpose
Prospective, noncomparative (nonrandomized, uncontrolled), consecutive interventional case series study - to evaluate the efficacy of intravitreal pegaptanib sodium in the treatment of choroidal neovascularization due to age-related macular degeneration in treatment-naive patients.

Material and methods
38 eyes of 38 patients were treated with intravitreal pegaptanib. All angiographic subtypes of lesions were qualified to the treatment. Intravitreal injections were performed every 6 weeks at the discretion of the treating ophthalmologist. Retreatment criteria were based on evaluation of presence of submacular fluid and/or increase in macular thickness seen in OCT, new retinal hemorrhage, and loss of visual acuity (VA).

Results
The VA outcomes were assessed at 48-th week of the study. The mean change in VA for all lesions was a loss of 9.4 ETDRS letters. Percent of patients losing less than 15 ETDRS letters in predominantly classic subgroup was 68%, minimally classic – 65% and pure occult – 72%. 7% of patients gained more than 1 ETDRS lines of VA whereas 2% more than 3 ETDRS lines. 8.5% of patients lost 30 and more ETDRS letters at 48-th week of the study. Results were better for smaller (<4 DA) lesions, eyes with better (> 54 ETDRS letters) baseline VA and for pure occult lesions.

Conclusions
Pegaptanib sodium effectively preserve vision in approximately 70% of patients with wet AMD in 1-year period of observation. Eyes with more advanced lesions seen at baseline have an increased risk of worse VA outcomes.