Terapia fotodinâmica com verteporfina associada à injeção intravítrea de antifator de crescimento endotelial vascular para tratamento de hemangioma circunscrito de coroide / Photodynamic therapy with verteporfin associated with intravitreal injection of vascular endothelial growth factor for the treatment of circumscribed choroidal hemangioma

RESUMO O hemangioma de coroide é um tumor vascular benigno, de coloração vermelho-alaranjada, bem delimitado, caracterizado por uma placa elevada. É um tumor raro, com prevalência de um caso a cada 40 tumores de coroide. O diagnóstico pode ser feito por meio da clínica associada à avaliação biomicroscópica e a exames complementares para diferenciação de outros tumores. O tratamento pode ser expectante nos casos assintomáticos. Para os casos sintomáticos ou com presença de fluido sub-retiniano, existem diversas terapias. O objetivo deste estudo foi relatar um caso de hemangioma circunscrito de coroide submetido a tratamento combinado de terapia fotodinâmica com verteporfina e injeção intravítrea de antiangiogênico (bevacizumabe). A decisão de tratar um hemangioma de coroide deve ser individualizada com base nos sintomas, na perda visual e em qualquer potencial de sua recuperação. O exame oftalmológico completo é necessário, mesmo em casos assintomáticos, para rastreamento precoce de doenças oculares.

ABSTRACT Choroid hemangioma is a benign, well-delimited orange-red, vascular tumor characterized by an elevated plaque. It is a rare tumor with a prevalence of one case in every 40 choroidal tumors. It can be diagnosed by the clinic associated with biomicroscopic evaluation and complementary tests to differentiate from other tumors. Treatment can be expectant in asymptomatic cases. For symptomatic cases or those with the presence of subretinal fluid, there are several therapies. The objective of this study was to report a case of circumscribed choroidal hemangioma submitted to combined treatment of photodynamic therapy with verteporfin and intravitreal injection of an antiangiogenic agent (bevacizumab). The decision to treat choroidal hemangioma must be individualized based on symptoms, visual loss, and any potential for recovery. A complete eye examination is necessary, even in asymptomatic cases, for early screening for eye diseases.

Preparation and enhanced photodynamic therapy of supramolecular nanoparticles to overcome tumor hypoxia / 药学学报

The therapeutic effect of tumor photodynamic therapy is severely limited by the hypoxic tumor microenvironment. Inhibiting tumor celloxygen consumption is a more effective way than increasing its oxygen supply to overcome the tumor hypoxia and enhance photodynamic therapy. To carry out this strategy, the supramolecular nanoparticles VER-ATO-SMN loaded with photosensitizer verteporfin (VER), oxygen-consuming inhibitor atovaquone (ATO), and stabilizer polyvinylpyrrolidone (PVP)-K30 were prepared by the nanoprecipitation method, and the optimal prescription was screened and optimized by single factor experiments. The results showed that the optimal prescription for VER-ATO-SMN was ATO∶VER (w/w) = 1∶1, PVP-K30 = 100 mg, N,N-dimethylformamide∶water (v/v) = 1∶10. The morphology, particle size, particle dispersion index and encapsulation efficiency of supramolecular nanoparticles were characterized. The VER-ATO-SMN showed a spherical morphology and was well dispersed. The hydrodynamic size of VER-ATO-SMN was 101.21 ± 4.30 nm as determined by dynamic light scattering (DLS). The encapsulation efficiencies of VER and ATO in VER-ATO-SMN prepared with the optimal prescription were 70.86% and 77.52%, respectively. The VER-ATO-SMN exhibited good laser stability and also showed high stability in conditions which simulated the physiological solution. Compared with free VER and VER liposome, VER-ATO-SMN performed enhanced therapeutic effect at the cell level. The mechanism was that VER-ATO-SMN could effectively incorporate into cells and improving the intracellular oxygen concentration by reducing the oxygen consumption of tumor cells could increase the amount of reactive oxygen species generated by VER mediated photodynamic therapy. The in vivo anticancer efficacy results of tumor-bearing mice suggested that VER-ATO-SMN could effectively inhibit the tumor growth or even completely eliminate the tumor. All animal experiments were performed in line with national regulations and approved by the Animal Experiments Ethical Committee of 900 Hospital of the Joint Logistics Team.

