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Current trends in photodynamic therapy
Author(s) -
Culham Louise
Publication year - 2006
Publication title -
ophthalmic and physiological optics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.147
H-Index - 66
eISSN - 1475-1313
pISSN - 0275-5408
DOI - 10.1111/j.1475-1313.2006.00402_8.x
Subject(s) - medicine , verteporfin , photodynamic therapy , adverse effect , choroidal neovascularization , ophthalmology , visual acuity , fluorescein angiography , retinal , photosensitizer , surgery , chemistry , organic chemistry
Background: Patients with wet age‐related macular disease (AMD) and subfoveal choroidal neovascular membrane (CNV) may be offered photodynamic therapy (PDT). Currently, Visudyne (Verteporfin) is the only photosensitizer approved by the FDA and randomized trials have shown that treatment can prevent severe vision loss. Combination therapy with Visudyne PDT and intravitreal triamcinolone may be additionally beneficial. In an effort to develop a more effective therapy, we have undertaken studies in primates and in patients with advanced AMD using a new photosensitizer, talaporfin sodium. Following dose‐ranging work in the normal primate retina, a study in humans investigated the safety and effectiveness of this drug. Methods: Eleven patients with vision of <6/60 and persistent leakage from CNV were recruited. Following talaporfin sodium injection of 0.5 mg kg −1 bodyweight, a light dose of between 24 and 48 J cm −2 was given with a 664 nm laser. Fluorescein angiography and visual acuity (VA) were performed before and after therapy. Adverse events were recorded. Follow‐up was for 14 days, but informal review was longer (in some cases ≥ 40 weeks). Results: All patients showed evidence of decreased leakage from CNV. No re‐opening of closed choroidal vessels was observed during extended follow‐up. At the last follow‐up, VA was stable in seven patients, improved in three and decreased in one (using >0.1 logMAR). Three adverse events were reported; two related to photosensitivity of the skin and one patient had closure of a branch retinal vein. Conclusion: Talaporfin sodium PDT showed extended closure of CNVs and therefore has potential for treating exudative AMD and other choroidal vascular anomalies.