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C. Li, M. Peracha, H. Gao; Comparison of Pegaptanib (Macugen) and Photodynamic Therapy With Verteporfin Combined With Intravitreal Triamicinolone (PDT + TAC) as Treatment for Subfoveal Choroidal Neovascularization Due to Age–Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2006;47(13):367.
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© ARVO (1962-2015); The Authors (2016-present)
Pegaptanib (Macugen) is one of the new regimens for the treatment of exudative age–related macular degeneration (AMD). The present study compares the visual acuity (VA) outcomes of patients treated with either intravitreal Macugen or photodynamic therapy (PDT) with Verteporfin combined with intravitreal Triamicinolone (PDT and TAC).
In this retrospective study, 18 eyes were treated with 0.3 milligrams (mg) intravitreal Macugen, and 19 eyes with PDT and TAC, in which 4 mg Triamicinolone was injected following standard PDT. VA outcomes were measured as changes expressed in LogMAR off of Snellen lines, recorded before treatments and at the end of the follow up. Intraocular pressure (IOP) changes during follow up were recorded. Statistical analysis was performed using the Student t–test.
In Macugen treatment group, each eye received average 2.4 treatments (range: 1–5) and follow up time 4.2 ± 2.6 months (ranges 1–8 months). Pretreatment VA was 1.06 ±0.66, ranges 2.3 – 0.4. Final VA was 0.98 ±0.57, ranges 2.6 – 0.1. VA and IOP were not significantly changed after Macugen treatment (p = 0.23 and p = 0.24, respectively). In PDT + TAC treatment group, each eye had average 1.2 treatments (range 1–2) and follow up time 8.7 ± 6.9 months (ranges 1.5 – 23 months). Pretreatment VA was 1.04 ± 0.49, ranges 2.3 –0.2. Final VA was 1.11 ± 0.60, ranges 2.3 – 0.2. VA was not significantly changed after PDT + TAC (p = 0.26). IOP was significantly higher after treatment (p < 0.01) and more eyes needed glaucoma treatment.
The VA change between Macugen and PDT + TAC groups had no significant difference (p = 0.10). However, the IOP increase in PDT + TAC group was significantly higher than that of Macugen (p<0.001). There was no endophthalmitis, vitreous hemorrhage, or retinal detachment as complication of either treatment.
This small series study shows that there was no significant difference in visual outcome between the Macugen and PDT+TAC groups. PDT + TAC treatment is often associated with significant IOP increase. Macugen was not demonstrated to cause IOP increase. Further study with larger sample size and longer follow up is warranted.
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