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S. Iyengar, D. Dyer, G. Fox, B. Cooper; Changes in Angiographic Characteristics with Pegaptanib Therapy for Neovascular Age–Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5703.
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To investigate the angiographic changes of pegaptanib therapy in patients with choroidal neovascularization (CNV) from age–related macular degeneration.
Retrospective case reviews (N=31) of patients receiving pegaptanib therapy were performed. We examined the outcomes of this therapy for neovascular macular degeneration specifically looking at pattern changes in angiography. We hypothesized that the occult component in patients with CNV would be more responsive to pegaptanib therapy. Patients underwent fluorescein angiography at the time of diagnosis and at each subsequent visit prior to the intravitreal injection of pegaptanib. Choroidal neovascular patterns were characterized as predominantly classic, minimally classic, or 100% occult.
Initial choroidal leakage patterns at diagnosis were predominantly classic (N=3), minimally classic (N=12), and 100% occult (N=16). In the predominantly classic group, there was no change in leakage pattern seen with pegaptanib therapy. In the minimally classic group, 6 did not change patterns, 1 changed from minimally classic to occult, 5 changed from minimally classic to predominantly classic. Of those in the 100% occult group, 15 did not change pattern and 1 changed to minimally classic.
We found minimal change in patients with the predominantly classic choroidal neovascularization. In the minimally classic group 45% changed to predominantly classic. This was manifested by a reduction in the occult component of the lesions. In the occult group, 81% did not change in pattern. Our findings support the hypothesis that the occult CNV in patients with neovascular AMD respond better to pegaptanib treatment, compared to classic CNV. The etiology of this trend has yet to be elucidated. We speculate that another isoform of VEGF may be responsible for the development of classic CNV.
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