Active loading of verteporfin into cationic liposome for neovasculature- and tumor-targeted photodynamic therapy / 药学学报

To target neovasculature and tumor cells, a novel cationic liposome with verteporfin (BPD) active-loaded in lumen (CLL) was designed and its basic in vitro and in vivo behaviors were evaluated in this study. Calcium acetate gradient loading method was applied to encapsulate BPD actively and cationic lipid (2,3-dioleoy-loxy-propyl)-trimethylammonium (DOTAP) was added by post-insertion for the positive charge of CLL. Results of characterization showed that the diameter and zeta-potential of CLL were around 100 nm and 28 mV, respectively. Compared with passive loading liposomes, CLL significantly enhanced the stability of BPD loading. What's more, the loaded BPD in lumen could switch off the fluorescence and photosensitization during blood circulation by homo-fluorescence resonance energy transfer (homo-FRET) effect, leading to the diminished phototoxicity to normal tissues. In vitro cellular uptake and cytotoxicity assay exhibited that positive charge dramatically enhanced the uptake of CLL both in vascular endothelial cells and tumor cells leading to superior therapeutic efficacy. In vivo study further showed that CLL reduced the clearance rate and increased tumor accumulation compared with passive loading group. Quantitative results of exvivo organ indicated that negligible CLL distributed in normal organs contributing to low phototoxicity. Animal experiments were conducted according to the Guidelines of the Experimental Animal Ethics Committee of Peking University Health Science Center and International Animal Experiments. In conclusion, we successfully designed a novel cationic targeting liposome that overcame the limitations of passive loading and significantly enhanced the efficacy of photodynamic therapy.

Efficacy analysis of ω-3 polyunsaturated fatty acids after treatment with Ranibizumab combined with photodynamictherapy on ARMD / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the efficacy of ω-3 polyunsaturated fatty acids in patients with age-related macular degeneration(ARMD)after receiving a poor response to the combination of ranibizumab and photodynamic therapy(PDT). <p>METHODS: Ninety-two cases(122 eyes)of patients with age-related macular degeneration in our hospital from February 2015 to January 2017 were selected as the subjects. All patients were given intravitreal ranibizumab injection combined with photodynamic therapy, according to the received light sensitive dose were randomly divided into half dose group(45 eyes of 60 cases)and full dose group(47 eyes of 62 cases), half dose group received half dose verteporfin(3mg/m²), the full dose group received full dose verteporfin(6mg/m²). The patients were followed up for 1mo, 3mo after treatment. After 3mo treatment, 41 eyes of 30 patients paitents who got choroidal neovascularization(CNV)leakage again or leakage increased were randomly divided into control group of 14 cases(20 eyes), experimental group of 16 cases(21 eyes). All patients were treated with ranibizumab combined with half dose verteporfin(3mg/m²), photodynamic therapy. The experimental group were added with ω-3 polyunsaturated fatty acids soft capsule(twice per day, 1 tablets per time, period of 6mo). All patients were followed up at 1, 3 and 6mo after treatment.best corrected visual acuity(BCVA), central macular retinal thick(CRT), intraocular pressure, total effective rate of CNV, the average number of injections of ranibizumab and adverse reactions were observed during the follwed up. <p>RESULTS: The BCVA, CRT, intraocular pressure before and after 1,3mo treatment and the total efficiency of CNV of half dose group were no statistical differences with the full dose group(<i>P</i>>0.05). The number of times ranibizumab injection of half dose group(1.1±0.8, 1.6±1.2)were lower than that in the full dose group(1.6±1.1, 2.5±1.7)at 1 and 3mo after treatment, the differences were statistically significant(<i>P</i><0.05). The BCVA and CNV in experimental group was higher, CRT and ranibizumab injection times were lower than that in the control group at 1,3 and 6mo after treatment, the differences were statistically significant(<i>P</i><0.05). No serious adverse reactions related treatment were occurred in all patients. <p>CONCLUSION: It is safe and effective to treat patients with age-related macular degeneration by ranibizumab combined with half dose photodynamic therapy. The combination of ω-3 polyunsaturated fatty acids can improve the therapeutic effect.

