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A Journal on Ophthalmology
Minerva Oftalmologica 2013 September;55(3):45-52
Treatment of diabetic macular edema with intravitreal pegaptanib sodium (Macugen®): morphologic and functional study
Paoletta M. 1, Chiosi F. 1, Boemio G. 1, Lanzini G. 1, Pascotto A. 1, Calò R. 2, Cardone M. 2, Rinaldi M. 1
1 Dipartimento di Oftalmologia Seconda Università degli Studi di Napoli Napoli, Italia;
2 Dipartimento di Scienze per la Salute Università degli Studi del Molise Campobasso, Italia
Aim: Aim of the study was to analyze whether morphologic (foveal thickness, FT) variations of clinically significant macular edema (CMO) in patients suffering from diabetes following intravitreal pegaptanib sodium (IVP) injection were associated with functional (macular sensitivity [MS] and color discrimination [CD]) changes.
Methods: A longitudinal, interventional, non-randomized study was performed. FT was assessed by optical coherence tomography, MS by microperimetry, best-corrected visual acuity (BCVA) by early treatment diabetic retinopathy study charts (ETDRS) and CD by Farnswoth-Munsell test. The treatment protocol consisted of three consecutive injections (0.3 mg/0.05 mL; baseline, week 6 and week 12). Follow-up checks were scheduled at 18 and 24 weeks after injections.
Results: Fifteen eyes of 15 patients with clinically significant CMO were included for analysis. After IVP a significant decrease of FT occurred with a mean reduction from baseline of 56.9% (P=0.0001). An improvement of functional parameters was recorded in all patients (BCVA from 18.2±8.5 letters to 25.5±8.4 letters, P<0.005, MS from 8.6±2.16 dB to 10.6±2.61 dB, P<0.001, color analysis from 376.1±125.6 TES to 116±34.6 TES, P=0.0001). A statistically significant correlation between FT and BCVA as well as MS and CD was also found. Neither ocular nor systemic adverse events were reported.
Conclusion: Intravitreal pegaptanib significantly reduced FT, with a concomitant improvement of MS and CD. This association emphasizes the efficacy of IVP in the treatment of CMO.