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L. Akduman, B. Kaderli, M. Kim, R. Brusatti, M. Jones; First Year Experience With Pegaptanib: Monotherapy versus Combined Therapy. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1784.
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To review our experience with Pegaptanib in patients with neovascular age-related macular degeneration (AMD) to determine whether outcomes would be improved by combining Pegaptanib with photodynamic therapy (PDT).
The charts of 20 patients who presented with neovascular AMD to our university clinic and received Pegaptanib monotherapy or combined therapy with Verteporfin were retrospectively reviewed. Main outcome measures consisted of number of treatments applied, Snellen best-corrected visual acuity (BCVA), angiographic lesion characteristics, and center field thickness (CFT) in optical coherence tomography.
Follow-up time was 7.7±2.7 months (range, 3 to 11 months). Ten patients (50%) were given Pegaptanib monotherapy (Group M) and 10 were given combination therapy with PDT (Group C).Patients received 2 to 9 (mean, 5.2) Pegaptanib injections. Group C received 1 to 4 (mean, 1.8) PDT treatments. Initial BCVA ranged from 20/50 to 20/3200 (mean, 20/509), final BCVA ranged from 20/70 to 20/3200 (mean, 20/759). Change in the BCVA at the last visit ranged from 2 lines of gain to 5 lines of loss (mean, 0.9 line loss). Four of the 10 eyes (40%) in Group C lost 3 lines or more. None of the eyes in Group M lost 3 lines or more vision (p=0.087). There was no significant change in the lesion size, but CFT decreased from 315±97 µm to 268±67 µm.
Until prospective controlled multicenter randomized trials show significant benefit from the combination of Pegaptanib and PDT, this combination therapy should be used with caution in patients with neovascular AMD.
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