But:  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), and to compare these outcomes with those obtained with the c­ombination of intravitreal pegaptanib sodium and macular laser photocoagulation, or with laser alone.

Materials and Methods:  We conducted a retrospective outcome analysis of eyes with DME treated with primary intravitreal pegaptanib sodium (intravitreal pegaptanib group). These results were compared with the ones of eyes treated with intravitreal pegaptanib sodium associated with macular laser photocoagulation (combined treatment group), and the ones of eyes treated with primary macular laser photocoagulation (macular laser photocoagulation group).

Results:  A total of 40 eyes of 40 patients with a minimum of 6 months’ follow-up were included for analysis. For the intravitreal pegaptanib group (13 eyes) we found significant changes in mean best-corrected visual acuity (BCVA) and reductions in mean central macular thickness (CMT) compared with baseline at the last follow-up visit (p=.0014 and p=.0001, respectively). For the macular laser photocoagulation group (15 eyes), we found no statistically significant changes in mean BCVA and CMT compared with baseline at the last follow-up visit (p>.05). For the ­combined treatment group (12 eyes) we found no significant changes in mean BCVA compared with baseline at the last follow-up visit (p>.05) despite significant reductions in mean CMT (p=.0188).

Discussion:  Intravitreal pegaptanib was found to produce significant improvements in mean BCVA and reductions in mean CMT from baseline, while with laser photocoagulation alone no significant changes in either measure were apparent. With combined treatment, the change in mean BCVA from baseline to final assessment was not significant despite a significant reduction in mean CMT from baseline.

Conclusion:  The overall outcomes suggest that intravitreal pegaptanib treatment alone may be superior to macular laser photocoagulation alone and to combined intravitreal pegaptanib treatment associated with macular laser photocoagulation in patients affected with DME.