Healio
Healio
November 01, 2006
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Progression and treatment of AMD

Images from patients with age-related macular degeneration treated with pegaptanib sodium (Macugen, Pfizer) illustrate the effects of anti-VEGF therapy.

The case studies below show various types of patients eligible for treatment with pegaptanib.

Results may be specific to these individual patients and may not be observed in all patients with wet AMD.

Small classic lesion

Figure A: Pigment epithelium detachment with leakageFigure B: Pigment epithelium detachment with leakage
Figure C: Pigment epithelium detachment with leakage
Figure D: Normal retinal appearance after treatment with pegaptanibFigure E: Normal retinal appearance after treatment with pegaptanib
Figure F: Normal retinal appearance after treatment with pegaptanib
Small classic lesion. The patient presented with an initial visual acuity of 20/400, with some pigment epithelium detachment on optical coherence tomography (OCT) and some leakage on fluorescein angiography (FA) and OCT (A, B, C). The patient received three doses of pegaptanib. At 4.5 months after the first dose, visual acuity was 20/40 with a normal retina appearance on FA and OCT (D, E, F).

Source: Suñer I


Occult lesion with good vision
Early stage choroidal neovascular lesion Early stage choroidal neovascular lesion Early stage choroidal neovascular lesion
Increased signs of CNV Increased signs of CNV Increased signs of CNV
Diminishing signs of lesion after pegaptanib Diminishing signs of lesion after pegaptanib
Diminishing signs of lesion after pegaptanib Occult lesion in 73-year-old woman. The patient presented with initial visual acuity of 20/50 and an early stage choroidal neovascular lesion (top row). No treatment was suggested and the patient’s visual acuity decreased to 20/200 with increased signs of CNV (middle row). The patient received pegaptanib, and six weeks after the first injection, visual acuity increased to 20/40 with diminishing signs of the lesion (bottom row).

Source: Verstraeten T


Large pigment epithelium detachment
Baseline
20/50		 Baseline 20/50
1 week
post 20/40		 1 week post 20/40
6 weeks
post 20/30		 6 weeks post 20/30

Large pigment epithelium detachment in 78-year-old man. At baseline (top), visual acuity was 20/50 with some occult leakage and large pigment epithelial detachment.

After one dose of pegaptanib, visual acuity improved at 1 week, although there appeared to be only a slightly modest change in the OCT (center) and continued to improve at 6 weeks (bottom) with a near complete resolution of the pigment epithelium detachment.

Source: Tolentino M


Occult lesion with pigment epithelium detachment

Baseline 20/400
1 week post 20/200
6 weeks post 20/30
18 weeks post 20/25 Occult lesion with pigment epithelium detachment in 68-year-old woman. At baseline (top row), visual acuity was 20/400 with some occult leakage. The patient was treated with pegaptanib. After 1 week (2nd row), angiogram showed little change but retinal height decreased and visual acuity improved to 20/200. At 6 weeks (3rd row), improvements continued with visual acuity of 20/30 and a normal -appearing retina. After the third dose, improvements continued at 18 weeks (4th row) with visual acuity of 20/25 and a normal retinal appearance by OCT.

Source: Tolentino M