NEIL M.BRESSLERMDAuthor Affiliations: Department of Ophthalmology, University of Vienna, Vienna, Austria (Drs Schmidt-Erfurth and Michels); and Department of Ophthalmology, Städt Klinikum, Karlsruhe, Germany (Dr Augustin).
Since its approval in 1999, photodynamic therapy (PDT) using
verteporfin has become the most important strategy in the treatment
of neovascular age-related macular degeneration (AMD). Verteporfin therapy has a proven benefit seen in many subtypes of choroidal neovascularization (CNV). In predominantly classic lesions, 59% of verteporfin-treated patients lost fewer than 3 lines as compared with 31% of sham-treated eyes.1 In patients with occult CNV with smaller lesions or lower levels of visual acuity, stable vision is seen in 51% of eyes in the verteporfin group while only 25% of sham-treated eyes maintained stable vision.2 Subgroup analysis suggests that verteporfin may also reduce the risk of vision loss in lesions with minimally classic features smaller than 4 Macular Photocoagulation Study disc areas. Most importantly, vision stabilization and absence of leakage activity was maintained during an extended follow-up of as long as 5 years with no relevant need for retreatment beyond 18 months. Although limited to specific subtypes of lesions, such a solid benefit has not been demonstrated so far by any other modality in the field.
Schmidt-Erfurth U, Michels S, Augustin A. Perspectives on Verteporfin Therapy Combined With Intravitreal Corticosteroids. Arch Ophthalmol. 2006;124(4):561-563. doi:10.1001/archopht.124.4.561