Abstract
Purpose: :
Neovascular age–related macular degeneration accounts for 90% of severe visual loss in elderly patients. Anti–angiogenic therapies have emerged as a primary treatment option for this condition. The purpose of this study is to investigate the efficacy of Macugen, a VEGF–binding aptamer, for neovascular AMD.
Methods: :
Retrospective analysis is performed on 22 patients receiving intravitreal injections of 0.3 mg Macugen for the treatment of neovascular AMD with intravitreal injections administered every six weeks. A subgroup analysis is performed between those patients with a history or prior CNVM treatment with other modalities (11 patients) versus those with no history of prior CNVM treatment (11 patients).
Results: :
We studied 22 patients with CNVM due to neovascular AMD. The mean follow–up is 34.1 weeks with a mean number of injections of 5.7. The mean pre–injection visual acuity (VA) is 0.79 (logMAR scale) with a mean post–treatment VA of 0.81. Ocular coherence tomography (OCT) analysis demonstrated a mean pre–injection foveal thickness of 240.7 microns, a mean post–treatment foveal thickness of 255.5 microns, a mean pre–injection macular volume of 6.75 mm3, and a mean post–treatment macular volume of 7.03 mm3. On subgroup analysis, those patients with a prior history of CNVM treatment have a mean number of injections of 5.6 with a mean follow–up of 33.8 weeks. The mean pre–injection VA is 0.75 with a mean post–treatment VA of 0.83. On OCT analysis, the mean pre–injection foveal thickness is 217.7 microns, the mean post–treatment foveal thickness is 233.6 microns, the mean pre–injection macular volume is 6.56 mm3, and the mean post–treatment macular volume is 6.76 mm3. In those patients with no prior history of CNVM treatment, the mean number of injections is 5.7 with a mean follow–up time of 34.4 weeks. The mean pre–injection VA is 0.84 with a post–treatment mean VA of 0.80. On OCT analysis, the mean pre–injection foveal thickness is 263.8 microns, the mean post–treatment foveal thickness is 277.4 microns, the mean pre–injection macular volume is 6.95 mm3, and the mean post–treatment macular volume is 7.31 mm3.
Conclusions: :
Our small series demonstrates that intravitreal Macugen injection for the treatment of neovascular AMD appears to stabilize neovascular AMD. On subgroup analysis, a history of prior treatment for CNVM with another modality had no effect on the efficacy of Macugen therapy for current CNVM treatment.
Keywords: age-related macular degeneration • choroid: neovascularization • macula/fovea