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Peter M. Brennen, Thomas R. Friberg, Andrew W. Eller, Samantha L. Rosenthal; Pegaptanib Sodium and its Effect on Retinal Thickness and Retinal Ischemia. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1701.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the effect of pegaptanib sodium, a vascular endothelial growth factor (VEGF) 165 inhibitor, on visual acuity, retinal thickness, and angiographically evident retinal capillary nonperfusion.
Nine subjects with more than two areas of capillary nonperfusion secondary to retinal vascular disease such as vein occlusion or diabetic macular edema and baseline 20/40 to 20/320 Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity (BCVA) were included. The study eye received 0.3 mg intravitreous pegaptanib at six week intervals for three injections and then at the discretion of the investigator until 52 weeks. Each visit included assesment of visual acuity, central retinal thickness by optical coherence tomography, and wide field fluoroscein angiography.
Mean baseline central retinal thickness was 475 microns (SD=197). After three injections (12 weeks), thickness decreased to 418 microns (SD=215). At 36 weeks, this effect did not persist, with retinal thickness increasing to 494 microns. In 56% of participants, BCVA increased by at least one ETDRS line. In 33%, BCVA decreased by at least one line, and in one participant, BCVA remained unchanged after three injections. No participants lost more than two ETDRS lines. In 44% of participants, capillary nonperfusion was improved when comparing baseline to 36 week angiography; furthermore, no participants had increase of capillary nonperfusion.
Pegaptanib appears to have a beneficial effect in treatment of retinal vasculopathies by suppression of VEGF 165. Chronic suppressive therapy may prevent progression of peripheral and equatorial retinal ischemia and directly influence diabetic macular edema. Further studies will be needed to evaluate optimal treatment frequency and long term BCVA benefits.
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