Pegaptanib for choroidal neovascularization in treatment-naïve exudative age-related macular degeneration

To evaluate the use of intravitreal pegaptanib in the treatment of choroidal neovascularization secondary to age-related macular degeneration (AMD) in treatment-naive patients.

In a consecu-tive, retrospective case series, treatment-naïve patients with exudative AMD were treated with intravitreal pegaptanib. Intravitreal injections were typically given every 6 weeks at the discretion of the treating physician. Snellen visual acuity (VA), clinical course, and adverse events were monitored. A minimum of three pegaptanib injections were given. Retreatment criteria included persistent submacular fluid, macular edema, new macular hemorrhage, and loss of vision.

The average change in VA for all lesions was a loss of 2.9 lines. Fifteen (14%) patients gained more than 3 lines of VA. The average number of in-jections was 4.8. Ninety-two of 111 lesions were able to be categorized by size. Sixty-six patients had small lesions (< 4 disc areas) with an average change of -2.0 lines, and 26 had large lesions (> or = 4 disc areas) with an average change of -5.4 lines (P < .02). Patients with larger lesions were at greater risk for severe visual loss (P < .01). The average follow-up was approximately 31 weeks (range: 12 to 82 weeks) after the first injection.

Pegaptanib therapy resulted in a 2.9 average line loss in patients when all lesions were considered. Small lesions responded favorably, with 15% of patients gaining more than 3 lines of VA. Larger lesions had an increased risk of progression and poor visual outcome.