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Anti-angiogenic therapy for retinal PED

examination, visual acuity assessment (ETDRS), and OCT. Reinjection of the initial medication occurred if there was evidence of intra- or subretinal fluid by OCT or an increase in RPE detachment.

Study endpoints were mean changes from baseline to month 6 in visual acuity (ETDRS and logMAR [logarithm of the minimum angle of resolution]), and in foveal thick- ness (OCT).

Informed consent was obtained. All applicable insti- tutional and governmental regulations concerning the ethical use of human volunteers were followed during this research.

Pegaptanib 0.3 mg N = 7

Bevacizumab 1.25 mg N = 8

36.1 ± 14.9 45.2 ± 19.8 +9.1 ± 25.3

49.5 ± 11.5 56.7 ± 10.5 +7.2 ± 12.3

1.00 ± 0.31 0.80 ± 0.40 0.20 ± 0.49

0.72 ± 0.23 0.57 ± 0.21 0.15 ± 0.26

Table 2 Changes from baseline to month 6 in visual acuity and foveal thickness by treatment group, mean ± standard deviation

Outcome

Visual acuity, ETDRS letters Baseline Month 6

Change, baseline to m Visual acuity, logMAR Baseline Month 6

Change, baseline to month 6

onth 6

Foveal thickness, µm Baseline Month 6

470.4 ± 140.8 382.2 ± 99.4

321.1 ± 77.3 268.2 ± 35.4

Change, baseline to month 6

88.2 ± 208.6

52.9 ± 70.7

Results

Characteristics of the 15 patients were similar across treat- ment groups at baseline (Table 1); two patients who received pegaptanib and three who received bevacizumab had been treated previously with PDT with verteporfin. A mean of 3.7 (range 3–4) and 3.4 (range 2–5) injections of pegaptanib and bevacizumab were administered, respectively.

Abbreviations: ETDRS, Early Treatment Diabetic Retinopathy Study; logMAR, logarithm of the minimum angle of resolution.

74.5

73.3

4 3

4 4

4 3

5 3

5 2

6 2

5 2

5 3

At baseline, mean visual acuity was lower and foveal thickness was greater in the pegaptanib treated patients (Table 2). Improvements in visual acuity measured by both ETDRS and logMAR and reductions in foveal thick- ness were seen in each treatment group between baseline and month 6, but functional and anatomical changes were greater for all outcomes among patients treated with pegap- tanib. The pattern of improvement varied by treatment (Figure 1). On average, pegaptanib-treated patients had

Bevacizumab 1.25 mg N = 8

Note: aNumber of patients unless otherwise specified. Abbreviation: PDT, photodynamic therapy.

Table 1 Patient baseline characteristicsa

Characteristic Pegaptanib 0.3 mg N = 7

Mean age (years) Gender Male Female Treated eye Left Right Phakic/pseudophakic Phakic Pseudophakic Previous treatment None PDT with verteporfin

A

Pegaptanib (n = 7) Bevacizumab (n = 8)

Mean visual acuity (letters, ETDRS)

65 60 55 50 45 40 35 30 25

57

49

36

32

Baseline

Month 1

60

56

36

45

Month 3

Month 6

B

Pegaptanib (n = 7) Bevacizumab (n = 8)

500

470

Mean foveal thickness (µm, OCT)

450

400

350

300

250

321

424

380

265

382

268

218

200

Baseline

Month 1

Month 3

Month 6

Figure 1 A) Mean visual acuity (VA; Early Treatment Diabetic Retinopathy Study [ETDRS] letters) at baseline and at months 1, 3 and 6 in eyes receiving pegaptanib or bevacizumab. B) Mean foveal thickness (µm) determined by optical coherence tomography (OCT) at baseline and at months 1, 3, and 6 in eyes receiving pegaptanib or bevacizumab.

Clinical Ophthalmology 2010:4

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