Abstract
Purpose: :
The treatment of fibrotic choroidal neovascular lesions with presence of residual peripheral activity in age related macular degeneration currently presents a great challenge. With visual loss threatening, there are only very few therapeutic options.While these patients are neither suitable for laser therapy nor for photodynamic therapy with Verteporfin, antiangiogenic drugs applied intravitreally are now available.Some patients however reject this therapeutic option because of potential complications such as endophthalmitis and the frequency of necessary injections. For these patients Anecortave acetate (Retaane®) which is applied as a juxtascleral depot injection may be a further treatment possibility.
Methods: :
Retrospective analysis of the data of 20 consecutive patients who rejected the initially recommended intravitreal treatment, and where Anecortave acetate was then applied as a single juxtascleral depot injection.Preoperatively, as well as in the first, third and sixth month postoperatively the following data was analysed: Visual acuity, fluorescein angiography, indocyanin green angiography, as well as optical coherence tomography.
Results: :
Mean visual acuity showed a stabilisation at a low level. Mean best corrected visual acuity could be maintained in 17/20 eyes (85%). There was no significant improvement of visual acuity. Using the OCT a minimal postoperative reduction of the mean macular oedema, from preoperativly 332µm to 316µm at the last postoperativ examination, could be shown. The drug was well tolerated in all patients and no complications were detected.
Conclusions: :
Administered as a juxtascleral depot injection Anecortave acetate (Retaane®) was shown to achieve a stabilisation of visual acuity and minimally reduce macula oedema.As a second line-therapy of classic and occult fibrotic lesions with active peripheral zones, Anecortave seems to be a vision conserving therapeutic option.
Clinical Trial: :
www.clinicaltrials.gov RFC012007
Keywords: age-related macular degeneration