Abstract
Purpose::
To assess the safety and efficacy of intravitreal injection of pegaptanib sodium (Macugen) for the management of proliferative diabetic retinopathy (PDR) and clinically significant macular edema (CSME), not responding to standard of treatment modalities.
Methods::
Retrospective chart review of 10 eyes from 10 patients from a private clinical setting. An intravitreal injection of 0.3 mg pegaptanib sodium was administered to each eye. Assessments were performed with Snellen visual acuity testing, slit lamp biomicroscopy, fundus exam, fluorescein angiography and optical coherence tomography (OCT).
Results::
Marked regression of neovascularization associated with PDR was noted in 90% of the eyes after intravitreal administration of pegaptanib. Additionally, foveal thickness was found to have improved appreciably. Stabilization in visual acuity was associated with these anatomical changes. No systemic complications have been identified through 6 months of follow up.
Conclusions::
These data demonstrate the tolerability and efficacy of intravitreal pegaptanib sodium as an adjunct in the treatment of PDR and CSME. Most notable is the marked regression of NVD and/or NVE in patients with PDR in addition to the decreasing anatomic extent of the concomitant CSME. Our findings suggest that selective VEGF blockade may allow for less laser therapy (with avoidance of its destructive side effects and induced macular edema) in treating diabetic retinopathy. Intravitreal pegaptanib sodium may reduce the progression of PDR and provide beneficial effects in preventing severe vision loss in patients not responding to standard therapy. Selective VEGF blockade may augment our practice patterns in treating diabetic retinopathy.
Keywords: diabetes • diabetic retinopathy • retinal neovascularization