Treatment of Intractable Diabetic Macular Edema with Pegaptanib Versus Bevacizumab, Both in Combination with Dexamethasone

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dc.contributor.author Leitner, Diana M
dc.contributor.author Chacko, David M
dc.contributor.author Twumasi-Ankrah, Philip
dc.contributor.author Ablah, Elizabeth
dc.date.accessioned 2012-08-27T19:51:38Z
dc.date.available 2012-08-27T19:51:38Z
dc.date.issued 2012-08-27
dc.identifier.uri http://hdl.handle.net/2271/1110
dc.description.abstract BACKGROUND: Diabetic macular edema is a significant cause of vision loss, and some patients do not respond optimally to existing treatments. This study compared the response of intractable diabetic macular edema to intravitreal injection of two anti-VEGF drugs, bevacizumab and pegaptanib, both in combination with dexamethasone. METHODS: A retrospective chart review was conducted to examine patients from an ophthalmology practice in one year with diabetic macular edema (DME), recurrent or persistent, after focal laser or intravitreal bevacizumab. Patients received bevacizumab/dexamethasone or pegaptanib/dexamethasone. Outcome measures were improvement in best corrected visual activity (converted to LogMAR) and central macular thickness (CRT). Data on adverse effects also were collected. RESULTS: The bevacizumab/dexamethasone group included 25 eyes which had pre-treatment LogMAR = 0.69 ± 0.49 (mean ± SD) and CRT = 419 ± 131. Post-treatment LogMAR was 0.70 ± 0.48 and CRT = 377 ± 107. The pegaptanib/dexamethasone group included 14 eyes; pretreatment LogMAR = 0.80 ± 0.55 and CRT = 520 ± 108. Post-treatment LogMAR was 0.77 ± 0.49 and CRT = 46 4 ± 106. Neither treatment had a significant effect on visual acuity. Both groups experienced a significant decrease in CRT over time (p = 0.006). The pegaptanib/ dexamethasone group had higher CRT at all times (p = 0.020), but the trend in CRT decrease was not different between the two groups. Intraocular pressure increased in both groups (p = 0.038). No other adverse effects were reported. CONCLUSIONS: Neither bevacizumab/dexamethasone or pegaptanib/dexamethasone significantly improved visual acuity in intractable DME, but both decreased central macular thickness. Differences in outcome measures between the two treatment groups were not significant. The only adverse effect seen was a small increase in intraocular pressure. en_US
dc.subject.mesh diabetic retinopathy
dc.subject.mesh macular edema
dc.subject.mesh pegaptanib
dc.subject.mesh bevacizumab
dc.title Treatment of Intractable Diabetic Macular Edema with Pegaptanib Versus Bevacizumab, Both in Combination with Dexamethasone en_US
dc.type Article en_US
rft.spage 83 en_US
dc.contributor.organization Institution:The University of Kansas Medical Center:KU School of Medicine-Wichita, 1010 North Kansas, Wichita, KS 67214-3199, USA. en_US
dc.ispartof.issn 1948-2035
dc.ispartof.issue 3 en_US
dc.ispartof.title Publication::Kansas Journal of Medicine en_US
dc.ispartof.volume 5 en_US

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