Half-dose verteporfin and half-fluence photodynamic therapy for chronic central serous chorioretinopathy / 眼科新进展

Objective To compare the efficacy and safety of half-dose verteporfin and half-fluence photodynamic therapy in chronic central serous chorioretinopathy (CSC).Methods The medical records of 42 patients (42 eyes) with chronic CSC were retrospectively reviewed.According to the difference of drug dose and laser parameters in the course of PDT,the patients were divided into two groups:half-dose group and half-fluence group.Half-dose group:22 patients (22 eyes) received half-dose verteporfin(3 mg· m-2)and standard PDT(83 s,50 J · cm-2).Half-fluence group:20 patients (20 eyes) received full-dose verteporfin (6 mg · m-2) and half-fluence PDT (42 s,25 J · cm-2).Patients were followed up at 1 month,3 months,6 months after PDT.The outcome measures was the proportion of eyes with complete resolution of subretinal fluid(SRF),the changes in best corrected visual acuity (BCVA) and central retinal thickness(CMT).Results At 6 months after PDT,22 eyes(100％) that received half-dose PDT showed complete resolution of SRF,19 eyes(95％)that received half-fulence PDT showed complete resolution of SRF.There was no statistical difference between two groups (P ＞ 0.05).At 6 months after PDT,the mean BCVA improved 7.2 letters in half-dose group and 6.7 letters in half-fluence group.There was no statistical difference compared with the improvement of BCVA between two groups(P ＞ 0.05).In half-dose group,mean baseline central retinal thickness was (351 ± 90) μm,which was decreased to (178 ±55) μm after 6 months,respectively (P ＜ 0.05).In half-fluence group,mean baseline central retinal thickness was (322 ± 96) μm,which was decreased to (181 ± 47) μm after 6 months,respectively (P ＜ 0.05).None of the patients developed retinal pigment epithelium atrophy and CNV.Conclusion Half-dose verteporfm PDT and half-fluence PDT are effective and safe in the treatment of chronic CSC.

Effect of YAP1 on erlotinib-resistance in lung adenocarcinoma cells / 军事医学

Objective To explore the effect of Yes-associated protein 1 (YAP1) and potential mechanism on erlotinib ( ER) resistance in lung adenocarcinoma.Methods In PC-9 cells and acquired ER resistant PC-9 ( PC-9/ER) cells, the expression changes in YAP1 gene were measured by quantitative real-time PCR( RT-qPCR) and Western blot.Indirect immunofluorescence was adopted to observe the location of YAP1.PC-9/ER cells were treated with the verteporfin ( VP, YAP1 inhibitor) for 24 h and 48 h, respectively.Expression changes in mRNA and proteins of YAP1, AKT and p-AKT were detected in the presence or absence of VP.The effect of VP was analyzed by drug resistance index using Cell Counting Kit 8(CCK-8) assay.Results The resistance index of PC-9/ER cells was (99.80 ±25.81).Compared with PC-9 cells, the expression levels of YAP1 mRNA and protein were increased in PC-9/ER.The inhibitory efficiency of VP was (50.96 ±5.86)%, and the levels of AKT and p-AKT proteins were down-regulated by the inhibition of YAP1 simultaneously.The half maximal inhibitory concentration (IC50) of PC-9/ER decreased from (11.10 ±2.72) to (1.47 ± 0.32)μmol/L (P =0.024).Resistance index was reduced to one eighth of the original.Conclusion These results indicate that the YAP1 mediates ER resistance in lung adenocarcinoma.Suppression of YAP1 can reduce the resistance through PI3K/AKT signaling pathway.Therefore, YAP1 may be a potential target for lung cancer gene therapy.

