Early Clinical Features Resulting From the Management of Minimally Classic CNV With Intra–Vitreal Pegaptanib

Abstract

Purpose: : To evaluate prospectively the early functional results and morphologic changes after intravitreal injection (IVT) of pegaptanib aptamer treatment for minimally classic CNV in AMD.

Methods: : Observational series of 22 eyes, followed for four and half months (intra–vitreal injections of pegaptanib every 6 weeks). All patients had complete examination, including ETDRS visual acuity, fluorescein angiography(FA), SLO–ICG ( Heidelberg retina angiograph; Heidelberg engineering, Heidelberg, Germany), OCT (Humphrey–ZEISS) before each IVT injection and at day 8, day 21 day after IVT.

Results: : Initial visual acuity varied between 20/63 and 20/250 and improved 3 lines during the first 4 months of follow up. FA disclosed a decrease in size and in leakage of the classic component and a stabilisation in size of the occult component in 13 eyes. On SLO–ICG, the lacy pattern regressed but the late staining plaque remained identical in 12 eyes. OCT examination demonstrated the decrease of intra and sub retinal fluid in 20 eyes although the hyper reflectivity of the RPE was still present . The initial mapping was centrally in a 357µ + 23 range and regressed of a mean of 100µ.

Conclusions: : These early examinations with different imaging systems provided baselines for evaluation of the modalities of response of CNV to this new therapeutic approach and possibly some predictor to guide re–treatment.

Keywords: age-related macular degeneration • growth factors/growth factor receptors • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)