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Andras Seres, Huba Kiss; Prospective Study of Pegaptanib in the Treatment of Serous Pigment Epithel Detachments Complicating Age- related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3788. doi: https://doi.org/.
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To evaluate the efficacy and safety of pegaptanib in the treatment of serous retinal pigment epithel detachments (PED) in age-related macular (AMD) degeneration and to assess the rate of PED rips associated with this treatment modality.
The study included 30 eyes of 30 patients diagnosed with previously untreated early lesions of PED secondary to AMD. Patients with visual acuity better than 20/100 and PED size less than 6 disc area were enrolled. All patients received pegaptanib intravitreal injections every 6 weeks for one year (9 injections). Best corrected visual acuity, colour and autofluorescence fundus photography and optical coherence tomography were performed each visit, together with fluorecein angiography at baseline and at one year. Primary endpoint was proportion of patients losing 15 or more ETDRS letters at one year. Rates of eyes losing 30 or more letters, rate of gainers, together with the rate of PED rips were calculated.
25 females and 5 males were recruited, the mean age at enrollment was 74 years. Eleven of the 30 patients (37%) lost more than 15 letters, 3 of these had severe visual loss of more than 30 letters. At least 5 letter gain was observed in 3 (10%) cases. Mean change of BCVA was -11 letters. Flattening of the PED was observed in 11 cases, however, mean BCVA loss was still 12 letters in this group mainly due to scarring or persistence of retinal edema. Intra -and subretinal fluid disappeared in 8 eyes. Rupture of the RPE occurred in 2 cases, one further case of RPE rip was observed 19 months after the end of the study, that patient received no treatment in that period. One other rip occurred in an untreated fellow eye.
Use of pegaptanib failed to protect our patients from visual loss and RPE rips. No important new safety concerns were found using the drug. The hope that the use of pegaptanib instead of more potent anti- VEGF agents like ranibizumab or bevacizumab might help to avoid RPE rips was not supported by our data.
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