Clinical efficacy and safety of 60％-dose verteporfin photodynamic therapy for chronic central serous chorioretinopathy / 中华实验眼科杂志

Background It is thought in recently that photodynamic therapy (PDT) is an effective treatment method for chronic central serous chorioretinopathy (CSC), but the dosage of verteporfin and its long-term efficacy and complications is rarely elucidated ever before.Objective This study was to observe the long-term efficacy and safety of 60％ dose verteporfin PDT for chronic CSC.Methods This is a retrospective study and a self-controlled design was used.The clinical data of 25 eyes of 21 chronic CSC patients who received 60％-dose verteporfin PDT in Henan Eye Institute from January 2009 to May 2010 were reviewed, with the male 18 (85.71％) and female 3 (14.29％) as well as monocular CSC 17 patients and binocular CSC 4 patients.The average ages of the patients were (43±5) years.Fundus fluorescein angiography (FFA) , indocyanine green angiography (ICGA), optical coherence tomography(OCT) and best corrected visual acuity (BCVA) were examined in all the patients before and after treatment.PDT with the 60％-dose verteporfin (3.6 mg/m2) was carried out on the CSC eyes.The treated eyes were examined 2 weeks, 1 month and 3 months after PDT.The BCVA,subfoveal choroid thickness,FFA and ICGA findings before and after PDT were compared.The following-up duration was 5 years or more.Results The BCVA before and 3 months after PDT were 0.5 ±0.1 and 0.9±0.2, respectively, with a statistically significant difference between them (t =19.17,P =0.00).The subfoveal choroidal thickness value 3 months after PDT was (326.56±39.47) μm,which was significantly reduced in comparison with (486.24 ±47.53) μm before PDT (t =25.17, P =0.00).FFA and ICGA showed that the leakage of fluorescein (hyperfluorescence) was disappeared in all the treated eyes.No systemic or local adverse effects and recurrence were observed during the follow-up period.Conclusions On the basis of the results of this study and available information,60％-dose verteporfin PDT seems to have a better long-term efficacy and safety than full-dose verteporfin in treating chronic CSC.

Research progress on cancer treatment targeting the Hippo-YAP signaling pathway / 中国肿瘤临床

Hippo pathway is a signaling network involved in the regulation of cell proliferation and apoptosis, whereas Yes-asso-ciated protein (YAP) is the major effector of the pathway. YAP is a candidate oncogene, and dysregulation of the Hippo-YAP pathway is closely related to the occurrence and progression of various tumors. Therefore, Hippo-YAP may provide a novel therapeutic target for cancer treatment. Some drugs or compounds that regulate the Hippo-YAP pathway activity, such as verteporfin, can inhibit the occur-rence or growth of tumors. This review mainly focuses on the progress of studies on the use of Hippo-YAP signaling pathway as a tar-get of cancer treatment strategies.

Tratamiento de hemangiomas coroideos con terapia fotodinámica / Choroidal hemangiomas treatment with photodynamic therapy

Objetivo: reportar tres casos de pacientes con hemangioma de coroides tratados con terapia fotodinámica (TFD) y realizar una revisión de la literatura sobre el tema. Diseño del estudio: estudio retrospectivo intervencionista, tipo serie de casos. Pacientes y metodología: revisión de historias clínicas y de exámenes complementarios de 3 pacientes con diagnóstico de hemangioma de coroides pre y post tratamiento con TFD en la Fundación Oftalmológica Nacional. Resultados: de los 3 casos presentados, dos se presentaron como hemangiomas de coroides circunscritos y uno difuso en un paciente con síndrome de Sturge ­ Weber. En todos los casos se observó mejoría de la agudeza visual, resolución del desprendimiento seroso de retina y regresión del tumor, sin efectos secundarios a la TFD. Conclusiones: el hemangioma coroideo es una patología con una baja incidencia, de evolución variable y difícil de predecir. La terapia fotodinámica es una alternativa no invasiva, de elección para hemangiomas coroideos sintomáticos, ya que no produce daño a las estructuras vecinas y presenta pocos efectos colaterales.

