Pegaptanib Sodium

How it works

It is a pegylated aptamer that selectively binds the VEGF-165 isoform, blocking it from activating its receptor and thereby reducing the abnormal choroidal neovascularisation and vascular leakage that damage the macula.

Prescribing in practice

• As with all intravitreal injections, there is a risk of endophthalmitis, intraocular inflammation, retinal detachment and raised intraocular pressure, so it must be given under aseptic conditions by a trained specialist.
• It has largely been superseded by more effective non-selective anti-VEGF agents, so its place in current practice is limited.
• Patients should be assessed for signs of intraocular infection before and after each injection.

Monitoring

Intraocular pressure and the eye should be checked after injection, and patients monitored for signs of endophthalmitis in the days following each treatment.

Counselling the patient

• Seek urgent attention if you develop eye pain, increasing redness, light sensitivity or worsening vision after an injection, as these may indicate infection.
• Attend all scheduled injection and review appointments to protect your vision.
• A brief gritty or uncomfortable sensation in the eye after injection is common.

Evidence & guidelines

Pegaptanib was the first anti-VEGF agent licensed for wet age-related macular degeneration, with efficacy shown in the VISION trial programme.