Abstract
Purpose: :
To compare visual acuity and macular thickness using best corrected visual acuity (BCVA)-ETDRS and OCT, in patients with diabetic macular edema (DME) who received pegaptanib sodium injection every 4 weeks.
Methods: :
13 eyes of 13 patients with DME received 0.3 mg of pegaptanib sodium injection every 4 weeks during a total of 24 weeks. At each monthly visit we obtained: (1) BCVA; (2) Central Macular Thickness (CMT) using STRATUS OCT; and (3) OCT thickness of the most edematous macular subfield (TMEMS). No additional treatment was performed.
Results: :
The 13 eyes were evaluated by retinal specialists for the presence of DME. All eyes presented with PDR or NPDR and CSME. 9 eyes (69%) had PDR and 4 eyes (31%) had NPDR. BCVA improved in 9 of the 13 patients (69%), decreased in none, and was stable in 4 (31%). Of those that improved VA, 2 (22%) improved 3 lines, 2 (22%) improved 2 lines, and 5 (56%) gained 1 line. 6 patients began the study with VA of 20/50 or worse, 3 (50%) gained 2 or more lines, while the other 3 remained stable.CMT decreased in 9 patients (69%) and increased in 4 (31%). Patients whose CMT increased, 3 (75%) were had stable VA, and 1 (25%) gained 2 lines. TMEMS improved in 6 patients (46%), worsened in 2 patients (15%) and was unchanged in 5 (39%). CMT showed significant improvement (>10%) in 6 patients (46%). Of the 4 patients that worsened, only 2 (15%) showed an increase in CMT >10%. Of 9 patients with PDR, 6 (67%) improved their VA; 3 (33%) gained 2 or more lines, and 3 (33%) reduced CMT by more than 10%. The NPDR group showed a gain of 1 line of VA in 3 of the 4 patients (75%) while only 1 (25%) improved more than 2 lines.
Conclusions: :
The administration of pegaptanib sodium injections every 4 weeks in patients with PDR or NPDR and CSME proves to be beneficial with maintaining or improving visual acuity. Changes in CMT do not consistently correlate with changes in VA. Patients who present with VA 20/50 or worse are more likely to improve VA by 2 or more lines. Patients with PDR are more likely to reduce macular thickness by more than 10% from baseline.
Keywords: diabetes • edema • visual acuity