Objective: to report three cases of patients with choroidal hemangioma treated with photodynamic therapy (PDT) and review of the literature. Study design: retrospective interventional study, cases reports. Patients and methods: review of medical records and ancillary tests were performed in 3 patients with choroidal hemangioma pre and post PDT treatment. Results: of the 3 cases reported, two had a circumscribed choroidal hemangioma and one a diffuse hemangioma associated with Sturge ­ Weber syndrome. All cases had improvement in visual acuity, resolution of serous retinal detachment and tumor regression without PDT side eff ects after follow-up. Conclusions: choroidal hemangiomas have a low incidence and an uncertain prognosis. Photodynamic therapy remains as a noninvasive alternative for symptomatic choroidal hemangiomas, without damage to surrounding structures and few side effects.

Different doses of verteporfin photodynamic therapy for central exudative chorioretinopathy / 中华实验眼科杂志

Background The dosage of verteporfin photodynamic therapy (PDT) for central exudative chorioretinopathy(CEC) depends on the calculation formula of Treatment of Age-related Macular Degeneration with Photodynamic Therapy Study Group(TAP)and Verteporfin in Photodynamic Therapy Study Group(VIP).Some local adverse responses or normal tissue damage have been noted under the standard dose of verteporfin during the treatment of CEC.So it is necessary to explore an appropriate therapeutic dosage of verteporfin.Objective This clinical study aimed to observe and compare the clinical efficacy and safety of different doses of verteporfin PDT for CEC.Methods Ninety eyes of 90 patients with CEC were enrolled in this study with the approval of the Ethic Commission of Affiliated Second Hospital of Nanchang University.Written informed consent was obtained before PDT.The patients were randomly divided into standard dose group,half dose group and 1/3 dose group.All of the patients received PDT.Standard dose(6 mg/m2),3 mg/m2 or 2 mg/m2 of verteporfin was applied in the three groups respectively,with the laser intensity 50 J/cm2.The patients were followed-up for 3 months.Repeat treating regimen was performed in the same way in the patient with fundus fluorescein leakage after initial PDT.Results The BCVA(logMAR) value was 0.44±0.36 after PDT in the standard dose group.Visual acuity improved in 20 patients (66.67％),stabilized in 8 patients(26.67％)and decreased in 2 patients (6.67％).The BCVA showed a significant difference between the preoperative and postoperative BCVA (t =6.719,P =0.000).CNV disappeared in 19 patients (63.33％),obviously improved in 7 patients (23.33％),partially disappeared in 3 patients (10.00％) and unchanged in 1 patient (3.33％).The central fovea thickness (CFT)value was significantly declined in postoperation compared with preoperation (t =5.758,P =0.000).Eight patients received secondary PDT with the recurrence rate 26.67％.In the half dose group,visual acuity improved in 18 patients(60.00％),stabilized in 11 patients(36.67％)and decreased in 1 patient (3.33％).CNV disappeared in 16 patients (53.33％),obviously improved in 8 patients (26.67％),partially disappeared in 5 patients (16.67％) and unchanged in 1 patient (3.33 ％).Significant difference was seen between the preoperative BCVA and postoperative BCVA(t=8.294,P =0.000).The decrease of C FT was significant in postoperation(t =8.493,P =0.000).Ten patients received secondary treatment with the recurrence rate 33.33％.In 1/3 dose group,visual acuity improved in 8 patients (26.67 ％),stabilized in 12 patients (40.00％),decreased in 10 patient (33.3％).CNV disappeared in 8 patients (26.67％),obviously improved in 8 patients (26.67％),partially disappeared in 6 patients (20.00％) and unchanged in 8 patient (26.67％).There was no significant difference between the preoperative BCVA and postoperative BCVA (t =0.536,P =0.596).The difference between preoperative CFT and postoperative CFT was insignificant(t =0.942,P=0.354).Fourteen patients received secondary PDT and 8 patients received three times with the recurrence rate 73.33％.Conclusions 3 mg/m2 verteporfin PDT for CEC shows a similar clinical efficiency and safety to 6 mg/m2 verteporfin.3 mg/m2 verteporfin PDT can decrease cost,but the effect of 2 mg/m2verteporfin PDT is not satisfacted.

