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Victor Gonzalez; The Impact on Vision and Regression of Retinal Neovascularization of Anti-VEGF Induction in Combination with Quarterly Anti-VEGF Maintenance or Selective PRP versus Standard PRP. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4599. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To determine if induction with intravitreal pegaptanib sodium for 3 injections every 6 weeks followed by quarterly maintenance or selective panretinal laser photocoagulation (PRP) versus standard PRP is better at preserving vision and inducing regression of retinal neovascularization.
Thirty eyes of 30 patients with high risk proliferative diabetic retinopathy (PDR) were randomized into three groups. Group A received 3 intravitreal pegaptanib injections at 6 week intervals, then 3 additional injections at 12 week intervals. Group B received 3 pegaptanib injections for induction followed by Selective Laser Photocoagulation. Group C received standard PRP. Evaluation of BCVA and percent regression of neovascularization by fluorescein angiography was performed at baseline and at one year.
This report includes 21 subjects that have completed the 1 year evaluation. The baseline mean ETDRS BCVA for group A (n=8), B (n=9) and C (n=4) was 77.25, 78.56 and 69.87 letters respectively. The 1 year mean ETDRS BCVA was 80.50, 83.82 and 73.38 letters respectively. At randomization, all patients had high risk characteristics as determined by percentage of NVD and NVE. At year 1, there was a decrease in the total area of neovascularization in groups A and B, and an increase in group C. Adverse events included a vitreous hemorrhage in 1 patients in group A, 3 patients in group B and 2 patients in group C. One patient in group B developed neovascular glaucoma.
These results indicate that variable dosing anti-VEGF treatment can help maintain and improve vision in patients with high risk characteristics and cause regression of total retinal neovascularization as compared to laser therapy.
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