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R.L. Ufret, M. Taban, O.F. M. Brasil, P.K. Kaiser; Correlation of Anatomic (OCT), Clinical and Angiographic Findings of Neovascular AMD Lesions Before and After Treatment With Pegaptanib Sodium . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5220.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze and correlate the anatomic (optical coherence tomography – OCT), angiographic and clinical characteristics of neovascular age–related macular degeneration (AMD) before and after treatment with intravitreal pegaptanib sodium (MacugenTM).
Retrospective interventional case series. Twenty eyes of twenty patients with neovascular AMD treated by intravitreal Macugen with at least 6–months follow–up underwent ophthalmic examination and OCT analysis for foveal thickness, subretinal fluid thickness (SRF), pigment epithelial detachment (PED) thickness, maximal retinal thickness (MRT), total lesion thickness, cystoid macular edema (CME), and choroidal neovascular membrane thickness at baseline, 6–weeks, 3–months, and 6–months after initial intravitreal Macugen therapy. Visual acuity in logMAR, adverse events, and intraocular pressure were also recorded at each visit. Fluorescein angiography was performed at baseline and at the 6–month visit.
82% of eyes required re–treatment at every visit. The mean number of treatments was 4.3 over the 6–month period, out of possible maximum 5. There was no statistically significant change in foveal thickness (140 µ at baseline vs. 170 µ at 6–months; p–value 0.26), PED thickness (112 µ at baseline vs. 100 µ at 6–months; p–value 0.21), MRT (326 µ at baseline vs. 324 µ at 6–months; p–value 0.46), total lesion thickness (588 µ at baseline vs. 544 µ at 6–months; p–value 0.10), or presence of CME with Macugen use. The only statistical significant change was a reduction in SRF (130 µ at baseline, 73 µ at 6–weeks (p–value 0.02), 42 µ at 3–months (p–value 0.03), and 60 µ at 6–months (p–value 0.03)). The location of the choroidal neovascular membrane was sub–retinal pigment epithelial in 2 patients and indeterminate in the others. Visual acuity was stabilized (0.85 (∼20/140) at baseline, 0.82 (∼20/130) at 6–weeks, 0.82 at 3–months, and 0.88 (∼20/150) at 6–months). 87% of patients lost fewer than 15 letters, 33% showed improvement of 5 letters or more, while 20% showed improvement by 15 letters or more at 6–months follow–up. It was not possible to identify any baseline lesion/retinal characteristic that would help predict visual outcomes.
Intravitreal Macugen injections for neovascular AMD results in stabilization of vision without significant anatomic changes in foveal thickness, PED, maximal retinal thickness, total lesion thickness, CME, and choroidal neovascular membrane thickness, except for a significant reduction in subretinal fluid thickness.
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