Combined Treatment of Photodynamic Therapy and Bevacizumab for Choroidal Neovascularization Secondary to Age-Related Macular Degeneration

PURPOSE: To evaluate the outcome of a combined photodynamic therapy and intravitreal injection of bevacizumab in choroidal neovascularization secondary to age-related macular degeneration. METHODS: Photodynamic therapy (PDT) was administered to 28 eyes followed by 3 consecutive bevacizumab injections. Patients were followed-up for more than 12 months. At baseline, 1, 3, 6, and 12 months post PDT, visual acuity (VA) and central macular thickness were measured using optical coherence tomography. RESULTS: The mean VA was significantly improved from logarithm of the minimal angle of resolution 0.86 at baseline to 0.69 at 1 month (p = 0.011), 0.63 at 3 months (p = 0.003), 0.64 at 6 months (p = 0.004) and 0.60 at 12 months (p < 0.001). Central macular thickness decreased significantly from 328.3 microm at baseline to 230.0 microm at 6 months and 229.9 microm at 1 year (p < 0.001). Reinjection mean number was 0.4 for 6 months and 0.8 for 12 months. By 1 year, retreatment was performed in 10 eyes (36%). CONCLUSIONS: PDT combined with three consecutive intraviteal bevacizumab injections was effective in improving VA and reducing central macular thickness.

Verteporfin photodynamic therapy of retinal capillary hemangioblastoma in von Hippel-Lindau disease.

An 18-year-old boy presented to us with bilateral retinal hemangioblastoma and von Hippel-Lindau disease with history of cerebral capillary hemangioblastoma and embryonic cell carcinoma of left testes. The vision in the right eye was already lost with development of secondary closed angle glaucoma, optic atrophy with subsequent development of bullous keratopathy. The multiple retinal angiomatous lesions in the seeing left eye were treated with various modalities like triple freeze thaw cryopexy, focal lasers and transpupillary thermo therapy in multiple sittings over a period of almost 20 years since detection. One particular angiomatous lesion in the left eye was showing resistance to all the above mentioned modalities and was finally successfully treated with verteporfin and photodynamic therapy to achieve complete regression without any post-treatment complication and with a sustained 20/20 vision till a follow-up of 15 months.

The Efficacy of Photodynamic Therapy With Verteporfin for Polypoidal Choroidal Vasculopathy: Retrospective Multi-Center Case Study

PURPOSE: To evaluate the efficacy of photodynamic therapy (PDT) with verteporfin for polypoidal choroidal vasculopathy (PCV) in Korean patients. METHODS: Clinical data of patients who were treated with PDT for PCV and followed up for more than 6 months were collected from 14 hospitals around the country. The changes in the best corrected visual acuity, angiographic outcome, retinal thickness measured by optical coherence tomography (OCT), and adverse effects of treatment were evaluated. RESULTS: Eighty six patients (86 eyes) were recruited (male: 75.6%, age: 65.9+/-8.3 years, mean follow-up: 14.8+/-10.2 months). The mean logMAR visual acuity at baseline was 0.55+/-0.32 and did not show any statistically significant difference from the final mean logMAR visual acuity (0.53+/-0.54) (p=0.639). The mean treatment session number of PDT was 2+/-1.2. Visual acuity stabilized or improved in 70.9% of patients. Visual acuity improved by more than 2 lines in 33 eyes (38.4%) and worsened by more than 2 lines in 21 eyes (24.4%) of patients. Vascular leakage decreased in 62.5% of patients in fluorescein angiography and polypoidal lesions disappeared or were reduced in 57.3% of patients in indocyanine green angiography. There was no systemic adverse effect of PDT, but increased subretinal hemorrhage after PDT occurred in 10 eyes (11.6%). CONCLUSIONS: In polypoidal choroidal vasculopathy, photodynamic therapy with verteporfin is safe and effective for preserving visual acuity and reducing vascular leakage and retinal thickness.

