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Karl E. Waite, Michael D. Bennett; Intravitreal Pegaptanib Sodium Prior to Pars Plana Vitrectomy in Proliferative Diabetic Retinopathy: An Update. Invest. Ophthalmol. Vis. Sci. 2012;53(14):354.
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To explore the efficacy and safety of pegaptanib sodium used as adjuvant therapy prior to pars plana vitrectomy in eyes with proliferative diabetic retinopathy (PDR) and tractional retinal detachment (TRD).
Consecutive patients with PDR who required pars plana vitrectomy due to vitreoretinal traction to the macula received intravitreal pegaptanib 0.3 mg injection 5 to 14 days prior to the surgical procedure. Eyes with vitreous hemorrhage precluding preoperative fundus assessment and those treated during the previous month with anti-VEGF agents were excluded from this analysis. Best corrected visual acuity (BCVA) was evaluated at baseline and after vitrectomy. The effects of pegaptanib on regression of retinal neovascularization and progression of macular traction were assessed by comparing color fundus photographs and optical coherence tomography (OCT) exams obtained pre- and post-injection. The ability to dissect vitreoretinal tractional membranes from the underlying retina was assessed by the surgeon.
Five patients have been treated with preoperative pegaptanib. Regression of neovascularization has been observed in follow-up images. There was no evidence of increased traction, postoperative hemorrhage, or endophthalmitis in any patient. Adverse events were consistent with the safety profile of pegaptanib.
This supports the potential use of intravitreal pegaptanib sodium as an adjuvant therapy prior to pars plana vitrectomy in diabetic retinopathy with tractional retinal detachment. Larger scale, randomized clinical studies are still required to appropriately evaluate the benefit of selective VEGF inhibition in this condition.
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