Sequential pegaptanib monotherapy following verteporfin
photodynamic therapy for choroidal neovascularization
Paul B. Griggs, R. C. Lee (Seattle)
Purpose: To review the clinical results of sequential pegaptanib monotherapy following
verteporfin photodynamic therapy for choroidal neovascularization.
Methods: A retrospective chart review identified patients in which pegaptanib therapy was
initiated following initial treatment of choroidal neovascularization with verteporfin photodynamic
therapy with or without adjuvant intravitreal triamcinolone acetonide administration.
Records were analyzed for Snellen visual acuity, choroidal neovascular lesion size, and lesion
subtype. In addition, the duration of verteporfin therapy, number of verteporfin treatments, and
number of intravitreal triamcinolone acetonide administrations, if utilized, was evaluated.
Additional analysis concluded the clinical status of each patient at the initiation of pegaptanib
therapy, the number of pegaptanib administrations performed at the time of data analysis, and the number of verteporfin
photodynamic therapy treatments performed following the initiation of pegaptanib therapy.
Results: Fifteen patients were identified who met the inclusion criteria. This included 13 patients in which one eye received
pegaptanib therapy and two patients in which both eyes ultimately received pegaptanib. The number of verteporfin
photodynamic therapy treatments performed prior to the addition of pegaptanib ranged between 1 and 13. The number of
triamcinolone acetonide injections during the course verteporfin ranged between 0 and 5. The number of pegaptanib
treatments administered at the time of data analysis ranged between 2 and 6. Four eyes received 1 to 2 verteporfin photodynamic
treatments following the initiation of pegaptanib therapy.
Conclusions: In the majority of cases, the Snellen visual acuity and lesion size remained relatively stable following the
initiation of pegaptanib therapy. In the period reported, it was unusual for lesion progression to occur and for combination
therapy with verteporfin photodynamic therapy to be required following the initiation of pegaptanib therapy. No adverse
events were noted in association with verteporfin photodynamic therapy or pegaptanib therapy. In summary, sequential
pegaptanib therapy appears to be safe and effective in stabilizing choroidal neovascularization that progresses and/or
remains active despite verteporfin photodynamic therapy with or without intravitreal triamcinolone acetonide administration.