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Verteporfin PDT for non-standard indications—a review of current literature

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Abstract

Background

Verteporfin photodynamic therapy (PDT) is approved for the treatment of predominantly classic subfoveal choroidal neovascularization (CNV) due to age-related macular degeneration (AMD), as well as for subfoveal CNV due to pathologic myopia and ocular histoplasmosis syndrome. Verteporfin PDT addresses the underlying pathology of ocular vascular disorders through its angio-occlusive mechanism of action, which reduces both visual acuity loss and the underlying leakage associated with lesions. Verteporfin PDT has also been associated with encouraging treatment outcomes in case studies involving patients with choroidal vascular disorders such as polypoidal choroidal vasculopathy, central serous chorioretinopathy, choroidal haemangioma, angioid streaks, and inflammatory CNV, i.e. conditions currently considered as non-standard indications of verteporfin PDT. In many studies, outcomes were better than expected based on the natural courses of each of these conditions. Although the anti-vascular endothelial growth factor (VEGF) therapies, ranibizumab and pegaptanib, have been approved for CNV due to AMD, their role in these other choroidal vascular disorders remains to be established. We summarize current literature that has documented the use of verteporfin PDT in these conditions.

Conclusions

The complex pathogenesis of CNV provides a rationale for investigating combination approaches comprising verteporfin PDT and anti-VEGF therapies. Randomized controlled studies are warranted to confirm the preliminary results of verteporfin PDT as a monotherapy or in combination with anti-VEGF therapies in the treatment of a variety of choroidal vascular conditions.

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Acknowledgements

The authors would like to acknowledge Susanna Ryan of Chameleon Communications International for providing medical writing support with funding from Novartis Pharma AG (Switzerland). The authors also acknowledge Neelima Gundupalle and Aditi Gandhe from Novartis Healthcare Pvt. Ltd., (India) for their editorial assistance.

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Authors and Affiliations

  1. Department of Ophthalmology, HK Sanatorium Hospital, Happy Valley, Hong Kong

    Wai Man Chan

  2. National Healthcare Group Eye Institute, Singapore; Department of Ophthalmology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore

    Tock-Han Lim

  3. Department of Ophthalmology, Ospedale di Melegnano, Milan, Italy

    Alfredo Pece

  4. Department of Ophthalmology, Hospital of the University of Coimbra, Coimbra, Portugal

    Rufino Silva

  5. Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Nagahisa Yoshimura

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  1. Wai Man Chan
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  2. Tock-Han Lim
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  5. Nagahisa Yoshimura
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Correspondence to Rufino Silva.

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Chan, W.M., Lim, TH., Pece, A. et al. Verteporfin PDT for non-standard indications—a review of current literature. Graefes Arch Clin Exp Ophthalmol 248, 613–626 (2010). https://doi.org/10.1007/s00417-010-1307-z

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  • DOI: https://doi.org/10.1007/s00417-010-1307-z

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