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Spotlight on Verteporfin in Subfoveal Choroidal Neovascularisation

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Abstract

Verteporfin (Visudyne®) therapy (photodynamic therapy with intravenous liposomal verteporfin) is the first treatment to effectively prevent the loss of visual acuity in patients with subfoveal choroidal neovascularisation (CNV) secondary to age-related macular degeneration (AMD), pathological myopia or presumed ocular histoplasmosis syndrome (POHS).

In adult patients with classic subfoveal CNV or occult with no classic subfoveal CNV secondary to AMD, or subfoveal CNV secondary to pathological myopia or POHS, verteporfin therapy slows or prevents loss of visual acuity. In well designed clinical trials, verteporfin therapy was superior to placebo in patients with subfoveal classic-containing CNV and occult with no classic CNV secondary to AMD at 12 and/or 24 months (Treatment of Age-related macular degeneration with Photodynamic therapy [TAP] Investigation and Verteporfin In Photodynamic therapy [VIP-AMD] trial) and in patients with pathological myopia at 12 months (Verteporfin In Photodynamic therapy [VIP-PM] trial). Limited data suggest that verteporfin therapy also prevents loss of visual acuity in patients with subfoveal CNV secondary to POHS.

Verteporfin therapy was generally well tolerated in clinical trials; most adverse events were mild to moderate in intensity and transient. The most frequently reported verteporfin therapy-related adverse events (incidence >2%) were visual disturbance, injection-site reactions, photosensitivity reactions and infusion-related back pain. Approximately 5% of patients with occult with no classic subfoveal CNV secondary to AMD reported severe vision decrease within 7 days of treatment in clinical trials; 3 months later, several patients had recovered some of this loss.

Conclusion: Photodynamic therapy with verteporfin, the first photosensitiser approved for the treatment of subfoveal CNV, is a well tolerated treatment that stabilises or slows visual acuity loss in adult patients with predominantly classic or occult with no classic subfoveal CNV secondary to AMD, and subfoveal CNV secondary to pathological myopia or POHS. Thus, verteporfin therapy provides a valuable option for the management of these patients for whom treatment options are few, and should be considered as a first-line therapy in these difficult-to-manage conditions.

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Notes

  1. The use of tradenames is for product identification purposes only and does not imply endorsement.

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Acknowledgements

The full text article in Drugs 2003; 63 (22): 2521–2554 was reviewed by: P. Kaiser, The Cleveland Clinic Foundation, Cole Eye Institute, Cleveland, Ohio, USA; M. Potter, University of British Columbia, Department of Ophthalmology, Vancouver, British Columbia, Canada; S. Sharma, Queen’s University, Department of Ophthalmology, Kingston, Ontario, Canada; M. Stur, University of Vienna Medical School, Allegemeines Krankenhaus, Department of Ophthalmology, Vienna, Austria; S. Wolf, Klinik und Poliklinik für Augenheilkunde, Leipzig, Germany.

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  1. Adis International Limited, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, Auckland, 1311, New Zealand

    Susan J. Keam, Lesley J. Scott & Monique P. Curran

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  1. Susan J. Keam
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  2. Lesley J. Scott
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  3. Monique P. Curran
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Correspondence to Susan J. Keam.

Additional information

This Spotlight is derived from abstract and summary text of an Adis Drug Evaluation originally published in Drugs 2003; 63 (22): 2521–2554. Reviewers of the original full text article are listed in the Acknowledgements section.

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Keam, S.J., Scott, L.J. & Curran, M.P. Spotlight on Verteporfin in Subfoveal Choroidal Neovascularisation. Drugs Aging 21, 203–209 (2004). https://doi.org/10.2165/00002512-200421030-00005

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