The Effect of Photodynamic Therapy with Verteporfin Retreatment on Corneal Neovascularization in Rabbits

PURPOSE: This study evaluated the effect and safety of photodynamic therapy (PDT) with verteporfin retreatment on patients with corneal neovascularization. METHODS: Corneal neovascularization was induced with a silk suture of the corneal stroma in 24 white rabbits (48 eyes). Four rabbits were examined histologically before performing PDT. Ten rabbits were chosen randomly, one eye from each rabbit was treated with PDT at 50 J/cm2, and the other eye was used as a control. Both eyes of the remaining 10 rabbits were treated with PDT at 150 J/cm2. One week later, one eye was further retreated with PDT at the same intensity. The area of corneal neovascularization was measured and evaluated histologically using light and electron microscopies. RESULTS: The least neovascularized area was observed in the retreated group (P=0.04). The histologic examination revealed fewer new corneal vessels in the retreated group, but the corneal epithelium, stroma, and endothelium showed a normal appearance. Results from electron microscopic examination demonstrated thrombi as well as destruction and nuclear fragmentation of the vascular endothelial cells. However, there were no other changes in the cornea except for vascular endothelial cells, even in the retreated group. CONCLUSIONS: In conclusion, these results suggest that PDT with verteporfin retreatment appears to be safe and significantly more effective in patients with regression of corneal neovascularization.

A Case of Photodynamic Therapy of Juxtafoveal Choroidal Neovascularization in Angioid Streaks

PURPOSE: To report a case of verteporfin photodynamic therapy (PDT) for juxtafoveal choroidal neovascularization (CNV) secondary to angioid streaks. CASE SUMMARY: An 54-year-old male presented with metamorphopsia of the right eye. It was diagnosed as juxtafoveal CNV secondary to angioid streaks and treated with verteporfin PDT-Best corrected visual acuity (BCVA) and macular thickness by optical coherence tomography (OCT) were measured. Over 14 month follow-up period, baseline BCVA was 0.3 and it increased to 0.4 by the final examination, while macular thickness decreased from 264 micrometer to 229 micrometer. No side effects of PDT were noted. CONCLUSIONS: Verteporfin PDT for CNV-associated with angioid streaks does not appear to significantly alter the course of the disease undergoing enlargement and disciform transformation of the neovascular process. However, we expected that the actual clinical findings improved during short term follow-up. The severity of symptoms of CNV-associated with angioid streaks in a single patient varies over time, so long-term follow-up and careful examination is needed.

Two Cases of Photodynamic Therapy with Verteporfin in Patients with Corneal Neovascularization

PURPOSE: To evaluate the clinical effect of photodynamic therapy (PDT) with verteporfin (Visudyne(R), Novartis Ophthalmics AG, Hettingen, Switzerland) in the treatment of corneal neovascularization. METHODS: We performed photodynamic therapy on one eye with corneal neovascularization associated with lipid keratopathy, and on another eye with corneal neovascularization after corneal perforation. Verteporfin was administrated intravenously for 10 minutes at a dose of 6 mg/m2 of body surface area. Fifteen minutes after the start of administration, a 689 nm nonthermal laser light (Opal photoactivator, Coherent Inc., USA) was delivered directly over the neovascular network for 83 seconds with a spot size of 4000 micrometer. The patients were followed up at 3 days, 1 week, 1 month, and 6 months after treatment. RESULTS: In both cases, new vessels were successfully occluded after the photodynamic therapy. No recanalization of new vessels was observed at last follow-up and no complications were observed. CONCLUSIONS: PDT with verteporfin is considered to be a safe and effective procedure to regress corneal neovascularization.

