Abstract
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▲ Verteporfin, a benzoporphyrin derivative monoacid ring A, is a photosensitising drug for photodynamic therapy (PDT) activated by low-intensity, nonheat-generating light of 689nm wavelength. Activation generates cytotoxic oxygen free radicals.
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▲ The specificity and uptake of verteporfin for target cells with a high expression of low density lipoprotein (LDL) receptors, such as tumour and neovascular endothelial cells, is enhanced by the use of a liposomal formulation and its rapid uptake by plasma LDL.
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▲ Verteporfin therapy (at light doses < 150 J/cm2) selectively damages neovascular endothelial cells leading to thrombus formation and specific occlusion of choroidal neovascular vessels in subfoveal lesions in patients with age-related macular degeneration (AMD).
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▲ Repeated applications of verteporfin therapy 6 mg/m2 improved or maintained visual acuity in the majority of patients with some classic subfoveal choroidal neovascularisation (CNV) secondary to AMD at 1 year’s follow-up in 2 large multicentre, placebocontrolled, double-blind trials.
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▲ Furthermore, in a subgroup of these patients with predominantly classic CNV secondary to AMD, there was a significantly more marked visual acuity (VA) benefit with 67.3% of verteporfin-treated eyes experiencing less than a 15-letter loss of VA versus 39.3% with placebo treatment.
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▲ Multiple applications of verteporfin therapy were well tolerated in patients with subfoveal CNV secondary to AMD. The most common adverse events were visual disturbances, injection site reactions, photosensitivity reactions and infusion-related back pain.
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References
Klein R, Klein B, Linton K. Prevalence of age-related maculopathy. Ophthalmology 1992; 99: 933–43
Kramer M, Miller JW, Michaud N, et al. Liposomal benzoporphyrin derivative verteporfin photodynamic therapy: selective treatment of choroidal neovascularization in monkeys. Ophthalmology 1996 Mar; 103: 427–38
Husain D, Miller JW. Photodynamic therapy of exudative age-related macular degeneration. Semin Ophthalmol 1997; 12(1): 14–25
Schmidt-Erfurth U, Birngruber R, Hasah T. Photodynamic therapy in ocular vascular disease. Laser Physics 1998; 8: 191–8
Fine SELL. Photodynamic therapy with verteporfin is effective for selected patients with neovascular age-related macular degeneration. Arch Ophthalmol 1999; 117: 1400–2
Levy JG. Photosensitizers in photodynamic therapy. Semin Oncol 1994 Dec; 21 Suppl. 15: 4–10
Richter AM, Waterfield E, Jain AK, et al. In vitro evaluation of phototoxic properties of four structurally related benzoporphyrin derivatives. Photochem Photobiol 1990 Sep; 52: 495–500
Richter A, Sternberg E, Waterfield E, et al. Characterisation of benzoporphyrin derivative, a new photosensitiser. Adv Photochemother 1988; 997: 132–8
Richter AM, Waterfield E, Jain AK, et al. Photosensitising potency of structural analogues of benzoporphyrin derivative (BPD) in a mouse tumour model. Br J Cancer 1991 Jan; 63: 87–93
Allison BA, Pritchard PH, Levy JG. Evidence for low-density lipoprotein receptor-mediated uptake of benzoporphyrin derivative [published erratum appears in Br J Cancer 1995 Jan; 71 (1): 214]. Br J Cancer 1994 May; 69: 833–9
Miller JW, Walsh AW, Kramer M, et al. Photodynamic therapy of experimental choroidal neovascularization using lipoprotein-delivered benzoporphyrin. Arch Ophthalmol 1995 Jun; 113: 810–8
Husain D, Miller JW, Michaud N, et al. Intravenous infusion of liposomal benzoporphyrin derivative for photodynamic therapy of experimental choroidal neovascularization. Arch Ophthalmol 1996 Aug; 114: 978–85
Schmidt-Erfurth U, Hasan T, Gragoudas E, et al. Vascular targeting in photodynamic occlusion of subretinal vessels. Ophthalmology 1994 Dec; 101: 1953–61
Lin SC, Lin CP, Feld JR, et al. The photodynamic occlusion of choroidal vessels using benzoporphyrin derivative. Curr Eye Res 1994 Jul; 13: 513–22
Reinke MH, Canakis C, Husain D, et al. Verteporfin photodynamic therapy retreatment of normal retina and choroid in cynomolgus monkey. Ophthalmology 1999; 106: 1915–23
Schmidt-Erfurth U, Miller J, Sickenberg M, et al. Photodynamic therapy of subfoveal choroidal neovascularization: clinical and angiographic examples. Graefes Arch Clin Exp Ophthalmol 1998 May; 236: 365–74
Miller JW, Schmidt-Erfurth U, Sickenberg M, et al. Photodynamic therapy with verteporfin for choroidal neovascularisation by age-related macular degeneration: results of a single treatment in a phase I and 2 study. Arch Ophthalmol 1999; 117: 1161–73
Schmidt-Erfurth U, Miller JW, Sickenberg M, et al. Photodynamic therapy with verteporfin for choroidal neovascularisation caused by age-related macular degeneration: results of retreatment in a phase 1 and 2 study. Arch Ophthalmol 1999; 117: 1177–87
Allison BA, Pritchard PH, Richter AM, et al. The plasma distribution of benzoporphyrin derivative and the effects of plasma lipoproteins on its biodistribution. Photochem Photobiol 1990 Sep; 52: 501–7
Richter AM, Waterfield E, Jain AK, et al. Liposomal delivery of a photosensitizer, benzoporphyrin derivative monoacid ring A (BPD), to tumour tissue in a mouse tumour model. Photochem Photobiol 1993 Jun; 57: 1000–6
Treatment of Age-related Macular Degeneration with Photodynamic Therapy Study Group. Photodynamic therapy of subfoveal choroidal neovascularisation in age-related macular degeneration with verteporfin. Arch Ophthalmol 1999; 117: 1329–45
Ciba Vision. Regulatory submissions. Viewpoint 1999 (News on the developments in photodynamic therapy): 3
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Scott, L.J., Goa, K.L. Verteporfin. Drugs & Aging 16, 139–146 (2000). https://doi.org/10.2165/00002512-200016020-00005
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DOI: https://doi.org/10.2165/00002512-200016020-00005