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C. M. Hemmerdinger, S. Izadi, R. M. K. Stewart, A. Kamal; 2 Year Results of Limited Intravitreal Macugen. Invest. Ophthalmol. Vis. Sci. 2008;49(13):315.
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Macugen (pegaptanib sodium) is indicated in neovascular macular degeneration. The VEGF Inhibition Study in Ocular Neovascularization (VISION) found patients receiving treatment were less likely to lose visual acuity than those in the control group at 54 weeks. Continuing treatment for two years provides further benefit. Treatment is however expensive, and not universally available on the National Health Service, UK. We report the 2 year results of patients receiving 3 to 5 doses of intravitreal Macugen.
A prospective study of patients with neovascular macular degeneration. Patients were assessed by one medical retina expert and included if they had an active lesion demonstrated on fluorescein or indocyanine green angiography. Intravitreal Macugen was at six week intervals until the clinical resolution of sub-retinal fluid or fluorescein angiography demonstrated fibrosis without late leakage. Visual acuity, intra-ocular pressure and adverse effects are reported
30 patients received an average of 3 injections of intravitreal Macugen and followed for a mean of 92 weeks. Angiography demonstrated 15 minimally classic, 11 occult and 4 classic lesions. Mean pre-treatment visual acuity was 0.63 (6/24) and mean IOP 16.4 mm/Hg. Post Macugen injection Snellen acuity remained stable (less than 1 line difference) in 15 patients, 1 patient gained more than one line of Snellen acuity and 14 lost more than one line. Occult lesions maintained better acuity than minimally classic (p=0.06). Overall there was a reduction in visual acuity to 0.79 (6/36) (P =0.01) although this change is not clinically significant. No significant change in intraocular pressure was seen (P=0.44). No significant adverse events were noted.
53% of patients maintained or improved by more than one line of Snellen acuity 2 years following treatment. No significant adverse events or complications were noted throughout the study. Limited Intravitreal Macugen may be used to stabilise vision in patients with neovascular macular degeneration when funding for continued treatment is not available.
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