What is Verteporfin
Verteporfin is a porphyrin derivative present in a 1:1 ratio of regioisomers. As a photosensitizing agent, verterporfin is used as part of photodynamic therapy (PDT).
Photodynamic therapy is a two-stage process requiring administration of the drug photosensitizer followed by an activating light source. With verteporfin, a nonthermal red light (689 nm wavelength laser light) is utilized.
Verteporfin PDT is used as a selective treatment for choroidal neovasularization (CNV) associated with macular degeneration. The verteporfin procedure helps prevent progression of the disease and preserve a patient’s vision. In comparison to conventional laser photocoagulation therapy, verteporfin PDT offers the advantage of selective tissue injury due to localization of verteporfin in the CNV complex and decreased retinal injury due to the use of a non-thermal light source.
A report of two randomized controlled trials of verteporfin PDT in patients with CNV in age-related macular degeneration showed that 61% of eyes assigned to verteporfin compared with 46% of eyes assigned to placebo maintained baseline visual acuity.
In subgroup analysis, verteporfin efficacy was demonstrated when the area of CNV occupied >= 50% of the entire lesion, especially when there was no occult CNV.
Verteporfin is being studied for the treatment of CNV due to other causes including angioid streaks or idiopathic causes.
Verteporfin is also under investigation for the treatment of skin cancer, psoriasis, and rheumatoid arthritis. In April 2000, the FDA approved verteporfin for the treatment of CNV in patients with the wet form of age-related macular degeneration.
The FDA approved verteporfin treatment of CNV associated with macular degeneration due to pathologic myopia or ocular histoplasmosis in September 2001.
Brand Name
Visudyne
Indications
- central serous chorioretinopathy
- choroidal neovascularization (CNV)
- macular degeneration
Side Effects
- anemia
- arthralgia
- asthenia
- atrial fibrillation
- back pain
- blepharitis
- blurred vision
- cataracts
- chest pain (unspecified)
- clastogenesis
- conjunctivitis
- constipation
- cough
- diaphoresis
- diplopia
- dizziness
- dyspnea
- edema
- elevated hepatic enzymes
- fever
- flushing
- headache
- hearing loss
- hypertension
- hypoesthesia
- influenza
- injection site reaction
- lacrimation
- leukocytosis
- leukopenia
- malaise
- musculoskeletal pain
- myasthenia
- nausea
- ocular hemorrhage
- ocular inflammation
- ocular pain
- ocular pruritus
- pharyngitis
- photosensitivity
- pruritus
- rash
- retinal detachment
- scotomata
- syncope
- urticaria
- vertigo
- visual impairment
- xerophthalmia
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- accidental exposure
- breast-feeding
- children
- dental work
- egg hypersensitivity
- extravasation
- geriatric
- hepatic disease
- ocular exposure
- porphyria
- porphyrin hypersensitivity
- pregnancy
- radiation therapy
- skin photosensitivity disorder
- sunlight (UV) exposure
- surgery
Interactions
- Abciximab
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- Acetohexamide
- Acitretin
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- Alectinib
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