Animal Study of Photodynamic Therapy with Verteporfin in Corneal Neovascularization

PURPOSE: To determine the efficacy of photodynamic therapy (PDT) with verteporfin (Visudyne(R), Norvatis Ophthalmics AG, Hettingen, Switzerland), a benzoporphyrin derivative, in the treatment of corneal neo-vascularization (CN) in a rabbit eye model. METHODS: CN was induced by placing instrastromal sutures in the cornea. Two weeks after suturing, verteporfin was administrated intravenously and 1 hour later, the right eye (treated group) was exposed to a laser with a 689 nm wavelength, and the left eye was used as the control. The changes in CN were analyzed using biomicroscopy and optical microscopy in twelve rabbits. RESULTS: The mean percentages of the neovascular area in the control and treated groups were 96.4 +/- 1.9% and 90.3 +/- 3.5% (P=0.009) at three days after the PDT, 88.6 +/- 4.6% and 71.6 +/- 6.2% (P<0.001) at one week, and 76.8 +/- 4.4% and 43.6 +/- 15.1% (P<0.001) at two weeks, respectively. Optical microscopy showed significant differences between the control and treated group in terms of the area and number of CN (P<0.05). CONCLUSIONS: PDT with verteporfin is a safe and effective procedure for regressing CN. However, a further study will be necessary.

Verteporfin therapy for subfoveal choroidal neovascularisation associated with choroidal osteoma / 国际眼科杂志(Guoji Yanke Zazhi)

· AIM: To report a case of verteporfin therapy for subfoveal choroidal neovascularisation associated with choroidal osteoma.· METHODS: A 32-year-old patient was diagnosed as subfoveal choroidal neovascularisation (CNV) associated with choroidal osteoma in the right eye, with present visual acuity (VA) of 20/80; N24. He underwent 2 sessions of photodynamic therapy (PDT) in the right eye for 12mo.· RESULTS: At the end of 12mo, the patient's VA was 20/200 with complete regression of the CNV.· CONCLUSION: PDT could be a treatment option in subfoveal CNV associated with choroidal osteoma.

Photodynamic Therapy with Verteporfin for Anterior Segment Neovascularization in Neovascualr Galucoma

PURPOSE: To evaluate photodynamic therapy (PDT) with verteporfin for iris and angle neovascularization in eyes with neovascular glaucoma. METHODS: We treat a patient who had neovascular glaucoma with iris and angle neovacularization and showed reduction of intraocular pressure (IOP) and the obliteration of neovascularization after PDT. PDT was performed following the treatment parameters used in age-related macular degeneration. The laser was directed at the anterior chamber angle and iris surface using a Goldmann three-mirror contact lens. Follow-up examination was performed 1, 2, 3, 5, 7, and 8 weeks after PDT, and included visual acuity, IOP, and iris fluorescein angiography (7 weeks after PDT). RESULTS: Two months after PDT, we observed a reduction of IOP and the improvement of iris fluorescein leakage. IOP diminished considerably after 1 week, and showed subsequent tendency toward stabilization without additional antiglaucoma medicine. CONCLUSIONS: Photodynamic therapy can be used safely and effectively in the early phase of neovascular glaucoma to achieve the obliteration of iris and angle neovascularization and induce IOP reduction.

Photodynamic Therapy with Verteporfin for Subfoveal Choroidal Neovascularization in Vogt-Koyanagi-Harada Syndrome

PURPOSE: We present a case of photodynamic therapy (PDT) with verteporfin for choroidal neovascularization (CNV) complicated by Vogt-Koyanagi-Harada syndrome. METHODS: A 46-year-old male who had bilateral subfoveal CNV complicated by Vogt-Koyanagi-Harada syndrome underwent 3 sessions of PDT with verteporfin in 1 year. RESULTS: After 3 sessions of PDT with verteporfin, maintenance of visual acuity was achieved without any complication as alteration of retinal pigment epithelium and aggravation of intraocular inflammation, but subfoveal fibrosis developed. CONCLUSIONS: PDT with verteporfin is a good treatment method without any complication for the CNV complicated by Vogt-Koyanagi-Harada syndrome, even though multiple sessions were needed.