Abstract
Purpose: :
To evaluate the functional, anatomical, vascular flow, effects of intravitreal Pegaptanib injections for retrofoveolar neovascular myopia maculopathy, at short and long term evolution.
Methods: :
20 eyes of 20 patients, 3 men, 17 women, with neovascular myopia maculopathy. 4 were inaugural cases, 16 have been previously treated by phototherapy. Patients received intravitreous pegaptanib sodium, 3 times, every 6 weeks in an inductive treatment, the next injections (IVT), depending on the follow-up results. First and 2 months’ interval follow-up exam included ETDRS visual acuity (VA), complete ophthalmic examination, fluorescein and infracyanine (ICG) angiography, and optical coherence tomography (OCT).VA and OCT were done before each IVT.
Results: :
VA improved in 70% inaugural cases, in 85% already treated cases. Angiographic diffusion disappeared in all cases, leakage reduced about 70% in 40% cases, about 30% in 75% cases. At ICG ,vascular flow, vessel’s diameter were 2/3 time less in 45% cases,1/3 in 75% cases .Diffuse oedema was 75% decreased in 43% cases , 30% reduced in 80% , pigment epithelial detachment(PED) was flattened and less dense in all cases, by OCT. No significant ocular or systemic side effects were observed. Most of patients had good functional, anatomical, vascular flow, results, with more stabilized lesions, less or no PDT needed. Inductive treatment was sufficient in 12 cases, needed added IVT in 7 cases, failed in 1 case. None retracted scar, haemorrhage, retinal and pigment epithelium atrophy was induced by Pegaptanib IVT .Less risks of pigment epithelium rupture, of increase of atrophic retinal area, previously existing or bordering on the neovascularisation, of neovascular net’s retraction, particularly when PED is prominent, were noted.
Conclusions: :
The results, with generally improved visual acuity and function, lack of fluorescein leakage, low neovascularisation’s flow in ICG, reduction of exudation on OCT, suggest Pegaptanib sodium IVT seem effective, more retinal protective, and allow to avoid retraction, atrophic , haemorrhagic effects, more frequent with those particularly flimsy retina, almost with atrophic preexisting area.