Intravitreal pegaptanib sodium (Macugen) for diabetic macular edema

Purpose To report the functional and anatomic outcomes resulting from the use of intravitreal pegaptanib sodium as primary therapy in patients with diabetic macular edema (DME). Methods We conducted a retrospective outcome analysis, by optical coherence tomography (OCT) and best-corrected visual acuity (BCVA), of eyes with DME treated with primary intravitreal pegaptanib sodium (Macugen). Moreover, we evaluated the foveal transverse photoreceptor (PR) band integrity in the OCT images, at the time of the last follow-up visit. Results Sixty-three eyes of 48 patients with a minimum of 6 months’ follow-up (FU) were included for analysis. Intravitreal pegaptanib was found to produce significant improvements in mean BCVA (p = 0.019) and reductions in mean central macular thickness (CMT) (p <0.001), as soon as the 6-weeks FU. Most eyes (60/63) required a mean of 3 repeated treatments, over a mean FU period of 6.7 +/- 1.2 months, to achieve significant improvements in mean BCVA (p <0.001) and mean CMT (p <0.001). In our series, the lower visual acuities tended to congregate in the group with the less-defined PR band (p <0.001), and the lower CMT tended to congregate in the group with the best- defined PR band (p=0.04), even though the higher CMT did not tend to congregate in the group with the less-defined PR band. Conclusion Our findings demonstrate that selective inhibition by intravitreal pegaptanib sodium of VEGF165 may produce a clinically meaningful and statistically significant benefit in the treatment of DME.