ThucAnh Thi Ho, MD (Chicago, IL), Pauline Townsend Merrill, MD (Chicago, IL)

PURPOSE:

To evaluate the role of combined intravitreal pegaptanib and photodynamic therapy with verteporfin (PDT) in the management of subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).

METHODS:

We performed a retrospective review on 11 eyes of 11 patients treated with combined pegaptanib and PDT. Pre-treatment and post-treatment Snellen visual acuity (VA), fluorescein angiography (FA), and optical coherence tomography (OCT) were compared.

RESULTS:

Pegaptanib was administered a mean of 8 days prior to PDT. All CNV lesions were subfoveal: 8 classic, 2 occult, and 1 minimally classic. The mean greatest linear diameter was 3 mm. The pre-treatment VA ranged from 20/50 to counting fingers. All but one eye had prior treatment: 5 with PDT alone, 2 with pegaptanib alone, 2 with combination PDT and triamcinolone acetonide, 1 with PDT and pegaptanib given 8 months apart. At the last followup visit (mean 11 weeks), all eyes remained within 1 line of pre-treatment VA. The central macular thickness on OCT decreased from a mean of 258μm pre-treatment to 203μm posttreatment. At last follow-up, only one of the 11 eyes required further treatment: a second combination pegaptanib and PDT application at week 15. Decreased or absence of leakage was observed on FA at last follow-up of the remaining 10 eyes. No ocular or systemic complications were observed post-treatment in any eye.

CONCLUSION:

Preliminary results suggest that combination anti-vascular endothelial growth factor therapy and PDT may stabilize subfoveal CNV with fewer treatment applications.