Keam Susan J, Scott Lesley J, Curran Monique P
Adis International Limited, Auckland, New Zealand.
Drugs Aging. 2004;21(3):203-9. doi: 10.2165/00002512-200421030-00005.
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.
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.
维替泊芬（Visudyne）疗法（静脉注射脂质体维替泊芬的光动力疗法）是首个有效预防年龄相关性黄斑变性（AMD）、病理性近视或疑似眼组织胞浆菌病综合征（POHS）继发的黄斑下脉络膜新生血管（CNV）患者视力丧失的治疗方法。在患有典型黄斑下CNV或隐匿性无典型黄斑下CNV继发于AMD，或病理性近视或POHS继发的黄斑下CNV的成年患者中，维替泊芬疗法可减缓或预防视力丧失。在精心设计的临床试验中，维替泊芬疗法在12个月和/或24个月时，对于黄斑下含典型病变的CNV以及隐匿性无典型CNV继发于AMD的患者（年龄相关性黄斑变性光动力治疗 [TAP] 研究和维替泊芬光动力治疗 [VIP-AMD] 试验），以及在12个月时对于病理性近视患者（维替泊芬光动力治疗 [VIP-PM] 试验），均优于安慰剂。有限的数据表明，维替泊芬疗法也可预防POHS继发的黄斑下CNV患者的视力丧失。维替泊芬疗法在临床试验中总体耐受性良好；大多数不良事件强度为轻至中度且为一过性。最常报告的与维替泊芬疗法相关的不良事件（发生率>2%）为视觉障碍、注射部位反应、光敏反应和输液相关背痛。在临床试验中，约5%的隐匿性无典型黄斑下CNV继发于AMD的患者在治疗后7天内报告视力严重下降；3个月后，部分患者视力有所恢复。
维替泊芬光动力疗法是首个被批准用于治疗黄斑下CNV的光敏剂，是一种耐受性良好的治疗方法，可稳定或减缓主要为典型或隐匿性无典型黄斑下CNV继发于AMD，以及病理性近视或POHS继发的黄斑下CNV的成年患者的视力丧失。因此，维替泊芬疗法为这些治疗选择有限的患者提供了一个有价值的选择，在这些难以治疗的情况下应被视为一线治疗方法。
