Photodynamic Therapy for Chorioretinal Diseases: A Practical Approach

Abstract

Photodynamic therapy (PDT) using verteporfin (VisudyneÒ; Bausch ? Lomb) is a treatment that is widely used to elicit cell and tissue death. In ophthalmology, PDT targets choroidal vascular abnormalities and induces selective occlusion of vessels. PDT was originally used in combination with full-dose verteporfin to treat neovascular age-related macular degeneration.Since the introduction of treatment with vascular endothelial growth factor receptor inhibitors, the clinical targets of PDT have shifted to other chorioretinal conditions, such as central serous chorioretinopathy, polypoidal choroidal vasculopathy, and choroidal hemangioma. In recent years, clinical studies have facilitated the optimization of treatment outcomes through changes in protocols, including the introduction of reduced treatment settings, such as PDT with half-dose verteporfin and half-fluence PDT. Here, we review PDT and its use for chorioretinal diseases from a practical perspective.Patients should be adequately informed to avoid direct sunlight after treatment, and side effects during and after PDT are rare.

European Prevalence of Polypoidal Choroidal Vasculopathy: A Systematic Review, Meta-Analysis, and Forecasting Study

“…We extracted statistics on country-specific population and forecast of population development for years 2022, 2025, 2030, 2035, and 2040 within an age strata of ≤ 64 years, 65–74 years, and ≥75 years ( Supplementary Data S1 ). These numbers were multiplied with the prevalence of neovascular AMD within each age stratum as estimated by Li et al [ 24 ]. The resulting estimate of current and future numbers of patients with neovascular AMD are summarized in Supplementary Data S2 .…”

“…The unknown estimate of the disease burden is a challenge for various reasons, e.g., when planning national health service or when applying for funding for PCV research, as it is not clear how many patients suffer from this disease. Further, the lack of an estimation of the disease burden can also hinder further political attention to the worldwide shortage of verteporfin (Visudyne ® , Cheplapharm Arzneimittel GmbH, Greifswald, Germany) which is used for PDT [ 24 ], and therefore, to a large extent, currently unavailable for patients with PCV [ 25 ].…”

Alkaloids as Photosensitisers for the Inactivation of Bacteria

“…One example of a drug as a photosensitiser for photodynamic therapy is Rostaprfin (Purlytin ® ) which is currently been investigated in phase II/III clinical trials for the treatments of metastatic breast cancer [ 23 ]. Nevertheless, other applications of PDT are poorly explored but remain with a bright future such as ophthalmology [ 25 , 26 ], urology [ 27 ], and antimicrobial infections [ 28 ]. In this line, only a few clinical investigations using antimicrobial photodynamic therapy (aPDT) have been reported, such as the use of α-aminolaevulinic acid for the treatment of chronic skin ulcers in lower limbs infected with P. aeruginosa [ 29 ] and the application of phenothiazinium dyes for the treatment of candidiasis infections [ 30 ].…”

Novel Short PEG Chain-Substituted Porphyrins: Synthesis, Photochemistry, and In Vitro Photodynamic Activity against Cancer Cells

“…To date, PDT has been shown as an effective modality in treating malignant and pre-malignant skin cancers [ 2 ], Barrett’s esophagus [ 3 ], unresectable cholangiocarcinoma [ 4 ], head and neck [ 5 ], lung [ 6 , 7 ], and bladder cancers [ 8 ]. PDT is also used for non-oncological purposes to treat dermatological diseases (e.g., acne, photoaging, and psoriasis), actinic keratosis [ 2 , 9 ], ophthalmological diseases (e.g., age-related macular degeneration, central serous chorioretinopathy, polypoidal choroidal vasculopathy, and choroidal hemangioma) [ 10 ], and dental diseases [ 11 ]. However, the high expectations of PDT were verified by reality, and this therapeutic approach has primarily been limited to clinical trials or palliative care and cannot achieve the status of standard cancer treatment [ 12 ].…”