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


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).


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.


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.


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