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M. Hoer, M. Avgitidou, J. Kirchhof; Pegaptanib-Enhancement of Intravitreal Bevacizumab Therapy for Choroidal Neovascularization. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1926.
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To investigate the effect of intravitreal pegaptanib-enhanced bevacizumab therapy for CNV due to age-related macular degeneration (AMD).
We treated 92 eyes of 92 patients suffering from wet AMD with a combination of intravitreal bevacizumab (2 mg) and pegaptanib (0.3 mg). All lesion types and sizes were included in this case series. All patients have been treated by one bevacizumab injection, followed by an injection of pegaptanib. Patients attended follow-up visits every 6 weeks, undergoing VA and intraocular pressure measurement, slit-lamp and ophthalmoscopic examination, and optical coherence tomography (OCT). Fluorescein angiography was performed every 3 months or earlier if OCT showed significant edema.
Retreatments: 21% of the patients needed a second treatment cycle consisting of both drugs. 59% of the patients received a retreatment with intravitreal bevacizumab. After a mean follow-up of 26 weeks (up to 62 weeks) 48% of the patients gained one or more lines of vision, 35% of the patients had stable vision, and 17% lost one or more lines. The decrease of retinal thickness as measured by OCT was significant (P<0.01). No adverse events have been observed.
The pegaptanib-enhanced bevacizumab therapy for CNV due to AMD is well tolerated and has a promising functional and morphological outcome. In addition, the combination of these two intravitreal anti-VEGF drugs reduces the number of re-treatments required. A prospective trial comparing this approach with conventional monotherapy is warranted.
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