[Treatment of neovascular age-related macular degeneration with intravitreal vascular endothelial growth factor inhibitor--secondary publication].
Subfoveal neovascularization is the most frequent cause of severe visual loss in patients with age-related macular degeneration (AMD). Pharmacologic inhibition of vascular endothelial growth factor (VEGF) is a new principle of treatment of this condition. The effects of intravitreal pegaptanib administered every sixth week for 48 weeks in three different dosages were examined in a prospective, double-masked, randomised trial against subconjunctival sham injection with change in visual acuity as the outcome parameter in 1,186 patients with subfoveal neovacularization in AMD. 70% of the patients treated with pegaptanib avoided moderate visual loss, compared to only 55% of the control group (p < 0.001 for 0.3 mg pegaptanib versus the control group, p < 0.001 for 1.0 mg and p = 0,03 for 3.0 mg). The improved visual prognosis was detectable beginning six weeks after the first injection (p < 0.002). Adverse events included endophthalmitis (1.3% of patients), traumatic lens damage (0.7%), retinal detachment (0.6%) and severe visual loss in one patient (0.1%). Intravitreal pegaptanib improves the visual prognosis in neovascular AMD. The long-term effect and safety of the treatment are not known.
Larsen
Michael
M
Amtssygehuset i Herlev, Øjenafdelingen, og Københavns Universitet, Klinisk Institut for Oto-Rhino-Laryngologi, Oftalmologi og Dermato-Venerologi. mla@dadlnet.dk
Sander
Birgit
B
Villumsen
Jørgen Ebbe
JE
Haamann
Per H
PH
la Cour
Morten
M
Lund-Andersen
Henrik
H
D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D052157:Aptamers, Nucleotide; D020256:Choroidal Neovascularization / Q000188:drug therapy*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007267:Injections; D008268:Macular Degeneration / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009841:Oligonucleotides / Q000008:administration & dosage*; D010778:Photochemotherapy; D016896:Treatment Outcome; D042442:Vascular Endothelial Growth Factors / Q000037:antagonists & inhibitors; D014792:Visual Acuity; D014822:Vitreous Body / Q000187:drug effects
D020533:Angiogenesis Inhibitors; D052157:Aptamers, Nucleotide; D009841:Oligonucleotides; D042442:Vascular Endothelial Growth Factors; C495058:pegaptanib