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April 2006

Perspectives on Verteporfin Therapy Combined With Intravitreal Corticosteroids

Author Affiliations

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).

Arch Ophthalmol. 2006;124(4):561-563. doi:10.1001/archopht.124.4.561

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.