Anecortave Acetate Monotherapy for the Treatment of Occult and Minimally Classic Choroidal Neovascularization in Age-related Macular Degeneration

Abstract

Abstract: : Purpose: Prospective case series evaluating the efficacy and safety of anecortave acetate in the treatment of choroidal neovascularization in patients with age-related macular degeneration ineligible for other investigational or approved treatments. Methods: Under an open label compassionate use protocol, 24 patients with occult or minimally classic choroidal neovascularization were treated with posterior juxtascleral administration of anecortave acetate (15 or 30 mg). Ocular examinations were performed within one week prior to treatment and at 2 weeks, 6 weeks, 3 months, 6 months, and 1 year after injection. ETDRS refraction and dilated fundus examination were performed at each visit. Fluorescein angiography was performed at the 6 month and 1 year visits. Re-treatment was performed at the discretion of the treating physician based upon evidence of improvement or clinical progression of the lesion. If re-treated, the examination cycle was repeated within the one year study interval. Three patients received photodynamic therapy prior to the study. Two patients received photodynamic therapy during the course of the study when the CNV lesion progressed to TAP eligibility. Results: Visual acuity improved from baseline in 25% (6 of the 24) at one year. Sixty seven percent (16 of 24) lost less than 15 letters of vision. Only 4 patients (17%) experienced severe visual loss at one year. Clinical improvement (decreased subretinal fluid, decreased subretinal hemorrhage, or reduced hyperfluorescence) was evident in 12 of the 24 patients as judged by the examiner. Sixteen patients recieved re-treatment. Adverse events were limited to disconfort in the injection area (3 patients) which resolved after one to two weeks. Conclusions: Anecortave acetate is safe and appears effective in the treatment of occult or minimally classic choroidal neovascularization.

Keywords: retina • age-related macular degeneration • clinical (human) or epidemiologic studies: tre