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Michael P. Ellis, David S. Dyer, Lindsey D. Dyer; 12 Month Analysis of Patients Treated with Pegaptanib Sodium, Bevacizumab or Combination Therapy for Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2012;53(14):389.
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To assess the long-term effectiveness of three different treatment regimens involving the administration of anti-vascular endothelial growth factor (VEGF) bevacizumab and pegaptanib sodium for treatment of Diabetic Macular Edema (DME).
A retrospective chart review of DME cases treated PRN (as needed) with either intravitreal bevacizumab, pegaptanib sodium or a combination therapy for 12 months. Efficacy was assessed among these 3 protocols among the 447 eyes included in the study. Pegaptanib Sodium was administered in 0.3 mg intravitreal injections PRN for both Macugen Only and the Combination Therapy. Bevacizumab was administered in 1.25 mg intravitreal injections. Combination Therapy was defined by receiving at least one injection of both intravitreal pegaptanib sodium and bevacizumab during the 12 month period. Center Point Thickness was measured by Optical Coherence Tomography and was assessed along with visual acuity through use of the Snellen chart. Clinical assessments were made by 6 retina doctors within a multi-center retina practice.
The 276 eyes treated with intravitreal bevacizumab only received an average of 2.1 injections during the 9.8 months of average follow-up. 75/276 (27.2%) eyes gained 3 lines or more, 250/276 (90.6%) eyes avoided losing 3 lines or more and center point thickness decreased by an average of 68.3 microns. The 141 eyes treated with intravitreal pegaptanib sodium only received an average of 4.4 injections during the 8.4 months of average follow-up. 26/141 (18.4%) eyes gained 3 lines or more, 127/141 (90.1%) eyes avoided losing 3 lines or more and center point thickness decreased by an average of 37.5 microns. The 30 eyes receiving a combination therapy received an average of 4.8 injections during the 8.6 months of average follow-up, 10/30 (33.3%) eyes gained 3 or more lines and 27/30 eyes (90%) avoided losing 3 lines or more and center point thickness decreased by an average of 125.1 microns.
Treatment of DME with the VEGF intravitreal bevacizumab and pegaptanib sodium have been shown to improve macular thickness. A combination therapy may maximize the effectiveness to treat macular edema. All three regimens may prove to be beneficial to increase and maintain visual acuity.
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