Macugen (pegaptanib sodium), manufactured by Eyetech Pharmaceuticals, Inc., and Pfizer, Inc., is the first treatment approved by the U.S. Food and Drug Administration for all forms of wet macular degeneration. Although the cause of wet macular degeneration is not known, it is believed that vascular endothelial growth factor (VEGF) induces angiogenesis, resulting in a neovascular process, the hallmark of wet macular degeneration. Macugen is a VEGF antagonist. In two controlled, double-blinded identical studies, Macugen 0.3 mg was shown to slow the progression of wet macular degeneration. Using strict aseptic technique, Macugen 0.3 mg is administered via intravitreal injection every six weeks for one to two years. Serious adverse reactions include endophthalmitis, retinal detachment, and iatrogenic traumatic cataract. Macugen is administered after a topical anesthetic, a subconjuctival block, or a combination of both is used to numb the injection site on the temporal sclera. Post-procedure patients may initially complain of transient vision loss, burning, pressure, eye pain, or "floaters". At time of discharge, patients should be informed of the signs and symptoms of infection and instructed in the administration of antibiotic drops and in proper follow-up care. Most patients are seen for follow up one week after injection and again in five weeks for additional treatment.