Eberhard Karl University Tuebingen-Center for Ophthalmology, Schleichstr. 12, Tuebingen 72076, Germany.
Expert Opin Drug Metab Toxicol. 2012 Aug;8(8):1023-41. doi: 10.1517/17425255.2012.701617. Epub 2012 Jul 5.
The benzoporphyrine derivative verteporfin has lost its importance to the treatment of the most frequent neovascular eye diseases. Nevertheless, it is still mandatory to define the remaining applications, role, and potential of verteporfin in ocular photodynamic therapy (PDT), including the dosages of administration, effectiveness, and safety profile.
Although verteporfin PDT has forfeited the first-line status and value of treating subfoveal choroidal neovascularization (CNV) due to age-related macular degeneration or pathologic myopia, the treatment remains the standard of care for choroidal haemangioma and polypoidal choroidal vasculopathy. PDT is effective in less pigmented choroidal melanoma as well as in retinal vascular proliferations and retinal angioma. Verteporfin was granted the orphan drug designation for the treatment of chronic or recurrent central serous chorioretinopathy (CSC).
Evidence-based data regarding optimized parameters (low fluence, reduced dose, fractionated irradiation) adapted to the treated diseases (target structure, dosimetry, blood supply) are scarce. Prospective and large clinical trials are missing, although the scientific community agrees on the fact that the standard treatment protocol does not necessarily provide the optimal efficacy to the specific disease or individual patient. Within the reviewed indications, the adverse effect profile is favorable compared with other therapies.
苯并卟啉衍生物维替泊芬在治疗最常见的新生血管性眼病方面已经失去了重要地位。然而，仍然有必要确定维替泊芬在眼光动力疗法（PDT）中的剩余应用、作用和潜力，包括给药剂量、疗效和安全性概况。
尽管维替泊芬 PDT 由于年龄相关性黄斑变性或病理性近视而失去了治疗黄斑下脉络膜新生血管（CNV）的一线地位和价值，但该治疗方法仍然是脉络膜血管瘤和息肉样脉络膜血管病变的标准治疗方法。PDT 对色素较少的脉络膜黑色素瘤以及视网膜血管增生和视网膜血管瘤也有效。维替泊芬被授予治疗慢性或复发性中心性浆液性脉络膜视网膜病变（CSC）的孤儿药指定。
关于针对特定疾病（目标结构、剂量学、血液供应）优化参数（低强度、降低剂量、分次照射）的循证数据稀缺。尽管科学界一致认为标准治疗方案不一定能为特定疾病或个体患者提供最佳疗效，但仍缺乏前瞻性的大型临床试验。与其他疗法相比，在审查的适应症中，维替泊芬的不良反应概况更为有利。
