Verteporfin PDT for non-standard indications--a review of current literature.
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.
Chan
Wai Man
WM
Department of Ophthalmology, HK Sanatorium Hospital, Happy Valley, Hong Kong.
Lim
Tock-Han
TH
Pece
Alfredo
A
Silva
Rufino
R
Yoshimura
Nagahisa
N
D000793:Angioid Streaks / Q000188:drug therapy; D056833:Central Serous Chorioretinopathy / Q000188:drug therapy; D015862:Choroid Diseases / Q000188:drug therapy*; D002830:Choroid Neoplasms / Q000188:drug therapy; D020256:Choroidal Neovascularization / Q000188:drug therapy; D006391:Hemangioma / Q000188:drug therapy; D006801:Humans; D016491:Peripheral Vascular Diseases / Q000188:drug therapy; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011166:Porphyrins / Q000627:therapeutic use*; D012164:Retinal Diseases / Q000188:drug therapy*; D000077362:Verteporfin
D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin