Aim: To evaluate the effect difference of ranibizumab and sodium pegaptanib in the ablation treatment of the retinal pigment epithelium (RPE) in age-related macular degeneration
Material and methods: Retrospective analysis of data of patients with age-related macular degeneration treated by means of anti-VEGF therapy at the Department of Ophthalmology, School of Medicine, Palacky University, Olomouc, Czech Republic, E.U. during the period May 2009 - October 2010. For the analysis were used data from patients with follow-up period longer than 6 months and present serous RPE ablation caused by occult choroidal neovascularization (CNV), verified by optic coherence tomography (OCT) and fluoresceine angiography (FAG).
Study group: Ranibizumab was used as treatment during the period in 37 eyes of 37 patients (average age 73.2 years; right eye (RE) in 20 cases, left eye (LE) in 17 cases. Sodium pegaptanib was applied in 17 eyes of 17 patients (average age 72.4 years; RE in 10 cases and LE in 7 cases), The follow-up period in the ranibizumab group was 8.51 (SD 3.32) months, and in the pegaptanib group 9.94 (SD 5.50) months.
Results: In the ranibizumab group decreased the average RPE ablation base from 2865 microm (SD 810 microm) to 2270 microm (SD 1265 microm) and the prominence of the ablation from 334 microm (SD 160) to 238 microm (SD 178 microm). In patients treated by pegaptanib, decreased the average basis from 3245 microm (SD 930 microm) to 2159 microm (SD 1185 microm), and the prominence of the ablation from 354 microm (SD 173 microm) to 208 microm (SD 107 microm). The statistical significance test did not prove significant differences (level of significance p = 0.05) in the change either of the base or the prominence of the RPE ablation in any group of patients (prominence p = 0.09, base p = 0.21; Mann-Whitney test). In three patients (8.1%) treated by ranibizumab, the RPE rupture occurred. No RPE rupture was recorded in patients treated by sodium pegaptanib.
Conclusion: Although no statistically significant difference in the efficacy of both drugs in the treatment of the RPE ablation was found, in patients treated by sodium pegaptanib, there is evident tendency of higher efficacy in decrease of the RPE ablation prominence, and lower incidence of RPE rupture. The study is limited by small number of patients and short follow-up period.